A TR - 220

Splinting for a finger dislocation (after reduction) the finger should be in what position and why?

30 degreees flexion for ~3 weeks

What is the most common direction of a GH dislocation.What are physical signs and symptoms of a Glenohumeral dislocation? ***********What is the difference between a subluxation and dislocation?

Anterior dislocation. Palpation of the axilla reveals prominence of the humeral head. Athlete carries effected arm in slight abduction and external rotation and is unable to touch opposite shoulder. Moderate to severe pain and disability

What Is the straight leg Raise special test and what is it testing for?

Applies pressure to the sacroiliac joint and may indicate a problem in the sciatic nerve, the sacroiliac joint, or the lumbar spine.

Know the following special tests and be able to briefly describe what they are for: Apprehension test, Empty can test, Neer's test and Hawkin'-Kennedy test. (pg 298)

Apprehension Test: arm abducted 90 degrees, shoulder slowly and gently externally rotated as far as allowed. Athlete with GH instability should apprehension in facial grimace Empty Can Test: tests for weak infraspinatus. Bring both arms into 90 degrees of forward flexion and 30 degrees horizontal adduction. Arms internally rotated as far as possible, thumbs pointing downward. Downward pressure applied. Weakness and pain can be detected.

What is the proper way to handle an asthma attack and when do they need referred to physician or Emergency Room? *********

Attempt to relax and reassure athlete. Give inhaler. If procedures don't work, seek medical attention

What is the typical mechanism of injury for a severe cervical fracture?

Axial loading (blow to the top of the head while in flexion) can result in an anterior compression

What is a boxer's fracture? Healing time?

Boxer's Fracture: fracture to the 5th metacarpal associated with boxing and MMA. Immobilized for 3-4 weeks

What are the 3 natural curves of the spine?

Cervical, thoracic and lumbar curves

What are some complications that can occur with an Elbow dislocation. How would you immobilize one of your athletes with an elbow dislocation? When calling the EMS what should you make sure to note about your evaluation of this injury?

Complications: injury to major nerves and blood vessels. Immobilize by elbow in position of flexion and splint applied for ~3 weeks. When calling EMT, check for pulse in wrist.

A deep direct blow to the upper arm or repeated trauma to this area may result in what injury? What is the acute treatment for a contusion to help prevent this condition from occurring. (similar to a quad contusion)

Contusions in the upper arm Care: PRICE applied for a minimum of 24 hrs post injury. Provide protection to contused area to prevent repeated episodes.

Note highlights from the Sickle Cell Trait document given in class and on blackboard What are recommended preventative strategies for coaches?*****************

Drink water take breaks Don't over do it

What are signs and symptoms of an asthma attack?

Early: anxious, sweating, paleness, flared nostrils, fasat breathing

What are 4 things you can do to help in the prevention of shoulder injuries?

Ensure proper physical conditioning Strengthen the muscles of the rotator cuff Proper warm up Proper safety equipment

What is the mechanism of injury for a clavicle fracture. How is this injury immobilized? Where along the bone does this fracture usually occur. How long do they take to heal?

Falling on an outstretched arm, fall on tip of shoulder, direct impact. Immobilized immediately by shoulder immobilizer. Immobilized by clavicle strap after seen by physician. Fracture occurs in middle 1/3 of clavicle. Takes 6-8 weeks to heal, followed by 3-4 weeks of protection/mobilization exercises

What are suggestions for preventing Lumbar Spine injuries.

Flexibility of trunk Core strength to ensure proper postural alignment Using proper technique

What are the motions of the GH shoulder joint?

Flexion Extension Abduction Adduction External rotation Internal rotation

What are the signs and symptoms of an AC Sprain? (know the difference between what a 1st,2nd,and 3rd degree sprain) What is the basic care of this injury?

Grade 1: point tenderness and discomfort during movement at joint between acromion process and outter end clavicle. No deformity. Grade 2: shows tearing or rupture of AC ligament and associated with stretching of coracoacromial ligament. Point tenderness during palpation of injury site, and athlete is unable to fully abduct arm or bring arm across chest Grade 3: rupture of the AC and coraclavicular ligaments with dislocation of clavicle. Gross deformity and prominence of the distal clavicle, severe pain, loss of movement, and instability of shoulder complex. Care: 1. application of cold and pressure to control local hemorrhage, 2. stability of joint by shoulder immobilizer, 3. referral to physician for official diagnosis

Which grade of a SC sprain could possibly be life-threatening and why?

Grade 3/posterior or "retro-sternal" dislocation. Due to hemorrhage and compromise of nearby trachea

What would you do if you had an athlete with a GH dislocation?

Immediate immobilization using a sling, reduction by a physician, and control of hemorrhage with icepacks.

Name 3 common bacterial skin infections?

Impetigo, Boil, Folliculitis

An ulnar nerve injury (funny bone) will produce numbness and tingling to what area in the hand? What is the usual mechanism of injury to this nerve?

In the 4th and 5th fingers.

