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CCSP

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most common location for vertebral dislocation

C5/6

When palpating the wrist the ________ (carpal name) is found just distal to the lunate.

Capitate

Proprioceptive of a lower leg can be best accomplished by using:

Carioca running

Proprioceptive of a lower leg can be best accomplished by using: Strengthening exercises Stationary bike riding Zigzag running Stretching exercises Carioca running

Carioca running

Select the two most common concussion signs or symptoms from the list below. Loss of consciousness. Cephalgia Confusion Dizziness Vomiting

Cephalgia Dizziness

Select the two most common concussion signs or symptoms from the list below.

Cephalgia, dizziness

Warm-Up

**under construction**

Which of the following is correct regarding infection associated with fractures - particularly with compound fractures? Modern antibiotics has not reduced the risk of infections. Does not interfere with normal healing Pathogen is usually secondary to Listeriosis infections Closed fractures are not immune to infections within the body or blood.1

Closed fractures are not immune to infections within the body or blood.1

What is the name of this wrist fracture? Smith Barton Weber Colles

Colles

The actual shortening of muscle during muscle contraction is due to the action of __________________, which enable the thin filaments to slide past the thick filaments.

Cross bridges

The actual shortening of muscle during muscle contraction is a function of....

Cross-bridges

When using aqueous ultrasound the wattage should be:

.5 increased

The ratio associated with cervical spine stenosis using Torg's Ratio is______.

.80

Fiber-type conversion (e.g., fast-twitch [FT] to slow-twitch[ST] conversion) has been shown to occur under which of the following conditions?

Cross-innervation of motor nerve to muscle fibers, chronic stimulation of FT motor units with low-frequency nerve stimulation

When a thigh contusion is in the acute stage, which of the following treatments should be used?

Cryotherapy and compression

The ratio associated with cervical spinal stenosis using Torg's Ratio is______. 0.80 1.0 1.2 3.5

0.80

The ratio associated with cervical spine stenosis using Torg's Ratio is______. 0.80 1.0 1.2 3.5

0.80

When a thigh contusion is in the acute stage, which of the following treatments should be used? Massage and anti-inflammatory medications Cryotherapy and compression Active stretching of the area Ultrasound and passive stretching Cortisone injection

Cryotherapy and compression

Athletes with Level1 and Level 2 pain can continue their sporting activities providing...

1) The injury does not predispose the athlete to additional injury 2) The injury can be protected from further deterioration 3) The method of protecting the injury will not place other participants at risk

Phases of the Inflammatory Response (3)

1. Acute phase 2. Repair phase 3. Remodeling phase

Major Coronary Risk Factors

1. Diagnosed hypertension or on antihypertensive medication 2. Serum cholesterol 240mg/dl 3. Cigarette smoking 4. Diabetes mellitus 5. Family history of disease in parent or siblings prior to age 55

Return to action criteria (RTP - General)

1. Minimal or no tenderness 2. Full active range motion 3. Normal pain free strength against resistance 4. No positive neurologic tests 5. No neurologic symptoms 6. Psychologically ready to return

Cervical Spine RTP Criteria

1. No neurological signs or symptoms 2. Normal or very near normal, pain free range of motion 3. Negative compression testing 4. Normal muscle strength 5. No instability 6. The athlete feels they are ready to RTP

Contract- Relax

1. Passive Pre-stretch 2. FULL ROM Concentric Contraction 3. Relax 4. Passive stretch

Hold- Relax With Agonist Contraction

1. Passive Pre-stretch 2. Isometric Contraction 3. Relax 4. Active Agonist Contraction/Stretch

Hold- Relax

1. Passive Pre-stretch 2. Isometric Contraction 3. Relax 4. Passive stretch

PRE - Progressive Resistance Exercise

1. Perform a small number of repetitions until fatigue 2. Allow sufficient rest between exercises for recovery 3. Increase the resistance as the ability to generate force increases.. Recommended that loads corresponding to an 8- to 12-repetition maximum (RM) be lifted in 1 to 3 sets, training 2 or 3 days each week. An 8RM to 12RM load is the amount of weight that can be lifted through the available range of motion 8 to 12 times before needing a rest.

The purpose of the health appraisal it to:

1. Provide information about the safety of starting the program 2. Provide information about the risk factors, and potential risk associated with cardiovascular disease so lifestyle education can be implemented 3. Develop an exercise program and prescription that will optimize adherence, minimize risk and maximize benefits.

According to the IOC there are XX medical conditions unique to the female athlete that may have long-term consequences that can be avoided through early detection and treatment.

1. RED-S 2. Iron deficiency Anemia

4 reasons a careful evaluation of individuals prior to exercise testing or exercise participation is important:

1. To assure the safety of exercise testing and exercise programs 2. To determine the appropriate type of exercise test or exercise program 3. to identify those in need of more comprehensive evaluation 4. To make appropriate recommendations for an exercise program.

To evaluate tumors consider the following:(6 points)

1. Type of bone [long, tubular, flat] 2. Region affected [hand, feet, spine, skull] 3. Location within the bone [diaphyseal, metaphyseal, epiphyseal, cortical, medullary, periosteal] 4. Number of locations involved 5. Aggressiveness of lesion - determined by pattern of destruction and periosteal reaction 6. Age

Major Symptoms or Signs of Cardiopulmonary or Metabolic Disease

1. pain or discomfort in the chest or surrounding areas that appears to be ischemic in nature 2. Unaccustomed shortness of breath or shortness of breath with mild exertion 3. Dizziness or syncope 4. orthopnea/paroxysmal nocturnal dyspnea 5. ankle edema 6. palpitations or tachycardia 7. claudication 8. known heart murmur

The protein requirements of athletes:

1.2 -1.7

In the Scoliosis paper the ACBSP helped sponsor a scoliosis commonly defined as a lateral spinal curvature of at least XX° when measured with Cobb's method and often results in a visible rib hump when the patient bends forward at the waist.

When using interferential the treatment time should be at least:

In the scoliosis paper the ACBSP helped sponsor a scoliosis commonly defined as a lateral spinal curvature of at least XX degrees when measured with Cobb's method and often results in a visible rib hump when the patient bends forward at the waist. 8 10 12 14

10 degrees

Daily exposure to heat while training will lead to acclimation to exercise in the heat. How many days are necessary?

10-14

Daily exposure to heat while training will lead to acclimation to exercise in the heat. How many days are necessary?

10-14 days

Par-Q Sensitivity

100% - the percent of people with medical contraindications to exercise who answer yes to one or more questions

One of the hallmark signs of heat stroke is increased core body temperature. At what temperature is the diagnosis of heat stroke made?

105

When using interferential the treatment time should be at least:

10min

The amount of rotational translation associated wit vertebral instability is ____ degrees. 3.5 8 10 11

The amount of rotational translation associated with vertebral instability is ____ degrees

The amount of rotational translation associated with vertebral instability is ____ degrees 3.5 8 10 11

Which of the following represents the correct pounds of weight that should be added to a person's arms to visualize AC joint separations?

Which of the following represents the correct pounds of weight that should be added to a person's arms to visualize AC joint separations? 0 - this view is not valid 4 6 8 12

Which of the following represents the correct pounds of weight that should be added to a person's arms to visualize AC joint seperations? o-this view is not valid 4 6 8 12

Bodyweight Guideline: Universal leg curl

15% of body weight

Which of the following represents the best selection to identify the iron intake for a 17 y/o male athlete?

15-20

According to the IOC there are XX medical conditions unique to the female athlete that may have long-term consequences that can be avoided through early detection and treatment 1 2 3 4

Bodyweight Guideline: Leg extension

20% of body weight

Bodyweight Guideline: Universal leg extension

20% of body weight

Bodyweight Guideline: Upright rowing

20% of body weight

Regular participation in training and athletic competition is associated with an increased risk for sudden cardiac death, with an average increased relative risk for athletes of approximately XX times greater compared to their nonathletic counterparts.

Bodyweight Guideline: Barbell bench press

30% of body weight

Bodyweight Guideline: Universal bench press

30% of body weight

How many standard views are required for a trauma series of the knee? 2 3 4 7

How many standard views are required for a trauma series of the knee? Group of answer choices

The following guideline is correct regarding hydration and heavy exercise.

4-8oz every 15min

Bodyweight Guideline: Barbell Squat

45% of body weight

Serial examinations on an acutely concussed individual are performed every ____ minutes. (insert the number)

The standards of care direct that serial examinations for the SRC patient in the acute setting occur every ____ minutes. 5 10 15 20

Bodyweight Guideline: Universal leg press

50% of body weight

How much carbohydrate is recommended to maintain adequate muscle glycogen stores during training?

6 - 10 grams CHO / kg of body wt

Which of the following measurements is consistent with spinal stenosis?(Canal measurement is first followed by the body measurement, the unit of measure is not included on purpose)

7 / 10

Which of the following measurements is consistent with spinal stenosis? (Canal measurement is first followed by the body measurement, the unit of measure is not included on purpose) 7 / 10 8.5 / 10 5 / 5 10 / 8.5

7 / 10 Correct Canal/Body is less than 0.8

The glenoid labrum increases the humeral head contact by __________ %?

The glenoid labrum increases the humeral head contact by __________ %? 4 0 5 0 6 0 7 0

Carbohydrate is the predominant energy substrate at exercise intensity levels of greater than.....

70% maximal oxygen uptake

Carbohydrate is the predominant energy substrate at exercise intensity levels of greater than..... 50% maximal oxygen uptake 60% maximal oxygen uptake 70% maximal oxygen uptake 80% maximal oxygen uptake

70% maximal oxygen uptake

What percent of SRC resolve within 7-10 days without any intervention? (Select the closest %) 20% 40% 60% 80%

80%

Par-Q Specificity

80% - the percent of people without medical contraindications to exercise who answer no to all the questions

What percent of shoulder complaints that present to us can be successfully treated with conservative means?

90%

What percent of shoulder complaints that present to us can be successfully treated with conservative means? 90% 75% 66 2/3% 50%

90%

What percentage of shoulder dislocations occurs in the anterior direction?

90-98%

What percentage of shoulder dislocations occurs in the anterior direction? 65% 75% 85% 95%

95%

What percentage of shoulder dislocations occurs in the anterior direction? Group of answer choices

95%

Torg's Ratio

< 0.80 (Spinal Canal Width/ Vertebral Body Width) is stenosis

Vertebral Instability

> 11 degrees of rotation or > 3.5 mm translation

Which of the following statements is true concerning elbow dislocation?

A fracture is frequently associated

Which of the following statements is true concerning elbow dislocation? The dislocation is usually posterior and medial The arm cannot be flexed A fracture is frequently associated Does not need to be treated as an emergency

A fracture is frequently associated

Salter-Harris fractures: Type 4

A fracture through all three elements of the bone, the growth plate, metaphysis, and epiphysis.

Salter-Harris fractures: Type 3

A fracture through growth plate and epiphysis, sparing the metaphysis.

Salter-Harris fractures: Type 2

A fracture through the growth plate and the metaphysis, sparing the epiphysis.

Ottawa Knee Rules

A knee X-ray series is only required for knee injury patients with any of these findings: 1. Age 55 or older 2. Isolated tenderness of the patella (that is, no bone tenderness of the knee other than the patella) 3. Tenderness at the head of the fibula 4. Inability to flex to 90 degrees 5. Inability to bear weight both immediately and in the emergency department (4 steps; unable to transfer weight twice onto each lower limb regardless of limping).

Define mild traumatic brain injury.

A patient with mild traumatic brain injury is a person who has had a traumatically induced physiological disruption of brain function, as manifested by at least one of the following: 1. any period of loss of consciousness; 2. any loss of memory for events immediately before or after the accident; 3. any alteration in mental state at the time of the accident (eg, feeling dazed, disoriented, or confused); and

Par-Q: 6. Is there a good physical reason not mentioned here why you should not follow an activity program even if you wanted to?

A physician should be consulted to determine if the condition necessitates special precautions during exercise training or it it contraindicates exercise training

Paget's Disease

A relatively common skeletal disorder of middle and old age people. It may be confined to one bone or involve the entire skeleton • Weak, dense, thick bone

Circuit Weight Training

A sequential series of weight training exercise that results in a system of continuous activity designed to bring about improving strength, muscular endurance, body composition, and aerobic capacity The exercise is performed in a series of all out bouts with short periods of rest between exercises The circuit usually included eight or more exercise stations, with a specific time requirement or repetition requirement Exercises alternate between upper body, lower body and trunk, to prevent muscle fatigue in any one muscle group

Salter-Harris fractures: Type 1

A transverse fracture through the growth plate (also referred to as the "physis")

Define concussion.

A traumatically induced transient disturbance of brain function and is caused by a complex pathophysiological process.

Extreme muscle soreness results primarily after a bout of _________________ exercise.Hint: a type of muscle contraction.

Eccentric

The form of resistance training where you resist the movement of an object is referred to as.....

Eccentric

Which some of the following reasons best explains why McMurray's test is not useful for all meniscal tears?

Effusion in the joint

Which some of the following reasons best explains why McMurray's test is not useful for all meniscal tears? Effusion in the joint An ineffective test Anderson's test is better The cartilage is not engaged by the femur

Effusion in the joint

Which of the following proteins has an amino acid profile most similar to the bodies needs?

Egg

Frostbite is first seen as

Erythemic color on cheeks?

Is it _________ for the team physician to coordinate a postseason meeting with appropriate team personnel administration to review the previous seasons.

