EXNS 200 Exam 2

Steps of rehab

1. providing correct 1st aid and controlling swelling 2. reducing pain 3. restoring full range of motion 4. restoring muscular strength, endurance, and power 5. reestablishing neuromuscular 6. maintaining cardiorespiratory fitness 7. Functional progression 8. Criteria for return to play

Possibility of death is significantly reduced if the body temperature is lowered to___________ within _____________

102°F / 30 minutes

Can be fatal if temperature rises to _______ or drops to between _______ and ______

107°F/ 77°F/85°F

Sutures should be put in within _______ hours following injury

12

The optimal level of carbohydrates is ______ grams per ______ ounces of water

14/ 8

Those who develop AIDS generally die within _________ years after the symptoms appear

3

What is the recovery time for HPV

6-8 weeks

Stimulates shivering that ceases below a body temperature of _______ to _________

85°F/ 90°F

Skin is scraped against a rough surface wearing away skin and exposing numerous blood capillaries

Abrasion *Foreign materials scraping against skin increases possibility of infection • Wound must be debrided and cleansed*

• One of the most common mental and emotional stress producers• Reflected by a vague fear, a sense of apprehension, and restlessness • Athlete may feel inadequate in a certain situation but is unable to say why • May cause heart palpitations, shortness of breath, sweaty palms, constriction in the throat, and headaches

Anxiety

•Skin is torn from the body •Associated with major bleeding

Avulsion wounds *•To reattach the torn tissue, the avulsed tissue should be placed on moist gauze, preferably saturated with saline solution • Should be taken along with the athlete to the hospital for reattachment*

Pathogenic microorganisms that can potentially cause disease

Bloodborne Pathogens

• Syndrome related to physical and emotional exhaustion leading to negative concept of self and sports attitudes and loss of concern for the feeling of others • Stems from overwork and can affect both the athlete and the coach • Detrimental to athletes' general health as they may:

Burnout

Symptoms include skin redness, swelling, tingling, and pain in the toes and fingers • Caused by problems of peripheral circulation • Can be avoided by preventing further cold exposure

Chill Blain

Results from prolonged and constant exposure to cold for more than 60 minutes with the temperature at 50 degrees or less

Chillblain

Activities that maximize performance while minimizing the possibility of injury

Conditioning exercise

Heat can be dissipated from the body through four mechanisms

Conduction Convection Radiation Evaporation

What emotion occurs when an athlete feels an overwhelming feeling of hopelessness or loneliness

Depression

What is most effective means for the body to dissipate heat when the temperature and radiant heat of the environment are higher than the body temperature?

Evaporation

• Sweat glands in the skin allow water to be transported to the surface, where it evaporates • While evaporating, water takes heat with it • When radiant heat and environment temperature are higher than body temperature, loss of heat through evaporation is key

Evaporative Heat Loss

• *Profuse sweating*, pale skin, mildly elevated temperature, dizziness, hyperventilation, and rapid pulse • Affected individual may develop heat cramps or become faint/dizzy • Decline in performance Results from inadequate fluid replacement

Exertional Heat Exhaustion

• Ingesting too much fluid before, during, and after exercise • Sodium deficiency in the diet or in ingested fluids over a period of prolonged exercise

Exertional Hyponatremia

• Sudden collapse with loss of consciousness; flushed, hot skin; *absence/minimal sweating*; shallow breathing; strong, rapid pulse; and a core temperature of 105°F

Exertional stroke

T or F Seek shelter in large trees, flag/light poles, standing water, telephone poles, pools, showers, and metal objects if lightening is around

False Avoid

T or F Core stability is not important for rehabilitation of any part of the body

False Dynamically stabilizes the entire kinetic chain during functional movements

T or F In case of an exertional heatstroke, the replacement of fluids is a critical step in initial first aid.

False Immediately immerse the athlete in a cold water bath up to his or her neck

T or F taping should be used as a substitute for rehab

False never

T or F There is a vaccination for HCV

False no vaccine

T or F An athlete's physician does not have final say in whether the athlete can return to full competition and practice

False physician does have final say

T or F HIV is most common bloodborne infection in the United States

False HCV/ Leading indication for liver transplant

T or F These is a vaccine for HIV

False no vaccine

What is the single most important step taken by a coach to minimize the chance of heat illnesses

Fluid replacement *only 50% of fluid is ever replaced and should therefore be replaced before, during, and after exercise*

•Involves ears, nose, cheeks, chin, fingers, and toes •Occurs with high wind and/or severe cold •Causes skin to appear firm with cold, painless areas that may peel and blister in 24-72 hours

