BOC Study Guide- Prentice Textbook

Catastrophic insurance

- benefits begin when the expencses have reached 25,000 and then are extended for a lifetime - in high schools, insurance kicks in when med, rehab, and transportation costs exceed 10,000 not covered by other insurance benefits

Exertional hyponatremia

- fluid/electrolyte disorder that results in an abnormally low concentration of sodium in the blood - from ingesting too much fluid - worsening headache, nausea and vomiting, swelling of hands and feet, lethargy, apathy, agitation, and low blood sodium - transport immediately to medical facility and mut be cleard by physician

Ligament healing

- immediately after injury, ~72 hrs thee is a loss of blood from damaged vessels and attraction of inflmmatory cells - next 6 weeks, vascular proliferation w/ new capillary growth begins to occur along with fibroblastic activity, forming a fibrin clot - gradually there is a decrease in fibroblastic activity, decrease in vascularity, and max increas in collagen density of a scar - maturation of a scar may require at least 12 mos

Health Maintenance Organization (HMO)

- provide preventative measures and limits where the individual can receive care - determine feeds using a capitation system, which lmits the amount that will be reimbursed for a specific service - permission must be obtained before can go to antoehr provier - pay 100% of medical costs as long as go to approved list of health care proviers (doesnt pay for anything outside of approved list) - no deductables, but have a copay

Malignant hyperthermia

- rare, genetically inherited muscle disorder that causes hypersensitivity to anesthesia and extreme exercise in hot environments - muscle breakdown - muscle temps increase fster than core temp - breakdown may damage the kidneys and cause acute renal failure - fatal if not treated immediately - should not compete in hot, humid environments

Physician-Hospital Organization (PHO)

-Involves a major hospital or hospital chain and its physicians -Contract directly with employers to provide services and/or contracts with managed care organizations

Athletic Training Code of Ethics

-Members shall respect the rights, welfare, and dignity of all -Members shall comply with the laws and regulations governing the practice of AT -Members shall maintain and promote high standards in their provision of services -Members shall not engage in conduct that could be construed as a conflict of interest or that reflects negatively on the profession (gambling) -Members shall accept responsibility for the exercise of sound judgement

Plantaris

-Origin: Lateral supracondylar ridge of femur above lateral head of gastrocnemius -Insertion: posterior surface of calcaneus -Actions *Plantar flexes foot and flexes knee*

Splinting of Lower-limb Fractures

-fractures of foot and ankle require splinting of foot and knee -fractures involving knee, thigh, or hip require splinting of whole leg and one side of trunk

Biofeedback

-immediate feedback for athlete about how effectively they can contract or relax muscle

anaerobic metabolism

-no oxygen, body turns to stored glycogen when ATP is used up -glycogen is broken down into glucose which is then metabolized within muscle cells to generate ATP for muscle contractions without oxygen -produces lactate

Aerobic Metabolism

-requires oxygen -burns lactate using oxygen (removing it) and creating more ATP than anaerobic -takes 20 minutes to clear lactate from your system

5 domains of athletic training

1) Injury/illness prevention and wellness protection 2) Clinical evaluation and diagnosis 3) Immediate and emergency care 4) Treatment and rehabilitation 5) Organizational and professional health and well being

Rib classifications

1-7: true ribs 8-10: false ribs 11-12: floating ribs

Cranial nerves

1. Olfactory- smell 2. Optic- vision 3. Oculomotor- PERRLA 4. Trochlear- up and down eye movements 5. Trigeminal-sensations of face 6. Abducens- lateral eye movements 7. Facial- muscles of face 8. Vestibulocochlear- hearing/balance 9. Glossopharyngeal- swallow 10. Vagus- swallowing, vitals 11. Accessory- shoulder shrug 12. Hypoglossal- tongue movements

Meninges layers

1. dura mater 2. arachnoid 3. pia mater 4. Subarachnoid

Proteins

15-20% needed for boy growth, maintenance and repair of all body tissues Amino acids

Football helmets are recertified every

2 years

Knee Plica

20% of individuals, knee fails to fully absorb synovial cavities -synovial fold s/s: recurrent episodes of pseudo locking of knee after sitting for long periods of time -15-20 degrees of flexion, snap maybe felt or heard -pain with going up/down stairs and squatting mangement: rest, NSAIDs, local heat, surgery if no response to treatment

Fats (lipids)

25-30% most concentrated source of energy -saturated and unsaturated

Electrical stimulating current

3 types: monophasic biphasic pulsatile

How long should activity take place after eating?

3-4 hours

Cool down

5 to 10 minutes decreases muscle soreness and problems

Cold or Ice immersion

50 to 60F 10 to 15 minutes

Carbohydrates

55-60% of diet most efficient source of energy sub groups -sugars, starches, fibers

Crutch fitting

6 inches from outer margin of foot, 2 inches from front of shoe elbow is flexed at 30 degree angle

Commotio Cordis

A blunt chest injury caused by a sudden, direct blow to the chest that occurs only during the critical portion of a person's heartbeat. immediate death

Point of Service plan

A combination of HMO and PPO -based on HMO structure but allows members to go outside to obtain service

Hypertrophic cardiomyopathy

A condition in which the heart muscle becomes abnormally thick. Limits blood flow

Air splint

A hollow, inflatable splint for immobilizing a part of the body. should not be used if it will alter a fracture or deformity

vapocoolant spray

A liquid that evaporates quickly when sprayed on the skin, causing quick superficial cooling of the skin. fluorimethane spray

true leg length discrepancy

ASIS to medial malleolus

Type of activity

Aerobic allow athlete to maintain a constant heart rate

Hold Relax Stretching

Affected body part is passively moved until resistance is felt -patient is told to contract the antagonist muscle isometrically -AT resists the movement for 10 seconds -Patient is told to relax for 10 seconds -AT moves patient into new position -Repeated 3 times

Frost nip

Affects the ears, nose, cheeks, chin, fingers and toes Occurs with high wind and cold skin appears very firm, cold painless areas May blister or peel after 24 hours Prevention: Apply firm sustained pressure on area (do not rub) or blow warm breath on area

Marfan's Syndrome

An inherited disorder that affects connective tissue — most commonly affects the heart, eyes, blood vessels and skeleton. People with this syndrome are usually tall and thin with disproportionately long arms, legs, fingers and toes. If your heart or blood vessels are affected, the condition can become life-threatening.

Muscle energy techniques

Are manually applied stretching techniques that use principles of neurophysiological to relax overactive muscles and or stretch chronically shortened muscles

Synovial joint injuries

Articulations of two bones surrounded by joint capsule w synovial membrane

Skull fractures

Blunt trauma S/s: severe headache, indention, blood in ear, nose bleed, Battle's sign, Raccoon eyes, spinal fluid from ear or nose management: immediate referral

Insulin Shock

Body has too much insulin and not enough blood sugar s/s: tingling in mouth, hands weakness, headaches, abdominal pain, irritability, tremors patient must adhere to proper diet, pre workout snack high in carbs and protein 40 minutes- have another snack ready

Myotomes function

C2- neck flexion C3- lateral flexion/extenson C4- shoulder shrug C5- shoulder abduction C6- elbow flexion/wrist extension C7- elbow extension wrist flexion C8- ulnar deviation/thumb extension T1- finger abduction/adduction L2- hip flexion L3- knee extension L4- ankle DF L5- big toe extension S1- PF/eversion/knee flexion/hip extension S2- PF/knee flex/ hip ext S4- bladder; rectum

Reflex Testing

C5- biceps C6- brachioradialis C7- triceps L2- adductor L4- patella S1- achilles S2-hamstrings

Female athlete triad

Combination of eating disorder, amenorrhea and osteoporosis

Role of Team Physician

Compiling Medical histories, diagnosis of injury, deciding on disqualification and return to play, attending practices and games, commitment to sports and athlete

Diabetes Mellitus

Complete or partial decrease in insulin production by pancreas s/s: frequent urination, constant thirst, weight loss, constant hunger, weakness, tiredness control diet insulin pump

Progressive resistance training

Contractions that overcomes some fixed resistance produced by equipment

Isometric exercise

Contracts the muscle statically without changing its length 5-10 reps at 10 seconds *breathing is important spikes systolic BP

Pressure points for hemorrhaging

Dorsal pedis popliteal femoral radial ulnar brachial axillary subclavian carotid facial temporal most common -brachial and femoral

Circuit training

Exercise stations that consist of various combinations of weight training, flexibility, calisthenics, and aerobic exercises 8- 12 stations repeated 3 times

Factors that impede healing

Extent of injury, edema, hemorrhage, poor vascular supply, muscle spasm, atrophy, corticosteroids, keloids and scars, infection, health, age, and nutrition, humidity, climate and oxygen

Vitamins

Fat soluble Water soluble Antioxidants

Last

Form in which the shoe is built Maybe straight, semicurved or curved

Continuous training

Frequency, Intensity, Type, Time

Muscle mechanoreceptors

Golgi tendon organ and muscle spindles

Muscle strain

Grade 1- some fibers have been stretched or torn -tenderness and pain in AROM -movement is painful but all ROM is possible Grade 2- number of fibers have been torn -active muscle contractions extremely painful -depression of divot can be felt -swelling and discoloration Grade 3- complete rupture -total LO motion or significant impairment -pain is intense but quickly diminishes bc nerve fiber separation

Ligament sprains

Grade 1- some stretching/separation of ligament fibers -minimal instability -mild to moderate pain -localized swelling and joint stiffness Grade 2- some tearing and separation -moderate instability -severe swelling and joint stiffness Grade 3- total tear -severe pain followed by little to no pain -usually requires surgery