Essential

It is ________for the team physician to coordinate a postseason meeting with appropriate team personnel administration to review the previous season. Essential Recommended Advised Encouraged

Essential

This tumor displays a permeative destructive pattern in the diaphyseal area of younger patients in the first or second decade. It is more commonly seen in males and has the following terms associted with its radiographic description; Sunburst or onionskin periosteal reaction Saucerization - this is when the cortex looks scooped out It can look like osteomyelitis Chondroblastoma Enchondroma Giant Cell Tumor Ewing's Sarcoma Polystotic fibrous dysplasia

Ewing's Sarcoma

Ewing's sarcoma

Oxygen Debt

Excess Post-Exercise Oxygen Consumption (EPOC)

Risks of Erythropoetin

Excessive blood viscosity resulting in cardiovascular complications

Hyperplasia-

Excessive proliferation of normal cells in normal tissue arrangement.

Name the muscle most commonly associated with tennis elbow.

Extensor carpi radialis brevis

The rationale for including an assessment of the urological system in the PPE is based on strong evidence.

A mallet finger always occurs at the PIP. True False

False

A mallet finger always occurs at the PIP. Group of answer choices

False

All active patients with ACL tears should have surgical reconstruction.

False

All active patients with ACL tears should have surgical reconstruction. True False

False

Amino acids are the primary source of energy during sprint exercise.

False

Amino acids are the primary source of energy during sprint exercise. True False

False

Carbohydrates (i.e., glucose) are the major source of fuel during most types of exercise, and fat generally contributes an insignificant amount to the energy supply of the exercising muscles.

False

Carbohydrates (i.e., glucose) are the major source of fuel during most types of exercise, and fat generally contributes an insignificant amount to the energy supply of the exercising muscles. True False

False

Cardiovascular abnormalities, such as hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy or congenital coronary arteries anomalies are typically silent until a potentially fatal arrhythmia occurs, and are always undetectable through a careful cardiovascular examination.

False

Cardiovascular abnormalities, such as hypertrophic cardiomyopathy, arrythmogenic right ventricular cardiomyopathy or congenital coronary arteries anomalies are typically silent until a potentially fatal arrhythmia occurs, and are always undetectable through a careful cardiovascular examination. T or F

False

Children should not participate in resistance training programs as the risk of injury far outweighs any benefits to be gained.

False

Children should not participate in resistance training programs as the risk of injury far outweighs any benefits to be gained. True False

False

Heart murmurs are best heard in the siting position.

False

Heart murmurs are best heard in the siting position. True False

False

In the majority of concussion cases, neuropsychological testing will be used to assist return to play decisions and will be done at the earliest possible time.

False

It is recognized by the panelists that conventional structural neuroimaging is abnormal in concussive injury.

False

Marfan syndrome is an uncommon connective tissue disorder.

False

Plasma insulin levels increase during exercise to assure muscle glucose uptake remains high.

False

Plasma insulin levels increase during exercise to assure muscle glucose uptake remains high. True False

False

Regarding cervical spine stenosis - is this statement True? The ratio method is 10 times more sensitive than measuring.

False

T/F Untrained individuals usually have no difficulty with vigorous exercise more than 15 to 20 min

False

T/F: In the majority of concussion cases, neuropsychological testing will be used to assist return to play decisions and will be done at the earliest possible time.

False

T/F: It is recognized by the panelists that conventional structural neuroimaging is abnormal in concussive injury.

False

T/F: Neuropsychological testing (Impact for example) or assessment may be the sole basis of management decisions in SRC.

False

T/F: There is good clinical evidence that mouthguards have a definite role in preventing concussion.

False

T/F: Under some circumstances a concussed individual may return to play to the event they were injured in.

False

T/F: With adolescent athletes, in some settings, where there are team physicians experienced in concussion management and sufficient resources (eg, access to neuropsychologists, consultants, neuroimaging, etc.), as well as access to immediate (ie, sideline) neuro-cognitive assessment, return to play management may be more rapid.

False

The rationale for including an assessment of the urological system in the PPE is based on strong evidence. t/f

False

There is good clinical evidence that mouthguards have a definite role in preventing concussion. Group of answer choices

False

Under some circumstances a concussed individual may return to play to the event they were injured in.

False

Regarding cervical spine stenosis - is this statement True? The ratio method is 10 times more sensitive than measuring. True False

False Nope 2.5 is correct

T/F: ACSM guidelines are sometimes referred to as the Cantu guidelines. We should use these guidelines.

False Dr. Cantu's grading system certainly is a great attempt, but the standard of care today is to not grade concussions.

Hard callus formation occurs after 2 weeks and lasts 2 months. True False

False Hard callus formation occurs after 3-4 weeks and lasts 3-4 months

T/F: There are certain scenarios where a concussed individual can return to play the day of the injury.

False NEVER return a SRC patient to play the same day.

As a result of aerobic training, the body is able to depend more on _______________ as the substrate for muscle contraction.

Fat

The image is a test is called the __________ test. Thumb in closed fist with ulnar deviation

Finkelstein's

The image is a test is called the __________ test. Thumb in closed fist with ulnar deviation

Finkelstein's (graded incorrect on fill in blank)

Select the following cervical fracture that exhibits the highest degree of neurological instability is a

Flexion teardrop fracture

Preventing Overtraining Syndrome

Follow cyclic training procedures & watch CHO intake

Overload

For a muscle to gain strength it must be overloaded beyond the point that they normally function at

The authority of the ACBSP to award a CAQ as a DACBSP or CCSP comes from which of the following? ACA FICS State Boards CCE

ACA State Boards

The authority of the ACBSP to award a CAQ as a DACBSP or CCSP comes from which of the following?

ACA, FICS (International Federation of Sports Chiropractic)

Which of the following consensus or position papers recognizing concussion were identified as key documents in the concussion unit? ACBSP Consensus Statement AMSSSM Position Paper Zurich 4th Consensus Statement NATA consensus Statement

ACBSP Consensus Statement Zurich 4th Consensus Statement AMSSSM Position Paper

Which of the following consensus or position papers recognizing concussion were identified as key documents in the concussion unit?

ACBSP Consensus Statement, AMSSSM Position Paper, Zurich 4th Consensus Statement

A knee hyperextension injury can damage that:

ACL and PCL

Forearm X-Ray Series

AP & Lateral

Leg (Tibia-Fibula) X-Ray Series

AP & Lateral

Clavicle X-Ray Series

AP or PA (15-30 degrees cephlad tube tilt) and AP Axial

Elbow X-Ray Series

AP, Lateral & Oblique

Foot X-Ray Series

AP, Lateral & Oblique

Ankle X-Ray Series

AP, Lateral & Oblique (15-20 degrees medial rotation)

Which of the following are (is) used to evaluate and grade concussions?

ATA

The two high-energy compounds critical for all physical activity are.... ATP and PCr AMP and PCr AMP and ADP ATP and ADP

ATP and PCr

The two high-energy compounds critical for all physical activity are.... Correct!

ATP and PCr

With anterior dislocation the arm is typically forced into which of the following directions?

Abduction, external rotation, extension

With anterior dislocation the arm is typically forced into which of the following directions? Abduction, external rotation, Abduction, external rotation Abduction, external rotation, extension Extension and external rotation

Abduction, external rotation, extension

Which of the following tendons is involved in DeQuervain's? Abductor pollicus brevis, extensor pollicus brevis Adductor pollicus brevis, extensor pollicus brevis Abductor pollicus brevis, extensor pollicus longus Abductor pollicus longus, extensor pollicus brevis

Abductor pollicus longus, extensor pollicus brevis

Which of the following tendons is involved in DeQuervain's?

Abductor pollicus longus, extensor pollicus brevis

The Thompson test is used to determine:

Achilles tendon rupture

The Thompson test is used to determine: Achilles tendon rupture Contracture of the hip Thoracic outlet syndrome Hip dislocation

Achilles tendon rupture

The Thompson test is used to determine: Achilles tendon rupture, Contracture of hip, TOS, or Hip Dislocation

Achilles tendon rupture,

The actual shortening of muscle during muscle contraction is due to the action of __________________, which enable the thin filaments to slide past the thick filaments. You Answered

Actin-myosin crossbridges

Which of the following is NOT a component required for negligence

All of the Above

Which of the following are (is) used to evaluate and grade concussions?

All of the Above (LOC, PTA, confusion)

Which of the following can be considered when evaluating a situation to identify if you are a "Good Samaritan"?

All of the above (Good faith, standards of care, site of rescue, gratuitous conduct)

The effectiveness of active warm-up to decrease stiffness appears to be related to the:

All of the above (type of warm up exercise, muscle tested, order of warm up)

Select all of the following heart murmurs that would require a cardiology referral. The fractions are based upon the Levine scale.

All systolic murmurs > 2/6 All diastolic murmurs

Select all of the following heart murmurs that would require a cardiology referral. The fractions are based upon the Levine scale. All systolic murmurs >2/6 All diastolic murmurs All systolic murmurs >1/6 All murmurs with a thrill

All systolic murmurs >2/6 All diastolic murmurs

Cells that are responsible for debridement of the injury site include neutrophils polymorphonuclear leukocytes monocytes macrophages all of the above

All the above

Oxygen Deficit

Anerobic contribution to the exercise at the beginning

Asymmetrical pupils are called ________________________.

Anisicoria

Where is the "bullet" or target lesion found? Foot Ankle Knee Hip Forehead

Ankle

Where is the "bullet" or target lesion found? Group of answer choices

Ankle

Which of the following is a land mark used in constructing the Q angle?

Anterior Tibial Tubercle

A knee hyperextension injury can damage that:

Anterior and posterior cruciate ligaments

The most common type of glenohumeral dislocation may result in persistent laxity of the

Anterior glenohumeral joint capsule

Which of the following is a land mark used in constructing the Q angle? Anterior tibial tubercle Superior pole of the patela PSIS AIIS

Anterior tibial tubercle

Progressive Resistance

As the muscle becomes stronger a proportionally greater resistance must be applied for further strength increases.

According to the IOC, The rationale for including an assessment of the pulmonary system in a PPE is to identify which of the following findings?

Asthma

Select from the following the best answer that identifies the presentation of the coarctation of the aorta during a PPE

Asymmetrical UE/LE pulses

Pelvic Avulsion Fractures

Avulsion fractures of apophyses and spines of the pelvis are usually considered uncommon injuries, • The diagnosis, suggested by physical findings, symptoms, patient's age and biomechanical analysis of the accident, is confirmed by radiographs.

Which of the following nerves is most commonly involved with multidirectional instability?

Axillary

Which of the following nerves is most commonly involved with multidirectional instability? Axillary Musculocutaneous Radial Ulnar

Axillary

Which of the following orthopedic examinations is performed by placing posterior pressure in the opposite direction of apprehension?

Fowler's relocation test

Which of the following orthopedic examinations is performed by placing posterior pressure in the opposite direction of apprehension? Fowler's relocation test Sulcus sign Load and shift test Hawkins test

Fowler's relocation test

View the diagram to the left. Which of the following is the correct location for a Jones fracture as indicated by color? (Hint: the other colors demonstrate avulsion and stress fracture locations) RED GREEN BLUE

GREEN

The contract relax proprioceptive neuromuscular facilitation training will stretch the : GTA golgi tendon appartus I band Muscle belly Cross-bridge

GTA golgi tendon appartus

This named fracture is also called a reverse Monteggia fracture, ________ consists of a fracture of the radius at the junction of the middle and distal thirds with distal radioulnar joint dislocation. This fracture pattern may be caused by a fall on an outstretched hand or from a direct trauma to the dorsal aspect of the wrist. Galeazzi's Fracture Smith's Fracture Bennett's Fracture Hill- Sach Fracture

Galeazzi's Fracture

This named fracture is also called a reverse Monteggia fracture, ________________ consists of a fracture of the radius at the justion of the middle and disatal thirds with distal radioulnar joint dislocation. This fracture pattern may be caused by a FOOSH or from a direct trauma to the dorsal aspect of the wrist. galeazzi's fracture smith's fracture bennett's fracture hill-sach fracture

Galeazzi's Fracture

This named fracture is also called a reverse Monteggia fracture, ___________ consists of a fracture of the radius at the junction of the middle and distal thirds with distal radioulnar joint dislocation. This fracture pattern may be caused by a fall on an outstretched hand or from a direct trauma to the dorsal aspect of the wrist.

Galeazzi's fracture

The Bankart to lesion occurs at which of the following locations?

Glenoid Fossa

The Bankart lesion occurs at which of the following locations?

Glenoid fossa

The Bankart to lesion occurs at which of the following locations? Humeral head Glenoid fossa Surgical neck of the humerus Inferior aspect acromion

Glenoid fossa

An athlete using oral contraceptives should consider increasing their

B6 intake

Which of the flowing represents the best method of delivering highest flow oxygen to a victim who is having difficulty breathing or is not breathing?

BVM

The fuel source most likely to limit endurance is ______________________.

Glycogen

All-out maximal exercise of 1-min duration would stress ____________.

Glycolytic

The contract relax proprioceptive neuromuscular facilitation training will stretch the :

Golgi tendon apparatus

Which of the following tendons is capable of developing tenosynovitis?

Biceps long head

Which of the following tendons is capable of developing tenosynovitis? Supraspinatus Infraspinatus Biceps long head Subscapularis

Biceps long head

Evidence of reckless disregard of human life or of the safety of persons exposed to this action's dangerous effects or that the entire want of care would raise the presumption of a conscious indifference to the rights of others which is the equivalent to an intentional violation of it - is the definition of _____________?

Gross Neg

Which of the following factors has the greatest influence on energy expenditure during running?

Body weight

Gross Negligence

Radiology: Cervical Conditions

Hangman's Fracture, Jefferson's fracture, Increased ADI, Unilateral / bilateral dislocation, Break in George's line, Compression fractures, Odontoid fractures, Clay Shoveler fractures, Hemangioma, degenerative disc disease, Spinal arthritis, Synostosis, Klippel-Feil syndrome, Cervical ribs, Osteoporosis, Platabasia, os odontoidium

The yellow arrow is pointing to a __________________ and when located posteriorly is the result of an _________________ dislocation

Hatchet deformity, anterior

Which of the following conditions is the first priority in evaluating and managing a patient who has increased shoulder pain with running?

