BOC Study Guide- Prentice Textbook
Catastrophic insurance
- benefits begin when the expencses have reached 25,000 and then are extended for a lifetime - in high schools, insurance kicks in when med, rehab, and transportation costs exceed 10,000 not covered by other insurance benefits
Exertional hyponatremia
- fluid/electrolyte disorder that results in an abnormally low concentration of sodium in the blood - from ingesting too much fluid - worsening headache, nausea and vomiting, swelling of hands and feet, lethargy, apathy, agitation, and low blood sodium - transport immediately to medical facility and mut be cleard by physician
Ligament healing
- immediately after injury, ~72 hrs thee is a loss of blood from damaged vessels and attraction of inflmmatory cells - next 6 weeks, vascular proliferation w/ new capillary growth begins to occur along with fibroblastic activity, forming a fibrin clot - gradually there is a decrease in fibroblastic activity, decrease in vascularity, and max increas in collagen density of a scar - maturation of a scar may require at least 12 mos
Health Maintenance Organization (HMO)
- provide preventative measures and limits where the individual can receive care - determine feeds using a capitation system, which lmits the amount that will be reimbursed for a specific service - permission must be obtained before can go to antoehr provier - pay 100% of medical costs as long as go to approved list of health care proviers (doesnt pay for anything outside of approved list) - no deductables, but have a copay
Malignant hyperthermia
- rare, genetically inherited muscle disorder that causes hypersensitivity to anesthesia and extreme exercise in hot environments - muscle breakdown - muscle temps increase fster than core temp - breakdown may damage the kidneys and cause acute renal failure - fatal if not treated immediately - should not compete in hot, humid environments
Physician-Hospital Organization (PHO)
-Involves a major hospital or hospital chain and its physicians -Contract directly with employers to provide services and/or contracts with managed care organizations
Athletic Training Code of Ethics
-Members shall respect the rights, welfare, and dignity of all -Members shall comply with the laws and regulations governing the practice of AT -Members shall maintain and promote high standards in their provision of services -Members shall not engage in conduct that could be construed as a conflict of interest or that reflects negatively on the profession (gambling) -Members shall accept responsibility for the exercise of sound judgement
Plantaris
-Origin: Lateral supracondylar ridge of femur above lateral head of gastrocnemius -Insertion: posterior surface of calcaneus -Actions *Plantar flexes foot and flexes knee*
Splinting of Lower-limb Fractures
-fractures of foot and ankle require splinting of foot and knee -fractures involving knee, thigh, or hip require splinting of whole leg and one side of trunk
Biofeedback
-immediate feedback for athlete about how effectively they can contract or relax muscle
anaerobic metabolism
-no oxygen, body turns to stored glycogen when ATP is used up -glycogen is broken down into glucose which is then metabolized within muscle cells to generate ATP for muscle contractions without oxygen -produces lactate
Aerobic Metabolism
-requires oxygen -burns lactate using oxygen (removing it) and creating more ATP than anaerobic -takes 20 minutes to clear lactate from your system
5 domains of athletic training
1) Injury/illness prevention and wellness protection 2) Clinical evaluation and diagnosis 3) Immediate and emergency care 4) Treatment and rehabilitation 5) Organizational and professional health and well being
Rib classifications
1-7: true ribs 8-10: false ribs 11-12: floating ribs
Cranial nerves
1. Olfactory- smell 2. Optic- vision 3. Oculomotor- PERRLA 4. Trochlear- up and down eye movements 5. Trigeminal-sensations of face 6. Abducens- lateral eye movements 7. Facial- muscles of face 8. Vestibulocochlear- hearing/balance 9. Glossopharyngeal- swallow 10. Vagus- swallowing, vitals 11. Accessory- shoulder shrug 12. Hypoglossal- tongue movements
Meninges layers
1. dura mater 2. arachnoid 3. pia mater 4. Subarachnoid
Proteins
15-20% needed for boy growth, maintenance and repair of all body tissues Amino acids
Football helmets are recertified every
2 years
Knee Plica
20% of individuals, knee fails to fully absorb synovial cavities -synovial fold s/s: recurrent episodes of pseudo locking of knee after sitting for long periods of time -15-20 degrees of flexion, snap maybe felt or heard -pain with going up/down stairs and squatting mangement: rest, NSAIDs, local heat, surgery if no response to treatment
Fats (lipids)
25-30% most concentrated source of energy -saturated and unsaturated
Electrical stimulating current
3 types: monophasic biphasic pulsatile
How long should activity take place after eating?
3-4 hours
Cool down
5 to 10 minutes decreases muscle soreness and problems
Cold or Ice immersion
50 to 60F 10 to 15 minutes
Carbohydrates
55-60% of diet most efficient source of energy sub groups -sugars, starches, fibers
Crutch fitting
6 inches from outer margin of foot, 2 inches from front of shoe elbow is flexed at 30 degree angle
Commotio Cordis
A blunt chest injury caused by a sudden, direct blow to the chest that occurs only during the critical portion of a person's heartbeat. immediate death
Point of Service plan
A combination of HMO and PPO -based on HMO structure but allows members to go outside to obtain service
Hypertrophic cardiomyopathy
A condition in which the heart muscle becomes abnormally thick. Limits blood flow
Air splint
A hollow, inflatable splint for immobilizing a part of the body. should not be used if it will alter a fracture or deformity
vapocoolant spray
A liquid that evaporates quickly when sprayed on the skin, causing quick superficial cooling of the skin. fluorimethane spray
true leg length discrepancy
ASIS to medial malleolus
Type of activity
Aerobic allow athlete to maintain a constant heart rate
Hold Relax Stretching
Affected body part is passively moved until resistance is felt -patient is told to contract the antagonist muscle isometrically -AT resists the movement for 10 seconds -Patient is told to relax for 10 seconds -AT moves patient into new position -Repeated 3 times
Frost nip
Affects the ears, nose, cheeks, chin, fingers and toes Occurs with high wind and cold skin appears very firm, cold painless areas May blister or peel after 24 hours Prevention: Apply firm sustained pressure on area (do not rub) or blow warm breath on area
Marfan's Syndrome
An inherited disorder that affects connective tissue — most commonly affects the heart, eyes, blood vessels and skeleton. People with this syndrome are usually tall and thin with disproportionately long arms, legs, fingers and toes. If your heart or blood vessels are affected, the condition can become life-threatening.
Muscle energy techniques
Are manually applied stretching techniques that use principles of neurophysiological to relax overactive muscles and or stretch chronically shortened muscles
Synovial joint injuries
Articulations of two bones surrounded by joint capsule w synovial membrane
Skull fractures
Blunt trauma S/s: severe headache, indention, blood in ear, nose bleed, Battle's sign, Raccoon eyes, spinal fluid from ear or nose management: immediate referral
Insulin Shock
Body has too much insulin and not enough blood sugar s/s: tingling in mouth, hands weakness, headaches, abdominal pain, irritability, tremors patient must adhere to proper diet, pre workout snack high in carbs and protein 40 minutes- have another snack ready
Myotomes function
C2- neck flexion C3- lateral flexion/extenson C4- shoulder shrug C5- shoulder abduction C6- elbow flexion/wrist extension C7- elbow extension wrist flexion C8- ulnar deviation/thumb extension T1- finger abduction/adduction L2- hip flexion L3- knee extension L4- ankle DF L5- big toe extension S1- PF/eversion/knee flexion/hip extension S2- PF/knee flex/ hip ext S4- bladder; rectum
Reflex Testing
C5- biceps C6- brachioradialis C7- triceps L2- adductor L4- patella S1- achilles S2-hamstrings
Female athlete triad
Combination of eating disorder, amenorrhea and osteoporosis
Role of Team Physician
Compiling Medical histories, diagnosis of injury, deciding on disqualification and return to play, attending practices and games, commitment to sports and athlete
Diabetes Mellitus
Complete or partial decrease in insulin production by pancreas s/s: frequent urination, constant thirst, weight loss, constant hunger, weakness, tiredness control diet insulin pump
Progressive resistance training
Contractions that overcomes some fixed resistance produced by equipment
Isometric exercise
Contracts the muscle statically without changing its length 5-10 reps at 10 seconds *breathing is important spikes systolic BP
Pressure points for hemorrhaging
Dorsal pedis popliteal femoral radial ulnar brachial axillary subclavian carotid facial temporal most common -brachial and femoral
Circuit training
Exercise stations that consist of various combinations of weight training, flexibility, calisthenics, and aerobic exercises 8- 12 stations repeated 3 times
Factors that impede healing
Extent of injury, edema, hemorrhage, poor vascular supply, muscle spasm, atrophy, corticosteroids, keloids and scars, infection, health, age, and nutrition, humidity, climate and oxygen
