ESC270 Prevention/Care of Sports Injuries FINAL
Describe the PROLIFERATION phase of bone healing.
- 3 to 21 days -> repair/regeneration - osteoclasts resorb damaged bone tissue - osteoblasts build new bone - callus is formed between fractured bone ends containing weak immature bone tissue that strengthens over time via bone remodeling (endochondral bone healing) - an alternative process, direct bone healing, enables new interwoven bone tissue to be deposited w/o formation of a callus. - healing takes place via endochondral process
What is the goal of a primary survey?
- assess the responsiveness of the injured person, check their airway, breathing, circulation, & to dictate actions & responsibilities
What are the signs & symptom of shock?
- cold, clammy, moist skin - shallow, irregular breathing; labored, rapid, gasping - profuse sweating - extreme thirst - dizziness - eyes are dull, sunken, pupils dilated - RAPID/WEAK PULSE - chalk like skin - restlessness, anxiety, fear, disorientation
Hypovolemic Shock
- excessive blood or fluid loss leading to inadequate circulation & O2 supply to all organs - possible causes: hemorrhage, dehydration, multiple trauma
where is the most common site for a tear in the musculotendinous unit? why?
- since tendons are stronger than their attached muscle, the muscle portion of the musculoteninous unit ruptures 1st - this area is associated w/ a biomechanically weak point because the muscle cross-sectional area is the smallest
What are the ways to manage shock?
1. activate EAP 2. elevate feet/legs 8-12 in if head/neck injury or leg fracture is not present. 3. elevate head/shoulders & feet if head injury suspected; keep flat if neck injury suspected. 4. put on side if vomiting/unconscious 5. splint fractures 6. maintain normal body temp 7. avoid rough handling 8. keep patient quiet/still 9. DO NOT give anything by mouth 10. monitor vitals every 2-5 min until EMS arrives.
What are the 5 parts of the EAP?
1. communication 2. location 3. access 4. assessment 5. re-check
What are 5 ways to reduce the risk of dehydration during PA:
1. have unlimited fluid available during exercise 2. drink cool fluids containing less than 8% CHOS 3. use individual H2O bottles to accurately measure fluid consumption 4. avoid caffeine, alcohol, carbonated drinks 5. replenish lost fluid w/ at least 24 oz of fluid for every pound of body weight lost
what are 5 red flags indicating serious emergency & activation of EMS?
1. unconsciousness/ loss of consciousness in presence of head trauma 2. no pulse 3. excessive arterial bleeding 4. respiratory distress/failure/airway obstruction 5. severe shock
What is the normal pulse rate of a child?
120 to 140 bpm
What is the normal BP for a female adult?
120/80 mmHg
Normal pulse rate for an adult is:
60-100 bpm
What is the most effect regulatory means of protecting the public? a. licensure b. registration c. state cert d. mandatory continuing edu requirements
A. Licensure
Who regulates professions to protect the public from harm by unqualified individuals? a. BOC b. Individual states c. Better business bureau d. NATA e. US govt
B. Individual States
T/F: force acting along the long axis of a structure is termed tensile force.
FALSE: its axial force
T/F: extensibility is the ability of a muscle to be stretched & to return to normal length after either lengthening or shortening.
FALSE: its flexibility extensibility = ability to be stretched or increased in length.
T/F: comminuted fractures are often produced by excessive torsional & bending loads.
FALSE: its greenstick fracture comminuted fractures = when loading is very rapid, the fracture contains multiple fragments
T/F: shivering during hypothermia usually starts when core temp drops below 90*F.
FALSE: when it drops below 90*F, shivering ceases & muscles become cold and stiff.
A situation in which danger is apparent, or should have been apparent, that results in an unreasonable unsafe condition is called:
Foreseeability of Harm
What are the steps involved in evaluating an injury and/or performing a secondary assessment including the use of HOPS?
