ESC270 Prevention/Care of Sports Injuries FINAL

Describe the PROLIFERATION phase of bone healing.

- 3 to 21 days -> repair/regeneration - osteoclasts resorb damaged bone tissue - osteoblasts build new bone - callus is formed between fractured bone ends containing weak immature bone tissue that strengthens over time via bone remodeling (endochondral bone healing) - an alternative process, direct bone healing, enables new interwoven bone tissue to be deposited w/o formation of a callus. - healing takes place via endochondral process

What is the goal of a primary survey?

- assess the responsiveness of the injured person, check their airway, breathing, circulation, & to dictate actions & responsibilities

What are the signs & symptom of shock?

- cold, clammy, moist skin - shallow, irregular breathing; labored, rapid, gasping - profuse sweating - extreme thirst - dizziness - eyes are dull, sunken, pupils dilated - RAPID/WEAK PULSE - chalk like skin - restlessness, anxiety, fear, disorientation

Hypovolemic Shock

- excessive blood or fluid loss leading to inadequate circulation & O2 supply to all organs - possible causes: hemorrhage, dehydration, multiple trauma

where is the most common site for a tear in the musculotendinous unit? why?

- since tendons are stronger than their attached muscle, the muscle portion of the musculoteninous unit ruptures 1st - this area is associated w/ a biomechanically weak point because the muscle cross-sectional area is the smallest

What are the ways to manage shock?

1. activate EAP 2. elevate feet/legs 8-12 in if head/neck injury or leg fracture is not present. 3. elevate head/shoulders & feet if head injury suspected; keep flat if neck injury suspected. 4. put on side if vomiting/unconscious 5. splint fractures 6. maintain normal body temp 7. avoid rough handling 8. keep patient quiet/still 9. DO NOT give anything by mouth 10. monitor vitals every 2-5 min until EMS arrives.

What are the 5 parts of the EAP?

1. communication 2. location 3. access 4. assessment 5. re-check

What are 5 ways to reduce the risk of dehydration during PA:

1. have unlimited fluid available during exercise 2. drink cool fluids containing less than 8% CHOS 3. use individual H2O bottles to accurately measure fluid consumption 4. avoid caffeine, alcohol, carbonated drinks 5. replenish lost fluid w/ at least 24 oz of fluid for every pound of body weight lost

what are 5 red flags indicating serious emergency & activation of EMS?

1. unconsciousness/ loss of consciousness in presence of head trauma 2. no pulse 3. excessive arterial bleeding 4. respiratory distress/failure/airway obstruction 5. severe shock

What is the normal pulse rate of a child?

120 to 140 bpm

What is the normal BP for a female adult?

120/80 mmHg

Normal pulse rate for an adult is:

60-100 bpm

What is the most effect regulatory means of protecting the public? a. licensure b. registration c. state cert d. mandatory continuing edu requirements

A. Licensure

Who regulates professions to protect the public from harm by unqualified individuals? a. BOC b. Individual states c. Better business bureau d. NATA e. US govt

B. Individual States

T/F: force acting along the long axis of a structure is termed tensile force.

FALSE: its axial force

T/F: extensibility is the ability of a muscle to be stretched & to return to normal length after either lengthening or shortening.

FALSE: its flexibility extensibility = ability to be stretched or increased in length.

T/F: comminuted fractures are often produced by excessive torsional & bending loads.

FALSE: its greenstick fracture comminuted fractures = when loading is very rapid, the fracture contains multiple fragments

T/F: shivering during hypothermia usually starts when core temp drops below 90*F.

FALSE: when it drops below 90*F, shivering ceases & muscles become cold and stiff.

A situation in which danger is apparent, or should have been apparent, that results in an unreasonable unsafe condition is called:

Foreseeability of Harm

What are the steps involved in evaluating an injury and/or performing a secondary assessment including the use of HOPS?