Vitamins
Fat soluble Water soluble Antioxidants
Last
Form in which the shoe is built Maybe straight, semicurved or curved
Continuous training
Frequency, Intensity, Type, Time
Muscle mechanoreceptors
Golgi tendon organ and muscle spindles
Muscle strain
Grade 1- some fibers have been stretched or torn -tenderness and pain in AROM -movement is painful but all ROM is possible Grade 2- number of fibers have been torn -active muscle contractions extremely painful -depression of divot can be felt -swelling and discoloration Grade 3- complete rupture -total LO motion or significant impairment -pain is intense but quickly diminishes bc nerve fiber separation
Ligament sprains
Grade 1- some stretching/separation of ligament fibers -minimal instability -mild to moderate pain -localized swelling and joint stiffness Grade 2- some tearing and separation -moderate instability -severe swelling and joint stiffness Grade 3- total tear -severe pain followed by little to no pain -usually requires surgery
Head Injury Assessment
History -consciousness, amnesia Observation -deformity Palpation -deformity, tenderness Special Tests -Neurological (Cranial Nerve tests) -Balance -Coordination -Cognitive
Types of shock
Hypovolemic Respiratory Neurogenic Psychogenic Cardiogenic Septic Anaphylactic Metabolic
Lateral Stabilizers of Knee
IT band- tense during knee EXT and FLEX o popliteus muscle stabilizes during knee FLEX when contracting, protects the lateral meniscus by pulling it posteriorly o biceps femoris stabilizes by inserting into the fibular head, IT band, and capsule
Graston Technique
Instrument Assisted Soft Tissue Mobilization that allows the clinicians to break up scar tissue and fascial restrictions, as well as stretch connective tissues and muscle fibers
Grade 3 Joint Mobilization
Large amplitude glide up to the pathological limit in the ROM -used when pain and resistance from spasm, inert tissue tension, or tissue compression limit movement near the end of range
Low Level Laser Therapy
Light Amplication by Stimulated Emission of Radiation used to stimulate healing process or modulate pain
Cartilage healing
Limited healing capacity course of healing depends on whether damage is to cartilage alone or also subchondral bone
Amyotrophic Lateral Sclerosis
Lou Gerig;s Disease. sclerosis of lateral regions of spinal cord along with degeneration of motor neurons and atrophy of muscles difficulty speaking, swallowing, and using hands no cure
Cerebral Contusion
MOI: Injury to brain that involves small hemorrhages within cortex, brain stem ro cerebellum S/s: LOC but quickly becomes alert and talkative -headache, dizziness and nausea Management: hospitalization with CT or MRI, no RTP until symptoms resolve
Peptic ulcer
MOI: acids secreted in the stomach destroy the mucous lining of the stomach or small intestine; sever anxiety S/S: gnawing pain; dyspepsia; heartburn; nausea; vomiting Tx: antacids; altering the diet
Epidural Hematoma
MOI: blow to the head or skull fracture s/s: LOC, initially no symptoms, gradually symptoms begin to worsen, intracranial pressure Management: refer out
Maxillary fracture
MOI: blow to upper jaw s/s: pain while chewing, nosebleeds, double vision, raccoon eyes management: airway maintained, referral in upright and forward leaning position
Liver Contusion
MOI: blunt trauma S/S: hemorrhage; shock; referred pain just below the right scapula, shoulder and substernal area; referred pain anterior left side of the chest Tx: refer to MD
Zygomatic Complex Fracture
MOI: classified as LeFort Fracture s/s: deformity, nose bleeds, double vision, raccoon eyes management: refer out
Orbital Fracture
MOI: direct blow s/s: diplopia (double vision), restricted eye movement, downward displacement of eye, pain, swelling, hemorrhaging management: refer out
Nasal Fracture
MOI: direct blow s/s: hemorrhaging is profuse, swelling immediate management: control bleeding and refer
Joint Contusions
MOI: direct blow against muscles crossing at joint, VMO frequently involved s/s: severe pain, loss of movement, acute inflammation, swelling management: depends on location and severity, compression wraps and ice
MCL Sprain
MOI: direct blow from lateral side or lateral tibial rotation Grade 1: joint is stable during valgus, little or no joint effusion, almost full passive and active ROM Grade 2: slight laxity during valgus, moderate swelling, inability to fully extend the knee Grade 3: empty end feel with valgus, hamstring guarding, effusion
PCL Sprain
MOI: direct blow to front of a bent knee, fan with full weight on anterior aspect of bent knee s/s: feeling pop in the back of the knee, TTP in fossa +godfrey's +sag sign +posterior drawer Management: pain and swelling, quad strengthening surgery: 6 weeks of immobilization in extension w full weight bearing on crutches
Peroneal nerve contusion
MOI: direct blow to nerve s/s: electric shock down leg, numbness, point tender, drop foot management: protective padding, return to activity when symptoms subside
Patellar fracture
MOI: direct hit or pull of quad tendon s/s: joint effusion, pain and point tenderness management: cold wrap w splint, refer out
Mandible fracture
MOI: fracture of lower jaw, frequently fractured near jaw's frontal angle s/s: pain when biting, loss of normal blood flow to teeth management: 4 to 6 weeks, refer out
ACL Sprain
MOI: most vulnerable when tibia is externally rotated and knee is in valgus -leg is rotated while foot is fixed -anterolateral instability -anteromedial instability s/s: -hear/feel pop, feel like knee is shifting +anterior drawer +lachman's -rapid swelling (2 hours) Management: surgery, pre-op quad strengthening, ROM and strength post op
Acute patellar subluxation/dislocation
MOI: planting of foot, deceleration, cutting- usually lateral displacement s/s: pain, swelling, loss of knee function, deformity, patellar apprehension Management: x-ray, braces for return to play
Patellar Tendinitis
MOI: repetitive jumping, kicking or running s/s: pain and tenderness at inferior pole of patella 1- pain after activity 2-pain during and after 3-pain during and well after mangement: ice, whirlpool, knee strap, friction massage
IT band friction syndrome
MOI: repetitive or overuse -genu varum -prontation of feet s/s: irritation at IT insertion +Ober's Management: correction of alignment issues, ice massage before and after activity, proper warm up, stretching
Mandible luxation
MOI: side blow to open mouth s/s: locked in open position Management: refer out
Patellar Tendon Rupture
MOI: sudden contraction of quads, not common if no inflammatory condition prior s/s: patellar is deformed (toward thigh), extension is not possible, significant pain followed by dull management: surgery
Meniscal tears
MOI: valgus force, weight bearing with rotary force, forceful extension s/s: effusion, joint line pain and loss of motion (feels stuck), pain with squatting management: initial MRI to determine type Menisectomy (partial weight bearing after surgery for about 2 weeks) or repair (5-6 weeks brace and crutches)
LCL Sprain
MOI: varus force, internal rotation of tibia S/s: pain and point tenderness over LCL swelling over LCL Tests: varus Treatment: similar to MCL
Sudden Cardia Death Syndrom
MOI; young individual dies for no apparent reason hypertrophic cardiomyopathy marfan's syndrome wolff-parkinson-white
Preparticipation Exams
Medical History -to identify any past or existing medical condition, updated yearly, reviewed by physician and ATs Physical exam -height, weight, body composition, blood pressure, pulse, vision, skin, nose, throat, heart, lung function, abdomen, lymphatic, genitalia, blood work Cardiovascular screen Maturity assessment -5 stages of maturity: Boys-pubic hair and genital development, girls- pubic hair and breast development (Stage 1- not evident, Stage 5- full development) -Stage 3: growth plates weaker than joint capsule and tendon attachments Orthopedic Screening
Otitis Media
Middle ear infection MOI: accumulation of fluid in middle ear -infection and inflammation s/s: intense ear pain, transient loss in hearing, tympanic will be bulging or bleeding Management: antiobiotics from physician
Paraffin Baths
Mixture consists of 25 kg of wax per 1 L mineral oil treatment for more angular body types Dip area in mixture 6-12 times avoid areas with open wounds
Hydration
Monitor color of urine -light yellow: hydrated -dark urine: dehydrated -clear urine: overhydrated Athletes should be drinking 17 to 20 fl ounces of water or sports drink 2-3 hours before exercises 7-10 fl ounces every 10-20 minutes during practice
infectious mononucleosis
Mono acute viral disease effects mainly children and young adults caused by Epstein-barr virus -severe fatigue, risk of spleen rupture, loss of appetite, enlarged neck lymph nodes
Subdural hematoma
Most common death MOI: acceleration/deceleration forces tear vessels that bridge dura mater and brain s/s: conscious if not complicated, dilation of pupil on same side of injury, rapid onset of injuries Management: immediately refer
Indemnity Plans
Most traditional form of billing for health care. Fee-for-service plan that allows the insured party to seek medical care without restrictions on utilization or cost. The provider charges the patient or a third-party payer for services provided.