H: history (CC, MOI) O: observation/inspection P: palpation S: special tests
decrease tactile sensation
HYPOesthesia
fatigue, dizziness, confusion, rapid/shallow respiration, & rapid/weak pule are signs of:
Heat Exhaustion
*** An athlete is NOT sweating, appears red/flushed, & has hot, dry skin. What condition might the athlete be experiencing?
Heat Stroke
If an athletic training commits an act that's their responsibility to perform, but uses the wrong procedure, the individual could be accused of:
MISfeasance
BP readings of 120-139 systolic & 80-89 diastolic are related to
PREhypertension
What are the parts of SOAP?
S: subjective (history) O: objective (observation) A: assessment P: plan (treatment goals)
T or F: shock & dehydration can cause HYPOtension.
TRUE
T or F: the severity of shock can vary dependent on the age of the individual.
TRUE
T/F: BRADYKININ increases vessel permeability & stimulates the nerve endings to cause pain.
TRUE
T/F: Phase 2 of a therapeutic exercise program focuses on the regaining of any deficits in ROM & restoring proprioception
TRUE
T/F: acclimatization is the single most important factor in preventing the onset of heat illness & altitude sickness
TRUE
T/F: although person continuously drinks H2O throughout an exercise bout, less than 50% of fluid lost will be replenished.
TRUE
T/F: during the ACUTE INFLAMMATORY phase, HEPARIN is released into the injured area & acts as an anticoagulant, which results in increased swelling.
TRUE
T/F: hemorrhage & edema cause pooling of tissue fluids & blood products, which increases pain & muscle spasms
TRUE
T/F: in TENDONS, the collagen fibers are arranged in a parallel pattern, enabling resistance of high, unidirectional tensile loads when the attached muscle contracts.
TRUE
T/F: lack of acclimatization, use of diuretics, & sodium depletion in the normal diet can lead to heat cramps
TRUE
T/F: ligaments contain more elastic than tendons.
TRUE
T/F: ligaments resist large tensile loads along their long axis.
TRUE
T/F: ligaments resist small tensile loads from directions other than along their long axis.
TRUE
T/F: stress is defined as force divided by the surface area over which the force is applied
TRUE
T/F: the severity of shock can vary depending on age of person
TRUE
the PPE should determine the general health, maturity, & fitness level of an individual & detect those at risk for injury or those who may have conditions that limit participation.
TRUE
*** While stretching for an overthrown ball, a 1st baseman strained an ADDuctor muscle. What type of force would have produced this injury?
Tensile
A wrong done by an individual for which the injured party seek a remedy for damages suffered is called:
Tort
Crepitus w/ movt, inflammation, local swelling, & nodule formation in the tendon sheath are characteristics of:
b. chronic tenosynovitis
The escape of fluid from the blood vessels into the joint cavity is called:
b. effusion
As air temp approaches body temp & exceeds 30.6*C (87*F),___________ becomes the major means of heat dissipation.
b. evaporation
During cold weather, body heat is gained through which mechanisms?
b. increase in basal metabolism c. shivering d. thyroxine & epinephrine production
What best describes stage 2 tendinitis?
b. pain during activity that DOES NOT restrict performance
What is collagen a major component of?
b. tendon c. ligament d. skin
What is the most important tool of the PPE?
medical history
committing an act that's one's responsibility to perform, but uses the wrong procedure, or the right procedure is improperly performed.
misfeasance
failing to perform one's legal duty of care.
negligence
an abnormal sensation characterized by numbness, tingling, or a burning sensation
paresthesia
Neurogenic Shock
peripheral blood vessels dilate causing insufficient blood volume
Septic Shock
severe, bacterial infection
hypertension contributes to:
shock
what's the difference between stress v. strain?
stress = force/surface area over which the force is applied; when body sustains force related to the likelihood of the injury strain = amount of deformation an object undergoes in response to an applied force
Psychogenic Shock
temporary dilation of blood vessels resulting in draining of blood from head w/ pooling of blood in abdomen
an individual affirms a subjective understanding of the risks of participation in the activity & one's voluntary choice to participate
assumption of risk
deterioration of tissue
atrophy
A tendon begins to develop tears when it's stretched ______% beyond normal length.