Heart

Which of the following conditions is the first priority in evaluating and managing a patient who has increased shoulder pain with running? Impingement syndrome Rotator cuff tendonitis Heart Subluxation complex of the shoulder

Heart

Which of the following conditions is the first priority in evaluating and managing a patient who has increased shoulder pain with running? Group of answer choices

Heart

During repeated days of exercise in a hot and humid environment.... You Answered

Hemoglobin and hematocrit are deceased

Cellular mediation

Histamine provided by platelets, mast cells and basophils to enhance permeability and arterial dilation; Serotonin provides for vasoconstriction • Bradykinin is a plasma protease that enhance permeability and causes pain; Heparin is provided by mast cells and basophils to prevent coagulation • Leukotrienes and prostaglandins are located in cell membranes and develop through the arachadonic acid cascade • Leukotrienes alter permeability • Prostaglandin add and inhibit inflammation

A bowler presents with pain on the radial aspect of her right wrist. This pain has been really progressing for the past two months and she now has severe pain with ulnar deviation of her wrist. She denies any trauma. Which of the following conditions does the rower most likely have?

DeQuervain's tenosynovitis

Care givers are also encouraged to evaluate the concussed athlete for affective symptoms. Which of the following is an affective symptom of concussion?

Depression

Care givers are also encouraged to evaluate the concussed athlete for affective symptoms. Which of the following is an affective symptom of concussion? Depression Convulsion Tinnitus Loss of consciousness

Depression

Which of the following conditions is most commonly associated with frozen shoulder syndrome?

Diabetes

Which of the following conditions is most commonly associated with frozen shoulder syndrome? Hyperthyroidism Ischemic heart disease Cervical spondylosis Diabetes

Diabetes

Which of the following is correct regarding "standard of care"?

Different levels within one profession

Lactate threshold is one of the best predictors of......

Distance running performance

Which of the following is INCORRECT regarding patient follow-up information after a concussion? Go to the ER if your headache increases. Do not go to school unit you are checked out again. You may take acetaminophen and/or paracetamol help your headache. Do not drive until your symptoms are resolved.

Do not go to school unit you are checked out again.

Which of the following is INCORRECT regarding patient follow-up information after a concussion?

Do not go to school until you are checked out again.

A runner who complains of patellar tendinitis should avoid running on

Downhill

A runner who complains of patellar tendinitis should avoid running on:

Downhill

Which of the followoing had the greatest influence on an athelete's dietary carbohydrate requirement?

Duration and frequency of exercise

An obligation that the law will give recognition to perform to a standard of care toward another person is called ?

Duty

An obligation that the law will give recognition to perform to a standard of care toward another person is called?

Duty of care?

The increase in the number of individual muscle fibers is referred to as....

Hyperplasia

The increase in strength with resistance training results from....

Hypertrophy of the muscle, increased motor unit recruitment, synchronization

Temperature is regulated by the

Hypothalamus

Which of the following is not a sign/symptom of exertional heat stroke?

Hypothermia

Playing with Pain - Pain Classifications

I. Pain only during athletic activity II. Pain persists only a short period time following athletic activity III. Pain during both athletic in routine activity IV. Pain initiated by daily activity

The extensor lag in the quadriceps refers to the:

Inability to extend the knee actively

Par-Q: 5. Has your doctor ever said that you have a joint problem such as arthritis that has been aggravated by exercise, or might be made worse by exercise

Inappropriate training may exacerbate existing musculoskeletal conditions. Persons with forms of arthritis with known associated systemic complications maybe at increased risk for medical complications during exercise.

With endurance training, mitochondria

Increase in both size and number

Anaerobic training results in which of the following changes within the muscle?

Increase in glycolytic enzymes

What is the first step to be performed in reducing a dislocated proximal interphalangeal joint?

Increase the deformity

What is the first step to be performed in reducing a dislocated proximal interphalangeal joint? Increase the deformity Long axis distraction Radiographic examination Correct medial/lateral displacement

Increase the deformity

Which of the following best explains the requirements for increased protein intake by athletes?

Increased need for tissue repair

This ligament inserts on the labrum and the humerus forming a sling for the humeral head.

Inferior glenohumeral ligament

This ligament inserts on the labrum and the humerus forming a sling for the humeral head. Inferior glenohumeral ligament Middle glenohumeral ligament Superior gelnohumeral ligament Coracoclavicular ligament

Inferior glenohumeral ligament

A process by which relevant information on a given medical procedure is given to patients/athletes followed by an affirmative decision by the patient to undergo a particular procedure or treatment is called

Informed Consent

Acute Phase

Initial reaction to an injury occurring 3 hours to 4 days following injury

The load and shift tests are for which of the following disorders?

Instability

The load and shift tests are for which of the following disorders? Instability Impingement Labrum tears Osteochondral defect

Instability

The load and shift tests are for which of the following disorders? Group of answer choices

Instability

Anterior translation greater than 3.5 millimeters of one cervical vertebra in relation to the body below should be considered a level of ____________ and may be associated with a(n)________________.

Instability, unilateral facet dislocation

Which of the following uses an endogenous approach?

Interferential

Which form of training has the potential to dynamically load the muscle maximally throughout the full range of motion?

Isokinetic

Observe the line along the superior aspect of the femoral neck.

Klein's line

Slipped Capital Femoral Epiphysis is identified radiographically by an abnormal ________ line and/or _____________ of the growth plate. Klein's line, widening Kohler's line, widening Rissler's line, narrowing Shenton's line, narrowing

Klein's line, widening

Slipped Capital Femoral Epiphysis is identified radiographically by an abnormal ___________ line and/or ________________ of the growth plate. Klein's line, widening Kohler's line, widening Risser's line, narrowing Shenton's line, narrowing

Klein's line, widening

Slipped Capital Femoral Epiphysis is identified radiographically by an abnormal ___________ line and/or ________________ of the growth plate. Group of answer choices

Klein's line, widening

Select all of the following neurological findings used to evaluate a concussion. LOC PTA Amnesia Length of coma Pupil irregularity Grade of concussion

LOC PTA Amnesia Pupil irregularity

Which of the following is the best orthopedic test for an acute ACL injury? Anterior drawer Losee Linder's Lachman

Lachman

Which of the following is the best orthopedic test for an acute ACL injury?

Lachman's

The major metabolic waste product that causes the muscles and blood to have a lower pH during exercise of increasing intensity is....

Lactate

During exercise of increasing intensity, the point at which blood lactate begins to accumulate above resting levels is called the _______________.

Lactate threshold

The third finger sign is associated with which of the following disorders?

Lateral epicondylitis

The third finger sign is associated with which of the following disorders? Road rage Lateral epicondylitis Golfers elbow OSU / Michigan get togethers

Lateral epicondylitis

OCD of the knee is most commonly located on the ____ aspect of the _____.

Lateral, medial aspect of the femoral condyles

OCD of the knee is most commonly located on the ____ aspect of the _____.

Lateral, medial femoral condyle

What is the correct name of this problem? Lisfranc Fracture Napoleonic Fracture Midfoot sprain Normal film

Lisfranc Fracture

Which of the following types of athletes would be expected to have the highest percentage of slow-twitch fibers in the muscles of their legs?

Long distance runner

There are two medical conditions identified by the IOC as being unique to the female athlete that may have long-term consequences that can be avoided through early detection and treatment. What are these two factors?

Low energy availability, low bone density

Insulin......

Lowers glucose circulating in the blood

Which of the following carpals is most commonly dislocated?

Lunate

Which of the following carpals is most commonly dislocated? Lunate Scaphoid Pisiform Hamate

Lunate

Which of the following carpals is most commonly dislocated? Group of answer choices

Lunate

A common DIP joint injury is extensor mechanism avulsion. This is commonly known as "________" and occurs when a player strikes the finger on a ball, helmet, or other piece of equipment.

Mallet Finger

A common DIP joint injury is extensor mechanism avulsion. This is commonly known as "________" and occurs when a player strikes the finger on a ball, helmet, or other piece of equipment.

Mallet finger

Treating Overtraining Syndrome

Marked reduction in training or complete rest

Proprioceptive Neuromuscular Facilitation

May be superior to other stretching methods because they facilitate muscular inhibition; Three specific muscle actions are used to facilitate the passive stretch; Both isometric and concentric muscle actions of the antagonist (the muscle been stretched) are used before a passive stretch of the antagonist to achieve autogenic inhibition; The isometric muscle action is referred to as hold and the concentric muscle action as contract.

Clavicle fractures most commonly occur at this location.

Mid 1/3

Clavicle fractures most commonly occur at this location. Medial 1/3 Mid 1/3 Lateral 1/3

Mid 1/3

Clavicle fractures most commonly occur at this location. Group of answer choices

Mid 1/3

The motor unit is composed of....

Motor neuron, muscle fibers

The term comminuted means

Multiple fracture fragments

What is the primary fuel or energy source for most sports?

Muscle Glycogen

What is the primary fuel or energy source for most sports?

Muscle glycogen

Low voltage electrical stimulation is best used to assist the treatment of:

Muscle spam and pain

Which of the following are examples of the type of sensory information detected by a proprioceptive sensor?

Muscle tension, tendon tension, deep pressure

_________________ delivers oxygen from the muscle cell membrane to the mitochondria.

Myoglobin

The thick filament comprising the myofibril is known as...

Myosin

Plyometrics enhance what anatomical area?

Neuromuscular mechanisms

Epinephrine and norepinephrine are referred to as _____________________________.

Neurotransmitters

Which of the following is INCORRECT regarding cartilage healing? Little or no direct blood supply Articular cartilage that fails to clot and has no perichondrium heals very slowly If injury involves subchondral bone (enhanced blood supply) granulation tissue is present and healing proceeds normally No capacity to heal One exception is a cartilage tear of the lateral 1/3 of the knee meniscus - This is called the vascular zone

No capacity to heal One exception is a cartilage tear of the lateral 1/3 of the knee meniscus - This is called the vascular zone

What is the correct delivery device for rescue oxygen delivery in a breathing patient

Non-rebreather mask

Which of the following imaging modalities identifies concussion?

None of the above

Which of the following imaging modalities identifies concussion? MRI CT SPECT None of the above

None of the above

Two major neurotransmitters involved in regulating our physiological responses to exercise are ....

Norepinephrine and acetylcholine

Which of the following conditions are most likely associated with a knee that aches, has recurrent swelling and on occasion may catch or lock.

OCD and meniscus

While working an 18 and under volleyball tournament an athlete sustains a concussion. She has a head ache and vomits on the court. What is the best course of action?

Observe and perform serial examinations

While working an 18 and under volleyball tournament an athlete sustains a concussion. She has a head ache and vomits on the court. What is the best course of action? Observe and perform serial examinations. Apply high flow O2 and observe for effect. Do no move the athlete, stabilize the cervical spine and activate EMS. Move her to the sideline and activate EMS.

Observe and perform serial examinations

Psoriatic arthritis

Occurs in three forms: 1. Rheumatoid like 2. Spondylitis with sacroiliitis 3. Inflammatory arthritis of the DIP joints

A painful loss of motion must be present for at least __________ before frozen shoulder syndrome can be diagnosed?

One month

A painful loss of motion must be present for at least __________ before frozen shoulder syndrome can be diagnosed? One-week One month Six weeks Two months

One month

A common companion to Little League elbow is _______ of the capitellum.

Osteochondritis dessicans

Which of the following conditions are most likely associated with a knee that aches, has recurrent swelling and on occasion may catch or lock.

Osteochondritis dissecans, fractured meniscus

_________ of the distal clavicle is a pathologic process involving resorption of the distal clavicle and is usually posttraumatic or caused by the repetitive microtrauma of weight lifting.

Osteolysis

DDx: Hx of a puncture route, fever, or infection

Osteomyelitis

Gout: Radiographic Hallmark

Overhang Edge Sign

Heavy to Light Program

Oxford Method • Uses the principle of heavy resistance and low repetitions, but in the reverse of the light to heavy program • Some authorities believed that the DeLorme method was to fatiguing and might cause to great a strain

The primary system for providing energy for a 2 hour bout of work is the....

Oxidative

Which energy system is predominate in endurance activities?

Oxidative

Which energy system is predominate in endurance activities? Oxidative ATP-CP Anaerobic Lactic Acid

Oxidative

Which of the following systems provides energy through aerobic metabolism?

Oxidative

Fingers X-Ray Series

PA, Lateral & Oblique

Thumb X-Ray Series

PA, Lateral & Oblique

Wrist X-Ray Series

PA, Lateral, Oblique, Scaphoid View (used with radial side wrist pain and a history of trauma; at least 10-15 degrees of cephlad tube tilt [15-40])

Which of the following is correct concerning an acute compartment syndrome?

Pain will not decrease

The glenoid labrum is _______ shaped.

Pear

This patient presents to you after a fall at a family picnic. Her complaint is some pain over the Lateral collateral ligament with varus stress testing. She is a 58 Y/O lady with some mild osteoarthritis and a negative past health history. What is the other significant finding on this film related to? ACL Tear Fracture of Rolando Pellegrini-Stieda Correct, this does not require treatment. Make sure you also R/O Osteosacroma. Avulsion of the lateral collateral ligament

Pellegrini-Stieda

This eponym refers to avulsion of the medial femoral condyle at the origin of the medial collateral ligament.

Pelligrini-Stieda

This eponym refers to avulsion of the medial femoral condyle at the origin of the medial collateral ligament. Terry Thomas Jones Banchart Pelligrini-Stieda

Pelligrini-Stieda

This eponym refers to avulsion of the medial femoral condyle at the origin of the medial collateral ligament. Terry Thomas Jones Banchart Pelligrini-Stieda

Pelligrini-Stieda

Par-Q: 7. Are you over age 65 and not accustomed to exercise?