Occupational Safety and Health Administration
OSHA, established standards for an employer to follow that govern occupation exposure to blood borne pathogens
Rhomboid minor
Origin: Spines of C7-T1 Insertion: Medial border of scapula superior to spine Action: Elevation, retraction and downward rotation of the scapula
Teres Major
Origin: axillary border of scapula Insertion: medial lip of bicipital groove Action: internal rotation, adduction, extension
Semimebranosus
Origin: ischial tuberosity Insertion: Medial condyle of tibia Action: flexes knee and extends hip
Semitendinosus
Origin: ischial tuberosity Insertion: proximal, medial surface of tibia near insertion of gracilis Action: flexion at knee; extension and medial rotation at hip
Abductor Pollicis Longus
Origin: middle one third of posterior radius, middle posterior ulna insertion: dorsal aspect of base of MC Action: thumb abduction, thumb extension, radial deviation, supination
Osteochondritis Dissecans
Partial or complete separation of the articular cartilage from the subchondral bone. slow onset s/s: achey pain, recurrent swelling, occasional catch or lock, atrophy of quads management: children- rest and immobilize teens and older- possible surgery w micro fracture procedure
Slow-reversal-hold relax
Patient moves body part to the point of resistance and is told to hold position -AT isometrically resists muscle for 10 seconds -Patient relaxes for 10 seconds
Secondary Insurance
Pays the remaining medical bills once the personal insurance company has made its payment
Epilepsy
Petit mal seizures- 5 to 15 seconds Tonic-Clonic- major episode lasts several minutes
Walking with cane or crutch
Placing the crutch tips ahead of the feet, the patient leans forward, straighten the elbows, pulls the upper cross piece firmly against the side of the chest, and swings or steps with uninjured leg between the stationary crutch. The patient should avoid pacing the major support in the axilla
Creatine
Positive: -increases workout intensity -lactic acid buffer -stimulates protein synthesis -decreases cholesterol -increases fat free mass Ingest 0.3g per kg of body weight per day split over 4-5 times/day 16 oz of water for each dose
Preferred Provider Organization (PPO)
Provide discount health care but also limit where a person can go for the treatment of an illness, and pay on a fee-for-service basis
Good Samaritan Law
Provides limited protection to someone who voluntarily chooses to provide first aid
Minimize swelling
RICE principle if it can be controlled, it can reduce rehab time needed
Health Insurance Portability and Accountability Act (HIPAA)
Regulates how individuals who have health information about an athlete can share that information with others and not be in violation of the privacy rule
Cerebral Concussions
Result of direct blow, acceleration/deceleration forces producing shaking of the brain s/s: disturbances in consciousness, anterograde or retrograde amnesia, headache, sensitivity to light and noise management: rest, no physical activity until RTP protocol completed
Straight last
Shoe is filled in on the inside/medial side of the shoe to increase stability for people who have flat arch or run on the inside of there foot (pronators)
Oblique fracture
Similar to spiral fractures, occur when one end receives a sudden torsion or twisting and the other end is fixed or stabilized
Types of muscle fibers
Slow-twitch (1) Fast twitch (2a, 2b, 2x)
Grade 4 Joint Mobilization
Small amplitude glide at the end range of motion -resistance limits movement in the absence of pain and spasm
Electrolyte replacement
Sports drinks are more efficient in replacing fluids due to carbs and sodium
Chondromalacia Patella
Stage 1- swelling and softening of articular cartilage Stage 2- fishing of softened cartilage Stage 3- deformation of the surface of articular cartilage caused by fragmentation s/s: pain in anterior aspect of patellar when going through flexion/extension -grating sensation + Clarke's sign management: pain free isometrics, NSAIDs, neoprene knee sleeves Surgery- moving VMO insertion forward, shaving patellar surfaces, removing patella
Minerals
Stored in liver and bones
Acute Exertional Rhabdomyolysis
Sudden catabolic destruction and degeneration of skeletal muscle, leakage of myoglobin (muscle protein) into vascular system -hot and humid environments -can result in gradual onset muscle weakness, swelling, pain, dark urine, renal failure and death -associated with sickle cell trait
Duty of care
The duty of all persons, as established by tort law, to exercise a reasonable amount of care in their dealings with others. Failure to exercise due care, which is normally determined by the reasonable person standard, constitutes the tort of negligence.
Ergonomic risk assessment
The evaluation of factors within a job that increase the risk of someone suffering a work-place-related ergonomic injury and what aspect of, or movement within, that job should be focused on to reduce this risk These factors include: awkward posture, repetitive movements without variation, forceful movement and vibrations
Antagonist muscle
The muscle opposite the agonist, which must relax and lengthen during contraction of the agonist.
Medical diagnosis
The ultimate determination of a patient's physical condition
Cutting devices for face masks
Three cutting devices-anvil pruners, trainers angel, FM extractor
Shoe selection
Toe box - 1/2 to 3/4 in between longest toe and front of shoe Sole -durable and provide shock absorption Shank -between sole and foot
Salter-Harris Fracture
Type 1: complete separation of the physis in relation to metaphysics without fracture Type 2: separation of the growth plate and a small portion of the metaphysis Type 3: fracture of the physis Type 4: fracture of a portion of the physis and metaphysis Type 5: No displacement of the physis but crushing force can cause a growth deformity
Ligaments of the hand
Ulnar collateral ligament of wrist, radial collateral ligament of wrist, palmar radiocarpal ligament, palmar ulnocarpal ligament, ulnar collateral ligament of digits, radial collateral ligaments of digits, interosseous metacarpal ligaments, palmar inter metacarpal ligaments, Triangular fibrocartilage complex, deep transverse ligaments (MC heads)
Apparent Leg Length Discrepancy
Umbilicus to medial malleolus
Heel cups
Used for a variety of conditions, including plantar fasciitis, heel spurs, Achilles tendonitis, and heel bursitis Heel cups maybe either hard plastic or spongy rubber
Joint Mobilization and Traction
Used to decrease joint pain by restoring accessory motion thus allowing for full, pain-free range of motion
MCL special tests
Valgus stress test 0, 25
Monitoring the heat index
Wet bulb globe temperature
Manual Muscle Strength Grading
Zero- no evidence of muscle contraction Trace- evidence of slight contraction with no joint movement Poor- complete ROM with gravity omitted Fair- complete ROM against gravity with no resistance Good- complete ROM against gravity with some resistance Normal- full ROM against gravity and full resistance
Dislocation
a bone is forced out of alignment and stays out until surgically or manually replaced or reduced first time should always be treated as a fracture- do not reduce
Subluxation
a bone is forced out of alignment but goes back into place -likely result in rupture of stabilizing ligaments and tendons -occasionally an avulsion fracture
Medicare
a federal insurance program for persons over the age of 65 and qualified disabled or blind persons regardless of income
Emergency Action Plan
a plan an organization develops that contains step-by-step procedures for dealing with various emergency situations
Stiffness
ability of a tissue to resist load
Modulation
ability of the electrical stimulating unit to change the magnitude or duration of the waveform could be continuous, interrupted or surging
Muscular endurance
ability to perform repetitive muscle contractions again some resistance
cardiorespiratory endurance
ability to perform whole body, large muscle group exercises for an extended period of time
Sickle cell trait reaction
abnormal hemoglobin molecules become deoxygenated as a results of exercise at a higher altitude causes enlarged spleen that has been known to rupture at high altitudes
Wolff-Parkinson-White Syndrome
abnormality in cardiac rhythm manifests itself as ventricular tachycardia
Acute onset muscle soreness
accompanies fatigue occurs immediately after exercise
Clinical diagnosis
accurately identifies the pathology of injury, the limitations and the possible disabilities associated with a condition.
Muscle healing
active contraction of muscle is critical in regaining normal tensile strength -rehab is usually longer than that for ligaments -be careful not to return to play too soon
Soft tissue mobilization
active release technique -place pressure over tender point and go through ROM -athlete actively moves body part
Hepatitis C
acute and chronic form of liver disease most common in US 80% show no signs or symptoms No vaccine
Controlling pain
acute pain control with RICE
Effects of immobilization
adverse muscular changes occur greatest atrophy occurs in slow twitch fibers neuromuscular efficiency returns within one week decreases normal lubrication for joints ligaments and bones become weaker full remodeling takes around 12 months or more Resting heart rate increases one hand bpm each day of immobilization
Contract relax stretching
affective body part is passively moved until resistance is felt -patient is told to contract muscle isotonicaly -AT resists for 10 seconds -Patient is told to relax for 10 seconds -AT moves patient into a new stretch position -Repeat 3 times
Biphasic current (AC)
alternating current the direction of the current flow reverses itself once during each cycle used for pain modulation or muscle contraction
Interval training
alternating periods of work with active recovery -60-80% of max HR -30-45% of Max HR Sport specific
Cardiac out-put
amount of blood pumped by the ventricle in liter per min
Anorexia Athletica
anorexia nerves without the starvation practice
ACL special tests
anterior drawer, lachmans, pivot shift Valgus/varus @ 0 degrees
Overtraining can bring
anxiety- feeling of uncertainty and apprehension Burnout- physiological and emotional exhaustion
Larsen-Johansson Disease and Osgood-Schlatter Disease
apophysitis with pain at attachment of patellar tendon at tibial tuberosity avulsion fracture of tibial tuberosity that has formed bony callus MOI: repeated avulsion of patellar tendon @ tuberosity Larsen-Johansson: similar but occurs at inferior pole of patella
Cryotherapy
application of cold temperatures can reach as far as 4 cm into body tissue
Thermotherapy
application of heat
Strain/Counterstrain Technique
approach to decrease muscle tension and guarding the can be used to normalize muscle function. -passive technique which places the body in the position of greatest comfort, therefore relieving pain
Dermatome
area of skin innervated by single nerve
Primary Survey
assess life threatening injuries -airway obstruction -no breathing -no circulation -profuse bleeding -shock Determine level of consciousness -unconscious call 911
Time of activity
at least 20 minutes
Medial meniscus