b. 5-8%
*** After a preseason physical exam, an offensive lineman is found to have mild hypertension. What activity restrictions are there for this athlete?
a. No activity restrictions
What is the potential impact of the federal Rehabilitation Act & Americans w/ Disabilities Act on a physician's authority in determining clearance for participation?
a. RA&ADA: states people have the legal right to participate in any competitive sport regardless of a preexisting medical condition. b. physician CANNOT totally exclude an athlete from playing, but they can recommend them not to play due to their medical condition due to the possibility of increasing the risk for further injury and/or death. c. physician can only tell patient risks; explain disadvantages; recommend other activities.
Which of the following are considered a noncardiac cause of sudden death?
a. commotio cordis c. exertional hyperthermia d. exercise-induced anaphylaxis
The common MOI for a muscle contusion is:
a. compression
Marfan syndrome is a genetic disorder that primarily effects:
a. connective tissue
for a muscle to shorten, it must:
a. contract concentrically
The PROLIFERATIVE phase of healing includes:
a. development of new blood cells (angiogenesis) b. formation of fibrous tissue (fibroplasia) c. wound contraction - generation of new epithelial tissue (re-epithelialization) days 3-21
What are HYPERmobile individuals more susceptible to?
a. disc prolapse b. dislocations c. ligament sprains
*** An athlete has been diagnosed w/ anemia. Which food would you suggest the athlete to incorporate in their daily diet?
a. dried apricots
The superficial discoloration or swelling outside a joint in the surrounding soft tissue is:
a. ecchymosis
What are accurate indicators of the need to hydrate during exercise?
a. headache b. profuse sweating d. dizziness
Small diameter, slow transmission nerves carry impulses for what sensation?
a. pain
What factors affect flexibility?
a. race (NA are more mobile than AA, who are more mobile than whites) b. joint adhesions d. swelling
Which of the following are signs of shock?
a. rapid/shallow respiration c. profuse sweating d. pale, clammy skin
The beginning of the ACUTE INFLAMMATORY phase is marked by:
a. vasoconstriction lasts for a few seconds to ~10 min.
Respiratory Shock
airway obstruction, pneumothorax, hemothorax
______________ is the 1st chemical mediator to appear during the INFLAMMATORY STAGE of tissue.
c. Histamine
What is the immediate assessment that occurs on the field when a life-threatening injury is present?
c. Primary Survey
the body's ability to sustain submax exercise over an extended period of time
c. aerobic capacity
absorption of heat through the feet by standing on a hot artificial turf is an example of heat exchange termed:
c. conduction
What is the most common cause of sudden death in those younger than age 35?
c. hypertrophic cardiomyopathy (26%)
What does the Primary Survey determine?
c. level of responsiveness & assess ABCs
Sudden death is most often precipitated by:
c. physical activity
in the female athlete, iron-deficiency is predominantly seen in:
c. those who maintain a low % of body fat (& endurance athletes)
applying ice, compression, & elevation to an acute injury decreased injury to the:
c. zone of secondary injury
What would help prevent hyperthermia?
d. acclimate to the environment
The plantar fascia is an example of an:
d. aponeurosis
what is the most PREVENTABLE cause of sudden death?
d. exertional hyperthermia
Rubor, calor, tumor, dolor, & loss of functions are symptoms of:
d. inflammation
What are HYPOmobile individuals more susceptible to?
d. muscle strains (nerve pinch syndroms, overstress tendinitis) *they are tight jointed
having a reduced concentration of O2
hypoxia
when an individual has total disregard for the safety of others.
gross negligence
a localized mass of blood & lymph confined w/in a space
hematoma
Cardiogenic Shock
injury to heart or previous heart attack
Metabolic Shock
insulin shock, diabetic coma, vomiting, diarrhea
committing a negligent act while providing care.
malpractice
Standard of Care refers to:
the level of competency that must be demonstrated by an individual educated in & practicing in a given profession.
What activities are used to measure power?
vertical jump throwing med ball vertical jump & reach stair climbing