Exam 5

What is the Lyon College 6 Step Graduated Return to Play Protocol for concussions?

1. No activity with complete physical and cognitive rest with the objective of recovery 2. light aerobic exercise such as walking or stationary bike with no resistance with the objective of increasing heart rate 3. sport specific light sport drills with no impact with the objective of increasing movement 4. complex drills with the objective of increasing coordination 5. full contact practice with the objective of increasing confidence 6. return to play

How many vertebrae are in the thoracic spine?

12

How many cranial and spinal nerves are in the body?

12 cranial; 31 pairs of spinal

How many bones are in the face?

18 with some in pairs

How can you manage kidney contusions?

24 hour observation and gradual increase of fluid intake, refer to physician, surgery may be required, bed rest and close observation for several weeks

How many bones does the skull have?

28

How much does the brain weigh and how much oxygen and blood supply does it require?

3 pounds; 2% body oxygen; 15% blood supply

How many openings does the diaphragm have and why?

3 to allow passage of the esophagus, abdominal aorta, and inferior vena cava

How many permanent teeth do adults have?

32

How many scalene muscles are in the body and what do they do?

3; help with breathing process

How many vertebrae are in the sacrum/coccyx segment of the spine?

4 fused together

What is the chance of survival if an athlete is found in a coma after getting a concussion?

40%

What are some facts about eye injuries?

40000 happen annually in US; most are preventable; leading sports include basketball, baseball, softball, and racket sports

How many vertebrae are in the lumbar spine?

5

How many vertebrae are in the insacral spine?

5 fused together

How many vertebrae are in the cervical spine?

7

What is a concussion?

A brain injury that's caused by a sudden blow to the head or to the body; the blow shakes the brain inside the skull, which temporarily prevents the brain from working normally; temporary impairment of brain function caused by impact to the head or by rotational force

What is facet syndrome?

A chronic inflammatory and degenerative change; can result from extension overload, repetitive strains, and impingement secondary to disc degeneration

What are depressed skull fractures?

A force pushes a portion of the skull inside toward the brain; bleeding under the skin or even a laceration requiring bleeding control will occur

What are hernias?

A lump of tissue that bulges through weaknesses in the abdominal wall; can result from increased abdominal pressure, which may occur if an athlete holds their breath while weightlifting or going to the bathroom

What is spondylolysis?

A stress fracture or bone degeneration of the vertebrae, especially at the location referred to as pars interarticularis; commonly occurs at L4-L5 and L5-S1

What are signs and symptoms of solar plexus contusions?

Abdominal pain, fear, anxiety, difficulty breathing; dissipate quickly and normal breathing should resume without medical intervention

What are treatments for an orbital blowout fracture?

Activate EMS, control bleeding, monitor athlete's vitals

What causes lumbar and thoracic spine pain?

Acute and chronic strains of the postural muscles; chronic strain may result from poor posture, poor mechanics, weakness, stiffness, and muscle restrictions

What type of strains are common?

Acute strains of cervical and thoracic muscles

What causes intervertebral disc herniation of the lumbar spine?

Acute trauma and cumulative stress

What are some statistics of concussions?

Affect 1.7 million, ED treats 173285 head injuries annually with 71% being male, ED visits increased by 60%, football most common for males 75% chance, soccer most common for females 50% chance, 78% occur during games, fewer than 10% involve loss of consciousness

Why is exercise progression important?

Allows for strength progression; should be challenging but not irritating to injury and is determined by the severity of the injury and the clinician's assessment of the patient's ability

What is lordosis?

An excessive forward curve of the lumbar spine

What is kyphosis?

An excessive forward curve of the thoracic spine; puts a great deal of stress at the back of the neck due to the forward head posture

What is scoliosis?

An excessive side to side or rotational curvature of the spine

What is a spontaneous pneumothorax?

An imperfection in the tissue of the lung that can break and cause the lung to collapse; athlete appears healthy but can experience difficulty breathing, chest pain, and possibly a bluish color of skin if breathing is poor; reporter in weight lifters and runners

What is cauliflower ear (hematoma auris)?

An injury common in wrestling; caused by wrestler not wearing headgear or head being pushed hard into the mat

What is a penetrating skull fracture?

An object has gone through the scalp, skull, and likely the brain

What fluid fills the anterior chamber of the eye?

Aqueous humor

Who are the primary rehabilitation team members?

Athletic trainer, physician, patient, orthopedist, podiatrist, ophthalmologist, psychologist or counselor, physical therapist

Who are additional primary rehabilitation team members?

Athletic training student or other healthcare students, parents or spouse, coach, school nurse

What do the muscles of the trunk and neck do?