What is Sciatica?

Inflammatory condition of the sciatic nerve that can accompany recurrent of chronic low back pain

Know the difference between Lateral Epicondylitis (tennis Elbow) and medial epicondylitis (golfer's elbow). Which muscles are involved (flexors or extensors?) What are some basic care strategies for each condition.

Lateral Epicondylitis - most common problems of elbow. Stems from a backhand stroke involving overextending the wrist. Repetitive extension of the wrist, causing irritation and inflammation to the insertion of the extensor muscle Care: PRICE, NSAIDs, analgesics as needed. Counterforce brace for 1-3 months. Medial Epicondylitis - from repeated forceful flexions of the wrists. Care: rest, cryotherapy or heat through ultrasound. Counterforce brace.

What structures are involved in impingement syndrome? Basic cause of this condition and basic care.

Long head of the biceps tendon. Subacromial bursa. Supraspinatus tendon. Cause: repetitive overhead activities such as throwing, swimming, spiking volleyball Care: PRICE initially. Restore normal biomechanics to shoulder.

What sports may commonly present with a Spondylolysis or Spondylolisthesis (we talked about 3 or 4 of them in class). What are 3 common care principles with these injuries?

More common among boys. Gymnastics, lifting weights, blocking in football, serving in tennis, spiking in volleyball, and using the butterfly stroke while swimming. Care: Bracing and bed rest for 1-3 days. Rehab should be focused on exercised that control or stabilize. Progressive trunk stabilization strengthening exercises. Avoid vigorous activity.

What is a Colles Fracture? What visible deformity does this cause? How would you splint?

Most common among forearm fractures, involving lower (distal) end of radius. Caused by falling on outstretched hand with extended wrist, forcing forearm up and back. Visible deformity to wrist. Bleeding profuse in area, with accumulated fluids causing extensive swelling in wrist. Splint the wrist then immobilize by putting limb in sling.

What athletes are more likely to develop forearm splints?

Most often in gymnastics.

What are guidelines for return to play from a Burner / Stinger?

One symptoms have completely resolved and no associated neurological symptoms may return. Also begin strengthening and stretching exercises.

What is Jersey Finger? What is the major sign of this injury? Approximate healing time?

Rupture of the flexor digitorum profundus tendon from its insertion on the distal phalanx. Major sign: DIP joint cannot be flexed and finger is in extended position. Healing time: if not surgically repaired, athlete is screwed. After surgery, ~12 weeks

What are the SAC , SCAT, Impact, and BESS tests? Know the basics purpose of each. ****

SCAT: on the field test for assessing concussion related signs and symtoms

This injury may be missed on the initial x-ray. It also often fails to heal due to poor blood supply and sometimes requires surgery.

Scaphoid fracture.

What are general signs and symptoms of a herniated Disk . Name 3 basic care procedures and / or suggestions for posture .

Signs: Centrally located pain that radiates on one side to the buttocks and down the back of the leg. Symptoms are worse when just woken up. Onset may be sudden or gradual. Care: Rest and ice initially. Back extensor and core stabilization exercises. Possible surgery.

Review the chart of suggestions for spinal postures (Focus box 20-1) "Recommended postures and practices for preventing low back pain" ******************

Sitting: don't sit too long, sit on firm straight back chair, avoid sitting with legs raised Standing: if standing for long periods - place 1 foot on stool or shift from foot to foot, stand tall, avoid arching back Lifting and carrying: don't use your back to lift, bend at knees and not waist. to carry, hold object at waist level close to your body and don't carry object on one side of your body

What is Mallet finger? Mechanism, signs and symptoms, treatment(especially splinting procedure)

Sometimes called baseball finger. Caused by a blow from a thrown ball that strikes the tip of the finger, jamming and avulsing the extensor tendon. Signs: athlete complains of pain at the distal interphalangeal joint. X-ray will show avulsion. Point tenderness. Treatment: PRICE. Splint in position of extension for 6-8 weeks

What is Gamekeeper's thumb?

Sprain to the ulnar collateral ligament of the MCP joint of the thumb

What are the 4 different shoulder joints?

Sternoclavicular joint Acromioclavicular joint Glenohumeral joint Scapulothracic joint

What are 3 suggestions for helping to prevent cervical spine injuries?

Strengthening the muscles of the neck. Having flexibility/full range of motion in the neck. Athletes in collision sports (football and rugby) must be taught proper techniques that reduce likelihood of injury.

What is the common mechanism of injury for a burner/ stinger (pinched nerve)?What are common signs and symptoms?

Stretching of the brachial plexus of nerves when the neck is forced laterally to the opposite side while the shoulder is depressed. Signs: burning sensation, numbness and tingling, and pain extending from the shoulder down to the hand with some loss of function of the arm and hand

What are the 4 rotator cuff muscles?