H: history (CC, MOI) O: observation/inspection P: palpation S: special tests

decrease tactile sensation

HYPOesthesia

fatigue, dizziness, confusion, rapid/shallow respiration, & rapid/weak pule are signs of:

Heat Exhaustion

*** An athlete is NOT sweating, appears red/flushed, & has hot, dry skin. What condition might the athlete be experiencing?

Heat Stroke

If an athletic training commits an act that's their responsibility to perform, but uses the wrong procedure, the individual could be accused of:

MISfeasance

BP readings of 120-139 systolic & 80-89 diastolic are related to

PREhypertension

What are the parts of SOAP?

S: subjective (history) O: objective (observation) A: assessment P: plan (treatment goals)

T or F: shock & dehydration can cause HYPOtension.

TRUE

T or F: the severity of shock can vary dependent on the age of the individual.

TRUE

T/F: BRADYKININ increases vessel permeability & stimulates the nerve endings to cause pain.

TRUE

T/F: Phase 2 of a therapeutic exercise program focuses on the regaining of any deficits in ROM & restoring proprioception

TRUE

T/F: acclimatization is the single most important factor in preventing the onset of heat illness & altitude sickness

TRUE

T/F: although person continuously drinks H2O throughout an exercise bout, less than 50% of fluid lost will be replenished.

TRUE

T/F: during the ACUTE INFLAMMATORY phase, HEPARIN is released into the injured area & acts as an anticoagulant, which results in increased swelling.

TRUE

T/F: hemorrhage & edema cause pooling of tissue fluids & blood products, which increases pain & muscle spasms

TRUE

T/F: in TENDONS, the collagen fibers are arranged in a parallel pattern, enabling resistance of high, unidirectional tensile loads when the attached muscle contracts.

TRUE

T/F: lack of acclimatization, use of diuretics, & sodium depletion in the normal diet can lead to heat cramps

TRUE

T/F: ligaments contain more elastic than tendons.

TRUE

T/F: ligaments resist large tensile loads along their long axis.

TRUE

T/F: ligaments resist small tensile loads from directions other than along their long axis.

TRUE

T/F: stress is defined as force divided by the surface area over which the force is applied

TRUE

T/F: the severity of shock can vary depending on age of person

TRUE

the PPE should determine the general health, maturity, & fitness level of an individual & detect those at risk for injury or those who may have conditions that limit participation.

TRUE

*** While stretching for an overthrown ball, a 1st baseman strained an ADDuctor muscle. What type of force would have produced this injury?

Tensile

A wrong done by an individual for which the injured party seek a remedy for damages suffered is called:

Tort

Crepitus w/ movt, inflammation, local swelling, & nodule formation in the tendon sheath are characteristics of:

b. chronic tenosynovitis

The escape of fluid from the blood vessels into the joint cavity is called:

b. effusion

As air temp approaches body temp & exceeds 30.6*C (87*F),___________ becomes the major means of heat dissipation.

b. evaporation

During cold weather, body heat is gained through which mechanisms?

b. increase in basal metabolism c. shivering d. thyroxine & epinephrine production

What best describes stage 2 tendinitis?

b. pain during activity that DOES NOT restrict performance

What is collagen a major component of?

b. tendon c. ligament d. skin

What is the most important tool of the PPE?

medical history

committing an act that's one's responsibility to perform, but uses the wrong procedure, or the right procedure is improperly performed.

misfeasance

failing to perform one's legal duty of care.

negligence

an abnormal sensation characterized by numbness, tingling, or a burning sensation

paresthesia

Neurogenic Shock

peripheral blood vessels dilate causing insufficient blood volume

Septic Shock

severe, bacterial infection

hypertension contributes to:

shock

what's the difference between stress v. strain?

stress = force/surface area over which the force is applied; when body sustains force related to the likelihood of the injury strain = amount of deformation an object undergoes in response to an applied force

Psychogenic Shock

temporary dilation of blood vessels resulting in draining of blood from head w/ pooling of blood in abdomen

an individual affirms a subjective understanding of the risks of participation in the activity & one's voluntary choice to participate

assumption of risk

deterioration of tissue

atrophy

A tendon begins to develop tears when it's stretched ______% beyond normal length.