People over 65 are at risk for certain chronic diseases. The exercise prescription may need to be modified for older individuals.

Par-Q: 4. Has a doctor ever said your blood pressure is too high?

Persons with blood pressure reading that are over 180/105 should add exercise training to their programs only AFTER starting medications to control their blood pressure.

Par- Q: 1. Has your doctor ever said you have heart trouble?

Persons with known heart disease are at an increased risk for cardiac complications during exercise. These persons should consult a physician and undergo exercise testing before starting an exercise program.

Repair Phase

Phase will extent from 48 hours to 6 weeks following cleaning of fibrin clot, erythrocytes, and debris

What is the PAR-Q?

Physical Activity Readiness Questionnaire

Which of the following tests is best described by applying a valgus stress to the extended knee while the hip and knee are flexed (form total extension) and the lower leg is held in internal rotation?

Pivot - shift

Which of the following tests is best described by applying a valgus stress to the extended knee while the hip and knee are flexed (from total extension) and the lower leg is held in internal rotation? Lachman Pivot -- shift Wilson McMurray

Pivot -- shift

The embryonic septa in the knee are called:

Plica

Onset Blood Lactate Accumulation (OBLA)

Point when performing exercise where lactate shows up in blood

Lactate Threshold (LT)

Point when performing exercise where lactate starts being made

Most hip dislocation are _________.

Posterior

As a result of an anterior dislocation, a defect in the _________________ articular surface of the humerus is known as a (n) ________________.

Posterior, hatchet or Hill-Sach deformity

An athlete who is prone to having lower leg stress fractures should be evaluated for:

Pronated foot

While working at a semi-professional football game one of the adult players becomes injured. You assess them and recommend that they be transported to a hospital. They refuse treatment even after you have told them why they really need additional care. The athlete then becomes aggressive toward you. Which of the following is the best and most correct action for you to take?

Protect yourself and call ambulance

Protect yourself and call an ambulance

Atlantoaxial Instability

RA (25%), Downs Syndrome (40%)

What is your impression of this radiograph?

Radial head dislocation

Five signs of inflammation

Redness: increased vasodilation, increased vascular permeability, release of histamine and other hormones. Edema: blocked lymph vessels, increased vascular permeability, bleeding from damaged vessels. Pain: hypersensitivity of nerves, pressure of edema on nerve endings, lowered excitation level of nerves. Temperature: increased local activity. Reduced function: secondary to pain, edema, injury to tissue.

Which of the following is a potential explanation for the neurogenic component of gains in muscular strength with resistance training?

Removal of autogenic inhibition

Which of the following activities would result in the greatest degree of muscle soreness within 24 to 48 hours after the exercise?

Running downhill at 6.0 mph, 10% grade

_________ lesions are injuries to the labrum that extend from anterior to the biceps tendon to posterior to the biceps tendon.

SLAP

Calcium ions, responsible for turning on muscle contraction, are stored in the....

Sarcoplasmic reticulum

Which of the following upper extremity fractures most commonly goes to non-union if missed?

Scaphoid

Which of the following upper extremity fractures most commonly goes to non-union if missed? Lunate Scaphoid Olecranon Epicondyle

Scaphoid

______________ is a strategy used in a population to detect a disease in individuals without signs or symptoms of that disease

Screening

______________ is a strategy used in a population to detect a disease in individuals without signs or symptoms of that disease.

Screening

We spend a lot of time learning about concussion to prevent _____________ from occurring.

Second Impact Syndrome

The "Y" view is for the _____ joint. Ankle Elbow Knee Shoulder Hip

Shoulder

The "Y" view is for the _______ joint.

Shoulder

The "Y" view is for the _______ joint. Ankle Elbow Knee Shoulder Hip

Shoulder

Which of the following orthopedics tests is the best test to identify triangular fibrocartilage complex injury?

Shuck

If swelling of the knee occurs gradually over 24 hours, which of the following would be the most likely problem?

Small Meniscus Tear

If swelling of the knee occurs gradually over 24 hours, which of the following would be the most likely problem?

Small meniscus tear

The basic difference between a power movement and a strength movement is.....

Speed of the movement

You are evaluating an athlete with a painful, swollen tibia. You're unsure if it is a contusion or fracture. What is the correct treatment?

Splint lower leg and arrange for further eval

You are evaluating an athlete with a painful, swollen tibia. You're unsure if it is a contusion or fracture. What is the correct treatment?

Splint the lower leg and arrange for further evaluation

You are evaluating an athlete with a painful, swollen tibia. You're unsure if it is a contusion or fracture. What is the correct treatment? Have the athlete walk and jump on it to see if it hurts Apply ice and give the athlete crutches Recommend ice and apply compression wrap Splint the lower leg and arrange for further evaluation

Splint the lower leg and arrange for further evaluation

What is the third step of the graduated return to play protocol?

Sport specific exercise

Which of the following is third step of the Graduated return-to-sport (RTS) strategy? Sport-specific exercise Non-contact training drills Light aerobic exercise Full contact practice

Sport-specific exercise

What is the third step of the graduated return to play protocol? Sports specific exercise. Non-contact training drills. High level aerobic activity. Combined aerobic and strength training drills.

Sports specific exercise.

Which of the following types of athletes would be expected to have the highest percentage of fast-twitch fibers in the muscles of their legs?

Sprinter

Which of the following can be considered when evaluating a situation to identify if you are a "Good Samaritan"?

Standard of care?

Which of the following are the best patient positions to auscultate heart sounds as identified in the course?

Standing, Supine

Which of the following methods of reducing a shoulder dislocation is the best method for a beginning doctor to use?

Stimson

Which of the following methods of reducing a shoulder dislocation is the best method for a beginning doctor to use? Kochler Rowe Radial Stimson

Stimson

The one-repetition maximum (1-RM) is a functional measure of.....

Strength

Frequency, Duration, and Intensity of Stretching

Stretching twice a week for five weeks has been shown to significantly improved flexibility; Each practice session should be preceded by warm-up and sport specific stretching; Individual stretches should be held to the point of mild discomfort, but not pain, for 30 seconds; Stretches should be preformed before practicing competition and also following practicing competition

Which of the following muscles provides for protection of the neurovascular structures of the upper extremity in combination with the clavicle?

Subclavius

Which of the following muscles provides for protection of the neurovascular structures of the upper extremity in combination with the clavicle? Subclavius Subscapularis Trapezius Pectoralis Major

Subclavius

The body area that pain is classically referred to with rotator cuff tendinitis is where?

Subdeltoid

The body area that pain is classically referred to with rotator cuff tendinitis is where? Near the medial border of the scapula Anterior shoulder Just posterior to the AC articulation Subdeltoid

Subdeltoid

Definition of ergogenic aid

Substance or phenomena that improve an athletes performance

A chiropractor working a sideline may be held to the same standard of care as that of a medical doctor.

An athlete using oral contraceptives should consider increasing their B6 intake.

Because of their larger ratio of surface area to body mass, children are more prone than adults to heat loss in cold climates.

In the asymptomatic athlete with no history of previous injury, there is limited evidence to prescribe orthopedic specific tests - even using more advanced functional tests - to identify athletes at risk.

It is established that during intense training and immediately following competitions, there is evidence of immune suppression in athletes that could predispose them to infective disease.

People older than 65 constitute one of the fastest-growing population segments.

Pulse oximetry should be used as an added tool for victim care, as it is possible for victims to show a normal reading but have difficulty breathing or to have a low reading but appear to be breathing normally.

The PPE can serve many purposes. It includes a comprehensive assessment of the athlete's current health status and risk of future injury or disease and, typically, is the entry point for medical care of the athlete.

The principle rationale for including ophthalmological assessment in the PPE is that ophthalmic conditions, particularly reduced visual acuity.

The pulse oximeter reading never should be used to withhold oxygen from a victim who appears to be in respiratory distress or when it is the standard of care to apply oxygen despite good pulse oximetry readings, such as in a victim with chest pain.

There is no longer any doubt that regular physical activity reduces the risk of premature mortality in general, and of coronary heart disease, hypertension, colon cancer, obesity, and diabetes mellitus in particular.

Which of the following modalities uses the "gate control" theory of pain reduction?

TENS

Karnoven Method of HR Training

Target Heart Rate = ((Maximum Heart Rate - Resting Heart Rate) × %Intensity) + Resting Heart Rate

Which of the follwoing IS NOT a rotator cuff muscle?

Teres Major

Which of the following IS NOT a rotator cuff muscle? Group of answer choices

Teres major

Which of the follwoing IS NOT a rotator cuff muscle? Supraspinatus Infraspinatus Teres major Subscapularis

Teres major

All-out maximal exercise of 6-s duration would stress.....

The ATP-PCr system

Ottawa Foot Rules

The Ottawa foot rules are for assessing whether a foot X-ray series is indicated. It states that they are indicated if there is any pain in the midfoot zone and any one of the following: • Bone tenderness at the base of the fifth metatarsal (for foot injuries) • Bone tenderness at the navicular bone (for foot injuries) • An inability to bear weight both immediately and in the emergency department for four steps.

A running back with a recently injured ankle is ready to return to practice. Which functional assessment is most appropriate for this athlete?

The athlete can participate in running forward, cutting and backpedaling

A running back with a recently injured ankle is ready to return to practice. Which functional assessment is most appropriate for this athlete? With taping the athlete can participate in straightahead running The athlete has full range of motion The athlete has 90% muscle strength and is able to do to raises The athlete can participate in running forward, cutting and backpedaling The athlete can participate in mountain biking

The athlete can participate in running forward, cutting and backpedaling

Par-Q: 2. Do you frequently suffer from pains in your chest?

The cause of chest pain should be identified before exercise is initiated.

Par-Q: 3. Do you often feel faint or have spells of severe diziness?

The cause of these symptoms must be identified. Exercise training should not be started until cardiac disorders have been excluded.

Light to Heavy Program

The individual starts with lighter weights, does a number of repetitions, rests, add more resistance, performs fewer repetitions, rests, and continues this process until a certain weight and repetition goal is met; Typically, used by athletes trying to gain greater mass and strength

DeLorme Method

The most commonly used method of training • Initial set at 50% of 10 RM • Second set at 75% of 10 RM • Third set at 100% of 10 RM

Which of the following is correct concerning an acute compartment syndrome? The pain does not decrease with rest A loosely applied compression bandage is helpful Application of ice is indicated Soft tissue massage is beneficial

The pain does not decrease with res

Which of the following is correct concerning an acute compartment syndrome?

The pain does not decrease with rest

Static flexibility:

The range of possible movement about a joint and its surrounding muscles during a passive movement Requires no voluntary muscle activity Provides greater range of motion than dynamic flexibility

With variable or accommodating resistance training machines....

The resistance varies in a manner attempting to replicate the strength curve

Other than genetics, what exerts the most significant control on whether a muscle fiber is of a Type I or Type II fiber type?

The type of neuron that stimulates it

The maximum force capability of a muscle is inversely related to;

The velocity of a concentric contraction

Odontoid Fractures

Three types (I, II, III)

Osgood-Schlatter disease occurs in the area of the:

Tibial Tubercle

Osgood-Schlatter disease occurs in the area of the:

Tibial tubercle

A concussion can be defined as an immediate and transient loss of neuronal function secondary to _____.

Trauma

Albright's Syndrome

Triad consists of: 1. Polystotic fibrous dysplasia 2. Precocious puberty 3. Cafe au lait spots

Endurance training results in greater storage of muscle...... Correct!

Triglyceride and glycogen

A formal agreement with an "entity" is a key difference between a sports physician and a team physician.

True

A formal agreement with an "entity" is a key difference between a sports physician and a team physician. T or F

True

A previous injury is the most consistent risk factor for new recurrent injuries.

True

A previous injury is the most consistent risk factor for new recurrent injuries. T or F

True

According to the IOC, the main purpose of the PPE is screen for injuries or medical conditions that may place an athlete at risk for safe participation.

True

According to the IOC, the main purpose of the PPE is to screen for injuries or medical conditions that may place an athlete at risk for safe participation. T or F

True

At the time an injury occurs, there is a brief period of vasoconstriction followed by vasodilation. True False

True

Athletes who have had an acute patellar dislocation may go into shock.

True

Collagen fibers arranged in parallel fashion have greater strength than those arranged in a haphazard fashion. true false

True

Collagen is produced during the proliferation phase. true false

True

Concussion may be caused either by a direct blow to the head, face, neck or an impulsive force transmitted to the head.

True

Early controlled mobilization of a soft tissue injury may enhance healing. True False

True

Generally speaking the meniscus has a poor blood supply.

True

If osteoclastic activity is not in balance with oesteoblastic activity bone becomes more susceptible to fractures. True False

True

If you hold yourself out by declaring you are a sports physician you may be held to the same standard of care as a sports physician.

True

If you hold yourself out by declaring you are a sports physician you may be held to the same standards of care as a sports physician. T or F

True

In the US, the ONLY recognized sports chiropractic certifications are the CCSP & and the DACBSP.

True

In the United States, the only recognized sports chiropractic certifications are the CCSP and the DACBSP. T or F

True

It has been demonstrated that adding a 12-lead EKG/ECG examination to history and physical examination results in a substantial increase in the ability to identify potentially lethal heart disorders however, it is not currently recommended by the American Heart Association and the EKG/ECG is not a part of the standard of care for the typical PPE in the United States.

True

It has been demonstrated that adding a 12-lead EKG/ECG examination to history and physical examination results in a substantial increase in the ability to identify potentially lethal heart disorders however, it is not currently recommended by the American Heart Association and the EKG/ECG is not part of the standard of care for the typical PPE in the United States. T or F

True

It is established that during intense training and immediately following competitions, there is evidence of immune suppression in athletes that could predispose them to infective disease.

True

Knowledge of energy systems will allow you to select the type of training for the specific sport of the athlete.