Attach to the spine via tendons and provide both wide range of movement and stability

What does the mnemonic ATC IS IT stand for in the principles of rehabilitation?

Avoid aggression, timing, compliance, individualization, specific sequencing, intensity, total patient

What can occur with hyperflexion injuries?

Avulsion fractures secondary to traction of attaching ligaments

What does cerebrospinal fluid do?

Bathes CNS in chemicals for proper function, helps maintain regular pressure around CNS, protects brain from impacts

What causes corneal abrasions or lacerations?

Being poked in the eye with a foreign object or by wearing contact lenses too long

Where are disks located and what do they do?

Between vertebrae; absorb shock, resist compression during activity, separate vertebrae allowing for movement and flexibility, provide space for nerves to exit spinal cord and enter the rest of the body; compressible

What do lacerations of the scalp do and require?

Bleed profusely because of the number of blood vessels; direct pressure is needed and the application of multiple gauze pads is usually necessary

What causes periorbital hematoma (black eye)?

Bleeding and discoloration under skin that affects the tissue surrounding the eye; ice application reduces pain and swelling

What causes solar plexus contusions?

Blow to the area of the diaphragm that can hit nerves in the solar plexus that can momentarily paralyze the diaphragm and impair breathing

What can cause nosebleeds (epistaxis)?

Blow to the nose, constantly blowing nose during cold, some medications that increase susceptibility

What causes myocardial contusions?

Blunt force impact to the chest over the heart

What causes testicular trauma?

Blunt trauma and contusion to the scrotum

What causes kidney contusions?

Blunt trauma directed at the lower back causing contusion, laceration, or rupture; can also be injured as a result of heat stroke

What is the most potentially serious and life threatening injury of the cervical spine?

Bone and joint pathologies

What are osteophytes?

Bone spurs; can arise from vertebral bodies secondary to degenerative disc changes that increase wear and compression of joint surfaces; most commonly found posteriorly

What are some sports that are high risk to concussions?

Boxing, football, ice hockey, martial arts, rugby, wrestling, lacrosse, cheerleading, skiing, auto racing, soccer, field hockey, basketball, skate boarding, equestrian sports, Irish step dancing, diving, gymnastics

What causes intervertebral disc herniation?

Can result from acute trauma causing compression, flexion, or extension of the cervical spine; most often caused by gradual weakening or failure of annulus fibrosis secondary to chronic or repetitive mechanical stress

How can acute soft tissue injuries occur in the cervical and upper thoracic spine?

Can result from direct contact, acute overstretching, or mechanical overload mechanisms

What causes sprains or separation of the costochondral joint?

Can result secondary to anteriorly directed trauma to the sternum or lateral compression of the chest wall

What causes transient neuropraxia?

Can result secondary to posterior disc herniation, spinal stenosis, congenital fusion, or instability in the cervical spine

What controls lung function and breathing rate?

Carbon dioxide receptors

What does the jugular vein do?

Carries deoxygenated blood away from the brain

What does the carotid artery do?

Carries oxygenated blood to the brain

What does the auditory canal do?

Carries sound to the tympanic membrane (eardrum); earwax found here and keeps dirt away from the eardrum

What are signs and symptoms of cervical fractures, dislocations, and subluxations?

Central spine pain, tenderness with palpation of involved spinous processes, muscle spasm, position deformity, unwillingness to move neck, bilateral sensory deficits (burning hands, paresthesia, numbness, loss of sensation), motor weakness, paralysis

What are signs and symptoms of intervertebral disc herniation of the lumbar spine?

Centralized back pain, point tenderness over spinal level, muscle spasm, sciatica

How can vertebral arteries be compromised?

Cervical fractures, dislocations, subluxations

What are the four segments of the spine?

Cervical, thoracic, lumbar, sacrum/coccyx

What is a cardiac contusion (commotio cordis)?

Characterized by immediate cardiac arrest and sudden death following a localized blunt blow to the chest; resuscitation attempts have failed and death usually results

What are side stitches?

Characterized by sharp pain or spasm along the lateral abdominal wall

What is costochondritis?

Chronic irritation and inflammation of the constochondral junction that can occur following acute, traumatic injury or as a result of chronic stress or repetitive activities such as coughing, rowing, or lifting

What is temporomandibular joint dysfunction (TMJ) characterized by?

Chronic joint pain and crepitus that may also produce headaches and neck pain

What is the trachea?

Circular rings of cartilage that make up the trunk of the respiratory tract

What are signs and symptoms of costochondritis?

Complaint of gradual onset of anterior chest wall pain, tenderness over affected joint, crepitus, mild inflammation

What are signs and symptoms of sternal fractures?

