Athletic Injuries Quiz 2

what athletes are susceptible to heat illness

athletes with large muscle mass overweight athletes athlete with increased fluid loss athletes consuming medications that have certain side effects athletes with poor fitness level, history of heat illnesses, or febrile conditions

how can the body dissipate or gain heat

conduction (direct contact) convection (contact with cool air or water) radiation (heat generated from metabolism) evaporation (sweat evaporating from the skin, majority of body heat dissipated this way

what is connective tissue composed of?

connective tissue fibers (collagen and elastin), ground substance, connective tissue cells

preventing heat illness

consume fluids and stay cool fluid and electrolyte replacement (should match sweat loss) monitor urine color and volume

what are the body's means of protection

mechanisms for stopping blood flow - local vasoconstriction (~10 minutes, decreases blood flow) - platelet reaction (promotes clot) - coagulation cascade (forms fibrin)

what are the bone trauma classifications

periostitis acute bone fractures stress fractures epiphyseal conditions apophyseal conditions

how does collagen heal

typically with type III collagen that is not arranged in an orderly fashion but is eventually replaced with type I collagen over time

what is chemical mediation

ultrastructural changes cause the release of chemical mediators (bradykinin, histamine, cytokines) signal to the body that something is wrong cause pain response change the permeability of blood vessel endothelium

how do we determine the precautions concerning participation in hot weather

wet bulb globe temperature index (WBGT) - dry bulb (standard mercury temp) - wet bulb (thermometer with wet gauz that is swung around in air) - black bulb (black casing that measures radiant heat)

what is the vulnerable zone for pain versus healing

where pain level and total tissue healing intersect as time after injury goes on --> increased chance of injury

how is ventilation measured

whirling thermometer / sling psychrometer

what is the disruption of pressure balance

with an injury, an increase in TOP which pulls fluid out of capillary and into interstitial fluid free proteins escape - comes from broken up tissue debris

what are the average healing times for bone, muscle, ligament, tendons, and hyaline cartilage

muscle = 4-6 weeks bone = 3-8 weeks ligament = 5 weeks to some strength, 80% after 1 year tendon = 3 months to 1 year hyaline cartilage = 6+ months

what occurs in maturation phase

muscle fibers form adhesions tendons and ligaments are slower to heal potential for atrophy with immobilization loss of strength and decreased rates of healing = length of immobilization begin strengthening as soon as its safe after injury to ensure hypertrophy

what are the bone functions

support, protection, movement, reservoir for Ca++, hematopoiesis

what is are the different types of joints

synarthrodial/fibrous - no movement amphiarthrodial/cartilagenous - some movement diarthrodial/synovial - lots of movement

what is uniform selection based on

temperature and humidity avoid rubberized suits

what can increase the chances of hypothermia

temperature in conjunction with wind chill and dampness

what are the tissue properties

tension, stretching, compression, shearing, bending

what nerve trauma conditions are there

neuritis, neurapraxia, axonotmesis, neurotmesis

exertional heat exhaustion

-inadequate fluid replacement - signs of profuse sweating, pale skin, mildly elevated temp, dizzy, hyperventilation, rapid pulse - core temperature will be ~102º - performance decreases - immediate treatment: fluid ingestion, place in cool environment

what happens in the inflammatory phase

0-6 days immediate injury: actual damage to cells and blood vessels metabolically the cells in the area do not function well nerves may be stretched

when do cross striated muscle fibers begin to appear on the muscle healing timeline

18 days post injury

what is soft tissue trauma of the skeletal muscle

of the muscle, tendon, MT junction, 2 joint muscles STRAIN acute muscle injuries, tendon injuries, muscle cramps/spasms, over-exertional, chronic muscular injuries acute - contusion, strain, cramps chronic - heterotopic calcificaiton, myositis ossificans, atrophy, contracture

what happens with bone growth?

ossification - typically at the metaphyseal more ossification at the impact of injury

what are exertional heat cramps

painful muscle spasms due to excessive water loss and electrolyte imbalance prevent by consuming extra fluids and maintaining electrolyte balance, treat with fluid ingestion, light stretch with ice massage

controlled-motion phase

promote healing develop mobile scar

what occurs with nerve trauma

radiating pain or referred pain

how does muscular fatigue encourage cold illness

rate of exercise begins to drop, rate of heat loss relative to heat production may shift impaired neuromuscular responses and exhaustion drop in core temp stimulates shivering (stops below 85-90ºF)

what occurs in the maturation phase

realignment of fibers along stress lines, production of type I collagen

what does a loss of 3-5% of weight mean

reduced blood volume and could be a health threat

what are the basic principles of trauma

tissues respond to stress (bone will remodel itself to become stronger to resist loading, but will become weaker if loading is reduced) joint tissues will respond to demands placed on it (reconstructed ACL)(not always good - osteoarthritis)

what kind of tendon injuries are there

rupture, avulsion fracture

exertional hyponatremia

abnormally low concentration of sodium in blood ingesting too much water before, during, and after exercise preventable

what occurs during edema formation

accumulation of the fluid portion of blood in interstitial tissue a disruption of normal fluid exchange 2/3s of the edema resorbs in venous end of capillaries, and 1/3s resorbs into lymphatics

what must happen for evaporation to occur

air must be relatively water free for evaporation to occur

what are the cardinal signs of inflammation

calor = heat rubor = redness dolar = pain tumor = swelling functio laesa = loss of function

what is elastin?

