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Athletic Injury Assessment > Soft Tissue Response > Flashcards

Soft Tissue Response Flashcards

1
Q

what are the 2 steps to a logical process to evaluate the extent of an injury

A
  1. understand the mechanism of the traumatic sequence
  2. understand how to methodically inspect an injury (HOPS)
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2
Q

what is soft tissue?

A

non-bony tissue
- skin, muscle, tendon, ligament, fascia, blood vessel, nerve
- common injuries include sprains, strains, contusions, tendinosis/tendinopathy
-each tissue will have a yield point (or elastic limit)

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3
Q

tissue structures are…

A

stronger in resisting forces from certain directions compared to others

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4
Q

what does the anatomical design of joints mean

A

that they are more susceptible to injury from a given direction

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5
Q

how is force categorized

A

according to direction from which force acts

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6
Q

define compression + example

A

axial loading along an axis
landing from a jump

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7
Q

define tension + example

A

stretching, pulling along an axis
lateral ankle sprain

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8
Q

define shearing + example

A

oppositely directly loads that are parallel
plant & turn

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9
Q

what injuries are a result of forces applied in different directions

A

abrasions
incisions
laceration
avulsion
puncture
blisters

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10
Q

what is open wound management

A

control bleeding
gauze to apply pressure
clean the wound (soap and water or saline; remove debris)
dress the wound
make sure ends are approximated; use butterfly or steri-strips or stitches

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11
Q

what are the two physical responses to physical trauma

A

inflammation and healing

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12
Q

what is necrosis

A

when deprived of oxygen results in cell death

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13
Q

what is hematoma

A

pool of blood with disrupted tissue

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14
Q

result of trauma primary injury

A

bleeding and damaged tissue

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15
Q

result of trauma secondary injury

A

damage occurring secondary to the primary injury

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16
Q

describe the components of blood

A

liquid fraction: plasma
- makes up 55%
formed elements: Blood cells
- makes up 45%
- RBC
- WBC
- Platelets (thrombocytes)

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17
Q

what is inflammation

A

complex biological response of vascular tissues to harmful stimuli such as pathogens, damaged cells, or irritants
includes a complex set of events – series of interrelated physical and chemical activities

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18
Q

what does inflammation do

A

localize the extent of the injury so there doesn’t become a secondary one
remove foreign material and dying tissues so that healing can begin

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19
Q

what are the 3 phases of inflammation

A
  1. acute vascular response/inflammation (4-6 days)
  2. repair and regeneration/proliferation (2-24 days)
  3. re-modeling and maturation (21 days - 2 years)
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20
Q

define vasodilation

A

widening of bloodvessel

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21
Q

define vasoconstriction

A

constriction of bloodvessel

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22
Q

define hypertrophy

A

increasing cell size

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23
Q

define atrophy

A

decreasing cell size

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24
Q

define necrosis

A

death of cell

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25
Q

describe phase 1 (acute vascular response)

A
  • injury
  • increase blood flow
  • mobilize and transport cells
  • remove damaged cells
  • body puts out new collagen

immediate vasoconstriction then histamine causes vasodilation and increased vascular permeability. WBC and macrophages get rid of unwanted substances and platelets seal off area. fluid leaks out of blood vessels and results in edema (swelling) causing secondary injury and then gets drained through lymphatic system

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26
Q

what are some signs and symptoms of inflammation

A

signs —> redness, swelling, heat, pain
symptoms —> loss of function, limited joint or muscle ROM, palpable tenderness

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27
Q

treatment for inflammation

A

decrease pain and swelling
prevent chronic inflammation
maintain mobility and strength in adjacent areas
injured areas rest

28
Q

describe phase 2 (repair and regeneration
(proliferation)

A

begins once the debris is cleared
the dense capillary network will form
fibroblasts proliferate damaged areas and makes collagen
collagen forms a loose mesh network of connective tissues at the injury site

new collagen fibers a laid down in a disorganized manner - in the form of a scar
weak links between each fibre
new tissue is weak and susceptible to disruption by overly aggressive activity

29
Q

signs and symptoms of proliferation

A

less warmth and swelling
palpable tenderness decreases
pain felt with tissue resistance or stretch of the tissue

30
Q

treatment focus of proliferation

A

ROM exercises
joint mobilization
light loads to promote tissue remodel

31
Q

describe phase 3 (remodelling and maturation)

A

begins once fibroblasts disappear
scar tissue collagen begins to align with direction of stress and the cross-link formation becomes more organized
scar tissue is avascular and inelastic
remodeling may take months to years to complete

32
Q

signs and symptoms of remodelling and maturation

A

improved ROM and strength
stretching, active contraction, resistive loads

33
Q

what is the therapist’s role in the three phases

A

minimize initial damage and promote the healing process - address the inflammatory response
ensure undue stress is avoided until tissues are ready (even on healthy tissues)