attached to the medial articular facet of the tibia and the joint capsule -posteriorly attaches to the fibers of semimembranosus
Medial Collateral Ligament
attaches at medial epicondyle of the femur and just beneath the attachment of the pes anserine on tibia -posterior aspect blends into semimembranosus and fibers of semimbranosus goes through capsule and attach to posterior aspect of medial meniscus -prevents valgus and external rotating forces
Hepatitus B Virus
attacks liver spread through blood flu-like symptoms can get vaccine
Myasthenia Gracis
autoimmune disease where antibodies attach the synaptic junctions between nerves and muscles drooping of upper eyelids and double visions
Multiple sclerosis
autoimmune inflammatory disease of CNS causes deterioration and permanent damage of the myelin sheath that surrounds nerve cell axon blurred vision with blind spots speech defects tremors muscle weakness in extremities Management: deal with symptoms, avoid over exertion and extreme temps, regular exercise plan
Screw Home Mechanism of Knee
axial rotation of the tibia relative to the femur -as knee extends tibia externally rotates -rotation occurs because medial femoral condyle is larger than laterla -gives great deal of stability in extension -when weight bearing, popliteus muscle must contract and externally rotate the femur to unlock the knee and allow flexion to occur
Septic shock
bacterial infection
Positional Release Therapy
based on strain/counter strain -difference is force applied over area -Find trigger point, move muscle into shortened state and patient is in less pain -hold for 90 seconds
Athletic trainers must ..... with athlete's response to injury
be a good listener, find out what the problem is, be aware of body language, project a caring image, explain injury to patient, manage stress of injury, help athlete return to competition
Formation of clot
begins 12 hours after injury and is complete in 48 hours thrombosplastin- prothrombin- thrombin- fibrinogen- insoluble fibrin clot
phase 1 - acute inflammatory response phase rehab
begins immediately when injury occurs and has lasted 4 days RICE rest is critical during this phase
Phase 2: Fibroblastic Repair Phase rehab
begins once inflammatory response ends 4 days to several weeks maintain cardiovascular fitness, restore full ROM, restore and increase strength and reestablish neuromuscular control
Workers Compensation
benefits for injured workers and goal is to return to workforce as soon as possible
Muscles of knee flexion
bicep femoris, semimebranosus, semitendinosus, gracilis, sartorius, gastroc, popliteus and plantaris
Modes of transportation-blood borne
blood semen Vaginal secretions Cerebrospinal fluid Synovial fluid
Hyphema
blood in anterior chamber of eye s/s: visible reddish tint to anterior chamber, vision is partially or completely blocked management: immediately referred to physician
hemothorax
blood in pleural cavity same as pneumothorax but with blood
Rib contusion
blow to rib cage inspiration and expiration painful s/s: point tenderness Management: wrapping with ace wrap, pain relieve with medication
Retinal detachment
blow to the eye, more common in near sighted athletes s/s: painless, "curtain falling over eye" Management: refer out
5 functions of bones
body support, organ protection, movement, calcium stores, and formation of blood cells
Wolff's Law
bone and soft tissue will respond to physical demands placed on them -injured structures should be exposed to progressive loads throughout rehab process
Stress fracture
bone may be vulnerable during first few weeks of intense physical activity -causes: overtraining, going back to competition too soon, improper training between events
Osteoblasts
bone producing cells
Osteoclasts
bone remolding cells
Linear fracture
bone splits along its length -jumping from height and landing in a way that puts stress on the long axis
Factors that limit Flexibility
bone structure, fat, skin, muscles and tendons, connective tissue, neural tissue tightness
Genu Varus
bow legged
Tendinosis
breakdown of a tendon without inflammation treatment is engaging in exercise to strengthen the tendon and consistently stretching the tendon
Closed fracture
broken bone with no open wound
Contusions
bruise ecchymosis- bluish/purpleish discoloration from bleeding under the skin
Myositis Ossificans
calcium deposits that result from repeated trauma formation of these calcium deposits can be seen w x ray -protect area w pad
Aquatic Exercise
can be used as assistive, supportive or resistive
Football shoulder pads
cantilever strap extends from front to back causes shoulder pads to arch above tip of shoulder- dispersing pressure into pads than shoulder
Macronutrients
carbohydrates fats proteins
Knee Rehab
cardio should be maintained throughout -non-weight bearing for 1 day allows healing process Joint mobs -incorporated as early as possible (patellar, anterior posterior tibial, CPM) Regaining ROM is critical (PNF initially) Muscular -isometric, isotonic, isokinetic, plyometric, eccentric, closed kinetic chain -working above and below injury site Neuromuscular Control -contracting muscle, proprioceptive exercises Functional Progression -walking, jogging, running, sprinting
Short bones
carpals and tarsals
Stretcher carrying
carry patient feet first carry head first if going up or down a hill
Etiology
cause of disease
Active trigger point
causes pain at rest firm pressure over point causes pain most common in postural support muscles
Vascular relation to inflammation
cell damage- vasoconstriction of vascular walls leading away from site of injury- lasts about 5 to 10 minutes
Athlete Heart syndrome
change in heart due to overtraining
Deformity
change in shape of tissue
CPR
check scene, call 911, initiate care for vitcim 30 compression to 2 breaths
Cytokines
chemokine, interleukins -help attract phagocytes -ingests other cells and foreign particles
Capsulitis
chronic inflammatory condition caused by repeated joint sprains and micro-traumas
Synovitis
chronic inflammatory condition caused by repeated joint sprains or microtraumas
Patellar special tests
clark's sign, patellar apprehension, glides ballotable patella and sweep
Bones of the shoulder
clavicle, scapula, humerus, sternum
Policies
clear and accurate written statements that identify the basic rules and principles used to control and expedite decision making
Extracellular matrix of clot
collagen elastin ground substance proteoglycans Glycosaminoglycans
Exclusive Provided Organizations
combination of HMO and PPO plans, restrictive in number and types of providers they have
Crykinetics
combination of cryotherapy and exercise immerse until numb exercise within limits of pain
obsessive-compulsive disorder
combination of emotional and behavioral symptoms -compulsive behaviors involving engaging in repetitive activities
Whirlpool baths
combination of massage and water immersion Temp should not exceed 104 Should not be used for full body immersion or for longer than 20 minutes
Mulligan Technique
combines passive accessory joint mobilization applied by an AT with active physiological movement by patient for purpose of correcting positional faults -mobilizations with movement
Rhinovirus
common cold upper respiratory infection by direct or indirect contact s/s: sore throat, stopped up nose and sneezing -mild fever colds last 5-10 days regardless of treatment
Grade 3 Sprain
complete rupture -no endpoint with marked laxity and pain will be severe initially then mild
Heart contusions
compression between sternum and spine management: refer
Anterior Cruciate Ligament
comprised of the anteromedial, intermediate, and posterolateral bands -prevents femur from moving posteriorly during weight bearing -limits anterior translation of tibia in non-weight bearing -stabilizes tibia against excessive internal rotation
Heat Rash
condition associated with a red, raised rash accompanied by prickling and tingling during sweat -usually occurs when skin is continuously wet with unevaporated sweat
Conductive heat exchange
contact with another object that results in loss or gain of heat
Fast twitch (type 2x)
contract more quickly and create more force than type 2a
Isometric contraction
contraction occurs when muscle contracts to increase tension but there is no change in muscle length
Hydroculator Packs
controlled in hot water at temp of 160 to 170 F Retains water and heat level for 20 to 30 minutes Limitation on heating deeper tissues Patients should not lay on the pack
Accident insurance
covers accidents -encourages an injured patient to receive prompt medical care
Liability insurance
covers claims of negligence on part of the individual -All ATs should carry this
Atrophy
decrease of muscle cause by decrease in the size of the cells in response to training
Ultrasound
deep heating modality thermal or non thermal effects Frequency- 1MHz = deep 3MHz= shallow Continuous = thermal Pulsed = nonthermal needs medium such as gel or water 5 to 10 minutes
Brittle
deform very little before failure
Plastic
deformation of tissue that exists after the load is removed
creep
deformation of tissue that occurs with application of a constant load over time
Active range of motion
degree to which a joint can be moved by muscle contraction
Passive range of motion
degree to which a joint may be passively moved to an end point in the range of motion
Kubler Ross Reactions
denial, anger, bargaining, depression, acceptance
Error and omissions insurance
designed to cover against suits claiming malpractice, wrongful actions, error and omissions, and acts of negligence
Things to consider with EAPs
develop separate ones for each sport -determine personnel who will be on field during practice and competitions -each person should understand their roles and responsibilities -decide what emergency equipment should be available -determine procedure for equipment removal
Rib fracture
direct blow s/s: deformity, severe pain during breathing, Pt tender management: refer out
Monophasic current (DC)
direct current flows in one direction only from positive poles to negative poles DC used for pain modulation or muscle contraction or to produce ion movement
Polarity
direction of the current flow
Myofascial Trigger Points
discreet, hypersensitive, nodule within a taut band of skeletal muscle and fascia
Personal protective equipment
disposable gloves nonabsorbent gowns/aprons masks and sheilds disposable mouth pieces for resuscitation
anorexia nervosa
distorted body image and major concern over weight gain limits calorie intake drastically
Latent trigger point
doesn't cause spontaneous pain but may restrict movement or cause muscle weakness -pain may be noticeable when pressure is applied
Tendon healing
during second week healing tendon adheres to the surrounding tissue to form single mass -during third week, tendon separates to varying degree from surrounding tissue -tensile strength is not sufficient for strong pull for 4-5 weeks
High Altitude Pulmonary Edema
dyspnea, cough, headache, weakness and unconsciousness treatment is to give oxygen and take to lower altitude
Isometric
early stage of rehab after long term immobilization increases static strength decreases atrophy can lessen swelling can increase strength at whatever angle weakness occurs
Bulimia nervose
eating disorder of binging and purging