Head Injury Assessment

History -consciousness, amnesia Observation -deformity Palpation -deformity, tenderness Special Tests -Neurological (Cranial Nerve tests) -Balance -Coordination -Cognitive

Types of shock

Hypovolemic Respiratory Neurogenic Psychogenic Cardiogenic Septic Anaphylactic Metabolic

Lateral Stabilizers of Knee

IT band- tense during knee EXT and FLEX o popliteus muscle stabilizes during knee FLEX when contracting, protects the lateral meniscus by pulling it posteriorly o biceps femoris stabilizes by inserting into the fibular head, IT band, and capsule

Graston Technique

Instrument Assisted Soft Tissue Mobilization that allows the clinicians to break up scar tissue and fascial restrictions, as well as stretch connective tissues and muscle fibers

Grade 3 Joint Mobilization

Large amplitude glide up to the pathological limit in the ROM -used when pain and resistance from spasm, inert tissue tension, or tissue compression limit movement near the end of range

Low Level Laser Therapy

Light Amplication by Stimulated Emission of Radiation used to stimulate healing process or modulate pain

Cartilage healing

Limited healing capacity course of healing depends on whether damage is to cartilage alone or also subchondral bone

Amyotrophic Lateral Sclerosis

Lou Gerig;s Disease. sclerosis of lateral regions of spinal cord along with degeneration of motor neurons and atrophy of muscles difficulty speaking, swallowing, and using hands no cure

Cerebral Contusion

MOI: Injury to brain that involves small hemorrhages within cortex, brain stem ro cerebellum S/s: LOC but quickly becomes alert and talkative -headache, dizziness and nausea Management: hospitalization with CT or MRI, no RTP until symptoms resolve

Peptic ulcer

MOI: acids secreted in the stomach destroy the mucous lining of the stomach or small intestine; sever anxiety S/S: gnawing pain; dyspepsia; heartburn; nausea; vomiting Tx: antacids; altering the diet

Epidural Hematoma

MOI: blow to the head or skull fracture s/s: LOC, initially no symptoms, gradually symptoms begin to worsen, intracranial pressure Management: refer out

Maxillary fracture

MOI: blow to upper jaw s/s: pain while chewing, nosebleeds, double vision, raccoon eyes management: airway maintained, referral in upright and forward leaning position

Liver Contusion

MOI: blunt trauma S/S: hemorrhage; shock; referred pain just below the right scapula, shoulder and substernal area; referred pain anterior left side of the chest Tx: refer to MD

Zygomatic Complex Fracture

MOI: classified as LeFort Fracture s/s: deformity, nose bleeds, double vision, raccoon eyes management: refer out

Orbital Fracture

MOI: direct blow s/s: diplopia (double vision), restricted eye movement, downward displacement of eye, pain, swelling, hemorrhaging management: refer out

Nasal Fracture

MOI: direct blow s/s: hemorrhaging is profuse, swelling immediate management: control bleeding and refer

Joint Contusions

MOI: direct blow against muscles crossing at joint, VMO frequently involved s/s: severe pain, loss of movement, acute inflammation, swelling management: depends on location and severity, compression wraps and ice

MCL Sprain

MOI: direct blow from lateral side or lateral tibial rotation Grade 1: joint is stable during valgus, little or no joint effusion, almost full passive and active ROM Grade 2: slight laxity during valgus, moderate swelling, inability to fully extend the knee Grade 3: empty end feel with valgus, hamstring guarding, effusion

PCL Sprain

MOI: direct blow to front of a bent knee, fan with full weight on anterior aspect of bent knee s/s: feeling pop in the back of the knee, TTP in fossa +godfrey's +sag sign +posterior drawer Management: pain and swelling, quad strengthening surgery: 6 weeks of immobilization in extension w full weight bearing on crutches

Peroneal nerve contusion

MOI: direct blow to nerve s/s: electric shock down leg, numbness, point tender, drop foot management: protective padding, return to activity when symptoms subside

Patellar fracture

MOI: direct hit or pull of quad tendon s/s: joint effusion, pain and point tenderness management: cold wrap w splint, refer out

Mandible fracture

MOI: fracture of lower jaw, frequently fractured near jaw's frontal angle s/s: pain when biting, loss of normal blood flow to teeth management: 4 to 6 weeks, refer out

ACL Sprain

MOI: most vulnerable when tibia is externally rotated and knee is in valgus -leg is rotated while foot is fixed -anterolateral instability -anteromedial instability s/s: -hear/feel pop, feel like knee is shifting +anterior drawer +lachman's -rapid swelling (2 hours) Management: surgery, pre-op quad strengthening, ROM and strength post op

Acute patellar subluxation/dislocation

MOI: planting of foot, deceleration, cutting- usually lateral displacement s/s: pain, swelling, loss of knee function, deformity, patellar apprehension Management: x-ray, braces for return to play

Patellar Tendinitis

MOI: repetitive jumping, kicking or running s/s: pain and tenderness at inferior pole of patella 1- pain after activity 2-pain during and after 3-pain during and well after mangement: ice, whirlpool, knee strap, friction massage

IT band friction syndrome

MOI: repetitive or overuse -genu varum -prontation of feet s/s: irritation at IT insertion +Ober's Management: correction of alignment issues, ice massage before and after activity, proper warm up, stretching

Mandible luxation

MOI: side blow to open mouth s/s: locked in open position Management: refer out

Patellar Tendon Rupture

MOI: sudden contraction of quads, not common if no inflammatory condition prior s/s: patellar is deformed (toward thigh), extension is not possible, significant pain followed by dull management: surgery

Meniscal tears

MOI: valgus force, weight bearing with rotary force, forceful extension s/s: effusion, joint line pain and loss of motion (feels stuck), pain with squatting management: initial MRI to determine type Menisectomy (partial weight bearing after surgery for about 2 weeks) or repair (5-6 weeks brace and crutches)

LCL Sprain

MOI: varus force, internal rotation of tibia S/s: pain and point tenderness over LCL swelling over LCL Tests: varus Treatment: similar to MCL

Sudden Cardia Death Syndrom

MOI; young individual dies for no apparent reason hypertrophic cardiomyopathy marfan's syndrome wolff-parkinson-white

Preparticipation Exams

Medical History -to identify any past or existing medical condition, updated yearly, reviewed by physician and ATs Physical exam -height, weight, body composition, blood pressure, pulse, vision, skin, nose, throat, heart, lung function, abdomen, lymphatic, genitalia, blood work Cardiovascular screen Maturity assessment -5 stages of maturity: Boys-pubic hair and genital development, girls- pubic hair and breast development (Stage 1- not evident, Stage 5- full development) -Stage 3: growth plates weaker than joint capsule and tendon attachments Orthopedic Screening

Otitis Media

Middle ear infection MOI: accumulation of fluid in middle ear -infection and inflammation s/s: intense ear pain, transient loss in hearing, tympanic will be bulging or bleeding Management: antiobiotics from physician

Paraffin Baths

Mixture consists of 25 kg of wax per 1 L mineral oil treatment for more angular body types Dip area in mixture 6-12 times avoid areas with open wounds

Hydration

Monitor color of urine -light yellow: hydrated -dark urine: dehydrated -clear urine: overhydrated Athletes should be drinking 17 to 20 fl ounces of water or sports drink 2-3 hours before exercises 7-10 fl ounces every 10-20 minutes during practice

infectious mononucleosis

Mono acute viral disease effects mainly children and young adults caused by Epstein-barr virus -severe fatigue, risk of spleen rupture, loss of appetite, enlarged neck lymph nodes

Subdural hematoma

Most common death MOI: acceleration/deceleration forces tear vessels that bridge dura mater and brain s/s: conscious if not complicated, dilation of pupil on same side of injury, rapid onset of injuries Management: immediately refer

Indemnity Plans

Most traditional form of billing for health care. Fee-for-service plan that allows the insured party to seek medical care without restrictions on utilization or cost. The provider charges the patient or a third-party payer for services provided.

Occupational Safety and Health Administration

OSHA, established standards for an employer to follow that govern occupation exposure to blood borne pathogens

Rhomboid minor

Origin: Spines of C7-T1 Insertion: Medial border of scapula superior to spine Action: Elevation, retraction and downward rotation of the scapula

Teres Major

Origin: axillary border of scapula Insertion: medial lip of bicipital groove Action: internal rotation, adduction, extension

Semimebranosus

Origin: ischial tuberosity Insertion: Medial condyle of tibia Action: flexes knee and extends hip

Semitendinosus

Origin: ischial tuberosity Insertion: proximal, medial surface of tibia near insertion of gracilis Action: flexion at knee; extension and medial rotation at hip

Abductor Pollicis Longus

Origin: middle one third of posterior radius, middle posterior ulna insertion: dorsal aspect of base of MC Action: thumb abduction, thumb extension, radial deviation, supination

Osteochondritis Dissecans

Partial or complete separation of the articular cartilage from the subchondral bone. slow onset s/s: achey pain, recurrent swelling, occasional catch or lock, atrophy of quads management: children- rest and immobilize teens and older- possible surgery w micro fracture procedure

Slow-reversal-hold relax

Patient moves body part to the point of resistance and is told to hold position -AT isometrically resists muscle for 10 seconds -Patient relaxes for 10 seconds

Secondary Insurance

Pays the remaining medical bills once the personal insurance company has made its payment

Epilepsy

Petit mal seizures- 5 to 15 seconds Tonic-Clonic- major episode lasts several minutes

Walking with cane or crutch

Placing the crutch tips ahead of the feet, the patient leans forward, straighten the elbows, pulls the upper cross piece firmly against the side of the chest, and swings or steps with uninjured leg between the stationary crutch. The patient should avoid pacing the major support in the axilla