34
Q

whats rehab therapy look like for muscle and tendons

A

muscle ~ 3 wk
tendon ~ 4-6 wk
early activity promotes full strength and ROM return. too early could cause increased bleeding and edema and decreased ROM

35
Q

whats rehab therapy look like for ligaments

A

ligaments ~ 6-12 months
stress during remodeling increase collagen strength
too early could increase length of fibers and increase joint laxity

36
Q

define shock

A

diminished amount of blood available to the circulatory system. As a result, not enough oxygen-carrying blood cells are available to tissues

37
Q

describe hypovolemic shock

A

caused by too little blood volume

38
Q

define cardiogenic shock

A

due to heart problems

39
Q

define anaphylactic shock

A

caused by severe allergic reaction

40
Q

define septic shock

A

due to infection

41
Q

describe neurogenic shock

A

caused by damage to the nervous system

42
Q

describe obstructive shock

A

caused by embolism, pneumothorax

43
Q

signs and symptoms of shock

A

signs
pulse; rapid or weak
skin; cool, clammy, pale
breathing; rapid, shallow
sweating; profusely
pupils; dilated, dull eyes
BP; steadily falling
unconsciousness

symptom
nausea

44
Q

whats the treatment for shock

A

comforting the athlete and screening the injury
maintain body heat, so warm blanket
elevate feet and legs
continue to monitor vitals

45
Q

what does RICE mean

A

Rest - prevent further damage (10min - 10 months)
Ice - only if huge injury or violent response reduces blood flow and increases stiffness
compression - reduces swelling, comfort
elevation - reduces swelling, limits blood, encourages venous return
support - stabilization and immobilization will prevent further injury

46
Q

what does POLICE mean

A

Protect
Optimal Loading
Ice - only if huge injury or violent response
compression
elevation

47
Q

what is return to play (RTP)

A

able to return to playing sports or participating in an activity at a pre-injury level

48
Q

what is return to sport (RTS)

A

if seen by physician and received medical clearance;
pain free
no swelling
no tenderness
80-100% strength
80-100% balance and coordination

49
Q

what is the interdisciplinary approach to functional mechanics

A

injury occurs due to failure of some biological structure (application of force > adaptation by body)

50
Q

what is the interdisciplinary approach to physiology

A

if tissues are strong, moderately flexible and not fatigued, there is a better chance of not getting injured

51
Q

what are 3 things to look at in psychological perspective

A
  1. predisposition to injury - identify those at risk
  2. reaction to injury - understand typical responses of athletes
  3. rehabilitation - optimizing recovery - speed of recovery and maintenance of performance levels
52
Q

what are some psychological issues relative to athletic injury

A

loss of social aspects
loss of identity
loss of importance
depression, anxiety, other behavioral factors (ED, grades, anger)

53
Q

what is the psychological response

A

injury occurs —- athlete has realized the severity of the injury —- thought process begins (cognitive appraisal)

54
Q

what questions are asked during cognitive appraisal

A

how bad?
how long will i be out?
surgery?
rehab/treatment?
can i get back to where i was athletically?
am i finished?
what else is there the do?

55
Q

what are the stages of the coping model

A

denial
anger
grief or desperation
depression
acceptance or reintegration

but EVERYONE reacts differently

56
Q

describe cognitive appraisal model

A

personal/situational factors influence cognitive appraisal of injury
appraisal influences emotional/behavioral responses, including recovery outcomes
takes into account individual differences in response to injury

57
Q

what is cognitive appraisal model influenced by

A

personal factors
- personality traits, locus of control, goals, what the athlete brings to the situation
situational factors (anxiety, focus, worry, emotion, confidence etcc)
- related to the athletes social context - sport, social, environment (familiarity, star player? length of rehab? social support etc..)

58
Q

what are 3 coping strategies

A
  1. appraisal focus - athlete modifies the way they think
  2. problem (action) focus - athlete makes an effort to do something active to alleviate stress
  3. emotion focus - athlete tries to regulate emotional consequences
59
Q

how to AT and coaches fit into injury

A

AT see athlete first (positive or negative for athlete)
coaches’ reaction to injury

WORDS HAVE A POWERFUL IMPACT

60
Q

what prevents athletes from being able to successfully cope with their injuries

A

adherence and positive attitude

61
Q

psychosocial strategies for athletes

A

keep the athlete involved with the team
use short term goals
create variety in rehabilitation
understand motivation
use effective communication
setting realistic goals
positive reinforcement

62
Q

how to use positive self talk

A

identify what
identify when
replace with positive

63
Q

how to use imagery

A

facilitate relaxation
facilitate healing process
control pain
maintain skill
block replay of injury

64
Q

what are other rehab interventions

A

education
goal setting
awareness
spare time
providing social support

65
Q

what is the rehab wheel

A

assesses areas to reduce stress to facilitate restoration of physiological and psychological states
PERSONAL and PHYSICAL

66
Q
A

Athletic Injury Assessment (6 decks)

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