Concentric and Eccentric muscle contractions
eccentric critical in decelerating limb
Yield point
elastic limit of tissue
Iontophoresis
electrical current to drive ions usually dexamethasone or hydrocortisone interferential current
Reduction of Atrophy for e-stim
electrically endured muscle contraction to prevent atrophy and loss of function high frequency biphasic current intensity should be 30 to 60 pps voluntary isometric contraction 15 to 20 minutes
Hypertrophy
enlargement of a muscle caused by an increase in the size of the cell in response to training
Bone growth
epiphysis growth plate is cartilaginous disc located near end of long bone
Shearing
equal but not directly opposite loads are applied to opposite surfaces forcing those to move in parallel directions relative to one another injury occurs when shearing force is greater than strength of tissue result in skin injuries like blisters or abrasions, disc injuries
Disinfectants
everything should be cleaned with 10 parts water one part bleach
Mechanical failure
exceeding the ability to with stand stress and strain causing tissue to breakdown
Isokinetic training
exercise at a fixed velocity of movement with accommodating resistance
Strain
extent of deformation of tissue under loading
Control of hemorrhage
external bleeding- control with direct pressure, elevation Internal bleeding- BP should be monitored
Load
external force acting on internal tissue
Equipment considerations for injuries
face mask should be removed first (30 seconds) leave shoulder pads and helmets in place - unless enough staff is present to remove or local procedure says differently -must remove both or none
Hemophilia
failure of the blood to clot profuse bleeding physical exertion may cause bleeding into muscles referral immediately
Negligence
failure to use ordinary or reasonable care
psychogenic shock
fainting, temporary dilation of blood vessels that reduces amount of blood in the brain
Fast-twitch
fast oxidative glycolytic fibers produce quick forceful contractions fatigue more rapidly then slow twitch useful in short term, high intensity activities
Fast twitch (type 2b)
fatigue rapidly, short term, high intensity anaerobic activity true "fast twitch"
Long bones
femur, tibia, fibula, humerus, radius, ulna, metatarsals, metacarpals, phalanges
Knee complex consists of
femur, tibia, patella
Granulation tissue
fibroblasts that produce collagen and elastin -begins to synthesize an extracellular matrix
Fibroblastic repair phase
fibroplasia- period of scar formation begins within a few days after injury and may last as long as 4 to 6 weeks granulation tissue occurs with breakdown of fibrin clot
Grade 1 Sprain
firm endpoint with little or no laxity and some pain
Lightning safety
flash to bang - number of seconds from lightening flash until sound of thunder. divide by 5 to determine distance >30 or take shelter 30 minutes must past the last sound of thunder to return to play
Influenza
flu type a is most common s/s: fever, cough, headache, chills, body aches bed rest, aspirin should be avoided under age of 18 bc reye's syndrome
Half ring splint
for fracture of femur - traction
Tension
force that pulls or stretches tissue is generate in response to equal and opposite external loads that pull structures apart strains and sprains usually occur
Dynamic stretching
forceful contraction of agonist muscle that results in stretching of the antagonist muscle controlled stretch
Capitation
form of reimbursement used by managed care providers in which members make a standard payment each month regardless of how much service is rendered to the member by the provider
Intensity of activity
found using heart rate
Third Party Administrator (TPA)
frequently used to administer services and to pay claims for self insured group plans, and function as a pseudo insurance company
Osteochondritis
general change in ossification center of epiphysis, especially in periods of rapid growth
Neurogenic shock
general dilation of the blood vessels within cardiovascular system
Vegetarianism
give consideration to calories being eaten, minerals like calcium, zinc, iron, and vitamin b12
Glucose
glycolysis breaks down to produce energy -used for immediate energy excess is stored as glycogen
Waveform
graphical representation of the shape, direction , amplitude and direction of particular electrical currents
Acute mountain sickness
headache, nausea, vomiting, sleep disturbance, dyspnea may last 3 days
Medicaid
health insurance for people with low incomes and limited resources and funded by federal government
Friction massage
heat producing
Duchenne muscular dystrophy
hereditary degeneration of skeletal muscle with association in loss of strength -diagnosed early I childhood s/s: occurs as child begins to walk, starts in lower body and works up
Muscle contraction for e-stim muscle strengthening
high frequency biphasic current intensity should be increased at a frequency of 50 to 60 pps to elicit a tetanic muscle contraction using a surging current of 15 seconds on and 50 seconds off 3x10 3 times a week
Tooth subluxation, luxation, avulsion
high impact to the upper or lower jaw; direct trauma s/s: tooth loosened or dislodged management: no immediate treatment refer to dentist within 48 hours, use milk/saliva/ save a tooth kit
Alta patellar alignment
high riding patella
Genu recurvatum
hyperextension of the knee
Current Procedure Terminology
identify specific medical procedures used in treating a patient
Parental Notification of injury
if minor, AT must contain consent from parents -if no informed consent exists, implied consent takes precedence to save their life
Pool extraction
if minor- AT can use rescue tube to pull athlete toward edge of pool if too far away- AT can get into pool and approach from the front, extend rescue tube and be pulled to edge if severe injury, AT should approach from behind, wrap arms under armpits with rescue tube between AT and athlete. c-spine injury: take arms of victim and place overhead squeezing them together to stabilize.Spine board should be submerged under patient and strapped in
Golgi tendon organ
if stretch is more than 6 seconds, GTO will override muscle spindles and allow relaxation of the antagonist muscle as a protective mechanism
Guidelines for working with unconscious
immediately note body position and level of consciousness/responsiveness Airway, breathing and circulation should be established immediately Injury to the neck and c-spine should always be considered If athlete is wearing helmet, it should never be removed until c-spine injury is ruled out
Runner's Anemia
impact of the foot as it strikes the surface destroys red blood cells performance decline, burning thighs decrease running distance
Flat bones
in the skull, ribs and scapula
Cardiogenic shock
inability of heart to pump enough blood to supply body
Greenstick fracture
incomplete breaks in the bone that have not yet ossified -usually In adolescents
Shortwave diathermy
increases temperature at deeper tissues
Therapeutic effects of thermotherapy
increasing extensibility of collagen tissue decreasing joint stiffness reducing pain reducing muscle spasm reducing inflammation, edema in the post acute phase of healing increasing blood flow treatment shouldn't exceed 30 minutes
Depression
individual experiences helplessness, misery, loss of energy, excessive guilt, diminished ability to think, changes in eating or sleeping, recurrent thoughts of death
posttraumatic stress disorder (PTSD)
individual who suffered a psychologically traumatic event
Tendinitis
inflammation of a tendon can have crepitus repetitive overuse continues and the inflamed or irritated tendon fails to heal, it will degenerate
Bursitis
inflammation of bursa at sites of bony prominences -synovial membrane that contains small amount of fluid -can restrict movement -fluid continues to be produced until irritation is eliminated
Neuritis
inflammation of nerve -symptoms range from minor nerve problems to paralysis
tenosynovitis
inflammation of tendon and synovial sheath -inflammation process produces byproducts that are sticky and tend to adhere to the synovial sheath surrounding it -treatment is to control inflammation
Meningitis
inflammation of the meninges of the brain and spinal cord -bacteria leads to death if not properly treated high fever, stiff neck, intense headache management: spinal tap for spinal fluid, antibiotics
Fat pads
infrapatellar fat pad is largest -cushions the front of the knee -separates patellar tendon from joint capsule anterior and posterior suprapatellar popliteal
Tibial nerve
innervates most of the hamstrings and gastroc
Common peroneal nerve
innervates short head of the biceps femoris -courses through popliteal fossa and wraps around fibular head
Femoral nerve
innervates the quad and sartorius muscles
Intracapsular swelling
inside joint capsule -can be moved manually from one side of joint to another
Pain modulation for e-stim Opiate pain control
intensity should be set as high as tolerable pulse duration should be as high as possible frequency should be 1 to 5 pps
Pain modulation for e-stim Descending pathways of pain control
intensity should be very high pulse duration should be 10 msecs frequency should be 80 pps
Muscle re-education for e-stim
intensity should produce a comfortable contraction at 30 to 50 pps 15 to 20 minutes several times a day
Pain modulation for e-stim Gate Control
intensity- light tingling sensation Pulse duration/frequency set as high as possible w/o muscle contraction
Stress
internal resistance to an external load
Neuropraxia
interruption in the conduction of an impulse down the nerve fiber -brought by compression or relatively mild, blunt blow close to the nerve
Ballistic stretching
involved bouncing movement in which repetitive contractions of the agonist are used to produce quick stretches of the antagonist can cause injury and muscle soreness
Superficial frostbite
involves only the skin and subcutaneous tissue -skin appears pale, hard, cold and waxy immerse tissue in warm water do not rub
third party reimbursement
involves reimbursement by the policyholder's insurance company for services performed by health care professionals
Semicurved last
is designed for the average or normal foot There is a small curve on the medial side of the foot to fit a normal arch
Rhythmic Stabilization PNF
isometric contractions of agonist and antagonist
Techniques of resistance training
isometric, isotonic, isokinetic, progressive resistance, circuit, plyometrics
Types of muscle contractions
isometrics, eccentric, concentric
Adherence to rehab program
keep patient interested provide positive feedback
Petrissage massage
kneading
Genu valgum
knock knees
Grade 2 Joint Mobilization
large amplitude glide within midrange of motion -used when spasm limits movement sooner with a quick oscillation than with a slow one, or when slowly increasing pain restricts movement halfway into the range
Liver functions
largest organ in body RUQ detoxifies harmful chemicals secrets blue to neutralize stomach acid Hepatitis is infection of liver caused by viral infection/alcohol consumption Cirrhosis is progressive disease of liver that results in scaring and fibrosis (liver failure)
Patella