Frost Nip

• Superficial frostbite involves only skin and subcutaneous tissue • Skin appears pale, hard, cold, and waxy • When rewarming, the area will first feel numb, then sting and burn • Affected area may blister and be painful for several weeks

Frostbite

In situations in which thunder or lightning may be present and you feel your hair stand on end and skin tingle, you are in imminent danger.... you should _______

Get down on the ground and assume a crouching position

___________ are an effective motivator for compliance to rehabilitation of an athletic injury, as well as for reaching goals in a general sports setting

Goals

• Flulike symptoms such as fatigue, weakness, nausea, abdominal pain, headache, fever, and possibly jaundice • It is possible that the individual will not exhibit signs and symptoms

HBV

•80% of those infected have no signs or symptoms •Symptoms include jaundice, mild abdominal pain, loss of appetite, nausea, fatigue, muscle or joint pain, and/or dark urine

HCV

Traditionally attributed to excessive water loss and electrolyte imbalance due to profuse sweating Painful muscle cramps Recent evidence suggests muscle fatigue that alters neuromuscular control facilitates a reflex contraction or cramp of the muscle

Heat Cramps/ Exercise-Associated Muscle Cramps

Physiological processes in the body will continue to function if body dissipates heat and the body temperature is maintained within a normal range

Heat Stress

• Associated with rapid physical fatigue during overexposure to heat • Caused by peripheral vasodilation, hypotension, or a pooling of blood in extremities

Heat syncope

Major cause of viral infection that results in swelling, soreness, and loss of normal function in the liver

Hepatitis B Virus (HBV)

Acute and chronic form of liver disease

Hepatitis C Virus (HCV)

Used postacutely (after swelling stops) • Increase blood and lymphatic flow • Facilitate reabsorption of by-products of injury process into the lymphatic system

Hot Packs

Where are Bloodborne Pathogens found

Human Blood, semen, vaginal secretions, cerebrospinal fluid, synovial fluid, and any other fluid contaminated with blood

Caused by a family of complex viruses that invade normal healthy cells, thus decreasing the effectiveness of the host cell in preventing disease Virus that destroys cells of the immune system

Human Immunodeficiency Virus (HIV)

Refers to an increase in body temperature

Hyperthermia

• Failure to warm up sufficiently or becoming chilled because of inactivity for varying periods • Low temperatures in conjunction with wind chill and dampness or wetness

Hypothermia

When does rehab process start

Immediately after injury

Wound with smooth edges that appears where a blow has been delivered over a sharp bone that is poorly padded

Incision

Incorporated in the later phases of the rehabilitation program Use fixed speed with accommodating resistance to provide maximal resistance throughout R O M

Isokinetic Exercises

Performed in the early phase of rehabilitation when a joint is immobilized for a period of time Increase static strength, assist in decreasing the amount of atrophy, and reduce swelling

Isometric exercises

Sharp, pointed object or direct blow tears the skin giving the wound appearance of a jagged - edge cavity

Lacerations

Return the injured athlete to practice or competition as quickly and safely as possible

Long - Term Goal

What are the at risk sports for transmitting HIV

Martial arts, wrestling, and boxing

Systematic manipulation of the soft tissues of the body

Massage

• Direct result of graded pressures and movements of the hand on the body • Encourage venous and lymphatic drainage and mildly stretch superficial and scar tissue

Mechanical response

Useful in restoring or developing an athlete's ability to produce dynamic movements associated with muscular power

Neuromuscular control

________________ provide a complete barrier around and over a wound and are air-tight and water-tight

Occlusive dressings

Result of imbalances between a physical load being placed on an athlete and his or her coping capacity Can lead to staleness and eventual burnout

Overtraining

• Increase circulation which in turn increases metabolism and aids in the removal of metabolites such as lactic acid • Aids in removing edema by increasing circulation at and around injury site

Physiological Response

Incorporated into the later stages of a rehabilitation program Use a quick stretch of a muscle to facilitate a subsequent concentric contraction

Plyometric Exercises

Useful in restoring or developing an athlete's ability to produce dynamic movements associated with muscular power

Plyometric Exercises

• Utilize isotonic contractions to generate force against resistance while the muscle changes length • *Concentric and eccentric strengthening exercises should be used*

Progressive resistance exercises (PRE)

Relaxation can be induced by slow, superficial stroking of the skin that is beneficial for tense, anxious athletes

Psychological Reponses

Direct penetration of tissues can introduce the tetanus bacillus into the bloodstream, possibly making the athlete a victim of lockjaw

Puncture wounds

Signs of Wound Infection

Same as those for inflammation Pain, heat, redness, swelling, and disordered function Pus may form due to accumulation of white blood cells Fever may occur as immune system fights bacterial infection

• Providing correct immediate first aid and management following injury to limit and control swelling • Reducing or minimizing pain • Restoring full range of motion • Reestablish core stability

Short - Term Goals

How is HCV transmitted?