True

Knowledge of energy systems will allow you to select the type of training for the specific sport of the athlete. True False

True

Optimal treatment of clavicle injuries stems from accurate diagnosis based on knowledge of the anatomy of the region and the biomechanics of injury. Fortunately, conservative treatment of these injuries usually leads to an excellent prognosis and ultimately a full return to sports.

True

Over 50 % of athletes with transient quadriplegia associated with athletic participation had spinal stenosis.

True

Over 50 % of athletes with transient quadriplegia associated with athletic participation had spinal stenosis. True False

True

Patellar dislocations almost always occur in the lateral direction.

True

Patellar dislocations can be reduced in the field setting.

True

Plain radiography is of limited utility in diagnosing symptomatic spondylolysis, both because of the relatively poor ability of plain films to show pars lesions compared with other imaging modalities and because of the inability to tell if a lesion that is visualized is symptomatic.

True

Provocative exercise testing useful in guiding RTP?

True

Removal of debris from the injury site begins within 5 to 6 h of the injury. true false

True

Scaphoid fracture account for 70 percentage of all carpal bone injuries. True False

True

Scaphoid fracture account for 70 percentage of all carpal bone injuries. Group of answer choices

True

Scaphoid fracture account for 70 percentage of all carpal bone injuries. t/f

True

T/F Persons of any age with symptoms suggestive of coronary, pulmonary, or metabolic disease should have a medical examination and a physician supervised maximal exercise test prior to beginning an exercise program.

True

T/F: A key concept in sideline assessment is the rapid screening for a suspected SRC, rather than the definitive diagnosis of head injury. Players manifesting clear on-field signs of SRC (eg, loss of consciousness, tonic posturing, balance disturbance) should immediately be removed from sporting participation.

True

T/F: All athletes, regardless of level of participation, should be managed using the same management principles.

True

T/F: Concussion may be caused either by a direct blow to the head, face, neck or an impulsive force transmitted to the head.

True

T/F: If you clearly observe the injury and the energy of the impact is very minor, but a concussion still occurs this person should be sent to the ER.

True

T/F: Provocative exercise testing useful in guiding RTP?

True

T/F: SRC is an evolving injury in the acute phase, with rapidly changing clinical signs and symptoms, which may reflect the underlying physiological injury in the brain.

True

T/F: SRC may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an impulsive force transmitted to the head.

True

T/F: SRC may result in neuropathological changes, but the acute clinical signs and symptoms largely reflect a functional disturbance rather than a structural injury and, as such, no abnormality is seen on standard structural neuroimaging studies.

True

T/F: SRCs can result in diverse symptoms and problems, and can be associated with concurrent injury to the cervical spine and peripheral vestibular system.

True

T/F: Sports Related Concussion (SRC) is often defined as representing the immediate and transient symptoms of traumatic brain injury (TBI).

True

T/F: Studies using advanced neuroimaging techniques have demonstrated that SRC is associated with changes in brain structure and function.

True

T/F: The ACBSP does not endorse any specific methodology of concussion management.

True

T/F: The cornerstone of concussion management is physical and cognitive rest until symptoms resolve and then a graded program of exertion prior to medical clearance and return to play.

True

T/F: There is no such thing as a minor concussion.

True

T/F: When pharmaco therapy is used to treat SRC, concussed athletes using a medication, who meet all other criteria to return, may return while taking a pharmacological agents/medications that is prescribed for their SRC.

True

Tears of the meniscus on the outside one third can heal.

True

The ACBSP does not endorse any specific methodology of concussion management.

True

The Achilles tendon is directly linked with the plantar fascia. Group of answer choices

True

The cornerstone of concussion management is physical and cognitive rest until symptoms resolve and then a graded program of exertion prior to medical clearance and return to play.

True

The evidence suggest that although there is a general health benefit from sports participation, injuries represent a significant side effect. T or F

True

The evidence suggests that although there is a general health benefit from sports participation, injuries represent a significant side effect.

True

The most common mechanisms of injury to the glenoid labrum in athletes and the general public are acute and chronic excessive traction and compression. True False

True

The most common mechanisms of injury to the glenoid labrum in athletes and the general public are acute and chronic excessive traction and compression. Group of answer choices

True

The number of capillaries in a wound decreases during the remodeling phase. true false

True

The team physician's duty depends on the time (Pre-even, Post event), location and other team members. T or F

True

The team physician's duty depends on the time (pre-event, post-event), location, and other team members.

True

The team physician's primary duty at a contest is the triage of the injured athlete.

True

The team physician's primary duty at a contest is the triage of the injured athlete. T or F

True

The two major muscle fiber types, ST and FT, have been shown to undergo conversion from one type to the other with cross-enervation. True False

True

The two major muscle fiber types, ST and FT, have been shown to undergo conversion from one type to the other with cross-innervation.

True

There are many different sports, levels of competition, and available medical resources that must be considered in determining the on-site medical bag and sideline medical supplies.

True

There are many different sports, levels of competition, and available medical resources that must be considered in determining the on-site medical bag and sideline medical supplies. T or F

True

There is a gender difference in concussion incidence and outcomes.

True

There is no evidence that sporting or physical activity is harmful to patients with scoliosis, with the possible exception of some cases immediately after surgery or instances of other under-lying pathology.

True

Vascular permeability begins the inflammation process and is initiated by histamine. true false

True

With adolescent athletes, in some settings, where there are team physicians experienced in concussion management and sufficient resources (eg, access to neuropsychologists, consultants, neuroimaging, etc.), as well as access to immediate (ie, sideline) neuro-cognitive assessment, return to play management may be more rapid.

True

With knee flexion the posterior capsule of the knee is loose.

True

With knee flexion, the posterior capsule of the knee is loose. True False

True

herT/F: Most consensus and agreement statements for managing SRC recommend that athletes rest until they become symptom-free. Accordingly, prescribed rest is one of the most widely used interventions in this population. The basis for recommending physical and cognitive rest is that rest may ease discomfort during the acute recovery period by mitigating post-concussion symptoms and/or that rest may promote recovery by minimizing brain energy demands following concussion. There is currently insufficient evidence that prescribing complete rest

True

T/F: Regarding SRC, young people do not have the same treatment plans as adults.

True Because they heal slower and are more vulnerable to head injury.

Acute fractures have 5 stages of healing. True False

True Correct! Hematoma formation, Cellular proliferation, Callus formation, Ossification, Remodeling

T/F: Concussion symptoms can last for months.

True Days, weeks, months or longer.

T/F: Concussions are cumulative.

True This is why when we see an athlete sustain a concussion with a low impact injury we should be suspicious they already were concussed.

T/F: SRC is now considered treatable.

True Yes, per the Berlin Conference.

T/F: There is a gender difference in concussion incidence and outcomes.

True More in female

Which of the following views is the best view to identify the most common osteochondral defect in the knee?

Tunnel

Which of the following views is the best view to identify the most common osteochondral defect in the knee? AP LAT Sunrise Tunnel

Tunnel This is correct! OCD of the knee is most commonly seen on the lateral aspect of the medial femoral condyle:)

Type ____ AC injuries involve a complete tear of the AC ligament and a mild sprain of the costoclavicular ligament.

Type 2

Type ____ AC injuries involve a complete tear of the AC ligament and a mild sprain of the costoclavicular ligament. Type 1 Type 2 Type 3 Type 4

Type 2

The ____________ muscle fibers constitute approximately 50% of the total muscle fibers in a given muscle in the normal, nonathletic population.

Type I

The ____________ muscle fibers constitute approximately 50% of the total muscle fibers in a given muscle in the normal, nonathletic population. Type I Type IIa Type IIb Type IIc

Type I

Select all of the following that are correct regarding the physical presentation of coarctation of the aorta.

UE/LE Asymmetrical pulse

Which of the following is a heating and mechanical method of treatment?

Which of the following is contraindicated with an acute quad contusion?

Ultra sound

Which of the following is a heating and mechanical method of treatment?

Ultrasound

Which of the following is contraindicated with an acute quad contusion?

Ultrasound

Which of the following is contraindicated with an acute quad contusion? Ice Compression Interferential Ultrasound

Ultrasound

Playing with Pain

Use your judgment in addition to the following guidelines when the main factor limiting participation is pain; Players returning before pain and tenderness have subsided and before they have a normal range of motion have increased risk of injuries

Acute Phase: First Hour

Vasoconstriction and coagulation occur to seal blood vessels and chemical mediators are released Immediately followed by vasodilation or blood vessel

Glucose False Positives =

Vit C

Intake of this vitamin may lead to false positives on urine analysis for glucose

Vitamin C

The exercise program

Warm-up and stretching exercises Endurance exercise Cool-down and stretching exercises Flexibility training Resistance training Recreational activities

Which of the following orthopedics tests is the best test to identify triangular fibrocartilage complex injury? Watsons Shuck Load and shift Finkelstein's

Watsons

The first phase of throwing is called ___________ phase

Wind Up

The first phase of throwing is called _______________ phase.

Wind Up

Ottawa Ankle Rules

X-rays are only required if there is any pain in the malleolar zone and any one of the following: • Bone tenderness along the distal 6 cm of the posterior edge of the tibia or tip of the medial malleolus • Bone tenderness along the distal 6 cm of the posterior edge of the fibula or tip of the lateral malleolus • An inability to bear weight both immediately and in the emergency department for four steps.

Identify the reasons that adolescents and pediatric concussion patients are managed differently than adults.

Young people are classified as special populations. Young people do not respond as fast in recovery.

Atrophy-

a decrease in the size of tdissue due to call death and re-absorption of

Secondary Osteoarthritis

a degenerative condition superimposed on or preexisting joint problem like a congenital hip dislocations or trauma

Dysplasia -

abnormal development of tissue.

Macrophages are responsible for debridement recruitment of other macrophages release of growth factors all of the above a and b only

all of the above

The increase in strength with resistance training results from....&10; hypertrophy of the muscle increased motor unit recruitment synchronization all of the above

all of the above

Tensile strength of a wound is directly related to the size of the inflammation number of neutrophils in the area amount of collagen present type of PMNs in the area none of the above

amount of collagen present

Hypertrophy -

an increase in the size of tissue without necessarily changing the number of cells.

A knee hyperextension injury can damage that: anterior and posterior cruciate ligaments meniscus patellar tendon medial collateral ligament

anterior and posterior cruciate ligaments

The most common type of glenohumeral dislocation may result in persistent laxity of the anterior glenohumeral joint capsule coracoclavicular ligament posterior glenohumeral joint capsule teres minor muscle

anterior glenohumeral joint capsule

People with SRC that cannot remember events since the injury occurred are said to have ____________ amnesia.

anterograde Anterograde amnesia is a loss of the ability to create new memories after the event that caused the amnesia, leading to a partial or complete inability to recall the recent past, while long-term memories from before the event remain intact.

Stieda fracture

avulsion fracture of the medial femoral condyle at the origin of the medial collateral ligament

Callus -

basis from which a structure develops.

Visceral pain

begins in organs and is diffused at first and may become localized

Which of the following factors has the greatest influence on energy expenditure during running? age gender training status body weight

body weight

Fiber-type conversion (e.g., fast-twitch [FT] to slow-twitch[ST] conversion) has been shown to occur under which of the following conditions? cross-innervation of motor nerve to muscle fibers chronic stimulation of FT motor units with low-frequency nerve stimulation both a and b there is no conversion

both a and b

The motor unit is composed of.... motor neuron muscle fibers motor cortex both a and b

both a and b motor neuron muscle fibers

Torus Fracture

buckling deformity of metaphysis of long bone almost exclusively seen in children

Epinephrine and norepinephrine are referred to as _____________________________.

catecholeamines Epinephrine and norepinephrine are released by the adrenal medulla and nervous system respectively. They are the flight/fight hormones that are released when the body is under extreme stress. During stress, much of the body's energy is used to combat imminent danger.

The actual shortening of muscle during muscle contraction is a function of.... T-tubules cross-bridges Z-lines sarcolemma

cross-bridges

Lactate threshold is one of the best predictors of...... muscle strength muscle endurance distance running performance sprint performance

distance running performance

A runner who complains of patellar tendinitis should avoid running on: soft surfaces hard surfaces uphill downhill curves on any surface

downhill

The following guideline is correct regarding hydration and heavy exercise.

drink 4-8 oz every 15 minutes

Which of the following had the greatest influence on an athlete's dietary carbohydrate requirement?

duration and frequency of exercise

Early mobilization versus immobilization in the treatment of lateral ankle sprains

early mobilization allows earlier return to work and may be more comfortable for patients, but long term outcomes are no different

Extreme muscle soreness results primarily after a bout of _________________ exercise. Hint: a type of muscle contraction.

eccentric

The form of resistance training where you resist the movement of an object is referred to as..... static-action training plyometrics isokinetics eccentric training

eccentric training

Which of the following proteins has an amino acid profile most similar to the bodies needs?

egg

What is the last test you should perform prior to returning a concussion athlete to play?

exertional/exercises/procational/exertion

Name the muscle most commonly associated with tennis elbow.

extensor carpi radialis (graded wrong on fill in blank)

Name the muscle most commonly associated with tennis elbow.

extensor carpi radialis brevis

A key characteristic of chronic inflammation is the continued presence of histamine. true false

false

A mallet finger always occurs at the PIP.

false

All active patients with ACL tears should have surgical reconstruction t/f

false

Marfan syndrome is an uncommon connective tissue disorder. True False

false

The shortest healing phase is the remodeling phase. true false

false

Treatment strategies for acute and chronic injuries are the same. true false

false

Skeletal Muscle: Type II B Fibers

fast twitch or fast glycolytic fibres, contain a low content of myoglobin, relatively few mitochondria, relatively few blood capillaries and large amounts glycogen. Type II B fibres are white, geared to generate ATP by anaerobic metabolic processes, not able to supply skeletal muscle fibres continuously with sufficient ATP, fatigue easily, split ATP at a fast rate and have a fast contraction velocity. Such fibres are found in large numbers in the muscles of the arms.