largest sesamoid bone in the body -3 medial facets, 1 lateral -tracks on the trochlear groove -can be affected by the pull of the quad muscles and patellar tendon, depth of the femoral condyles and shape of patella
Isokinetic exercise
late phase of rehab more functional can be used as return to play criteria
Patellafemoral stress syndrome
lateral deviation of patella in femoral groove -tightness of hamstrings, gastroc -tightness of lateral retinaculum -increased q angle -tight IT band -pronation of foot -patella alta -weak VMO -weak hip ADD s/s:TTP over lateral side, swelling, dull ache in center management: strengthen VMO/add -stretch hamstrings, gastroc, IT band -McConnell taping
Frog-eyed patella
lateral-riding patella caused by hip retroversion (external rotation of the femur) or external tibial rotation
Tort
legal wrongs against a person
Duration
length of time current is flowing aka pulse width or pulse duration
High Altitude Cerebral Edema
life threatening condition that can lead to death or coma increases cerebral edema and blood flow same treatment as HAPE
Exertional heat stroke
life threatening emergency- most severe CNS abnormalities, potential tissue damage from elevated body temp Sudden collapse, altered consciousness, seizure, confusion, rectal temp >104, rapid strong pulse, decreased BP Aggressive and immediate full body cooling
Shoe upper
light weight and drying should be well ventilated extra padding in achilles tendon region
Epiphysis
located at the end of long bones -bulbous in shape providing space for muscle attachment
Maturation and remodeling phase
long term process -realigning collagen fibers that make up scar tissue according to the tensile forces -by end of 3 weeks a firm, strong, contracted, nonvascular scar exists
Diabetic Coma
loss of sodium, potassium and ketone through frequent urination -produces ketoacidosis s/s: labored breathing, fruity smelling breath, nausea, dry mouth, flushed skin, mental concussion, LOS followed by coma monitor blood glucose levels, insulin injection
Baja patellar alignment
low riding patella
Hypothermia
low temperatures (wind and dampness) prevention: dress in thin layers than can be added and removed
Splinting of Upper-Limb Fractures
lower arm and wrist fractures should be splinted in position of elbow flexion and should be supported by sling -fractures around shoulder complex are immobilized by sling and upper body is secured to the body -hand and finger dislocations and fractures should be splinted and buddy taped
Arch support
made of durable yet soft material and should smoothly join in with insole
Popliteal artery
main blood supply for knee
Diaphysis
main shaft of the long bone hollow and cylindrical, covered by impact bone
Muscular strength
maximal force that can be applied by a muscle during a single maximum contraction
Phase 3: Maturation and Remodeling rehab
may last several years ultimate goal of this phase is return to play sports specific exercise
Meniscal special tests
mcmurray's, apley's compression/distraction, thessaly's
Cane fitting
measurement is taken from superior aspect of greater trochanter
Mechanism
mechanical description of cause
Pathomechanics
mechanical forces that are applied to a living organism and adversely change the body's structure and function
Seasonal Affective Disorder
mental depression during certain seasons of the year (common in winter months) -fatigue, diminished concentration, day time drowsiness -more common in women -light stress therapy
Phonophoresis
method of transporting molecules through the skin with ultrasound
Dehydration
mild - 2% of body weight loss -can still impair cardiovascular and thermoregulatory response Symptoms: thirst, dry mouth, headache, dizziness, irritability, lethargy, cramps Should be drinking what they lost and ensuring proper electrolyte balance
National Operating Committee on Standards for Athletic Equipment
minimal safety requirements for helmets
Hemarthrosis
moderate amount of swelling that occurs immediately after injury and is caused by synovial fluid and by blood in the joint
Exertional heat exhaustion
moderate form of heat illness that occurs from environmental heat stress and strenuous physical exercise -results from dehydration Symptoms: pale skin, profuse sweating, stomach cramps, nausea, vomiting, dizziness, body temp <104 -move to shaded area and give fluids, excess equipment should be removed
Fast twitch (type 2a)
moderate resistance to fatigue
Indications for electrical stimulation
modulate pain depolarization of motor nerve fibers -elecit muscle contraction
Pneumothorax
moi: blow to chest or opening in chest wall causing lung to collapse due to pressure s/s: difficulty breathing, one side of chest rising more than other, pain with breathing management: refer out
Contusion of bladder, urethra, ureters
moi: blunt force can avulse a ureter, contuse or rupture urinary bladder s/s: pain and discomfort in lower abdomen nausea/vomiting signs of shock blood coming from urethra management: check urine for blood always empty bladder before practice or games
Spermatic cord contusion
moi: direct blow s/s: nausea, vomiting, inflammation of area refer to MD immediately
Costochondral Separation and Dislocation
moi: direct blow, twisting forces s/s:pain is in between ribs, point tender on one side of origin of ribs
Kidney contusion
moi: external force, usually to the back -injury depends on force and angle of blow s/s: shock, nausea, vomiting, rigidity of back muscles, hematuria, lower abdominal region painful toward back management: refer out
Appendicitis
moi: inflammation of appendix, obstruction/lymph swelling or tumor s/s: McBurney's point, low grade fever, nausea and vomiting refer to MD
Pancreatitis
moi: inflammation of pancreas, may occur from chronic alcoholism s/s: vomiting, constipation, tenderness and rigidity with palpation chronic: jaundice, diarrhea, pain that radiates into back management: rehydration
GERD (gastroesophageal reflux disease)
moi: reflux or backwards flow of acidic gastric content into esophagus due to malfunction of lower sphincter regulated with medication
Rib Tip syndrome
moi: rib slip and impinge on intercostal nerve causing pain s/s: pain is localized in upper abdomen and lower costal area popping sensation or slipping reproduced by translation motion on rib (+ is clicking) management: compression wrap and abdominal brace
Ruptured globe
moi: trauma to eye by object smaller than eye s/s: severe pain, visual issues, diplopia, irregular pupils, increased pressure management: refer
Water
most abundant nutrient in body 60% of body weight
Delayed Onset Muscle Soreness (DOMS)
most intense 24 to 48 hours then subsides delayed muscle pain leading to muscle tension, swelling and stiffness may be caused by very small tears in muscle or disruption of connective tissue Static or PNF stretching
Agonist muscle
muscle contracting to cause movement
Muscle guarding
muscle contraction in response to pain
Musculotendinous unit injury
muscle fibers possess the ability to contract as well as properties of irritability, conductivity and elasticity -smooth, cardiac, skeletal
Progressive resistance exercises
muscle is changing length done using tubing, free and machine weights or manual resistance
Eccentric muscle contraction
muscle lengthens while continuing to contract generates greater amount of force than concentric deceleration movement should take 2 to 4 seconds
Concentric contraction
muscle shortens while contracting acceleration movement fatigue more rapidly should take 1 to 2 seconds
Exertional heat cramp
muscle spasms that occur in commonly calf and abdomen -excessive loss of water and electrolytes -acclimatization can also play role
Myotome
muscles or group of muscles innervated by specific nerve group
sovereign immunity
neither the government nor any individual who is employed by the government can be held liable for negligence
Nerve healing
nerve cells cannot regenerate once it dies, peripheral nerves can regenerate if injury does not affect cell body -regeneration is very slow
Frequency of activity
no fewer than 3 times a week one rest day a week
Q angle
normal limits: 10=males and 15=females
Rapid form vacuum immobilizer
not useful for injuries that are angulated and must be splinted in position they are found. Air suctioned out of cast to form solid splint
Lateral meniscus
o-shaped -attached to the lateral articular facet on the superior aspect of the tibia -loosely attaches to the lateral articular capsule and popliteal tendon
Blowout fracture
occur to the wall of the eye orbit as a result of a blow
Gate Control Theory
occurs at spinal cord level -body cannot process two pains at once
Transverse fracture
occurs in a straight line -direct outside blow
Contercoup fracture
occurs on opposite side of point of trauma
Convective Heat Exchange
occurs when a mass of air or water moves around an individual
Respiratory Shock
occurs when lungs are unable to supply enough oxygen to circulating blood -trauma that produces a pneumothorax or injury to breathing control center
Depression fracture
often in flat bones -caused by falling and striking head on a hard, immovable surface
Preparing athlete with open wound
open wounds must be covered with dressing that is fixed in place and won't move Athlete must be removed from competition and return when deemed safe by medical staff uniforms with blood must be cleaned before return to activity
Sartorius
origin- ASIS insertion- proximal medial surface of tibia flexes knee, hip flexion and external rotation
Popliteus
origin- lateral condyle of femur insertion- posterior surface of tibia action- flexes leg
serratus anterior
origin: 1-8 insertion of ribs insertion: vertebral border of scapula action: scapular protraction, upward rotation
Rectus femoris
origin: ASIS insertion: tibial tuberosity via patellar tendon knee extension
Psoas Major
origin: T12 body of vertebra, L1-5 transverse processes and bodies insertion: lesser trochanter of femur Action: hip flexion, hip external rotation, trunk flexion
vastus intermedius
origin: anterior surface of femur insertion: tibial tuberosity via patellar tendon knee ext
Teres minor
origin: axillary border of scapula insertion: GT of humerus action: shoulder external rotation
Coracobrachialis
origin: coracoid process of scapula insertion: middle one third of humerus action: shoulder flexion, shoulder abduction
Brachialis
origin: distal one half of humerus insertion: coranoid process of ulna action: elbow flexion (wrist in neutral)
Extensor Carpi Radialis Longus
origin: distal one third of lateral supracondylar ridge of humerus, lateral epicondyle of humerus insertion: dorsal aspect of base of 2nd MC action: wrist extension, radial deviation, pronation, and elbow extension
gluteus maximus
origin: dorsal ilium, sacrum, and coccyx insertion: gluteal tuberosity of femur and iliotibial tract action: hip extension, hip external rotation, abduction
Vastus lateralis
origin: greater trochanter insertion: tibial tuberosity via patellar tendon knee ext
Iliacus
origin: iliac fossa, AISI insertion: lesser trochanter of femur action: hip flexion, hip external rotation, pelvic anterior tilt
Gracilis
origin: inferior ramps of pubis Insertion: medial surface of tibia Knee flex and internal rotation
Infraspinatus
origin: infraspinous fossa of scapula insertion: greater tubercle of humerus action: shoulder external rotation