Creatine

Positive: -increases workout intensity -lactic acid buffer -stimulates protein synthesis -decreases cholesterol -increases fat free mass Ingest 0.3g per kg of body weight per day split over 4-5 times/day 16 oz of water for each dose

Preferred Provider Organization (PPO)

Provide discount health care but also limit where a person can go for the treatment of an illness, and pay on a fee-for-service basis

Good Samaritan Law

Provides limited protection to someone who voluntarily chooses to provide first aid

Minimize swelling

RICE principle if it can be controlled, it can reduce rehab time needed

Health Insurance Portability and Accountability Act (HIPAA)

Regulates how individuals who have health information about an athlete can share that information with others and not be in violation of the privacy rule

Cerebral Concussions

Result of direct blow, acceleration/deceleration forces producing shaking of the brain s/s: disturbances in consciousness, anterograde or retrograde amnesia, headache, sensitivity to light and noise management: rest, no physical activity until RTP protocol completed

Straight last

Shoe is filled in on the inside/medial side of the shoe to increase stability for people who have flat arch or run on the inside of there foot (pronators)

Oblique fracture

Similar to spiral fractures, occur when one end receives a sudden torsion or twisting and the other end is fixed or stabilized

Types of muscle fibers

Slow-twitch (1) Fast twitch (2a, 2b, 2x)

Grade 4 Joint Mobilization

Small amplitude glide at the end range of motion -resistance limits movement in the absence of pain and spasm

Electrolyte replacement

Sports drinks are more efficient in replacing fluids due to carbs and sodium

Chondromalacia Patella

Stage 1- swelling and softening of articular cartilage Stage 2- fishing of softened cartilage Stage 3- deformation of the surface of articular cartilage caused by fragmentation s/s: pain in anterior aspect of patellar when going through flexion/extension -grating sensation + Clarke's sign management: pain free isometrics, NSAIDs, neoprene knee sleeves Surgery- moving VMO insertion forward, shaving patellar surfaces, removing patella

Minerals

Stored in liver and bones

Acute Exertional Rhabdomyolysis

Sudden catabolic destruction and degeneration of skeletal muscle, leakage of myoglobin (muscle protein) into vascular system -hot and humid environments -can result in gradual onset muscle weakness, swelling, pain, dark urine, renal failure and death -associated with sickle cell trait

Duty of care

The duty of all persons, as established by tort law, to exercise a reasonable amount of care in their dealings with others. Failure to exercise due care, which is normally determined by the reasonable person standard, constitutes the tort of negligence.

Ergonomic risk assessment

The evaluation of factors within a job that increase the risk of someone suffering a work-place-related ergonomic injury and what aspect of, or movement within, that job should be focused on to reduce this risk These factors include: awkward posture, repetitive movements without variation, forceful movement and vibrations

Antagonist muscle

The muscle opposite the agonist, which must relax and lengthen during contraction of the agonist.

Medical diagnosis

The ultimate determination of a patient's physical condition

Cutting devices for face masks

Three cutting devices-anvil pruners, trainers angel, FM extractor

Shoe selection

Toe box - 1/2 to 3/4 in between longest toe and front of shoe Sole -durable and provide shock absorption Shank -between sole and foot

Salter-Harris Fracture

Type 1: complete separation of the physis in relation to metaphysics without fracture Type 2: separation of the growth plate and a small portion of the metaphysis Type 3: fracture of the physis Type 4: fracture of a portion of the physis and metaphysis Type 5: No displacement of the physis but crushing force can cause a growth deformity

Ligaments of the hand

Ulnar collateral ligament of wrist, radial collateral ligament of wrist, palmar radiocarpal ligament, palmar ulnocarpal ligament, ulnar collateral ligament of digits, radial collateral ligaments of digits, interosseous metacarpal ligaments, palmar inter metacarpal ligaments, Triangular fibrocartilage complex, deep transverse ligaments (MC heads)

Apparent Leg Length Discrepancy

Umbilicus to medial malleolus

Heel cups

Used for a variety of conditions, including plantar fasciitis, heel spurs, Achilles tendonitis, and heel bursitis Heel cups maybe either hard plastic or spongy rubber

Joint Mobilization and Traction

Used to decrease joint pain by restoring accessory motion thus allowing for full, pain-free range of motion

MCL special tests

Valgus stress test 0, 25

Monitoring the heat index

Wet bulb globe temperature

Manual Muscle Strength Grading

Zero- no evidence of muscle contraction Trace- evidence of slight contraction with no joint movement Poor- complete ROM with gravity omitted Fair- complete ROM against gravity with no resistance Good- complete ROM against gravity with some resistance Normal- full ROM against gravity and full resistance

Dislocation

a bone is forced out of alignment and stays out until surgically or manually replaced or reduced first time should always be treated as a fracture- do not reduce

Subluxation

a bone is forced out of alignment but goes back into place -likely result in rupture of stabilizing ligaments and tendons -occasionally an avulsion fracture

Medicare

a federal insurance program for persons over the age of 65 and qualified disabled or blind persons regardless of income

Emergency Action Plan

a plan an organization develops that contains step-by-step procedures for dealing with various emergency situations

Stiffness

ability of a tissue to resist load

Modulation

ability of the electrical stimulating unit to change the magnitude or duration of the waveform could be continuous, interrupted or surging

Muscular endurance

ability to perform repetitive muscle contractions again some resistance

cardiorespiratory endurance

ability to perform whole body, large muscle group exercises for an extended period of time

Sickle cell trait reaction

abnormal hemoglobin molecules become deoxygenated as a results of exercise at a higher altitude causes enlarged spleen that has been known to rupture at high altitudes

Wolff-Parkinson-White Syndrome

abnormality in cardiac rhythm manifests itself as ventricular tachycardia

Acute onset muscle soreness

accompanies fatigue occurs immediately after exercise

Clinical diagnosis

accurately identifies the pathology of injury, the limitations and the possible disabilities associated with a condition.

Muscle healing

active contraction of muscle is critical in regaining normal tensile strength -rehab is usually longer than that for ligaments -be careful not to return to play too soon

Soft tissue mobilization

active release technique -place pressure over tender point and go through ROM -athlete actively moves body part

Hepatitis C

acute and chronic form of liver disease most common in US 80% show no signs or symptoms No vaccine

Controlling pain

acute pain control with RICE

Effects of immobilization

adverse muscular changes occur greatest atrophy occurs in slow twitch fibers neuromuscular efficiency returns within one week decreases normal lubrication for joints ligaments and bones become weaker full remodeling takes around 12 months or more Resting heart rate increases one hand bpm each day of immobilization

Contract relax stretching

affective body part is passively moved until resistance is felt -patient is told to contract muscle isotonicaly -AT resists for 10 seconds -Patient is told to relax for 10 seconds -AT moves patient into a new stretch position -Repeat 3 times

Biphasic current (AC)

alternating current the direction of the current flow reverses itself once during each cycle used for pain modulation or muscle contraction

Interval training

alternating periods of work with active recovery -60-80% of max HR -30-45% of Max HR Sport specific

Cardiac out-put

amount of blood pumped by the ventricle in liter per min

Anorexia Athletica

anorexia nerves without the starvation practice

ACL special tests

anterior drawer, lachmans, pivot shift Valgus/varus @ 0 degrees

Overtraining can bring

anxiety- feeling of uncertainty and apprehension Burnout- physiological and emotional exhaustion

Larsen-Johansson Disease and Osgood-Schlatter Disease

apophysitis with pain at attachment of patellar tendon at tibial tuberosity avulsion fracture of tibial tuberosity that has formed bony callus MOI: repeated avulsion of patellar tendon @ tuberosity Larsen-Johansson: similar but occurs at inferior pole of patella

Cryotherapy

application of cold temperatures can reach as far as 4 cm into body tissue

Thermotherapy

application of heat

Strain/Counterstrain Technique

approach to decrease muscle tension and guarding the can be used to normalize muscle function. -passive technique which places the body in the position of greatest comfort, therefore relieving pain

Dermatome

area of skin innervated by single nerve

Primary Survey

assess life threatening injuries -airway obstruction -no breathing -no circulation -profuse bleeding -shock Determine level of consciousness -unconscious call 911

Time of activity

at least 20 minutes

Medial meniscus

attached to the medial articular facet of the tibia and the joint capsule -posteriorly attaches to the fibers of semimembranosus

Medial Collateral Ligament

attaches at medial epicondyle of the femur and just beneath the attachment of the pes anserine on tibia -posterior aspect blends into semimembranosus and fibers of semimbranosus goes through capsule and attach to posterior aspect of medial meniscus -prevents valgus and external rotating forces

Hepatitus B Virus

attacks liver spread through blood flu-like symptoms can get vaccine

Myasthenia Gracis

autoimmune disease where antibodies attach the synaptic junctions between nerves and muscles drooping of upper eyelids and double visions

Multiple sclerosis

autoimmune inflammatory disease of CNS causes deterioration and permanent damage of the myelin sheath that surrounds nerve cell axon blurred vision with blind spots speech defects tremors muscle weakness in extremities Management: deal with symptoms, avoid over exertion and extreme temps, regular exercise plan

Screw Home Mechanism of Knee

axial rotation of the tibia relative to the femur -as knee extends tibia externally rotates -rotation occurs because medial femoral condyle is larger than laterla -gives great deal of stability in extension -when weight bearing, popliteus muscle must contract and externally rotate the femur to unlock the knee and allow flexion to occur

Septic shock

bacterial infection

Positional Release Therapy

based on strain/counter strain -difference is force applied over area -Find trigger point, move muscle into shortened state and patient is in less pain -hold for 90 seconds

Athletic trainers must ..... with athlete's response to injury

be a good listener, find out what the problem is, be aware of body language, project a caring image, explain injury to patient, manage stress of injury, help athlete return to competition