Skeletal Muscle: Type II A Fibers

fast twitch or fast oxidative fibres, contain very large amounts of myoglobin, very many mitochondria and very many blood capillaries. Type II A fibres are red, have a very high capacity for generating ATP by oxidative metabolic processes, split ATP at a very rapid rate, have a fast contraction velocity and are resistant to fatigue. Such fibers are infrequently found in humans.

People older than 65 constitute one of the _______________population segments

fastest-growing

As a result of aerobic training, the body is able to depend more on _______________ as the substrate for muscle contraction. fat carbohydrate protein there is no change in substrate

fat

Psychogenic pain

felt by the individual but is emotional rather than physical

Select the following cervical fracture that exhibits the highest degree of neurological instability is a mild compression fracture extension teardrop fracture flexion teardrop fracture Clay Shoveler's fracture Type I odontoid

flexion teardrop fracture

Select the following cervical fracture that exhibits the highest degree of neurological instablity is a mild compression fracture extension teardrop fracture flexion teardrop fracture Clay Shoveler's fracture Type I odontoid

flexion teardrop fracture

Nightstick Fracture

fracture of forearm (usually in distal third and transverse) from direct blow while shielding head from a blow

Shepherd's fracture

fracture of the lateral tubercle of the posterior process of the talus

Which of the following conditions are most likely associated with a knee that aches, has recurrent swelling and on occasion may catch or lock. osteochondritis dissecans anterior cruciate ligament tear fractured meniscus Baker's cyst

fractured meniscus one more as well I think Bakers Cyst

fractured meniscus Bakers Cyst(wrong answers)

A __________ located posteriorly is the result of an ___________ dislocation bankart lesion, anterior flap fracture, posterior hatchet deformity, anterior hatchet deformity, posterior

hatchet deformity, anterior

because of their larger ratio of surface area to body mass, children are more prone than adults to __________________

heat loss in cold climates

During repeated days of exercise in a hot and humid environment.... plasma volume is decreased hemoglobin and hematocrit are decreased red blood cell volume is decreased none of the above

hemoglobin and hematocrit are decreased

The major claim for this modality is that there is little cutaneous stimulation, and the treatment is more comfortable.

high voltage piulsed stimulation

The most important historical question to ask when evaluating an athlete with a concussion pertains to the _____________ .

history/prior injury/prior concussion

The increase in the number of individual muscle fibers is referred to as.... atrophy hypertrophy hyperplasia hypoplasia

hyperplasia hypertrophy is increase in size of the muscle cells not number

Temperature is regulated by the :

hypothalamus

Which of the following is not a sign/symptom of exertional heat stroke?

hypothermia

Hill-Sachs fracture

impacted posterior humeral head fracture occurring during anterior shoulder dislocation

The extensor lag in the quadriceps refers to the:

inability to extend the knee actively

The extensor lag in the quadriceps refers to the: inability to extend the hip actively inability to flex the hip actively inability to extend the knee actively inability to extend any passively

inability to extend the knee actively

Greenstick Fracture

incomplete transverse fracture on one side of bone that occurs almost exclusively in children

Anaerobic training results in which of the following changes within the muscle? increased muscle respiratory capacity increase in oxidative enzymes increase in glycolytic enzymes none of the above

increase in glycolytic enzymes

When using aqueous ultrasound the wattage should be:

increased 0.5 Watts

Which of the following best explains the requirements for increased protein intake by athletes?

increased need for tissue repair

This ligament inserts on the labrum and the humerus forming a sling for the humeral head.

inferior GH ligament

Which of the following orthopedic examinations is performed by placing posterior pressure in the opposite direction of apprehension?

instability tests: Modified jobe's relocation test

Anterior translation greater than 3.5 millimeters of one cervical vertebra in relation to the body below should be considered a level of _________ and may be associated with a(n)________________. hypermobility, unilateral facet dislocation instability, unilateral facet dislocation hypermobility, mild sprain instability, fracture

instability, unilateral facet discolcation

Anterior translation greater than 3.5 millimeters of one cervical vertebra in relation to the body below should be considered a level of ____________ and may be associated with a(n)________________. hypermobility, unilateral facet dislocation instability, unilateral facet dislocation hypermobility, mild sprain instability, fracture

instability, unilateral facet dislocation

vigorous exercise

intensity > 60%

Which of the following uses an endogenous approach?

interferential

Which form of training has the potential to dynamically load the muscle maximally throughout the full range of motion? free weights isometric isokinetic variable resistance

isokinetic

The major metabolic waste product that causes the muscles and blood to have a lower pH during exercise of increasing intensity is.... bicarbonate nitrogen carbon dioxide lactate

lactate

most important view to evaluate cervical spine trauma

lateral view

OCD of the knee is most commonly located on the ____ aspect of the _____. medial, lateral femoral condyle lateral, lateral femoral condyle medial, medial femoral condyle lateral, medial femoral condyle

lateral, medial femoral condyle

neck pain that is increased with cervical spine flexion and extension is associated with...

ligamentous instability

Which of the following types of athletes would be expected to have the highest percentage of slow-twitch fibers in the muscles of their legs? sprinter shot putter weight lifter long distance runner

long distance runner

What does LOC stand for?

loss of consciousness

Insulin...... lowers glucose circulating in the blood promotes gluconeogenesis inhibits glycogenesis is not involved in protein and amino acid metabolism

lowers glucose circulating in the blood

Define mild traumatic brain injury.

mTBI is a brain injury caused by a blow to the head or a violent shaking of the head and body. GCS score between 13-15.

A common DIP joint injury is extensor mechanism avulsion. This is commonly known as "________" and occurs when a player strikes the finger on a ball, helmet, or other piece of equipment. mallet finger coaches finger little leaguer's finger Haouldack's finger

mallet finger

The term comminuted means displaced involves both cortex irregular borders multiple fracture fragments

multiple fracture fragments

The term comminuted means displaced involves both cortex irregular borders multiple fracture fragments

multiple fracture fragments

Which of the following are examples of the type of sensory information detected by a proprioceptive sensor? pain in an internal organ pain and joing angle muscle tension, tendon tension, deep pressure heat and cold

muscle tension, tendon tension, deep pressure

_________________ delivers oxygen from the muscle cell membrane to the mitochondria. hemoglobin myoglobin haptoglobin sarcoplasm

myoglobin

The thick filament comprising the myofibril is known as.... actin sarcolemma myosin tropomyosin

myosin

Plyometrics enhance what anatomical area? energy stores neuromuscular mechanisms elastic energy of the muscle strength of the connective tissue

neuromuscular mechanisms

Two major neurotransmitters involved in regulating our physiological responses to exercise are ..... norepinephrine and acetylcholine dopamine and carnitine sarcolemma and ovaltine histamine and calcitonin

norepinephrine and acetylcholin

Pelvic Avulsion Fracture: Common Location

occurs at ischial tuberosity, AIIS, ASIS, superior corner of pubic symphysis and iliac crest

Deep somatic pain

originates in tendons, muscles, joints, periosteum and blood vessels

A common companion to Little League elbow is _______ of the capitellum. osteochondritis dissecans fracture avulsion avascular necrosis

osteochondritis dissecans

The primary system for providing energy for a 2 hour bout of work is the.... oxidative ATP-CP system glycolytic glucogenic

oxidative

Which of the following systems provides energy through aerobic metabolism? oxidative ATP-CP system glycolytic glucogenic

oxidative

Low voltage electrical stimulation is best used to assist the treatment of:

pain, muscle spasm

The glenoid labrum is _______ shaped.

pear

The glenoid labrum is _______ shaped. pear apple round delta

pear

What tool do you need to use to identify if the condition in the previous question is a pathological problem? Correct Answers pen light

pen light/light/flashlight

The embryonic septa in the knee are called: plica synovial cartilage infrapatellar fat

plica

Most hip dislocation are _________. posterior anterior extension external roation

posterior

As a result of an anterior dislocation, a defect in the _________________ articular surface of the humerus is known as a (n) ________________. anterior, Bankart posterior, flap fracture posterior, hatchet or Hill-Sachs deformity anterior, flap fracture

posterior, hatchet or Hill-Sachs deformity

As a result of an anterior dislocation, a defect in the _________ articular surface of the humerus is known as a (n) ______________. anterior, Bankart posterior, flap fracture posterior, hatched or Hills-Sachs deformity anterior, flap fracture

posterior, hatchet or Hills-Sachs defomity

The optimal time to begin therapeutic exercise is usually during the inflammation phase proliferation phase early portion of the remodeling phase end of the remodeling phase any of the above

proliferation phase

An athlete who is prone to having lower leg stress fractures should be evaluated for

pronated Foot

An athlete who is prone to having lower leg stress fractures should be evaluated for: tight Achilles tendon weak anterior tibialis musculature tight plantar fascia pronated foot

pronated foot

___________reading never should be used to withhold oxygen from a victim who appears to be in respiratory distress or when it is the standard of care to apply oxygen despite good pulse oximetry readings, such as in a victim with chest pain.

pulse oximeter

The protein requirements of athletes:

range from 1.2 - 1.7 g/kg body weight

NSAID medications are used following injury to reduce inflammation, thereby reducing pain provide vasoconstriction effect decrease prostaglandin production increase prostaglandin production a and c b and c b and d

reduce inflammation, thereby reducing pain decrease prostaglandin production

Which of the following is a potential explanation for the neurogenic component of gains in muscular strength with resistance training? periodization transient hypertrophy removal of autogenic inhibition neurogenic facilitation

removal of autogenic inhibition

Which of the following activities would result in the greatest degree of muscle soreness within 24 to 48 hours after the exercise? running uphill at 6.0 mph, 10%grade running on the level at 6.0 mph running downhill at 6.0 mph, 10% grade there would be identical degrees of soreness

running downhill at 6.0 mph, 10% grade

Calcium ions, responsible for turning on muscle contraction, are stored in the.... sarcolemma T-tubules cross-bridges sarcoplasmic reticulum

sarcoplasmic reticulum

Which of the following upper extremity fractures most commonly goes to non-union if missed?

scaphoid

Cutaneous pain

sharp, bright and burning with fast and slow onset

Skeletal Muscle: Type I Fibers

slow twitch or slow oxidative fibers, contain large amounts of myoglobin, many mitochondria and many blood capillaries. Type I fibers are red, split ATP at a slow rate, have a slow contraction velocity, very resistant to fatigue and have a high capacity to generate ATP by oxidative metabolic processes. Such fibers are found in large numbers in the postural muscles of the neck.

If swelling of the knee occurs gradually over 24 hours, which of the following would be the most likely problem? Osgood Schlatter's disease and osteochondritis dissecans bursitis osteochondral fracture small meniscus tear

small meniscus tear

most common sign of cervical spine fracture or dislocation

spinal pain

Which of the following types of athletes would be expected to have the highest percentage of fast-twitch fibers in the muscles of their legs? sprinter shot putter middle distance runner long distance runner

sprinter

extension teardrop fracture

stable injury

The one-repetition maximum (1-RM) is a functional measure of..... strength power muscular endurance all of the above

strength

Which of the following are the best patient positions to auscultate heart sounds as identified in the course? supine sitting standing squatting

supine standing

All-out maximal exercise of 6-s duration would stress..... the ATP-PCr system the glycolytic system the oxidative system the ATP-PCr, glycolytic, and oxidative systems

the ATP-PCr system

All-out maximal exercise of 1-min duration would stress ____________. the ATP-PCr system the glycolytic system the oxidative system the ATP-PCr, glycolytic, and oxidative systems

the glycolytic system

Repetition Maximum (RM)

the maximum amount of weight a muscle can lift for that specific number of repetitions

With variable or accommodating resistance training machines.... the resistance varies randomly as you progress through the range of motion the resistance varies in a manner attempting to replicate the strength curve the resistance varies with the speed of movement none of the above

the resistance varies in a manner attempting to replicate the strength curve

The basic difference between a power movement and a strength movement is..... the distance moved the force generated the speed of movement the two are the same

the speed of movement

Other than genetics, what exerts the most significant control on whether a muscle fiber is of a Type I or Type II fiber type? training program the type of neuron that stimulates it age none of the above

the type of neuron that stimulates it

The maximum force capability of a muscle is inversely related to; the velocity of a concentric contraction the angle of pennation the cross-sectional size of the muscle the number of cross-bridge heads bound to actin the size of the neuromuscular junction

the velocity of a concentric contraction (note: speed and force are inversely related)

Health Classification - Apparently Healthy

those who are aymptomatic with no more than one major coronary risk factor

Health Classification - Individuals at higher risk

those who have symptoms suggestive of possible cardiopulmonary or metabolic disease and/or two or more major risk factors

Health Classifications - Individuals with disease

those with known cardiac, pulmonary, or metabolic disease

Osgood-Schlatter disease occurs in the area of the: patella patellar tendon quadricpes tibial tubercle tibial plareau

tibial tubercle

Metaplasia -

transformation of tissue from one type to another that is not normal for that tissue.