Spread by contact with blood of infected person •Sharing needles or syringes •Sharing personal care items that may have blood on them tattoo

• Numerous reasons including training too hard and long without proper rest • Attributed to emotional problems stemming from daily worries, fears, and anxiety

Staleness

If exposed to HIV what is the testing procedure

Testing should occur at six weeks, at three months, and at one year after exposure

• Bacterial infection that may cause fever and convulsions • Occurs most often with a puncture wound

Tetanus

Exercises used in a rehabilitation program

Therapeutic exercise

Incorporated into rehabilitation programs • Cryotherapy and thermotherapy • Ultrasound and electrotherapy • Light therapy and massage • Traction and intermittent compression

Therapeutic modalities

T o F People with HIV may go as long as 8 to 10 years before developing any signs or symptoms

True

T or F All wounds should be treated as though they have been contaminated with microorganism

True

T or F If thunder and/or lightning can be heard or seen, stop activity and seek protective shelter immediately

True

T or F Infected person's blood may test positive for the HBV antigen within 2 to 6 weeks after symptoms develop

True

T or F Isokinetic measures are used as criteria in making decisions for athlete's return to functional activity following injury

True

T or F Replacing fluids with sports drinks is more effective than replacing fluids with water alone

True

T or F Deep lacerations, incisions, or occasionally puncture wounds may require some sort of manual closure using sutures

True

T or F Injury prevention is physiological and psychological

True Athletes under stress emotionally are more prone to injury than those who are adjusted emotionally

T or F In cold disorders is fluid replacement critical

True Dehydration decreases blood volume, which reduces the amount of fluid available for tissue warming

T or F Single negative test does not prove that a person is not infected.

True initial test is negative, the test should be repeated

T or F Injury to a joint is always followed by some associated loss of motion

True • Resistance of the muscle and its tendon to stretch • Contracture of the ligaments and capsule around a joint

Dangerous therapeutic modality if not administered by professional

Ultrasound

Most individuals who test positive for HIV will eventually develop ______________.

acquired immunodeficiency syndrome (AIDS)

What are the reaction to injury and rehabilitation for chronic rehab

anger, frustration dependence, independence, apprehension

Ability to _____________ and maintain ______________ stability is essential to reacquiring athletic skills

balance/postural

what is the most neglected component of a rehabilitation program

cardiorespiratory fitness

recurring

chronic

Convection

contact with cool air or water mass

Conduction

direct contact with a cooler object

During progressive resistance exercise, both _________________ and _____________ contractions are incorporated

eccentric and isotonic contractions

What are the reaction to injury and rehabilitation for long term

fear, anger loss of vigor, irrational thoughts, alienation

what is the goal for rehab

for the injured athlete is to return to activity as quickly and safely as possible

Series of gradually progressive activities designed to prepare an individual for return to a sport Sport-specific skills are broken into components

functional progressions

Involves a single maximal effort to gauge how close the athlete is to a full return to activity

functional testing Agility runs, side stepping, vertical jumps, hopping, and co-contraction tests

Radiation

heat generated from metabolism

Used for minimizing swelling and providing analgesia following injury

ice bags

What are the reaction to injury and rehabilitation for termination rehab

isolation, grief process loss of athletic identity

greater than 4 weeks

long term

Bacteria is known as _____________ is more difficult to treat

methicillin-resistant Staphylococcus aureus (M R S A)

____________ lead to lack of attentional focus and muscle tension, which in turn leads to the stress-injury connection

negative stressors

factors that influence reactions to injury and rehabilitation are

past history, coping skills, social support, and personality traits

Stress may be _______ or ________

positive or negative

Neglecting balance issues may predispose athletes to ______

re-injury

What are the reaction to injury and rehabilitation for short term

shock, relief impatience

less than 4 weeks

short term

Formula for disinfectant

solution of one part bleach to ten parts water

Evaporation

sweat evaporating from the skin surface

First-aid management should be directed toward controlling __________

swelling

career ending

terminating

Decision about how to progress the rehab program should be based on ______________.

the limitations of the healing process

T or F Certain combinations of various antiviral drugs, which have been labeled "cocktails," can slow replication of the virus and improve prospects for survival

true

T or F Gloves and bandages should be placed in sealed white bags prior to disposal in regular trash containers

true

T or F Some strains of Staphylococcus aureus have become resistant to some antibiotics

true

T or F First-aid techniques can be considered the most critical part of a rehabilitation program

true Initial management of an injury critically influences the rehabilitative process