Bicep femoris
origin: ischial tuberosity, lateral lip of femur insertion: lateral surface of head of fibula, lateral condyle of tibia knee flex
gluteus medius
origin: lateral aspect of ilium insertion: Greater trochanter Action: hip abduction, flexion, internal rotation
Gluteus mimimus
origin: lateral aspect of ilium insertion: greater trochanter action: hip abduction, flexion, internal rotation,
Extensor digitorum
origin: lateral epicondyle of humerus insertion: dorsal aspect of base of 2nd to 5th phalanges Action: finger extension at 2nd to 5th phalanges, wrist extension, elbow extension
Extensor Capri Ulnaris
origin: lateral epicondyle of humerus, middle one third of posterior ulnar insertion: dorsal aspect of base of 5th MC action: wrist extension, ulnar deviation, elbow extension
Supinator
origin: lateral epicondyle of humerus, supinator crest of ulna insertion: proximal one third of lateral radius action: supination
Brachioradialis
origin: lateral supracondylar ridge of humerus insertion: radial styloid process action: elbow flexion, forearm supination, forearm pronation
triceps brachii
origin: long head- infraglenoid tubercle of scapula; lateral head- proximal one half of humerus; medial head- distal one half of humerus insertion: olecranon process of ulna Action: long head- elbow extension, shoulder extension, shoulder adduction; lateral head- elbow extension; medial head- elbow extension
biceps brachii
origin: long head- supraglenoid tubercle of scapula, short head- coracoid process of scapula action: long head/short head- elbow flexion, forearm supination, shoulder flexion, shoulder abduction
Flexor carpi radialis
origin: medial epicondyle of humerus insertion: base of second metacarpal, base of third MC action: wrist flexion, radial deviation, elbow flexion, pronation
palmaris longus
origin: medial epicondyle of humerus insertion: palmar aponeurosis Action: wrist flexion, forearm pronation, and elbow flexion
Flexor carpi ulnaris
origin: medial epicondyle of humerus, proximal two thirds of posterior ulna insertion: pisiform, hook of hamate, base of 5th MC action: wrist flexion, ulnar deviation, elbow flexion
Vastus medialis
origin: medial lip of femur insertion: tibial tuberosity via patellar tenon knee ext
Pronator teres
origin: medial supracondylar ridge of humerus insertion: middle one third of lateral radial action: forearm pronation, elbow flexion
Flexor Pollicis Longus
origin: middle anterior aspect of radius, medial epicondyle of humerus, coronoid process of ulna insertion: base of distal phalanx of thumb action: thumb flexion, wrist flexion, radial deviation, elbow flexion
Gastrocnemius
origin: posterior lateral condyle of femur, popliteal surface of femur Insertion: posterior surface of calcaneus via achilles tendon Knee flexion
Extensor Pollicis Brevis
origin: posterior radius insertion: dorsal aspect of base of 1st phalanx action: thumb extension abductor, radial deviation, wrist extension
Extensor Pollicis Longus
origin: posteroloateral aspect of middle one third of ulna insertion: dorsal aspect of base of 1st distal phalanx action: thumb extension, wrist extension, radial deviation, supination
Flexor Digitorum Profundus
origin: proximal three fourths of ulna insertion: base of 2nd to 5th distal phalanges action: finger flexion, wrist flexion
Piriformis
origin: sacrum, posterior ischium insertion: greater trochanter action: hip external rotation, hip abduction, hip extension
Rhomboid Major
origin: spinous processes of T2-T5 insertion: medial (vertebral) border of scapula action: scapular retraction, elevation and upward rotation
Subscapularis
origin: subscapular fossa of scapula insertion: lesser tubercle of humerus action: shoulder internal rotation
Supraspinatus
origin: supraspinous fossa of scapula insertion: greater tubercle of humerus Action: shoulder abduction
Flexor digitorm superficialis
origin: ulnar head- medial epicondyle of humerus, coranoid process of ulna; radial head- proximal two thirds of anterior radius insertion: palmar aspect of 2nd to 5th phalanges (PIP joint) action: finger flexion, wrist flexion, elbow flexion
Bone Healing
osteoblasts, osteoclasts, Short bones- 3 week immobilization Long bones- 6-8 weeks
Extracapsular swelling
outside joint capsule -tends to localize over injured structure and then migrate down
Periosteum
outside of bone contains blood supply to the bone
Meniscus
oval fibrocartilage that deepens the articular facets of the tibia red-red zone: outer 1/3 (good vascular) red-white zone: middle 1/3 (minimal blood) white-white zone: inner 1/3 (avascular)
Muscle soreness
overexertion in strenuous exercise resulting in muscular pain
Open fracture
overlying skin is lacerated by protruding bone fragments
Altitude considerations
oxygen deficiency red blood cells become less saturated altitude illnesses
Muscle spindle
pain perception -stimulus-nociceptors- arc reflex- dorsal horn of spinal cord - amygdula - afferent fibers back to stimulus
Referred pain
pain that is felt at point of the body rather than its origin
Muscle cramps
painful and involuntary muscle contractions that occur most commonly in calf, abdomen or hamstrings
Static stretching
passively stretching a given antagonist muscle by placing it in a maximal position of stretch and holding it there for an extended period 30 seconds 3-4 times
Squinting patella
patella positioned medially increased q angle hip internal rotation
Slow-reverse-hold PNF
patient moves a body part isotonically using agonist muscles and immediately follows that movement with an isometric contraction -designed to develop strength at a specific ROM
Slow reversal PNF
patient moves through complete ROM against maximum resistance -release the movement pattern before exercise is completed
Four point gait
patient stands on both feet moves one crutch forward and steps forward with opposite foot
Tapotement massage
percussion
Secondary survey
performed after life-threatening injuries have been ruled out Pulse, respiration, blood pressure, PERRLA, skin color, temperate, movement
Phobias
persistent, irrational fear and avoidance of a specific object, activity, or situation -increased heart rate, difficulty breathing, sweating, dizziness
Bursae
pieces of synovial tissue separated by a. thin film of fluid -reduces friction between structures (muscle and bone, tendon and bone, tendon and ligament)
General Health insurance
policy that covers illness, hospitalization, and emergency care
Conditions that interfere with bone healing
poor blood supply, poor immobilization, infection, soft tissue between severed ends of bone
Muscles of internal rotation of tibia
popliteal, semitendinosis, semimbranosus, sartorius and gracilis
PCL special tests
posterior drawer, godfrey's, sag sign, valgus/varus @ 0
Joint Capsule Knee
posterolateral- reinforced by IT band, popliteus, bicep femoris, LCL Posteromedial- reinforced by MCL, pes anserine tendons, semimembranosus and posterior oblique ligament anterolateral- reinforced by IT band, patellar tendon, and lateral patellar retinaculum Anteromedial- reinforced by superficial MCL and medial patellar retinaculum
Overexposure to sun
premature aging and skin cancer -sunscreen 30 minutes before exposure
Warm up
prepare the body physiologically for upcoming work -increases skeletal muscle temperature and blood flow -increases muscle elasticity -dynamic stretching
Bursitis of Knee
prepatellar, deep infrapatellar, suprapatellar MOI: overuse of tendon, direct blow s/s: localized swelling, redness, increased temp Management: compression wrap, NSAIDs, aspiration Watch for infection
Heel counter
prevents foot from rolling side to side at heel strike
Compression
produced by external loads applied towards one another on opposite surfaces in opposite directions
ATP
produced from the breakdown of nutrient food -ultimate form of usable energy for muscles -produced in muscle tissue from blood glucose or glycogen -Used during sudden outburst of activity in intense, short term exercise
Gradual acclimatization
progressive exposure should occur over 7-10 day period equipment restrictions aid
Rhythmic Initiation PNF
progressive series, first passive movement then active assisted movement, followed by active movement through an agonist pattern
Frostbite (chilblains)
prolonged and constant exposure to the cold for many hours -skin redness, swelling, tingling, and pain
Elasticity
property that allows tissue to return to normal following deformity
Re-establishing Neuromuscular control
proprioception, kinesthesia dynamic stability pre-paratory and reactive muscle characteristics conscious and unconscious functional motor patterns
ACL prevention
proprioception, neuromuscular control, weight training, landing cues, stretching and plyometric training -soft knees, load hips, quiet sound, toe to heel
Functional knee braces
protect grade 1 or 2 sprains of ACL custom molded designed to control rotational stresses or tibial translation
Mouth guards
protects teeth, absorbs blows to chin, can prevent concussions -also minimize lacerations to the lips, cheek and fractures of mandible
Family Education Rights and Privacy Act (FERPA)
protects the privacy of student education records, rights of educational records move to student after age of 18 or when student attends a school beyond high school
Hernia
protrusion of abdominal viscera through abnormal opening in muscle wall -most often in groin area refer to MD
Cerebral function
questions that assess general affect, level of consciouness, intellectual performance, emotional status, thought content, sensory interpretation, and language skills
Cranial nerves assessment
quickly assessing quality of: sense of smell, eye tracking, imitation of facial expressions, biting down, balance, swallowing, tongue protrusion, strength of shoulder shrug
Radiant heat exchange
radiant heat from sun can increase body temp
Effects of inactivity
rapid general loss of fitness
Heat Syncope
rapid physical fatigue during overexposure to heat -standing place for long periods of time -peripheral vasodilation of superficial vessels hypotension or pooling of blood in extremities which results in dizziness, fainting and nausea -replace fluids and lay athlete in a cool environment
Vibration massage
rapid shaking
Second Impact Syndrome
rapid swelling and herniation of brain after second head injury before initial had healed s/s: within minutes patient's condition rapidly decreases, dilated pupils, loss of eye mvmt, LOC leading to coma, respiratory failure, mortality rate of 50% Management: at hospital within 5 minutes Let athletes heal before returning to play from concussion
Muscle spasm
reaction to trauma to musculoskeletal system clonic- involuntary alternating contractions and relaxation periods Tonic- constant contraction for a period of time
iron deficiency anemia
red blood cells are too small, hemoglobin is decreased s/s: performance decline, burning thighs, dizziness, fatigue iron supplement, proper diet including red meat and dark poultry, avoid coffee and tea
Inflammatory response
redness, swelling, tenderness, heat, loss of function
Pre-operative phase rehab
reduction of swelling before surgery can improve post surgery rehabilitation
Frequency