Endurance training results in greater storage of muscle...... triglyceride and glycogen glycogen and albumin amino acids cytoplasm

triglyceride and glycogen

All drugs have the potential to produce undesirable side effects. true false

true

Athletes who have had an acute patellar dislocation may go into shock. True False

true

Generally speaking the meniscus has a poor blood supply. True False

true

Patellar dislocations almost always occur in the lateral direction. True False

true

Patellar dislocations can be reduced in the field setting. True False

true

Patellar dislocations can be reduced in the field setting. t/f

true

Platelets release phospholipids to stimulate the clotting mechanism. True False

true

Skeletal muscle healing and repair follow the same course as other soft tissues developing tensile strength. This is called Wolff's Law. True False

true

Tears of the meniscus on the outside one third can heal. True False

true

The Achilles tendon is directly linked with the plantar fascia.

true

The Achilles tendon is directly linked with the plantar fascia. True False

true

The most common mechanisms of injury to the glenoid labrum in athletes and the general public are acute and chronic excessive traction and compression. t/f

true

The principle rationale for including ophthalmological assessment in the PPE is that ophthalmic conditions, particularly reduced visual acuity. t/f

true

With knee flexion the posterior capsule of knee is loose

true

true or false: According to the ACSM: "it is unnecessary for asymptomatic, apparently healthy men under 40 and women under 50, with fewer than CAD risk factors to have a medical evaluation prior to embarking on a program of vigorous (60% VO2 max) exercise training"

true

flexion teardrop fracture

unstable flexion fracture

Which of the following orthopedics tests is the best test to identify triangular fibrocartilage complex injury? Watsons Shuck Load and shift Finkelstein's

unsure not load and shift

Le Fort's fracture of the ankle

vertical fracture of distal fibula with avulsion of medial malleolus

Frostbite is first seen as:

white spots

The first phase of throwing is called _______________ phase.

wind up

The first phase of throwing is called _______________ phase.

wind up/cocking

Osteoarthritis

• A common disorder • Primary osteoarthritis is most frequently encountered • It likes the spine, large weight bearing joins, the first carpal metacarpal joint, the first MTP joint, and the DIP joints. • Any joint can undergo degenerative change\ • Osteoarthritis is reserved for synovial diarthrodial joints.

Osteogenesis Imperfecta

• A genetic disorder in which abnormal bone collagen is synthesized by the osteocytes. • Characterized by severe osteoporosis with the radiographic appearance of deformed form bones with common pathologic fractures.

Eosinophilic granuloma

• A pathologic compression fracture -vertebra plana • may occur with this condition in the spine • Long bones looks like a well-circumscribed destructive lesion there may be no sclerotic margins if the region is inactive or resolving • This can mimic benign or malignant tumors

Shoulder X-Ray Series

• AP (External rotation & Internal rotation) • Lateral (scapular Y view): Rotate body into a 45-60 degree anterior oblique (patient faces away from the tube); body of the scapula should be perpendicular to the film • Axillary view & glenohumeral 'true' AP view Optional - West Point (Inferior axial projection of the shoulder, Arm abducted to 90, patient is prone, Forearm points to the floor, Cassette is perpendicular to the table [sandbags or cassette holder], 25 degree angle P-A & 25 degree angle medially [a double angle view])

Knee X-Ray Series

• AP Weight bearing • Lateral (30 degrees flexion preferred) • Tunnel (to rule out OCD) • Patellar View (Sunrise & Merchant)

Risks of Human Growth Hormone

• Acromegaly • Cardiomyopathy • Glucose intolerance • Hypertension

Healing Stages of Acute Fracture: Ossification

• Adequate immobilization and compression will result in new Haversian systems developing • Haversian canals allow for the laying down of primary bone • Ossification is complete when bone has been laid down and the excess callus has been resorbed by osteoclasts.

ADI Ranges

• Adult Normal = < 3 • Child Normal = < 4 • ADI of 6.5 - 11 is HIGHLY associated with neurological s/s and usually have fusion

DAPRE - Daily Adjusted Progressive Resistance Exercise

• Allows for the different rates individuals regain strength in an injured area • Uses weight adjustments and PRE • The number of repetitions used in the third set determines the adjusted working weight for the fourth set • The number of repetitions used in the fourth set determines the weight used for the next exercise session

Gate Theory of Pain

• Area in dorsal horn of spinal cord causes inhibition of pain impulses ascending to cortex • Pain stimuli exceeding threshold results in pain perception • Stimulation of large fast nerves can block signal of small pain fiber input

Predicting overtraining syndrome

• Changes in blood enzyme levels • Changes in oxygen consumption at a standardized work rate • Changes in electrocardiogram • Heart rate response to a standardized work rate (Best) • Blood lactate response to a standardized work rate

Paget's Disease: Osteoblastic or Cold Phase

• Characterized by bone deposition and osteosclerosis • Course trabeculated bone • Bone is more dense and wider in diameter yet significantly weaker than normal bone • Pathologic fracture may occur • The bone scan is usually normal during the osteoblastic phase • You may see an enlarged, distorted head and bowing deformities of the extremity

Paget's Disease: Resorption Phase

• Characterized by osteoporosis and intense bone resorption • Intense local bone resorption (osteoporosis circumscripta in the skull) advancing wedge in long bones

Major Symptoms or Signs of Cardiopulmonary or Metabolic Disease

• Chest Pain or discomfort that appears to be ischemic in nature • SOB or SOB w/ mild exertion • Dizziness or syncope • Orthopnea/paroxysmal nocturnal dyspnea • Ankle edema • Palpitations or tachycardia • Claudication • Known heart murmur

Enchondroma

• Circular and punctuate calcifications in the medullary region • Popcorn like • will affect the cortical margins • Clumps of calcified cartilage • Multiple enchondroma is called Ollier's disease

S/S of Overtraining Syndrome

• Decreased appetite and body weight • Myalgias • Colds, allergies, or both • Occasional nausea • Elevated resting heart rate • Elevated blood pressure

Multiple myeloma

• Destructive lesion with erosion of the surfaces of the cortex • Lesions arise from medullary cavity and involve cortical bone secondarily • No soft tissue mass • No reactive sclerosis • Well-defined punched out lytic lesions of varying size • Likely to be seen on the test • Approached out lesions in the skull

Chondrosarcoma

• Destructive medullary lesion with cortical destruction • Sunburst periosteal reaction • Extension of the tumor beyond cortex • Scattered punctate calcifications within the soft tissue mass

Mechanisms of Overtraining Syndrome

• Disturbances of autonomic nervous system function • Disturbances of endocrine function • Suppression of immune function

Principle of Individuality

• Each person must be considered as unique individuals are unlikely to show precisely the same adaptations to a given training program • variations in cellular growth rates, metabolism, neuronal, and endocrine regulation leads to individual variations

Chondromyxoid fibroma

• Eccentric expansile lesion • Thick sclerotic margin with central calcifications • Likes the tibia • Rare

Osteoblastoma

• Eccentric oval lucency with surrounding sclerosis involving both the cortical and medullary regions • Findings resemble those of a giant osteoid osteoma (nidus)

Giant Cell Tumor

• Eccentric, expansile lucent lesion • May extend into the articular end of the bone • Usually, little reactive sclerosis • Tumors are usually benign but can reoccur locally • Small number metastases to the lung • Terms: buttress formation

Proposed ergogenic benefits of Caffeine

• Enhanced alertness, concentration, and reaction time • Reduced fatigue • Increased mental alertness and concentration • Elevated mood • Decreased reaction time • Delayed onset of fatigue • Enhanced catecholamine release, FFA mobilization, and triglyceride use

Risks of Blood Doping

• Excessive blood viscosity resulting in cardiovascular complications • Allergic reactions or infections resulting from blood infusions

Important components of the exercise prescription

• Exercise mode • Exercise frequency • Exercise duration • Exercise intensity

Simple Bone Cyst

• Expansile, well demarcated, medullary lucency with a sclerotic margin • A cavity lined with a fibrous membrane and filled with serous fluid • Occurring children and teenagers • Falling fragment sign • Does not usually extend wider than the growth plate

Factors That Impede Healing

• Extent of injury • Edema • Hemorrhage • Poor Vascular Supply • Separation of Tissue • Muscle Spasm • Atrophy • Corticosteroids • Keloids and Hypertrophic • Scars • Infection • Humidity • Climate • Oxygen • Tension • Health • Age • Nutrition

Factors That Impede Healing

• Extent of injury • Edema • Hemorrhage • Poor Vascular Supply • Separation of Tissue • Muscle Spasm • Atrophy • Corticosteroids • Keloids and Hypertrophic Scars • Infection • Humidity, Climate, Oxygen Tension • Health, Age, and Nutrition

Healing Stages of Acute Fracture: Cellular Formation

• Granulation forms constructing fibrous union between fractured ends • Capillary buds allow endosteal cells influx from cambium layer • Cells evolve from fibrous callus to cartilage, to woven bone • High oxygen tension = fibrous tissue • Low oxygen tension = cartilage tissue • Bone growth will occur with optimal oxygen tension and compression

Atlantoaxial Instability: Sports that need screening for at risk populations

• Gymnastics • Diving • Swimming (Butterfly) • High Jump • Pentathalon • Soccer

Reiter's syndrome

• He can't see, he can't pee, and he can not dance with me. Nuff Said? • Inflammatory arthritis

Quantifying exercise intensity

• Heart rate (Training heart rate & Training heart rate range) • Metabolic equivalents • Ratings of perceived exertion

PAR-Q (7)

• Heart trouble • Chest pain • Faint/dizziness • High blood pressure(>180/105) • Joint problem aggravated/worsened by exercise • Good physical reason not mentioned • Over age 65 and not accustomed to exercise

Radiology: Thoracic Conditions

• Hemangioma • Osteoarthritis • Osteoporosis • Rib fractures • Degenerative disc disease • Ankylosing Spondylitis, • Compression fractures • Pneumothorax • Osteomyelitis

Healing Stages of Fracture

• Hematoma formation • Cellular proliferation • Callus formation • Ossification • Remodeling

Healing Stages of Acute Fracture

• Hematoma formation • Cellular proliferation • Callus formation • Ossification • Remodeling

Adaptations to aerobic training

• Improved aerobic endurance • Increased maximal oxygen uptake • Changes in the hormones that regulate metabolic functions

Proposed ergogenic benefits of Human Growth Hormone

• Increased FFM • Decreased body fat • Increased strength • Enhanced anabolic effects of steroids • Enhanced healing after injury occurs

Methods of Overloading (8)

• Increased Weight or Resistance • Increased Sets or Repetitions • Increased Frequency • Increased Rate of Movement • Duration • Rest Interval • Muscle Isolation • Range of Motion

Proposed ergogenic benefits of Anabolic steroids

• Increased muscle mass and strength • Facilitation of rapid post-training recovery • Improved aerobic capacity • Increased fat-free mass (FFM) • Increased strength

Proposed ergogenic benefits of Blood doping

• Increased oxygen-carrying capacity of blood • Increased aerobic endurance

Proposed ergogenic benefits of Erythropoietin

• Increased oxygen-carrying capacity of blood • Increased aerobic endurance

Risks of Anabolic steroids

• Interruption of normal bone growth in adolescents • Testicular atrophy, reduced sperm count, and breast enlargement in men • Breast regression, menstrual cycle disruption, and masculinization in women • Liver damage • Cardiomyopathy • Personality changes

Osteoarthritis - Hallmark Radiographic Signs

• Joint space narrowing • Subchondral sclerosis • Subchondral cyst • Osteophytic formations • Vacuum phenomena • Degenerative Intervertebral Disc

Aneurismal Bone Cyst

• Large medullary expansile blowout lucency • likes the tibia • About to the growth plate • Cortical margins are really messed up • The lesion is wider than the growth plate

Scar formation

• Less viable than normal tissue, may compromise healing • Firm, inelastic mass devoid of capillary circulation • Develops from exudate with high protein and debris levels resulting in granulation tissue • Invaded by fibroblasts and collagen forming a dense scar and while normally requiring 3-14 weeks may require 6 months to contract

Cartilage Healing

• Limited capacity to heal • Little or no direct blood supply • Chrondrocyte and matrix disruption result in variable healing • Articular cartilage that fails to clot and has no perichondrium heals very slowly • If area involves subchondral bone (enhanced blood supply) granulation tissue is present and healing proceeds normally

Fibrosarcoma

• Localized, expansile, destructive and permeative lesion • Well-organized periosteal reaction

Chronic Inflammation

• Long onset and duration • Presence of non-granular leukocytes and extensive scar tissue

Cellular response

• Mast cells (connective tissue cells) and leukocytes (basophils, monocytes, neutrophils) enter area • Mast cells with heparin and histamine serve as first line of defense • Basophils provide anti-coagulant • Neutrophils and monocytes are responsible for small and large particles undergoing phagocytosis - ingestion of debris and bacteria

Fibrous Cortical Defect

• Most common benign bone tumor • Appears as a small oval lucency in the cortex • fine sclerotic margin, which is contiguous with the cortex

Polystotic fibrous dysplasia

• Multiple expansile lesions • Can have pathologic fracture • Cafe au lait spots

Healing Stages of Acute Fracture: Remodeling

• Occurs following callus resorption and trabecular bone is laid along lines of stress • Bioelectric stimulation plays a major role in completing the remodeling process - Osteoblasts are attracted to the electronegative (concave/compression) side - Osteoclasts are attracted to the electropositive (convex/tension) side • The process is complete when the original shape is achieved or the structure can withstand imposed stresses

Pelvic Avulsion Fracture: Epidemiology

• Occurs in adolesent males twice as often as females • occurs more often in gymnastics and soccer

Osteochondromas

• Osteochondromas arise from the surfaces of long bones, ribs, and scapula • Solitary osteochondromas have a sessile or pedunculated appearance (They point away from the joint) • Hereditary multiple osteochondromas: Multiple sessile or pedunculated osteochondromas • Terms to remember include: Broad-based exostoses, Cartilage cap

Rheumatoid arthritis

• Osteoporosis • Diffuse joint space narrowing • Central or marginal erosion's leading to articular destruction • Bone erosion at the insertions of tendons, ligaments and capsules • Joint effusion • Alignment deformities • Inflammatory arthritis

Osteoid Osteoma

• Oval appearing lucency with a nidus formation • These can be seen in the spine, it will look like and large white pedicle

Remodeling

• Overlaps repair and regeneration • First 3-6 weeks involves laying down of collagen and strengthening of fibers • 3 months to 2 years allowed for enhanced scar tissue strength • Balance must be maintained between synthesis and lysis • Take into consideration forces applied and immobilization / mobilization time frames relative to tissue and healing time