Formation of clot

begins 12 hours after injury and is complete in 48 hours thrombosplastin- prothrombin- thrombin- fibrinogen- insoluble fibrin clot

phase 1 - acute inflammatory response phase rehab

begins immediately when injury occurs and has lasted 4 days RICE rest is critical during this phase

Phase 2: Fibroblastic Repair Phase rehab

begins once inflammatory response ends 4 days to several weeks maintain cardiovascular fitness, restore full ROM, restore and increase strength and reestablish neuromuscular control

Workers Compensation

benefits for injured workers and goal is to return to workforce as soon as possible

Muscles of knee flexion

bicep femoris, semimebranosus, semitendinosus, gracilis, sartorius, gastroc, popliteus and plantaris

Modes of transportation-blood borne

blood semen Vaginal secretions Cerebrospinal fluid Synovial fluid

Hyphema

blood in anterior chamber of eye s/s: visible reddish tint to anterior chamber, vision is partially or completely blocked management: immediately referred to physician

hemothorax

blood in pleural cavity same as pneumothorax but with blood

Rib contusion

blow to rib cage inspiration and expiration painful s/s: point tenderness Management: wrapping with ace wrap, pain relieve with medication

Retinal detachment

blow to the eye, more common in near sighted athletes s/s: painless, "curtain falling over eye" Management: refer out

5 functions of bones

body support, organ protection, movement, calcium stores, and formation of blood cells

Wolff's Law

bone and soft tissue will respond to physical demands placed on them -injured structures should be exposed to progressive loads throughout rehab process

Stress fracture

bone may be vulnerable during first few weeks of intense physical activity -causes: overtraining, going back to competition too soon, improper training between events

Osteoblasts

bone producing cells

Osteoclasts

bone remolding cells

Linear fracture

bone splits along its length -jumping from height and landing in a way that puts stress on the long axis

Factors that limit Flexibility

bone structure, fat, skin, muscles and tendons, connective tissue, neural tissue tightness

Genu Varus

bow legged

Tendinosis

breakdown of a tendon without inflammation treatment is engaging in exercise to strengthen the tendon and consistently stretching the tendon

Closed fracture

broken bone with no open wound

Contusions

bruise ecchymosis- bluish/purpleish discoloration from bleeding under the skin

Myositis Ossificans

calcium deposits that result from repeated trauma formation of these calcium deposits can be seen w x ray -protect area w pad

Aquatic Exercise

can be used as assistive, supportive or resistive

Football shoulder pads

cantilever strap extends from front to back causes shoulder pads to arch above tip of shoulder- dispersing pressure into pads than shoulder

Macronutrients

carbohydrates fats proteins

Knee Rehab

cardio should be maintained throughout -non-weight bearing for 1 day allows healing process Joint mobs -incorporated as early as possible (patellar, anterior posterior tibial, CPM) Regaining ROM is critical (PNF initially) Muscular -isometric, isotonic, isokinetic, plyometric, eccentric, closed kinetic chain -working above and below injury site Neuromuscular Control -contracting muscle, proprioceptive exercises Functional Progression -walking, jogging, running, sprinting

Short bones

carpals and tarsals

Stretcher carrying

carry patient feet first carry head first if going up or down a hill

Etiology

cause of disease

Active trigger point

causes pain at rest firm pressure over point causes pain most common in postural support muscles

Vascular relation to inflammation

cell damage- vasoconstriction of vascular walls leading away from site of injury- lasts about 5 to 10 minutes

Athlete Heart syndrome

change in heart due to overtraining

Deformity

change in shape of tissue

CPR

check scene, call 911, initiate care for vitcim 30 compression to 2 breaths

Cytokines

chemokine, interleukins -help attract phagocytes -ingests other cells and foreign particles

Capsulitis

chronic inflammatory condition caused by repeated joint sprains and micro-traumas

Synovitis

chronic inflammatory condition caused by repeated joint sprains or microtraumas

Patellar special tests

clark's sign, patellar apprehension, glides ballotable patella and sweep

Bones of the shoulder

clavicle, scapula, humerus, sternum

Policies

clear and accurate written statements that identify the basic rules and principles used to control and expedite decision making

Extracellular matrix of clot

collagen elastin ground substance proteoglycans Glycosaminoglycans

Exclusive Provided Organizations

combination of HMO and PPO plans, restrictive in number and types of providers they have

Crykinetics

combination of cryotherapy and exercise immerse until numb exercise within limits of pain

obsessive-compulsive disorder

combination of emotional and behavioral symptoms -compulsive behaviors involving engaging in repetitive activities

Whirlpool baths

combination of massage and water immersion Temp should not exceed 104 Should not be used for full body immersion or for longer than 20 minutes

Mulligan Technique

combines passive accessory joint mobilization applied by an AT with active physiological movement by patient for purpose of correcting positional faults -mobilizations with movement

Rhinovirus

common cold upper respiratory infection by direct or indirect contact s/s: sore throat, stopped up nose and sneezing -mild fever colds last 5-10 days regardless of treatment

Grade 3 Sprain

complete rupture -no endpoint with marked laxity and pain will be severe initially then mild

Heart contusions

compression between sternum and spine management: refer

Anterior Cruciate Ligament

comprised of the anteromedial, intermediate, and posterolateral bands -prevents femur from moving posteriorly during weight bearing -limits anterior translation of tibia in non-weight bearing -stabilizes tibia against excessive internal rotation

Heat Rash

condition associated with a red, raised rash accompanied by prickling and tingling during sweat -usually occurs when skin is continuously wet with unevaporated sweat

Conductive heat exchange

contact with another object that results in loss or gain of heat

Fast twitch (type 2x)

contract more quickly and create more force than type 2a

Isometric contraction

contraction occurs when muscle contracts to increase tension but there is no change in muscle length

Hydroculator Packs

controlled in hot water at temp of 160 to 170 F Retains water and heat level for 20 to 30 minutes Limitation on heating deeper tissues Patients should not lay on the pack

Accident insurance

covers accidents -encourages an injured patient to receive prompt medical care

Liability insurance

covers claims of negligence on part of the individual -All ATs should carry this

Atrophy

decrease of muscle cause by decrease in the size of the cells in response to training

Ultrasound

deep heating modality thermal or non thermal effects Frequency- 1MHz = deep 3MHz= shallow Continuous = thermal Pulsed = nonthermal needs medium such as gel or water 5 to 10 minutes

Brittle

deform very little before failure

Plastic

deformation of tissue that exists after the load is removed

creep

deformation of tissue that occurs with application of a constant load over time

Active range of motion

degree to which a joint can be moved by muscle contraction

Passive range of motion

degree to which a joint may be passively moved to an end point in the range of motion

Kubler Ross Reactions

denial, anger, bargaining, depression, acceptance

Error and omissions insurance

designed to cover against suits claiming malpractice, wrongful actions, error and omissions, and acts of negligence

Things to consider with EAPs

develop separate ones for each sport -determine personnel who will be on field during practice and competitions -each person should understand their roles and responsibilities -decide what emergency equipment should be available -determine procedure for equipment removal

Rib fracture

direct blow s/s: deformity, severe pain during breathing, Pt tender management: refer out

Monophasic current (DC)

direct current flows in one direction only from positive poles to negative poles DC used for pain modulation or muscle contraction or to produce ion movement

Polarity

direction of the current flow

Myofascial Trigger Points

discreet, hypersensitive, nodule within a taut band of skeletal muscle and fascia

Personal protective equipment

disposable gloves nonabsorbent gowns/aprons masks and sheilds disposable mouth pieces for resuscitation

anorexia nervosa

distorted body image and major concern over weight gain limits calorie intake drastically

Latent trigger point

doesn't cause spontaneous pain but may restrict movement or cause muscle weakness -pain may be noticeable when pressure is applied

Tendon healing

during second week healing tendon adheres to the surrounding tissue to form single mass -during third week, tendon separates to varying degree from surrounding tissue -tensile strength is not sufficient for strong pull for 4-5 weeks

High Altitude Pulmonary Edema

dyspnea, cough, headache, weakness and unconsciousness treatment is to give oxygen and take to lower altitude

Isometric

early stage of rehab after long term immobilization increases static strength decreases atrophy can lessen swelling can increase strength at whatever angle weakness occurs

Bulimia nervose

eating disorder of binging and purging

Concentric and Eccentric muscle contractions

eccentric critical in decelerating limb

Yield point

elastic limit of tissue

Iontophoresis

electrical current to drive ions usually dexamethasone or hydrocortisone interferential current

Reduction of Atrophy for e-stim

electrically endured muscle contraction to prevent atrophy and loss of function high frequency biphasic current intensity should be 30 to 60 pps voluntary isometric contraction 15 to 20 minutes

Hypertrophy

enlargement of a muscle caused by an increase in the size of the cell in response to training

Bone growth

epiphysis growth plate is cartilaginous disc located near end of long bone

Shearing

equal but not directly opposite loads are applied to opposite surfaces forcing those to move in parallel directions relative to one another injury occurs when shearing force is greater than strength of tissue result in skin injuries like blisters or abrasions, disc injuries

Disinfectants

everything should be cleaned with 10 parts water one part bleach

Mechanical failure

exceeding the ability to with stand stress and strain causing tissue to breakdown

Isokinetic training

exercise at a fixed velocity of movement with accommodating resistance

Strain

extent of deformation of tissue under loading

Control of hemorrhage

external bleeding- control with direct pressure, elevation Internal bleeding- BP should be monitored

Load

external force acting on internal tissue

Equipment considerations for injuries

face mask should be removed first (30 seconds) leave shoulder pads and helmets in place - unless enough staff is present to remove or local procedure says differently -must remove both or none

