sports med Flashcards
why is power lifting dangerous for teens
risk of apophyseal avulsion fx
heat exhaustion
milder form of heat illness
- mild dehydration
- core temp < 104
- HA, N/V, thirsty
sweating in heat exhaustion or heat stroke?
exhaustion
heat stroke
- temp > 105
- flushed, hot, DRY skin
- CNS depression- confused, vertigo, syncope, lethargy
- severe dehydration
dangers of untreated heat stroke
end organ damage 2/2 endotoxin and cytokine release
treatment of heat stroke (4)
- rehydrate with IV fluids only
- pressors if needed
- evaporative cooling is less stressful and just as effective as ice bath
- don’t cool below 101 as this can lead to hypothermia
grade 1 spain
minor stretching of the ligament
minimal discomfort or loss of fxn
grade 2 sprain
ligaments are partially torn
tenderness and swelling
ecchymosis
some loss of function
grade 3 sprain
ligament is completely torn
significant pain, tenderness, swelling, loss of function
when can a child with a sprain return to sports (5)
- full ROM
- full strength
- no swelling
- no pain
- no joint instability
most common ankle injury
sprain of the anterior talofibular ligament
pain over the physis in a pre adolescent child
assume salter harris 1 fx
EVEN if xray nl
injury with change in direction off a pivoted knee
subluxation of the patella
can hear a pop with injury
sx with subluxation of the patella
pain over the lateral aspect of the patella with deformity over the medial aspect
can hear a pop with injury
how does prepatellar bursitis present
anterior knee pain over the patella with swelling
NSAIDs and padding
patellofemoral syndrome
- presents as anterior knee pain
- sports with running, jumping, or squatting
- *more common in females d/t higher q angle
- no role for xray
tx for patellofemoral syndrome
- knee brace
- patellar taping
- NSAIDs
- refer to ortho if no improvement in 4-6 mos
injury 2/2 blunt trauma to thigh which presents with large aea of swelling
soft tissue hematoma
pain over the anatomical snuff box
scaphoid fx of the wrist
negative xrays are common
complication to worry about with supracondylar fx
neurovascular compromise
look for pain on passive extensions
sign on xray c/w supracondylar fx
posterior fat pad- 2/2 effusion a/w fx
*anterior fat pad can be nl
an 11 y/o FOOSH while supinated and extended- what is the injury?
elbow dislocation
a 13 y/o hit directly to the arm causing it to laterally rotate on impact- what is the injury?
epiphyseal fx
patient falls back on a posteriorly rotated, abducted arm- what is the injury?
anterior humeral dislocation
patient with pain over the distal clavicle with prominence noted over the area or point tenderness- what is the injury?
acromioclavicular injury
patient with injury 2/2 direct force to the posterior shoulder with pain over the sternoclavicular joint and possible respiratory discomfort- what is the injury?
posterior sternoclavicular dislocation
pt with shoulder and upper arm pain, withOUT asymmetry on exam- what is the injury?
proximal humeral head fx
pt wth shoulder pain with elevating and lowering the arm, without any deformity. In addition this will present as chronic pain most likely in the absence of acute injury
rotator cuff injury
do shoulder dislocations need imaging?
yes! dx clinical, but need to evaluate for additional fx
management of shoulder dislocation
sling and need to fill place between arm and body with pillow
return to play criteria
1- complete rest, stay home and relax
2- walk around/light activity- no activities with resistance (weight lifting)
3- movement c/w sport they wish to return to, minimal resistance
4- training drills, no contact
5- full contact
6- return to play
should you remove equipment for patient injured on playing field?
NO
always leave helmet on
remove facemask to a/w respiratory
sport that causes most neck injuries
football
these 4 things mandate no contacts sports
1- splenomegaly
2- hepatomegaly
3- 1 kidney
4- repeated concussions
what is the leading cause sports related eye injury
baseball
physiologic findings of anabolic steroids (5)
- voice change
- hirsutism in females
- gynecomastia in males
- hypertension
- mood change
- **NO arrhythmia or seizures!!
lab findings with anabolic steroid use
- elevated LFTs
- low HDL
- increased LDL
- oligospermia and azoospermia
cardiac findings that you need to refer to cards for in teen athletes (3)
- fixed splint second heart sound
- systolic murmur 3/6 or greater
- any diastolic murmur