b. 5-8%

*** After a preseason physical exam, an offensive lineman is found to have mild hypertension. What activity restrictions are there for this athlete?

a. No activity restrictions

What is the potential impact of the federal Rehabilitation Act & Americans w/ Disabilities Act on a physician's authority in determining clearance for participation?

a. RA&ADA: states people have the legal right to participate in any competitive sport regardless of a preexisting medical condition. b. physician CANNOT totally exclude an athlete from playing, but they can recommend them not to play due to their medical condition due to the possibility of increasing the risk for further injury and/or death. c. physician can only tell patient risks; explain disadvantages; recommend other activities.

Which of the following are considered a noncardiac cause of sudden death?

a. commotio cordis c. exertional hyperthermia d. exercise-induced anaphylaxis

The common MOI for a muscle contusion is:

a. compression

Marfan syndrome is a genetic disorder that primarily effects:

a. connective tissue

for a muscle to shorten, it must:

a. contract concentrically

The PROLIFERATIVE phase of healing includes:

a. development of new blood cells (angiogenesis) b. formation of fibrous tissue (fibroplasia) c. wound contraction - generation of new epithelial tissue (re-epithelialization) days 3-21

What are HYPERmobile individuals more susceptible to?

a. disc prolapse b. dislocations c. ligament sprains

*** An athlete has been diagnosed w/ anemia. Which food would you suggest the athlete to incorporate in their daily diet?

a. dried apricots

The superficial discoloration or swelling outside a joint in the surrounding soft tissue is:

a. ecchymosis

What are accurate indicators of the need to hydrate during exercise?

a. headache b. profuse sweating d. dizziness

Small diameter, slow transmission nerves carry impulses for what sensation?

a. pain

What factors affect flexibility?

a. race (NA are more mobile than AA, who are more mobile than whites) b. joint adhesions d. swelling

Which of the following are signs of shock?

a. rapid/shallow respiration c. profuse sweating d. pale, clammy skin

The beginning of the ACUTE INFLAMMATORY phase is marked by:

a. vasoconstriction lasts for a few seconds to ~10 min.

Respiratory Shock

airway obstruction, pneumothorax, hemothorax

______________ is the 1st chemical mediator to appear during the INFLAMMATORY STAGE of tissue.

c. Histamine

What is the immediate assessment that occurs on the field when a life-threatening injury is present?

c. Primary Survey

the body's ability to sustain submax exercise over an extended period of time

c. aerobic capacity

absorption of heat through the feet by standing on a hot artificial turf is an example of heat exchange termed:

c. conduction

What is the most common cause of sudden death in those younger than age 35?

c. hypertrophic cardiomyopathy (26%)

What does the Primary Survey determine?

c. level of responsiveness & assess ABCs

Sudden death is most often precipitated by:

c. physical activity

in the female athlete, iron-deficiency is predominantly seen in:

c. those who maintain a low % of body fat (& endurance athletes)

applying ice, compression, & elevation to an acute injury decreased injury to the:

c. zone of secondary injury

What would help prevent hyperthermia?

d. acclimate to the environment

The plantar fascia is an example of an:

d. aponeurosis

what is the most PREVENTABLE cause of sudden death?

d. exertional hyperthermia

Rubor, calor, tumor, dolor, & loss of functions are symptoms of:

d. inflammation

What are HYPOmobile individuals more susceptible to?

d. muscle strains (nerve pinch syndroms, overstress tendinitis) *they are tight jointed

having a reduced concentration of O2

hypoxia

when an individual has total disregard for the safety of others.

gross negligence

a localized mass of blood & lymph confined w/in a space

hematoma

Cardiogenic Shock

injury to heart or previous heart attack

Metabolic Shock

insulin shock, diabetic coma, vomiting, diarrhea

committing a negligent act while providing care.

malpractice

Standard of Care refers to:

the level of competency that must be demonstrated by an individual educated in & practicing in a given profession.

What activities are used to measure power?

vertical jump throwing med ball vertical jump & reach stair climbing