Hemophilia

failure of the blood to clot profuse bleeding physical exertion may cause bleeding into muscles referral immediately

Negligence

failure to use ordinary or reasonable care

psychogenic shock

fainting, temporary dilation of blood vessels that reduces amount of blood in the brain

Fast-twitch

fast oxidative glycolytic fibers produce quick forceful contractions fatigue more rapidly then slow twitch useful in short term, high intensity activities

Fast twitch (type 2b)

fatigue rapidly, short term, high intensity anaerobic activity true "fast twitch"

Long bones

femur, tibia, fibula, humerus, radius, ulna, metatarsals, metacarpals, phalanges

Knee complex consists of

femur, tibia, patella

Granulation tissue

fibroblasts that produce collagen and elastin -begins to synthesize an extracellular matrix

Fibroblastic repair phase

fibroplasia- period of scar formation begins within a few days after injury and may last as long as 4 to 6 weeks granulation tissue occurs with breakdown of fibrin clot

Grade 1 Sprain

firm endpoint with little or no laxity and some pain

Lightning safety

flash to bang - number of seconds from lightening flash until sound of thunder. divide by 5 to determine distance >30 or take shelter 30 minutes must past the last sound of thunder to return to play

Influenza

flu type a is most common s/s: fever, cough, headache, chills, body aches bed rest, aspirin should be avoided under age of 18 bc reye's syndrome

Half ring splint

for fracture of femur - traction

Tension

force that pulls or stretches tissue is generate in response to equal and opposite external loads that pull structures apart strains and sprains usually occur

Dynamic stretching

forceful contraction of agonist muscle that results in stretching of the antagonist muscle controlled stretch

Capitation

form of reimbursement used by managed care providers in which members make a standard payment each month regardless of how much service is rendered to the member by the provider

Intensity of activity

found using heart rate

Third Party Administrator (TPA)

frequently used to administer services and to pay claims for self insured group plans, and function as a pseudo insurance company

Osteochondritis

general change in ossification center of epiphysis, especially in periods of rapid growth

Neurogenic shock

general dilation of the blood vessels within cardiovascular system

Vegetarianism

give consideration to calories being eaten, minerals like calcium, zinc, iron, and vitamin b12

Glucose

glycolysis breaks down to produce energy -used for immediate energy excess is stored as glycogen

Waveform

graphical representation of the shape, direction , amplitude and direction of particular electrical currents

Acute mountain sickness

headache, nausea, vomiting, sleep disturbance, dyspnea may last 3 days

Medicaid

health insurance for people with low incomes and limited resources and funded by federal government

Friction massage

heat producing

Duchenne muscular dystrophy

hereditary degeneration of skeletal muscle with association in loss of strength -diagnosed early I childhood s/s: occurs as child begins to walk, starts in lower body and works up

Muscle contraction for e-stim muscle strengthening

high frequency biphasic current intensity should be increased at a frequency of 50 to 60 pps to elicit a tetanic muscle contraction using a surging current of 15 seconds on and 50 seconds off 3x10 3 times a week

Tooth subluxation, luxation, avulsion

high impact to the upper or lower jaw; direct trauma s/s: tooth loosened or dislodged management: no immediate treatment refer to dentist within 48 hours, use milk/saliva/ save a tooth kit

Alta patellar alignment

high riding patella

Genu recurvatum

hyperextension of the knee

Current Procedure Terminology

identify specific medical procedures used in treating a patient

Parental Notification of injury

if minor, AT must contain consent from parents -if no informed consent exists, implied consent takes precedence to save their life

Pool extraction

if minor- AT can use rescue tube to pull athlete toward edge of pool if too far away- AT can get into pool and approach from the front, extend rescue tube and be pulled to edge if severe injury, AT should approach from behind, wrap arms under armpits with rescue tube between AT and athlete. c-spine injury: take arms of victim and place overhead squeezing them together to stabilize.Spine board should be submerged under patient and strapped in

Golgi tendon organ

if stretch is more than 6 seconds, GTO will override muscle spindles and allow relaxation of the antagonist muscle as a protective mechanism

Guidelines for working with unconscious

immediately note body position and level of consciousness/responsiveness Airway, breathing and circulation should be established immediately Injury to the neck and c-spine should always be considered If athlete is wearing helmet, it should never be removed until c-spine injury is ruled out

Runner's Anemia

impact of the foot as it strikes the surface destroys red blood cells performance decline, burning thighs decrease running distance

Flat bones

in the skull, ribs and scapula

Cardiogenic shock

inability of heart to pump enough blood to supply body

Greenstick fracture

incomplete breaks in the bone that have not yet ossified -usually In adolescents

Shortwave diathermy

increases temperature at deeper tissues

Therapeutic effects of thermotherapy

increasing extensibility of collagen tissue decreasing joint stiffness reducing pain reducing muscle spasm reducing inflammation, edema in the post acute phase of healing increasing blood flow treatment shouldn't exceed 30 minutes

Depression

individual experiences helplessness, misery, loss of energy, excessive guilt, diminished ability to think, changes in eating or sleeping, recurrent thoughts of death

posttraumatic stress disorder (PTSD)

individual who suffered a psychologically traumatic event

Tendinitis

inflammation of a tendon can have crepitus repetitive overuse continues and the inflamed or irritated tendon fails to heal, it will degenerate

Bursitis

inflammation of bursa at sites of bony prominences -synovial membrane that contains small amount of fluid -can restrict movement -fluid continues to be produced until irritation is eliminated

Neuritis

inflammation of nerve -symptoms range from minor nerve problems to paralysis

tenosynovitis

inflammation of tendon and synovial sheath -inflammation process produces byproducts that are sticky and tend to adhere to the synovial sheath surrounding it -treatment is to control inflammation

Meningitis

inflammation of the meninges of the brain and spinal cord -bacteria leads to death if not properly treated high fever, stiff neck, intense headache management: spinal tap for spinal fluid, antibiotics

Fat pads

infrapatellar fat pad is largest -cushions the front of the knee -separates patellar tendon from joint capsule anterior and posterior suprapatellar popliteal

Tibial nerve

innervates most of the hamstrings and gastroc

Common peroneal nerve

innervates short head of the biceps femoris -courses through popliteal fossa and wraps around fibular head

Femoral nerve

innervates the quad and sartorius muscles

Intracapsular swelling

inside joint capsule -can be moved manually from one side of joint to another

Pain modulation for e-stim Opiate pain control

intensity should be set as high as tolerable pulse duration should be as high as possible frequency should be 1 to 5 pps

Pain modulation for e-stim Descending pathways of pain control

intensity should be very high pulse duration should be 10 msecs frequency should be 80 pps

Muscle re-education for e-stim

intensity should produce a comfortable contraction at 30 to 50 pps 15 to 20 minutes several times a day

Pain modulation for e-stim Gate Control

intensity- light tingling sensation Pulse duration/frequency set as high as possible w/o muscle contraction

Stress

internal resistance to an external load

Neuropraxia

interruption in the conduction of an impulse down the nerve fiber -brought by compression or relatively mild, blunt blow close to the nerve

Ballistic stretching

involved bouncing movement in which repetitive contractions of the agonist are used to produce quick stretches of the antagonist can cause injury and muscle soreness

Superficial frostbite

involves only the skin and subcutaneous tissue -skin appears pale, hard, cold and waxy immerse tissue in warm water do not rub

third party reimbursement

involves reimbursement by the policyholder's insurance company for services performed by health care professionals

Semicurved last

is designed for the average or normal foot There is a small curve on the medial side of the foot to fit a normal arch

Rhythmic Stabilization PNF

isometric contractions of agonist and antagonist

Techniques of resistance training

isometric, isotonic, isokinetic, progressive resistance, circuit, plyometrics

Types of muscle contractions

isometrics, eccentric, concentric

Adherence to rehab program

keep patient interested provide positive feedback

Petrissage massage

kneading

Genu valgum

knock knees

Grade 2 Joint Mobilization

large amplitude glide within midrange of motion -used when spasm limits movement sooner with a quick oscillation than with a slow one, or when slowly increasing pain restricts movement halfway into the range

Liver functions

largest organ in body RUQ detoxifies harmful chemicals secrets blue to neutralize stomach acid Hepatitis is infection of liver caused by viral infection/alcohol consumption Cirrhosis is progressive disease of liver that results in scaring and fibrosis (liver failure)

Patella

largest sesamoid bone in the body -3 medial facets, 1 lateral -tracks on the trochlear groove -can be affected by the pull of the quad muscles and patellar tendon, depth of the femoral condyles and shape of patella

Isokinetic exercise

late phase of rehab more functional can be used as return to play criteria

Patellafemoral stress syndrome

lateral deviation of patella in femoral groove -tightness of hamstrings, gastroc -tightness of lateral retinaculum -increased q angle -tight IT band -pronation of foot -patella alta -weak VMO -weak hip ADD s/s:TTP over lateral side, swelling, dull ache in center management: strengthen VMO/add -stretch hamstrings, gastroc, IT band -McConnell taping

Frog-eyed patella

lateral-riding patella caused by hip retroversion (external rotation of the femur) or external tibial rotation

Tort

legal wrongs against a person

Duration

length of time current is flowing aka pulse width or pulse duration

High Altitude Cerebral Edema

life threatening condition that can lead to death or coma increases cerebral edema and blood flow same treatment as HAPE

Exertional heat stroke

life threatening emergency- most severe CNS abnormalities, potential tissue damage from elevated body temp Sudden collapse, altered consciousness, seizure, confusion, rectal temp >104, rapid strong pulse, decreased BP Aggressive and immediate full body cooling

Shoe upper

light weight and drying should be well ventilated extra padding in achilles tendon region

Epiphysis

located at the end of long bones -bulbous in shape providing space for muscle attachment