can be stretched nearly 3x the resting length without damage protein substance adds elasticity to connective tissue yellow color

what is wound contraction

capillary arcades collapse and make wounds smaller and less red

what happens with injury?

cardinal signs of inflammation

what happens during secondary hypoxic injury

cells do not function well, hemorrhage, cells die

what are the anatomic properties of soft tissue?

collagen - primary constituent of skin, tendon, ligaments & cartilage, protein substance strong in resisting tensile forces, wavy configuration (elastic-type deformation or stretch)

protection phase

control effects of inflammation promote early healing and prevent deleterious effects of rest

what are the goals of the inflammatory phase

defend the body against foreign substances dispose of dead and dying tissue so the next phase can occur

what occurs in the proliferative phase

development of new tissue decrease in capillaries, absorptio of type III collagen

to maintain homeostasis, what must the body do

dissipate heat

what happens during secondary enzymatic injury

enzymes are released from dead cells and affect the nearby healthy cells

what is fibroplasia

fibrous tissue formation accumulation of exudate (fibroblasts produce immature collagen, very haphazard), release attachment factors so that blood vessels attach (oxygen is very important and provides energy to fibroplasia)

what is angiogenesis

formation of new blood vessels, growth factors allow epithelial walls to begin forming capillary buds

what bad stuff happens during inflammation?

free proteins escape from the vessels and after phagocytosis which cause edema formation leukocytes allow the release of prostaglandins and bradykinin which sensitive peripheral nerves all the chemicals allow the inflammation to get out of hand

what are the wound classification of skin soft tissue trauma

friction blister, abrasion, contusion, laceration, avulsion, incision, puncture, amputation

what is heat syncope

heat collapse rapid fatigue and overexposure, standing in heat for long periods peripheral vasodilation/pooling of blood in extremities place athlete in cool environment, consume fluids, lay down

what must be monitored when monitoring heat index

heat, sunshine, humidity ambient air temperature and relative humidity

what is articular cartilage

hyaline nearly frictionless surface ("ice on ice") joint articulation/motion control shock absorption joint nutrition *Does not repair!

what are the 4 key features of a synovial joint

joint capsule/ligaments synovial membrane hyaline cartilage joint space w/ synovial fluid

what are functional joint characteristics

joint stability (static and dynamic), functional stability vs mechanical stability - contribution of articular or extra-articular structures

exertional heat stroke

life-threatening sudden onset - sudden collapse, LOC, flushed hot skin, minimal sweating, shallow breathing, strong rapid pulse, core temperature of >=104 - lower temperature within 45 mins, strip clothing, immerse in cool water, transport to hospital

how does a strain occur?

load --> stress --> strain --> yield point --> mechanical failure

what are the types of bones

long, flat, irregular, short

What is trauma?

mechanical injury - force applied to any part of the body that results in a harmful disturbance in function or structure

what are the two different types of trauma?

microtrauma (microtearing of the muscle fibers, the sheath around the muscle, and the connective tissue) and macrotrauma (major trauma injury)

why do people use sports drinks

more effecting than just replacing fluids with water flavoring increases desire to consume water prematurely stops thirst response small amounts of sodium help in retention of water different drinks have different nutrient levels more CHO results in slower absorption

what is gradual acclimatization

most effective method of avoiding heat stress being accustomed to heat and exercising in eat 80% acclimatization can be achieved during first 5-6 days with 2 hour morning and afternoon practices

what else does damage control do

vasodilation allows leukocytes to adhere to lining of vessels (margination and pavementing), chemical mediators make vessel walls more permeable so leukocytes can escape (emigrate), move towards area to be cleaned (chemotaxis) and engulf (phagocytosis)

what is damage control for inflammation

vasodilation enhances blood flow and surrounding inactive capillaries and venules open up this brings neutrophils and macrophages to clean the area via phagocytosis (1. neutrophils 2. monocytes and macrophages)

what occurs in the inflammatory phase?

vasodilation, increased capillary membrane permeability, phagocytosis, growth of new capillaries macrophages predominate, type III collagen production

what is ground substance?

viscous substance that provides structure for connective tissue stretched out protein parts with polysaccharide links called glycosaminoglycans (GAG's) proteoglycans - macromolecules is a chain of GAGs together Hyaluronic acid thread binds all and forms proteoglycan aggregate

what is the maturation phase

3 weeks - 1 year goal is remodeling of the fibrous matrix to form mature scar tissue - decreased fibroblastic activity - increased organization of new tissue - decreased water content - decreased blood flow - resumption of normal cell activity in the area - scar tissue is fibrous, inelastic, nonvascular, less functional and flexible

what is the proliferative phase

3-21 days the goal is to repair and regenerate tissue, however can only replace with scar tissue cellular process, vascular process (angiogenesis - formation of new vessels), collagenization (fibroplasia - fibrous tissue formation), contraction - wound becomes smaller

what is capillary filtration pressure

CFP = (CHP + TOP)-(THP + COP) CHP - capillary hydrostatic pressure forces fluid out of capillary THP - tissue hydrostatic pressure forces fluid out of tissue TOP - tissue oncotic pressure pulls fluid out of capillary COP - capillary oncotic pressure pulls fluid out of tissue

what are acute ligament trauma

SPRAIN, rupture

return-to-function phase

increase strength and scar alignment develop functional independence

what are the 3 predictable phases and how long do they last

inflammatory - 0-6 days proliferative/repair - 3-21 days maturation/remodeling - up to 1 year these phases can overlap even though they are separate