Psychological Aspects of Pain

• Pain can be subjective and psychological • Pain thresholds vary per individual • Pain is often worse at night due to solitude and absence of external distractions • Personality differences can also have an impact

Scaphoid Fracture

• Pain in the anatomical snuffbox • Plain film x-ray can miss many of them & MRI is more sensitive and specific for occult Fx • Immobilize in thumb spica splint

Projected (Referred) Pain

• Pain which occurs away from actual site of injury/irritation • unique to each individual and case • May elicit motor and/or sensory response A-alpha fibers are sensitive to pressure and can produce paresthesia; Three types of referred pain include: myofascial, sclerotomic, and dermatomic

Patella X-Ray Series

• Patella View: Merchant (supine) & Settegast / Hughston (prone) • AP • Lateral

Ewing's Sarcoma

• Permeative destructive lesion • Likes the diaphyseal area • Younger patients in the first or second decade • Prefers males • It can look like osteomyelitis but osteomyelitis likes the metaphysis • Sunburst or onionskin periosteal reaction • Saucerization (cortex looks scooped out)

Adaptations to anaerobic training

• Phosphagen system adaptations • Glycolytic system adaptations • Mechanical efficiency improvements • Increased muscle oxidative capacity • Increased muscle buffering capacity

Ankylosing Spondylitis

• Predominantly in males • Inflammatory arthritis that initially involves the spine and large joints • The spine is involved in and ascending fashion begin with the sacroiliac joints which fuse early • Spinal ligaments become calcified and the facet joints fuse • Progresses to the typical bamboo spine

Considerations for determining optimal training load

• Progressive overload • Training volume • Training intensity

Ligament Healing

• Proper care will result in acute, repair, and remodeling phases in same time required by other vascular tissue • Repair phase will involve random laying down of collagen which, as scar forms, will mature and realign in reaction to joint stresses and strain • Full healing may require 12 months

Acute Phase: Goals

• Protect • Localize • Decrease injurious agents • Prepare for healing and repair

AC Joint X-Ray Series

• R/O fracture first! • AP - Bilateral with weights Use 10-15 pound weights tied to the wrists (do not have the patient hold the weights)

Regeneration

• Related to health, nutrition and tissue type • Dependent on levels of debris (phagocytosis), endothelial production (hypoxia and macrophages stimulate capillary buds) • Production of fibroblasts (revascularization allows for enhanced fibroblast activity and collagen production which is tied to Vitamin C, lactic acid, and oxygen

Methods for monitoring training changes.

• Repeated measurements of maximal oxygen uptake • Lactate threshold tests • Lactate measurement during steady-state exercise

Repair Phase- 3 individual phases

• Resolution (little tissue damage and normal restoration) • Restoration (if resolution is delayed) • Regeneration (replacement of tissue by same tissue)

Cardinal Signs of Inflammation

• Rubor (redness) • Tumor (swelling) • Color (heat) • Dolor (pain) • Functio laesa (loss of function)

Tillaux fracture

• Salter-Harris III avulsion of anterior tubercle of tibia • MOI: forced lateral rotation of foot

Gouty Arthritis

• Secondary to hyperuricemia • Persistent hyperuricemia leads to the deposits of urate crystals around the joints. • After years of recurrent episodes radiographic changes may appear. • Soft tissue masses/ tophi with erosions of both sides of the joint. Remainder of the joint will not be affected.

Adaptations of muscle tissue

• Shift in muscle fiber metabolic characteristics (FTb to FTa) • Increased number of capillaries • Increased myoglobin content • Increased mitochondrial size and number • Increased mitochondrial enzyme activity • Increased muscle glycogen and triglyceride stores • Increased FFA use and decreased glycogen use during submaximal exercise

Acute Inflammation

• Short onset and duration • Change in hemodynamics, production of exudate, granular leukocytes

Healing Stages of Acute Fracture: Callus Formation

• Soft callus is a random network of woven bone • Osteoblasts fill the internal and external calluses to immobilize the site • Calluses are formed by bone fragments that bridge the fracture gap • The internal callus creates a rigid immobilization early • Hard callus formation occurs after 3-4 weeks and lasts 3-4 months • Hard callus is a gradual connection of bone filaments to the woven bone • Less than ideal immobilization produces a cartilagenous union instead of a bony union

Osteomyelitis: Radiographic findings

• Soft tissue swelling • Bony destruction • Increase sclerosis (Involcrum reactive new bone) • Periosteal elevation • Small artery calcification

Radiology: Lumbar Conditions

• Spondylolisthesis • Compression fractures • Spondylolysis • Spina bifida • Paget's • Ankylosing spondylitis • Transverse process fractures

Dynamic Flexibility

• The available range of motion during active movements • Requires voluntary muscle actions

Monostotic fibrous dysphasia

• The most common benign rib lesion • Localized medullary expansile lesion with a sclerotic margin and faint calcifications

Metastatic Tumors

• These tumors are usually multi-focal • a solitary metastasis may sometimes be confused with the primary bone tumor. • Bone metastasis may be purely destructive (lytic) or sclerotic (blastic) or a mixture of the two lytic and blastic • Certain radiologic findings like an expansile lytic lesions in metastatic kidney and thyroid carcinoma may suggest the nature of a primary tumor

Principle of Specificity

• To maximize benefits training must be specifically matched to the type of activities the person engages in • Training adaptations are highly specific to the type of activity, volume, and intensity of activity performed.

Principle of Disuse

• Training benefits are lost if training is discontinued or reduced abruptly • When training is stopped the fitness level will drop to the level that will meet the demands of daily use.

Principle of Progressive Overload

• Training must work the muscles harder than normal, as the body adapts the training must progress to a higher level • All training programs must include the concepts of overload and progressive training

Important aerobic training considerations

• Training volume • Training intensity • Interval compared with continuous training

Healing Stages of Acute Fracture: Hematoma Formation

• Trauma to the periosteum and surrounding soft tissue occurs due to the initial bone trauma • During the first 48 hours a hematoma within the medullary cavity and the surrounding tissue develops • Blood supply is disrupted by clotting vessels and cellular debris • Dead bone results in an inflammatory response (vasodilation, exudate cell migration)

Activity that different m. fiber types are used for

• Type I: aerobic • Type IIA: long-term anerobic • Type IIB: short term anerobic

Mitochondrial density of m. fiber types

• Type I: high • Type IIA: high • Type IIB: low

Oxidative capacity of m. fiber types

• Type I: high • Type IIA: high • Type IIB: low

Capillary density of m. fiber types

• Type I: high • Type IIA: intermediate • Type IIB: low

Resistance to fatigue of m. fiber types

• Type I: high • Type IIA: intermediate • Type IIB: low

Glycolytic capacity of m. fiber types

• Type I: low • Type IIA: high • Type IIB: high

Force production of m. fiber types

• Type I: low • Type IIA: high • Type IIB: very high

Contraction Time of m. fiber types

• Type I: slow • Type IIA: fast • Type IIB: very fast

Size of motor neuron of m. fiber types

• Type I: small • Type IIA: large • Type IIB: very large

Major storage fuel of m. fiber types

• Type I: triglycerides • Type IIA: CP & Glycogen • Type IIB: CP & Glycogen

Acute Phase: Second Hour

• Vasodilation decreases blood flow • Increased blood viscosity resulting in edema (swelling) • Exudate increases (high concentration of RBC's) due to increased vessel permeability • Permeability changes generally occur in capillary and venules • Margination occurs causing leukocytes to fill the area and line endothelial walls • Through diapedesis and chemotaxis leukocytes move to injured area

Proposed ergogenic benefits of Diuretics

• Weight loss • Drug masking

Osteogenic sarcoma

• Well-circumscribed subcortical sclerosis with • sunburst or onions skin • periosteal reaction or Codman's triangle • Crosses the growth plate • Tumor bone in the soft tissues * pathognomonic sign

Chondroblastoma

• Well-demarcated circular lucency • Central calcification• Will cross the physis

Nonossifying Fibroma

• a cortical lucency • Wavy sclerotic margin

Wagstaffe-LeForte Fractures

• avulsion at the fibular attachent • forced lateral rotation of foot

Pott's fracture

• bimalleolar fracture of the ankle • MOI: eversion of ankle (AKA Dupuytren's Fx)

Dupuytren's fracture

• bimalleolar fracture of the ankle • MOI: eversion of ankle (AKA Pott's Fx)

Bow Fracture

• change in shape to bone resulting in broad curve of bone almost exclusive to children often in radius or ulna • exclude Fx in paired bone

Pilon/Pestle Fracture

• comminuted fracture of distal tibia • high speed auto accidents or falls from a height

Essex-Lopresti fracture

• comminuted radial head fracture with interosseous membrane disruption and distal radioulnar joint subluxation • MOI: fall from height

Bumper fracture

• compression fracture of lateral tibial plateau • MOI: forced valgus of knee when struck from side by car bumper

Barton's fracture

• distal radius fracture involving the articular surface with dislocation of the radiocarpal joint • MOI: FOOSH

Colles fracture

• distal radius fracture with dorsal angulation, impaction and radial drift • MOI: FOOSH

Smith's fracture

• distal radius fracture with volar displacement • MOI: FOOSH with wrist in flexed position

Lisfranc fracture

• fracture dislocation of midfoot • MOI: forced plantar flexion of foot or dropping heavy weight on foot

Bankart's fracture

• fracture of anterior glenoid associated with anterior shoulder dislocation • MOI: external rotation and abduction of shoulder

Jones fracture

• fracture of base of 5th metatarsal extending into intermetatarsal joint • MOI: inversion of ankle

Boxer's fracture

• fracture of distal 1st/2nd metacarpal • MOI: punching solid object

Bosworth fracture

• fracture of distal fibula with posterior dislocation of the proximal fibula behind the tibia • MOI: severe external rotation of the foot

Jefferson fracture

• fracture of first cervical vertebra • MOI: compression of neck

Beak Fracture

• fracture of the superior protion of calcaneal tuberosity • cuased by avulsion of Achilles tendon

Chance fracture

• horizontal fracture of vertebral body hyper-flexion of spine • MOI: seen in car accidents when only a lap belt is used

Lead Pipe Fracture

• incomplete transverse fracture of one cortex whith a buckling deformity on the other side (Greenstick and Torus Fx) • occurs almost exclusively in children

Bennett's fracture

• intra-articular fracture of base of first metacarpal • MOI: axial load along metacarpal in a partially flexed thumb

Chauffeur's fracture

• intra-articular fracture of radial styloid • MOI: forced ulnar deviation of the wrist causing avulsion of the radial styloid • AKA Hutchinson's Fracture

Hutchinson's Fracture

• intra-articular fracture of radial styloid • MOI: forced ulnar deviation of the wrist causing avulsion of the radial styloid (AKA Chauffeur's Fx)

Duverney fracture

• isolated fracture of the iliac wing • MOI: direct trauma

Segond fracture

• lateral tibial plateau avulsion fracture with anterior cruciate ligament tear • MOI: internal rotation of the knee

Risk with cervical flexion of 30 degrees

• loses its flexibility and acts as a segmented column • Problem with axial compression

Teardrop Fracture

• most severe fracture of cervical spine • results from combination of extreme flexion & compressive forces • commonly results from a dive into a shallow pool of water • associated w/ acute anterior cervical cord syndrome • quadriplegia, loss of sensations of pain, temp, and touch • in adult, this frx occurs most commonly at C5-C6 • Unstable as result of complete disruption of both ligamentous and bony structures;

Monteggia fracture

• proximal ulna fracture with dislocation of radial head • MOI: blow to forearm

Galeazzi fracture

• radius shaft fracture with dislocation of distal radioulnar joint • MOI: blow to forearm

Pelvic Avulsion Fracture: History

• seen almost exclusively in adolescent athletes • result of the sudden, forceful or unbalanced contraction of the attached musculo-tendinous unit, while the subject is engaged in a sporting event such as kicking a ball, running or jumping. • related to the time of ossification nuclei appearance and their fusion to the corresponding pelvic tuberosities. • In acute injuries, the athletes experiences sudden, shooting pain referred to the involved tuberosity and loss of muscular function • swelling and local tenderness can be appreciated by palpation and evoked during movements passively imposed upon the appropriate limb.

Le Fort fractures

• series of facial fractures • MOI: direct trauma to face

Essex-Lopresti Fracture

• severely comminuted fracture of the radial head associated with subluxation of the distal radioulnar jt. • associated with radial deviation of the hand

Clay shoveller's fracture

• spinous process fracture of C6, C7 or T1 • MOI: forced hyper-flexion of neck

Maisonneuve fracture

• spiral fracture of proximal fibula • MOI: external rotation of ankle

Septic Arthritis

• spreads from or focus of osteomyelitis. • Rapid cartilage destruction may present with joint narrowing within 48 hours. That is why these people need a rapid referral. • will cross the disk space • disk space narrowing with end plate destruction and reactive new bone formation.

DAPRE Guidelines for adjusted working weight

• strength can be redeveloped much more quickly than it was developed initially. • Patients perform maximal repetitions during their third and fourth sets, with the number or repetitions performed used as a basis for adjusting the resistance for the fourth set and next day, respectively. • Each side of the body should be worked independently • Prevents the injured limb from depending on the non-injured one • It establishes a functional strength-development goal for the injured side.

March fracture

• stress fracture of a metatarsal shaft • MOI: heavy or unaccustomed exercise

Toddler's fracture

• undisplaced spiral fracture of distal tibia in children under 8 years old • MOI: low-energy trauma, often rotational

Aviator's Fracture

• vertical fracture of the neck or body of talus • caused by talus being driven up against the ant. Lip of the tibia

Malgaigne's fracture

• vertical pelvic fracture through both pubic rami and the ilium or sacroiliac joint with vertical displacement • MOI: high energy impact to pelvis (front to back)

CCSP

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