Maturation and remodeling phase

long term process -realigning collagen fibers that make up scar tissue according to the tensile forces -by end of 3 weeks a firm, strong, contracted, nonvascular scar exists

Diabetic Coma

loss of sodium, potassium and ketone through frequent urination -produces ketoacidosis s/s: labored breathing, fruity smelling breath, nausea, dry mouth, flushed skin, mental concussion, LOS followed by coma monitor blood glucose levels, insulin injection

Baja patellar alignment

low riding patella

Hypothermia

low temperatures (wind and dampness) prevention: dress in thin layers than can be added and removed

Splinting of Upper-Limb Fractures

lower arm and wrist fractures should be splinted in position of elbow flexion and should be supported by sling -fractures around shoulder complex are immobilized by sling and upper body is secured to the body -hand and finger dislocations and fractures should be splinted and buddy taped

Arch support

made of durable yet soft material and should smoothly join in with insole

Popliteal artery

main blood supply for knee

Diaphysis

main shaft of the long bone hollow and cylindrical, covered by impact bone

Muscular strength

maximal force that can be applied by a muscle during a single maximum contraction

Phase 3: Maturation and Remodeling rehab

may last several years ultimate goal of this phase is return to play sports specific exercise

Meniscal special tests

mcmurray's, apley's compression/distraction, thessaly's

Cane fitting

measurement is taken from superior aspect of greater trochanter

Mechanism

mechanical description of cause

Pathomechanics

mechanical forces that are applied to a living organism and adversely change the body's structure and function

Seasonal Affective Disorder

mental depression during certain seasons of the year (common in winter months) -fatigue, diminished concentration, day time drowsiness -more common in women -light stress therapy

Phonophoresis

method of transporting molecules through the skin with ultrasound

Dehydration

mild - 2% of body weight loss -can still impair cardiovascular and thermoregulatory response Symptoms: thirst, dry mouth, headache, dizziness, irritability, lethargy, cramps Should be drinking what they lost and ensuring proper electrolyte balance

National Operating Committee on Standards for Athletic Equipment

minimal safety requirements for helmets

Hemarthrosis

moderate amount of swelling that occurs immediately after injury and is caused by synovial fluid and by blood in the joint

Exertional heat exhaustion

moderate form of heat illness that occurs from environmental heat stress and strenuous physical exercise -results from dehydration Symptoms: pale skin, profuse sweating, stomach cramps, nausea, vomiting, dizziness, body temp <104 -move to shaded area and give fluids, excess equipment should be removed

Fast twitch (type 2a)

moderate resistance to fatigue

Indications for electrical stimulation

modulate pain depolarization of motor nerve fibers -elecit muscle contraction

Pneumothorax

moi: blow to chest or opening in chest wall causing lung to collapse due to pressure s/s: difficulty breathing, one side of chest rising more than other, pain with breathing management: refer out

Contusion of bladder, urethra, ureters

moi: blunt force can avulse a ureter, contuse or rupture urinary bladder s/s: pain and discomfort in lower abdomen nausea/vomiting signs of shock blood coming from urethra management: check urine for blood always empty bladder before practice or games

Spermatic cord contusion

moi: direct blow s/s: nausea, vomiting, inflammation of area refer to MD immediately

Costochondral Separation and Dislocation

moi: direct blow, twisting forces s/s:pain is in between ribs, point tender on one side of origin of ribs

Kidney contusion

moi: external force, usually to the back -injury depends on force and angle of blow s/s: shock, nausea, vomiting, rigidity of back muscles, hematuria, lower abdominal region painful toward back management: refer out

Appendicitis

moi: inflammation of appendix, obstruction/lymph swelling or tumor s/s: McBurney's point, low grade fever, nausea and vomiting refer to MD

Pancreatitis

moi: inflammation of pancreas, may occur from chronic alcoholism s/s: vomiting, constipation, tenderness and rigidity with palpation chronic: jaundice, diarrhea, pain that radiates into back management: rehydration

GERD (gastroesophageal reflux disease)

moi: reflux or backwards flow of acidic gastric content into esophagus due to malfunction of lower sphincter regulated with medication

Rib Tip syndrome

moi: rib slip and impinge on intercostal nerve causing pain s/s: pain is localized in upper abdomen and lower costal area popping sensation or slipping reproduced by translation motion on rib (+ is clicking) management: compression wrap and abdominal brace

Ruptured globe

moi: trauma to eye by object smaller than eye s/s: severe pain, visual issues, diplopia, irregular pupils, increased pressure management: refer

Water

most abundant nutrient in body 60% of body weight

Delayed Onset Muscle Soreness (DOMS)

most intense 24 to 48 hours then subsides delayed muscle pain leading to muscle tension, swelling and stiffness may be caused by very small tears in muscle or disruption of connective tissue Static or PNF stretching

Agonist muscle

muscle contracting to cause movement

Muscle guarding

muscle contraction in response to pain

Musculotendinous unit injury

muscle fibers possess the ability to contract as well as properties of irritability, conductivity and elasticity -smooth, cardiac, skeletal

Progressive resistance exercises

muscle is changing length done using tubing, free and machine weights or manual resistance

Eccentric muscle contraction

muscle lengthens while continuing to contract generates greater amount of force than concentric deceleration movement should take 2 to 4 seconds

Concentric contraction

muscle shortens while contracting acceleration movement fatigue more rapidly should take 1 to 2 seconds

Exertional heat cramp

muscle spasms that occur in commonly calf and abdomen -excessive loss of water and electrolytes -acclimatization can also play role

Myotome

muscles or group of muscles innervated by specific nerve group

sovereign immunity

neither the government nor any individual who is employed by the government can be held liable for negligence

Nerve healing

nerve cells cannot regenerate once it dies, peripheral nerves can regenerate if injury does not affect cell body -regeneration is very slow

Frequency of activity

no fewer than 3 times a week one rest day a week

Q angle

normal limits: 10=males and 15=females

Rapid form vacuum immobilizer

not useful for injuries that are angulated and must be splinted in position they are found. Air suctioned out of cast to form solid splint

Lateral meniscus

o-shaped -attached to the lateral articular facet on the superior aspect of the tibia -loosely attaches to the lateral articular capsule and popliteal tendon

Blowout fracture

occur to the wall of the eye orbit as a result of a blow

Gate Control Theory

occurs at spinal cord level -body cannot process two pains at once

Transverse fracture

occurs in a straight line -direct outside blow

Contercoup fracture

occurs on opposite side of point of trauma

Convective Heat Exchange

occurs when a mass of air or water moves around an individual

Respiratory Shock

occurs when lungs are unable to supply enough oxygen to circulating blood -trauma that produces a pneumothorax or injury to breathing control center

Depression fracture

often in flat bones -caused by falling and striking head on a hard, immovable surface

Preparing athlete with open wound

open wounds must be covered with dressing that is fixed in place and won't move Athlete must be removed from competition and return when deemed safe by medical staff uniforms with blood must be cleaned before return to activity

Sartorius

origin- ASIS insertion- proximal medial surface of tibia flexes knee, hip flexion and external rotation

Popliteus

origin- lateral condyle of femur insertion- posterior surface of tibia action- flexes leg

serratus anterior

origin: 1-8 insertion of ribs insertion: vertebral border of scapula action: scapular protraction, upward rotation

Rectus femoris

origin: ASIS insertion: tibial tuberosity via patellar tendon knee extension

Psoas Major

origin: T12 body of vertebra, L1-5 transverse processes and bodies insertion: lesser trochanter of femur Action: hip flexion, hip external rotation, trunk flexion

vastus intermedius

origin: anterior surface of femur insertion: tibial tuberosity via patellar tendon knee ext

Teres minor

origin: axillary border of scapula insertion: GT of humerus action: shoulder external rotation

Coracobrachialis

origin: coracoid process of scapula insertion: middle one third of humerus action: shoulder flexion, shoulder abduction

Brachialis

origin: distal one half of humerus insertion: coranoid process of ulna action: elbow flexion (wrist in neutral)

Extensor Carpi Radialis Longus

origin: distal one third of lateral supracondylar ridge of humerus, lateral epicondyle of humerus insertion: dorsal aspect of base of 2nd MC action: wrist extension, radial deviation, pronation, and elbow extension

gluteus maximus

origin: dorsal ilium, sacrum, and coccyx insertion: gluteal tuberosity of femur and iliotibial tract action: hip extension, hip external rotation, abduction

Vastus lateralis

origin: greater trochanter insertion: tibial tuberosity via patellar tendon knee ext

Iliacus

origin: iliac fossa, AISI insertion: lesser trochanter of femur action: hip flexion, hip external rotation, pelvic anterior tilt

Gracilis

origin: inferior ramps of pubis Insertion: medial surface of tibia Knee flex and internal rotation

Infraspinatus

origin: infraspinous fossa of scapula insertion: greater tubercle of humerus action: shoulder external rotation

Bicep femoris

origin: ischial tuberosity, lateral lip of femur insertion: lateral surface of head of fibula, lateral condyle of tibia knee flex

gluteus medius

origin: lateral aspect of ilium insertion: Greater trochanter Action: hip abduction, flexion, internal rotation

Gluteus mimimus

origin: lateral aspect of ilium insertion: greater trochanter action: hip abduction, flexion, internal rotation,

Extensor digitorum

origin: lateral epicondyle of humerus insertion: dorsal aspect of base of 2nd to 5th phalanges Action: finger extension at 2nd to 5th phalanges, wrist extension, elbow extension

Extensor Capri Ulnaris

origin: lateral epicondyle of humerus, middle one third of posterior ulnar insertion: dorsal aspect of base of 5th MC action: wrist extension, ulnar deviation, elbow extension