refers to number of waveforms being emitted by electrical stimulating unit identified by pulse per second, cycles per second or hertz
Autogenic inhibition
relaxation of antagonist muscle during contractions
Histamine
released from injured mast cells -causes vasodilation and increased cell permeability
Chronic inflammation
repeated acute micro traumas and overuse -low concentrations of chemical mediators
Leukotrinenes
responsible for margination -neutrophils and macrophages line up along cell wall -increases permeability
Impacted fracture
results from fall from height
Reflex of Sympathetic Dystrophy
results from immobilization of injured body part due to pain hypersensitivity to touch, shining of skin early recognition is essential disrupting normal sympathetic response
human immunodeficiency virus (HIV)
retrovirus that causes AIDS no vaccine greatest risk is through sexual contact with infected partner Athlete cannot be discriminated against for having HIV
SAM splint
reusable and can be folded and unfodled repeatedly
Osteochondral knee fracture
rotation of direct trauma that compresses articular cartilage between femoral condyles and tibial plateau s/s: diffuse pain along the joint line immediate effusion crepitus and pain with weight bearing when standing or walking management: referral, MRI to diagnose fx site
Lateral collateral ligament
round, fibrous cord about the size of a pencil -attaches to the lateral epicondyle of the femur and to the head o the fibula -prevents varus and internal rotating forces
Spiral fracture
s-shaped separation -planted and rotation in opposite directions
Corneal Abrasions
s/s: severe pain and watering of eye, photophobia and spasm Dye and cobalt blue light can diagnose Management: patch and send to physician
Principles of Conditioning
safety, warm up/cool down, motivation, overload, consistency, progression, intensity, specificity, individuality, minimal stress
Nutrition
science of substance in food that are essential to life -growth, repair and maintenance of all tissues -regulatory of body processes and production of energy
Avulsion fracture
separation of a bone fragment from attachment of a ligament or tendon
Diastasis
separation of articulating bones
Deep frostbite
serious injury indicating tissues are frozen, requires hospitalization rapid rewarming through hot drinks, heating pads or hot water
Statue of Limitations
sets a specific length of time that individuals may sue for damages from negligence
Anaphylactic shock
severe allergic reaction -epipen
Metabolic shock
severe illness goes untreated or extreme loss of body fluid -low BP -pulse is rapid and weak -breathing is shallow and rapid elevate feet and legs
Apophyseal
severs disease or osgood-schlatter
Psychological response to injury
short term injuries- 4 weeks Long term injuries- >4 weeks Chronic- recurring Terminating- career ending
Isotonic training
shortening and lengthening the muscle through a complete range of motion
Sickle Cell Anemia
sickling of red blood cells, common in African Americans, Native Americans and Mediterraneans Less potential for transporting o2 and are more fragile sickling cells can cause blockages in blood vessels sever pain in limbs and abdomen extreme fatigue
Slow-twitch (type 1)
slow oxidative fibers carry more oxygen long duration aerobic type activities
Grade 1 Joint Mobilization
small amplitude glide at the beginning of the ROM -used when pain and spasm limit movement early in ROM
Grade 5 Joint Mobilization
small amplitude quick thrust delivered at the end ROM -usually accompanied by a popping sound called a manipulation
Proper fitting football helmets
snug around the head w no gaps between cheek pads and head -cover back of skull -2 fingers above the eyebrows -Facemask 3 fingers from nose -chin strap should be equal distance from center of helmet
Electrolyte requirements
sodium, chloride, potassium, mangesium and calcium -help maintain balance of water inside and outside cells
Grade 2 sprain
soft endpoint with some laxity and moderate pain
Posterior Cruciate Ligament
some port of the PCL is taut throughout full rOM -resists internal rotation of the tibia -prevents hyperextension -limits anterior translation of the femur during weight bearing -limits posterior translation of the tibia during non-weight bearing
Splinting of spine and pelvis
spine board
Hypovolemic Shock
stems from trauma in which there is a blood loss -brain bleed= increased BP -internal bleeding= decreased BP
Muscle contraction for e-stim Muscle pumping
stimulate circulation by pumping fluid and blood through venous and lymphatic channels High voltage monophonic current Intensity should be increased to elicit muscle contraction Frequency of 20 to 40 pps Surge mode with on/off mode set at 5 sec each Active contraction should be encouraged Treatment time 20 to 30 minutes
Total body conditioning
strength, neuromuscular control, flexibility, cardiovascular and muscle endurance, agility, speed and balance
Proprioceptive neuromuscular facilitation
stretching technique that involves combinations of altering contractions and stretches -all techniques use a 10 second active push phase followed by a ten second passive relax phase, repeated 3 times for a total of 60 seconds
Training effect
stroke volume increases while heart rate is reduced at a given exercise load
Effleurage massage
stroking
Epidemiology
study of infectious disease in a population
Ligaments of the shoulder
superior AC ligament, coracoclavicular ligament, coracoacromial ligament, glenohumeral ligament, coracohumeral ligament, anterior sternoclavicular ligament, interclavicular ligament
Ambulatory aid
support or assistance given to an injured patient that can walk
Factors affecting ligament healing
surgically repaired ligaments have healed with decreased scar formation and are generally stronger -exercised ligaments are stronger than those who have been immobilized
Evaporative heat loss
sweat glands in skin allow water to be transported to the surface Water evaporates to cool the body Normal person can sweat off 1 quart of water every 2 hours Impaired if relative humidity reached 65-75%
Otitis Externa
swimmer's ear MOI: bacterial infection of ear canal, water gets trapped s/s: pain, dizziness, itching, discharge, hearing loss Management: refer for antibiotics, alcohol solutions before and after swim
Muscular power
the ability to generate force rapidly
Maximum aerobic capacity
the greatest rate at which oxygen can be taken in and used during exercise
Misfeasance
the improper performance of an otherwise proper or lawful act
Assumption of risk
the individual, through expressed or implied agreement, assumes that some risk or danger will be involved in the particular undertaking
Procedures
the process by which something is done
Liability
the state of being legally responsible for the harm one causes another person
Stroke volume
the volume of blood pumped out by a ventricle with each heartbeat
Comminuted fracture
three or more fragments at a fracture site -caused by hard blow or awkward fall
Ductile
tissue can deform significantly before failing
Myofascial release
to relieve soft tissue from an abnormal grip of tight fascia -foam rolling -aka soft tissue mobilization
Cerebellar Function
touching finger to nose, drawing alphabet in the air with foot, heel to toe walking
Torsion
twisting in opposite directions from opposite ends of a structure usually causes spiral fractures
Serrated fracture
two bony fragments have a sawtooth, sharp edged fracture line
Information to provide 911
type of emergency situation Type of suspected injury Present condition of athlete Current assistance being given location of phone being used Exact location of emergency and how to enter facility
Plyometric exercise
type of exercise that takes advantage of the stretch-shortening cycle rapid stretch of a muscle eccentrically followed by rapid concentric contraction
Ligaments of elbow
ulnar collateral ligament, radial collateral ligament, annular ligament
Panic attacks
unexpected and unprovoked emotionally intense experience of terror and fear -usually occur at night
Parnoia
unrealistic and unfound suspicion about specific people or things
Repeated contraction PNF
used for general weakness or weakness at a point -patient moves isotonically against a maximum resistance of the AT until he or she experiences fatigue
Manual conveyance
used for mildly injured athlete a greater distance that the person could walk with ease
Tripod gait
used for stairs up starting with the uninjured leg Down with the crutches and injured leg first
Pulsatile current
used in interferential pre-modulated and also called Russian currents
Ice massage
used over tendons, belly of muscle, bursae or trigger points 5-10 mins Overlapping circles in a 10 to 15 cm area
Intermittent compression
used to control swelling after acute injury and to reduce pitting edema
Dynamic splint
used to provide long duration tension on a healing structure
Bending
usually fractures
Effusion with ACL tear
usually within first hour after injury
Speed play
varied terrain ex. cross country courses
LCL special tests
varus stress test 0, 25
Therapeutic effects of cryotherapy
vasoconstriction slowing metabolism
Knee Extension Muscles
vastus medialis, vastus lateralis, vastus intermedius, rectus femoris
Irregular Bones
vertebral column and skull
Blood Borne Pathogens
viruses transmitted through contact with blood or other body fluids
Intensity
voltage output of stimulation unit Low voltage = 150 V -monophasic Low Voltage = 500V -biphasic
Heat stress
vulnerable in hot, humid climates and if young or elderly
Lactovegetarianism
watch for zinc and iron levels
Micronutrients
water, vitamins and minerals
Osteoarthritis
wearing down of hyaline cartilage -repeated trauma glucosamine sulfate- treatment
Malfeasance (act of commission)
when an individual commits an act that is not legally his to perform
Nonfeasance (act of omission)
when an individual fails to perform a legal duty
Specific Adaptations to Imposed Demands
when body is subjected to stress and overloads of varying intensities, it will gradually adapt to overcome whatever demands are placed on it
Open kinetic chain
when foot or Hand is off the groun
Closed kinetic chain
when hand or foot is on the ground more functional
Fitting shoulder pads- football
width of shoulder is measured inside of shoulder pad should cover the tip of the shoulder in direct line with lateral aspect cups should cover deltoids neck opening must allow athlete to raise arms overhead and not allow the pad to slide if a split clavicle shoulder pad is used, the channel for the top of the shoulder must be in proper position straps under arm must hold pads firmly in place
Prophylatic knee brace
worn on lateral surface of knee to protect MCL
Five components to make muscle energy techniques effective
· Active muscle contraction by the patient · A muscle contraction oriented in a specific direction · Some control of contraction intensity by the patient · Control of the joint position by the athletic trainer · Appropriate counterforce applied by the athletic trainer
Curved last
· Is built with a large curve on the medial side of the shoe and has a wider outside portion of the shoe to provide more forefoot stability · Is built for people with a high arch and for runners who run on the outside of their foot (supinators)