Subscapularis Supraspinatus Infraspinatus Teres major

MRSA - Know signs and symptoms (spider bite) . Why is this so important to recognize and refer immediately? ****

Symptoms: begin as small red bumps that look like pimples or big bites. Infection results in redness, swelling, and tenderness at site of infection. Can transform into painful boil. It is contagious

Influenza is not the same as the stomach flu. Vaccinations are effective for decreasing the amount of influenza cases each year. Influenza includes what symptoms? How is it different than a cold?

Symptoms: fever, cough, headache, malaise, inflamed respiratory mucous membranes, congestion and loss of smell. Flu can develop into bronchitis.

Iron Deficiency Anemia is common in female athletes? T or F

T

What is Olecranon bursitis? Causes and care. What would you watch for to make sure this bursa is not getting infected. (it is somewhat common for bursa to become infected)

The olecranon bursa lying between the end of the olecranon process and skin becomes injured. Cause: the location makes it prone to acute of chronic injury. direct blows of falling on the tip of the bent elbow Care: acute - ice and compression applied for 20 minutes. chronic - program of protective therapy.

What is the anatomical snuffbox? Pain in this area is usually indicative of injury to what bone?

Triangular deepening on the radial, dorsal aspect of the hand—at the level of the carpal bones, specifically, the scaphoid and trapezium bones Injury to scaphoid bone.

What are the two major ligaments in the elbow?

Ulnar collateral ligament Radial collateral ligament

Tinea = Fungus. Pedis - foot What are basic care guidelines for athletes foot ?

Use topical cream applied ~2x/day

What would be a mechanism for an elbow sprain - be able to list a common sport mechanism (i.e. gymnast blocking off the horse, improper throwing technique, wrestling take down landing on an outstretched arm with a valgus stress at the elbow (think of it as a little knee)

Usually caused by hyperextension or a force that bends pr twists the lower arm outward, causing damage to the MCL in the arm, as occurs during cocking or throwing.

Skin Infections: What are the basic classifications (bacterial, etc)

Viral - virus enters body and may trigger disease or remain dormant. destroys host cell Bacterial: cause is pathogens. two types - strep and staph Fungal: most common is ringworm

What questions do you need to ask to rule out a spinal cord injury (make sure to stabilize neck while doing so) If any of these questions are positive then immobilize and activate EMS.

What do you think happened? Did you hit someone with or land directly on the top of your head? Were you knocked out or unconscious? Do you have any pain in your neck or directly in your spine? Do you have tingling, numbness or burning in your shoulders, arms, or hands? Do you have equal muscle strength in both hands? Are you able to move your ankle and toes? Any changes in bowel or bladder routines?

What is the carrying angle?

a small degree of cubitus valgus, formed between the axis of a radially deviated forearm and the axis of the humerus

What are 2 possible mechanism of injuries for a Sacro-iliac injury?

forward bending with knees locked out during lifting twisting both feet on the ground, stumbling forward, falling backward, stepping too far down and landing heavily on one leg.

Buddy taping is useful for what finger injury(s)?

interphalangeal 2nd - 5th finger injuries. dislocation of phalanges

Name 3 important concepts in doing CORRECT Core Stabilization exercises **

training program should be systematic, progressive, and functional. core is composed of lumbar, pelvic and hip regions.

Fungal infections like this environment (3 factors as discussed in class)

warm, moist, dark environment

What are some prevention strategies (think Little league baseball , softball, tennis)

wear appropriate padding to reduce force of impact Learn how to fall properly Limit number of repetitions of throwing a ball Maintain appropriate levels of strength and endurance Stretch muscles

Sickle Cell Trait as discussed in class- This is different than sickle cell anemia as discussed in book.

you carry a sickle cell gene, but it does not normally cause illness.

Shingles or Herpes Zoster - Name 3 characteristics - and referral procedure - is this contagious? Can someone in a contact sport compete with this condition?

Reappearance of the chicken pox virus that has remained dormant. Appears when the immune system is compromised. Appears on face or trunk. It can be contagious.

As discussed in class what is PEARL when referring to checking the eyes.

P upils E qual A nd R eactive to L ight

What is Torticollis ( a common condition) What are basic care instructions? This will generally get better on its own in ______________time frame.

Pain on one side of the neck when awakening. A small piece of synovial membrane lining the joint capsule is impinged or trapped between the cervical vertebrae. Care: hold or heat and massage may be needed to modulate pain. Gradually engage in strengthening and stretching exercises. Takes ~2-3 days

A burner or stinger is an injury to what structure?

Pinched nerve resulting from stretching or compression of the brachial plexus

A finger dislocation should be reduced by the coach immediately ??????? true or false ???? Why or why not?

Reduction should be performed by physician .

Every student-athlete with diabetes should have a diabetes management plan and an emergency kit with supplies.

T

What is a wrist ganglion cyst? Basic Treatment?

Tumor or swelling on top of a joint or the covering of a tendon (tissue that connects muscle to bone). Often on back of the wrist. Care: combo of aspiration and chemical catheterization, with application of pressure pad. Surgical removal is best

Know the basics of a Coccyx injury.

may include sprains, contusions or fractures