Supinator

origin: lateral epicondyle of humerus, supinator crest of ulna insertion: proximal one third of lateral radius action: supination

Brachioradialis

origin: lateral supracondylar ridge of humerus insertion: radial styloid process action: elbow flexion, forearm supination, forearm pronation

triceps brachii

origin: long head- infraglenoid tubercle of scapula; lateral head- proximal one half of humerus; medial head- distal one half of humerus insertion: olecranon process of ulna Action: long head- elbow extension, shoulder extension, shoulder adduction; lateral head- elbow extension; medial head- elbow extension

biceps brachii

origin: long head- supraglenoid tubercle of scapula, short head- coracoid process of scapula action: long head/short head- elbow flexion, forearm supination, shoulder flexion, shoulder abduction

Flexor carpi radialis

origin: medial epicondyle of humerus insertion: base of second metacarpal, base of third MC action: wrist flexion, radial deviation, elbow flexion, pronation

palmaris longus

origin: medial epicondyle of humerus insertion: palmar aponeurosis Action: wrist flexion, forearm pronation, and elbow flexion

Flexor carpi ulnaris

origin: medial epicondyle of humerus, proximal two thirds of posterior ulna insertion: pisiform, hook of hamate, base of 5th MC action: wrist flexion, ulnar deviation, elbow flexion

Vastus medialis

origin: medial lip of femur insertion: tibial tuberosity via patellar tenon knee ext

Pronator teres

origin: medial supracondylar ridge of humerus insertion: middle one third of lateral radial action: forearm pronation, elbow flexion

Flexor Pollicis Longus

origin: middle anterior aspect of radius, medial epicondyle of humerus, coronoid process of ulna insertion: base of distal phalanx of thumb action: thumb flexion, wrist flexion, radial deviation, elbow flexion

Gastrocnemius

origin: posterior lateral condyle of femur, popliteal surface of femur Insertion: posterior surface of calcaneus via achilles tendon Knee flexion

Extensor Pollicis Brevis

origin: posterior radius insertion: dorsal aspect of base of 1st phalanx action: thumb extension abductor, radial deviation, wrist extension

Extensor Pollicis Longus

origin: posteroloateral aspect of middle one third of ulna insertion: dorsal aspect of base of 1st distal phalanx action: thumb extension, wrist extension, radial deviation, supination

Flexor Digitorum Profundus

origin: proximal three fourths of ulna insertion: base of 2nd to 5th distal phalanges action: finger flexion, wrist flexion

Piriformis

origin: sacrum, posterior ischium insertion: greater trochanter action: hip external rotation, hip abduction, hip extension

Rhomboid Major

origin: spinous processes of T2-T5 insertion: medial (vertebral) border of scapula action: scapular retraction, elevation and upward rotation

Subscapularis

origin: subscapular fossa of scapula insertion: lesser tubercle of humerus action: shoulder internal rotation

Supraspinatus

origin: supraspinous fossa of scapula insertion: greater tubercle of humerus Action: shoulder abduction

Flexor digitorm superficialis

origin: ulnar head- medial epicondyle of humerus, coranoid process of ulna; radial head- proximal two thirds of anterior radius insertion: palmar aspect of 2nd to 5th phalanges (PIP joint) action: finger flexion, wrist flexion, elbow flexion

Bone Healing

osteoblasts, osteoclasts, Short bones- 3 week immobilization Long bones- 6-8 weeks

Extracapsular swelling

outside joint capsule -tends to localize over injured structure and then migrate down

Periosteum

outside of bone contains blood supply to the bone

Meniscus

oval fibrocartilage that deepens the articular facets of the tibia red-red zone: outer 1/3 (good vascular) red-white zone: middle 1/3 (minimal blood) white-white zone: inner 1/3 (avascular)

Muscle soreness

overexertion in strenuous exercise resulting in muscular pain

Open fracture

overlying skin is lacerated by protruding bone fragments

Altitude considerations

oxygen deficiency red blood cells become less saturated altitude illnesses

Muscle spindle

pain perception -stimulus-nociceptors- arc reflex- dorsal horn of spinal cord - amygdula - afferent fibers back to stimulus

Referred pain

pain that is felt at point of the body rather than its origin

Muscle cramps

painful and involuntary muscle contractions that occur most commonly in calf, abdomen or hamstrings

Static stretching

passively stretching a given antagonist muscle by placing it in a maximal position of stretch and holding it there for an extended period 30 seconds 3-4 times

Squinting patella

patella positioned medially increased q angle hip internal rotation

Slow-reverse-hold PNF

patient moves a body part isotonically using agonist muscles and immediately follows that movement with an isometric contraction -designed to develop strength at a specific ROM

Slow reversal PNF

patient moves through complete ROM against maximum resistance -release the movement pattern before exercise is completed

Four point gait

patient stands on both feet moves one crutch forward and steps forward with opposite foot

Tapotement massage

percussion

Secondary survey

performed after life-threatening injuries have been ruled out Pulse, respiration, blood pressure, PERRLA, skin color, temperate, movement

Phobias

persistent, irrational fear and avoidance of a specific object, activity, or situation -increased heart rate, difficulty breathing, sweating, dizziness

Bursae

pieces of synovial tissue separated by a. thin film of fluid -reduces friction between structures (muscle and bone, tendon and bone, tendon and ligament)

General Health insurance

policy that covers illness, hospitalization, and emergency care

Conditions that interfere with bone healing

poor blood supply, poor immobilization, infection, soft tissue between severed ends of bone

Muscles of internal rotation of tibia

popliteal, semitendinosis, semimbranosus, sartorius and gracilis

PCL special tests

posterior drawer, godfrey's, sag sign, valgus/varus @ 0

Joint Capsule Knee

posterolateral- reinforced by IT band, popliteus, bicep femoris, LCL Posteromedial- reinforced by MCL, pes anserine tendons, semimembranosus and posterior oblique ligament anterolateral- reinforced by IT band, patellar tendon, and lateral patellar retinaculum Anteromedial- reinforced by superficial MCL and medial patellar retinaculum

Overexposure to sun

premature aging and skin cancer -sunscreen 30 minutes before exposure

Warm up

prepare the body physiologically for upcoming work -increases skeletal muscle temperature and blood flow -increases muscle elasticity -dynamic stretching

Bursitis of Knee

prepatellar, deep infrapatellar, suprapatellar MOI: overuse of tendon, direct blow s/s: localized swelling, redness, increased temp Management: compression wrap, NSAIDs, aspiration Watch for infection

Heel counter

prevents foot from rolling side to side at heel strike

Compression

produced by external loads applied towards one another on opposite surfaces in opposite directions

ATP

produced from the breakdown of nutrient food -ultimate form of usable energy for muscles -produced in muscle tissue from blood glucose or glycogen -Used during sudden outburst of activity in intense, short term exercise

Gradual acclimatization

progressive exposure should occur over 7-10 day period equipment restrictions aid

Rhythmic Initiation PNF

progressive series, first passive movement then active assisted movement, followed by active movement through an agonist pattern

Frostbite (chilblains)

prolonged and constant exposure to the cold for many hours -skin redness, swelling, tingling, and pain

Elasticity

property that allows tissue to return to normal following deformity

Re-establishing Neuromuscular control

proprioception, kinesthesia dynamic stability pre-paratory and reactive muscle characteristics conscious and unconscious functional motor patterns

ACL prevention

proprioception, neuromuscular control, weight training, landing cues, stretching and plyometric training -soft knees, load hips, quiet sound, toe to heel

Functional knee braces

protect grade 1 or 2 sprains of ACL custom molded designed to control rotational stresses or tibial translation

Mouth guards

protects teeth, absorbs blows to chin, can prevent concussions -also minimize lacerations to the lips, cheek and fractures of mandible

Family Education Rights and Privacy Act (FERPA)

protects the privacy of student education records, rights of educational records move to student after age of 18 or when student attends a school beyond high school

Hernia

protrusion of abdominal viscera through abnormal opening in muscle wall -most often in groin area refer to MD

Cerebral function

questions that assess general affect, level of consciouness, intellectual performance, emotional status, thought content, sensory interpretation, and language skills

Cranial nerves assessment

quickly assessing quality of: sense of smell, eye tracking, imitation of facial expressions, biting down, balance, swallowing, tongue protrusion, strength of shoulder shrug

Radiant heat exchange

radiant heat from sun can increase body temp

Effects of inactivity

rapid general loss of fitness

Heat Syncope

rapid physical fatigue during overexposure to heat -standing place for long periods of time -peripheral vasodilation of superficial vessels hypotension or pooling of blood in extremities which results in dizziness, fainting and nausea -replace fluids and lay athlete in a cool environment

Vibration massage

rapid shaking

Second Impact Syndrome

rapid swelling and herniation of brain after second head injury before initial had healed s/s: within minutes patient's condition rapidly decreases, dilated pupils, loss of eye mvmt, LOC leading to coma, respiratory failure, mortality rate of 50% Management: at hospital within 5 minutes Let athletes heal before returning to play from concussion

Muscle spasm

reaction to trauma to musculoskeletal system clonic- involuntary alternating contractions and relaxation periods Tonic- constant contraction for a period of time

iron deficiency anemia

red blood cells are too small, hemoglobin is decreased s/s: performance decline, burning thighs, dizziness, fatigue iron supplement, proper diet including red meat and dark poultry, avoid coffee and tea

Inflammatory response

redness, swelling, tenderness, heat, loss of function

Pre-operative phase rehab

reduction of swelling before surgery can improve post surgery rehabilitation

Frequency

refers to number of waveforms being emitted by electrical stimulating unit identified by pulse per second, cycles per second or hertz

Autogenic inhibition

relaxation of antagonist muscle during contractions

Histamine

released from injured mast cells -causes vasodilation and increased cell permeability