T or F Heat illness can still occur in a cold environment

true Occurs when the body is dehydrated and unable to dissipate heat through sweating

T or F Avoid using hydrogen peroxide and bacterial solutions initially when cleaning a wound

true the wound should be cleaned with copious amounts of soap and water

T or F sharps should be disposed of in a leakproof and puncture-resistant container

true Container should be red or orange and labeled as a biohazard

Criteria for return to play

• Athlete is fully reconditioned • Athlete has regained full ROM, strength, neuromuscular control, cardiovascular fitness, and sports-specific functional skills • Athlete is mentally prepared

Biohazard warning labels should be fixed to:

• Containers for regulated waste • Refrigerators containing blood • Containers used to store or ship potentially infectious materials

Treatment of frostbite

• Deep frostbite indicates frozen skin requiring hospitalization • Gradual rewarming is required, including hot drinks, heating pads, or hot water bottles that are 100°F to 110°F • Tissue will become blotchy red, swollen, painful, and possibly gangrenous

Phases of an injury

• Denial • Anger • Bargaining • Depression • Acceptance

symptoms of overtraining

• Deterioration in the usual standard of performance • Chronic fatigue and apathy • Loss of appetite, indigestion, and weight loss • Inability to sleep or rest • Increased risk for acute and overuse injuries and infections

Treatment for Heat Exhaustion

• Fluid ingestion in a cool environment • Intravenous replacement of large quantities of fluids • Returning the patient's core temperature to 102°F

symptoms of burnout

• Have headaches, gastrointestinal disturbances, sleeplessness, and chronic fatigue • Experience feelings of depersonalization, increased emotional exhaustion, reduced sense of accomplishment, cynicism, and depressed mood

Treatment of Exertional Hyponatremia

• If hyponatremia is suspected and blood sodium levels cannot be determined on-site, the athlete should be transported immediately to a medical facility • Delivery of sodium, certain diuretics, or intravenous solutions may be necessary

What are some stress management techniques

• Imagery • Relaxation strategies • Cognitive restructuring • Thought stoppage

Exertional Heatstroke Treatment

• Immediately immerse the athlete in a cold water bath up to his or her neck • Remove equipment and clothing • Sponge him or her down with cool water and fan with a towel • Ice bags may be placed at the neck and over other major arterial vessels

Treatment for Heat Illness

• Lay the athlete down in a cool environment • Elevate lower extremities • Replace fluids

Signs and symptoms of Exertional Hyponatremia

• Progressively worsening headache; nausea and vomiting; swelling of the hands and feet; lethargy, apathy, or agitation; and low blood sodium • Very low concentration of sodium can compromise the central nervous system, creating a life-threatening situation

Wrapping and taping techniques are routinely used for various reasons including

• Providing compression to minimize swelling in the initial management of an injury • Reducing the chances of injury by applying tape prophylactically (for prevention) before an injury occurs • Providing additional stability to an injured structure

Reactive phases to the injury process

• Reaction to injury • Reaction to rehabilitation • Reaction to return to play or termination of career

Treatment for chillblain

• Remove wet or constrictive clothing • Cover with warm, loose, dry clothing or blankets • Do not disturb blisters • Apply friction massage, apply creams or lotions, or use high levels of heat • Continually monitor the affected area for return of circulation and sensation

Signs if HIV

• Transmitted by exposure to infected blood or other bodily fluids or by intimate sexual contact • Fatigue, weight loss, muscle or joint pain, painful or swollen glands, night sweats, and fever

Treatment for Heat Cramps

• Treat with fluid ingestion and light stretching with an ice massage • Avoid fatigue and overexertion during exercise to reduce the likelihood of altered neuromuscular control • Return to play is unlikely because of continued cramping

Treatment for Frost Nip

•Apply firm pressure to the affected areas *(without rubbing)* •Blow hot breath on the spot •Place hands in armpits if the fingertips are affected

HPV Prevention

•Good hygiene and avoid high - risk activities •Survives up to 1 week in dried blood or contaminated surfaces •Vaccine to prevent contracting virus•3 shots over 6 months • OSHA - Occupational Safety and Health Administration •Mandated that employer must offer vaccination to any employees exposed to blood or other bodily fluids at no cost

Extent of pain is partly dependent on the following:

•Severity of the injury •Athlete's response to pain •Athlete's perception of pain •Circumstances under which the injury occurred

Define Flash bang method

•Sight lightning and start counting until the thunder is heard •Divide the number of seconds by 5 to determine the number of miles away the lightning is *Lightning--> 20 seconds counted--> Thunder --> 20/5 = 4 miles away