Chronic inflammation

repeated acute micro traumas and overuse -low concentrations of chemical mediators

Leukotrinenes

responsible for margination -neutrophils and macrophages line up along cell wall -increases permeability

Impacted fracture

results from fall from height

Reflex of Sympathetic Dystrophy

results from immobilization of injured body part due to pain hypersensitivity to touch, shining of skin early recognition is essential disrupting normal sympathetic response

human immunodeficiency virus (HIV)

retrovirus that causes AIDS no vaccine greatest risk is through sexual contact with infected partner Athlete cannot be discriminated against for having HIV

SAM splint

reusable and can be folded and unfodled repeatedly

Osteochondral knee fracture

rotation of direct trauma that compresses articular cartilage between femoral condyles and tibial plateau s/s: diffuse pain along the joint line immediate effusion crepitus and pain with weight bearing when standing or walking management: referral, MRI to diagnose fx site

Lateral collateral ligament

round, fibrous cord about the size of a pencil -attaches to the lateral epicondyle of the femur and to the head o the fibula -prevents varus and internal rotating forces

Spiral fracture

s-shaped separation -planted and rotation in opposite directions

Corneal Abrasions

s/s: severe pain and watering of eye, photophobia and spasm Dye and cobalt blue light can diagnose Management: patch and send to physician

Principles of Conditioning

safety, warm up/cool down, motivation, overload, consistency, progression, intensity, specificity, individuality, minimal stress

Nutrition

science of substance in food that are essential to life -growth, repair and maintenance of all tissues -regulatory of body processes and production of energy

Avulsion fracture

separation of a bone fragment from attachment of a ligament or tendon

Diastasis

separation of articulating bones

Deep frostbite

serious injury indicating tissues are frozen, requires hospitalization rapid rewarming through hot drinks, heating pads or hot water

Statue of Limitations

sets a specific length of time that individuals may sue for damages from negligence

Anaphylactic shock

severe allergic reaction -epipen

Metabolic shock

severe illness goes untreated or extreme loss of body fluid -low BP -pulse is rapid and weak -breathing is shallow and rapid elevate feet and legs

Apophyseal

severs disease or osgood-schlatter

Psychological response to injury

short term injuries- 4 weeks Long term injuries- >4 weeks Chronic- recurring Terminating- career ending

Isotonic training

shortening and lengthening the muscle through a complete range of motion

Sickle Cell Anemia

sickling of red blood cells, common in African Americans, Native Americans and Mediterraneans Less potential for transporting o2 and are more fragile sickling cells can cause blockages in blood vessels sever pain in limbs and abdomen extreme fatigue

Slow-twitch (type 1)

slow oxidative fibers carry more oxygen long duration aerobic type activities

Grade 1 Joint Mobilization

small amplitude glide at the beginning of the ROM -used when pain and spasm limit movement early in ROM

Grade 5 Joint Mobilization

small amplitude quick thrust delivered at the end ROM -usually accompanied by a popping sound called a manipulation

Proper fitting football helmets

snug around the head w no gaps between cheek pads and head -cover back of skull -2 fingers above the eyebrows -Facemask 3 fingers from nose -chin strap should be equal distance from center of helmet

Electrolyte requirements

sodium, chloride, potassium, mangesium and calcium -help maintain balance of water inside and outside cells

Grade 2 sprain

soft endpoint with some laxity and moderate pain

Posterior Cruciate Ligament

some port of the PCL is taut throughout full rOM -resists internal rotation of the tibia -prevents hyperextension -limits anterior translation of the femur during weight bearing -limits posterior translation of the tibia during non-weight bearing

Splinting of spine and pelvis

spine board

Hypovolemic Shock

stems from trauma in which there is a blood loss -brain bleed= increased BP -internal bleeding= decreased BP

Muscle contraction for e-stim Muscle pumping

stimulate circulation by pumping fluid and blood through venous and lymphatic channels High voltage monophonic current Intensity should be increased to elicit muscle contraction Frequency of 20 to 40 pps Surge mode with on/off mode set at 5 sec each Active contraction should be encouraged Treatment time 20 to 30 minutes

Total body conditioning

strength, neuromuscular control, flexibility, cardiovascular and muscle endurance, agility, speed and balance

Proprioceptive neuromuscular facilitation

stretching technique that involves combinations of altering contractions and stretches -all techniques use a 10 second active push phase followed by a ten second passive relax phase, repeated 3 times for a total of 60 seconds

Training effect

stroke volume increases while heart rate is reduced at a given exercise load

Effleurage massage

stroking

Epidemiology

study of infectious disease in a population

Ligaments of the shoulder

superior AC ligament, coracoclavicular ligament, coracoacromial ligament, glenohumeral ligament, coracohumeral ligament, anterior sternoclavicular ligament, interclavicular ligament

Ambulatory aid

support or assistance given to an injured patient that can walk

Factors affecting ligament healing

surgically repaired ligaments have healed with decreased scar formation and are generally stronger -exercised ligaments are stronger than those who have been immobilized

Evaporative heat loss

sweat glands in skin allow water to be transported to the surface Water evaporates to cool the body Normal person can sweat off 1 quart of water every 2 hours Impaired if relative humidity reached 65-75%

Otitis Externa

swimmer's ear MOI: bacterial infection of ear canal, water gets trapped s/s: pain, dizziness, itching, discharge, hearing loss Management: refer for antibiotics, alcohol solutions before and after swim

Muscular power

the ability to generate force rapidly

Maximum aerobic capacity

the greatest rate at which oxygen can be taken in and used during exercise

Misfeasance

the improper performance of an otherwise proper or lawful act

Assumption of risk

the individual, through expressed or implied agreement, assumes that some risk or danger will be involved in the particular undertaking

Procedures

the process by which something is done

Liability

the state of being legally responsible for the harm one causes another person

Stroke volume

the volume of blood pumped out by a ventricle with each heartbeat

Comminuted fracture

three or more fragments at a fracture site -caused by hard blow or awkward fall

Ductile

tissue can deform significantly before failing

Myofascial release

to relieve soft tissue from an abnormal grip of tight fascia -foam rolling -aka soft tissue mobilization

Cerebellar Function

touching finger to nose, drawing alphabet in the air with foot, heel to toe walking

Torsion

twisting in opposite directions from opposite ends of a structure usually causes spiral fractures

Serrated fracture

two bony fragments have a sawtooth, sharp edged fracture line

Information to provide 911

type of emergency situation Type of suspected injury Present condition of athlete Current assistance being given location of phone being used Exact location of emergency and how to enter facility

Plyometric exercise

type of exercise that takes advantage of the stretch-shortening cycle rapid stretch of a muscle eccentrically followed by rapid concentric contraction

Ligaments of elbow

ulnar collateral ligament, radial collateral ligament, annular ligament

Panic attacks

unexpected and unprovoked emotionally intense experience of terror and fear -usually occur at night

Parnoia

unrealistic and unfound suspicion about specific people or things

Repeated contraction PNF

used for general weakness or weakness at a point -patient moves isotonically against a maximum resistance of the AT until he or she experiences fatigue

Manual conveyance

used for mildly injured athlete a greater distance that the person could walk with ease

Tripod gait

used for stairs up starting with the uninjured leg Down with the crutches and injured leg first

Pulsatile current

used in interferential pre-modulated and also called Russian currents

Ice massage

used over tendons, belly of muscle, bursae or trigger points 5-10 mins Overlapping circles in a 10 to 15 cm area

Intermittent compression

used to control swelling after acute injury and to reduce pitting edema

Dynamic splint

used to provide long duration tension on a healing structure

Bending

usually fractures

Effusion with ACL tear

usually within first hour after injury

Speed play

varied terrain ex. cross country courses

LCL special tests

varus stress test 0, 25

Therapeutic effects of cryotherapy

vasoconstriction slowing metabolism

Knee Extension Muscles

vastus medialis, vastus lateralis, vastus intermedius, rectus femoris

Irregular Bones

vertebral column and skull

Blood Borne Pathogens

viruses transmitted through contact with blood or other body fluids

Intensity

voltage output of stimulation unit Low voltage = 150 V -monophasic Low Voltage = 500V -biphasic

Heat stress

vulnerable in hot, humid climates and if young or elderly

Lactovegetarianism

watch for zinc and iron levels

Micronutrients

water, vitamins and minerals

Osteoarthritis

wearing down of hyaline cartilage -repeated trauma glucosamine sulfate- treatment

Malfeasance (act of commission)

when an individual commits an act that is not legally his to perform

Nonfeasance (act of omission)

when an individual fails to perform a legal duty

Specific Adaptations to Imposed Demands

when body is subjected to stress and overloads of varying intensities, it will gradually adapt to overcome whatever demands are placed on it

Open kinetic chain

when foot or Hand is off the groun

Closed kinetic chain

when hand or foot is on the ground more functional

Fitting shoulder pads- football

width of shoulder is measured inside of shoulder pad should cover the tip of the shoulder in direct line with lateral aspect cups should cover deltoids neck opening must allow athlete to raise arms overhead and not allow the pad to slide if a split clavicle shoulder pad is used, the channel for the top of the shoulder must be in proper position straps under arm must hold pads firmly in place

Prophylatic knee brace

worn on lateral surface of knee to protect MCL

Five components to make muscle energy techniques effective

· Active muscle contraction by the patient · A muscle contraction oriented in a specific direction · Some control of contraction intensity by the patient · Control of the joint position by the athletic trainer · Appropriate counterforce applied by the athletic trainer

Curved last

· Is built with a large curve on the medial side of the shoe and has a wider outside portion of the shoe to provide more forefoot stability · Is built for people with a high arch and for runners who run on the outside of their foot (supinators)