Complaints of losing their breath immediately following injury, feeling pain with deep inhalation, localized pain, tenderness, ecchymosis, swelling, possible deformity may be seen during examination

What are signs and symptoms of brachial plexus injuries?

Complaints of temporary weakness or inability to move arm, usually short lived and extremity typically regains full function within minutes, neurological symptoms may persist for days or months depending on the severity of the nerve disruption

What causes thoracic outlet syndrome (TOS)?

Compression of the subclavian artery as it exists through the thoracic outlet; the; the most common vascular condition in the cervical region; brachial plexus complex exists through the thoracic outlet and can also be affected by compressive forces

What causes thoracic and lumbar spine injuries?

Considerable mechanical and muscular forces exerted during running, jumping, twisting, bending, and lifting

What is the right lower quadrant of the abdominal cavity?

Contains the large and small intestines, appendix, portion of the bladder, uterus, right ovary, prostate

What is the left lower quadrant of the abdominal cavity?

Contains the large and small intestines, portion of the bladder, uterus, left ovary, prostate

What are suture joints?

Cranial bones with articulations

What are signs and symptoms of osteophytes?

Decreased ROM, postural changes, neck discomfort that increases with lateral rotation and extension, neurological symptoms that increase as intervertebral narrowing progresses

What are signs and symptoms of a hemothorax?

Difficulty breathing, bluish skin color, unconsciousness, rapid/weak pulse, sweating, hypotension, coughing up frothy blood, shock

What causes nasal fractures and what are some symptoms?

Direct blow to the nose; hearing a snap, pain, swelling, deformity, difficulty breathing, crepitus during palpation, black eyes from internal bleeding

What are spinous processes and their superficial ligaments vulnerable to?

Direct contact and contusions; result in point tenderness, localized swelling, pain with flexion and extension, considerable muscle swelling, stiffness, and spasm resulting in loss of ROM and function

What causes tooth fractures?

Direct impact to the lower jaw or teeth

How are pinna lacerations treated?

Direct pressure to control bleeding; if portion is avulsed, detached part should be wrapped in sterile gauze, put in a plastic bag, and placed in ice

What causes TMJ?

Direct trauma, arthritic conditions, poor approximation of teeth when biting down, muscular tension, grinding of teeth at night

What causes nerve compression injuries to the lumbar spine?

Disc herniation or degenerative osteophytes causing stenosis of the foramen

What are signs and symptoms of an orbital blowout fracture?

Double vision, numbness of lip and upper jaw on the same side of injury, deformity of orbit (eye sunken into socket), immediate swelling, conjunctiva discoloration, nose bleed on same side of injury, eye may bulge as athlete attempts to blow nose

What causes brachial plexus injuries (aka burners/stingers)?

Due to compression or stretching of C5 through T1 nerve roots as they exit the cervical spine

What do sound waves vibrate in the ear?

Eardrum and ossicles; amplifies and changes from air to liquid

Who are secondary rehabilitation team members?

Emergency medical technicians, orthotist, pharmacist, kinesiologist, exercise physiologist, nutritionist, attorney, supervisor, peers

Why is program progression important in rehabilitation progression?

Emphasizes different goals

What is the cerebellum responsible for?

Equilibrium, muscle actions, some reflexes

What do short term goals of rehabilitation do?

Established weekly or bi-weekly and gives the patient a direction; less overwhelming

Why is examination and assessment important in rehabilitation?

Evaluates goal attainment; for each deficiency you find, you decide what realistic short term goals the patient can achieve within a specific time frame; should be reassessed regularly to decide on new and appropriate short term goals

What does the upper trapezius do?

Extends the cervical spine; attaches to the occipital bone and fans out to each side of the neck before attaching to the acromion process of the scapula

What does the right atrium do?

Fills with blood from the vein, carrying waste products and carbon dioxide

What does the left atrium do?

Fills with oxygenated blood from the lungs

How is the abdominal cavity divided?

Four quadrants by imaginary horizontal lines running across the abdomen through the navel and imaginary vertical lines running from the sternum through the navel to the area between the legs

What is an orbital blowout fracture?

Fracture of the thin bones beneath the eye in orbit absorbing pressure from the blow that forces the globe posteriorly

What are linear skull fractures?

Fracture that goes around the skull; although no bones are moved out of place, there are tears in the blood vessels on the inside of the skull

What sports are spondylolysis and spondylolisthesis common in?

Gymnasts, weightlifters, football linemen

What are symptoms of post concussion syndrome?

Headache, ringing in ears, dizziness, confusion

What are symptoms of intracranial hemorrhage?

Headaches, nausea, vomiting, loss of consciousness, paralysis of extremities on the opposite side of injury, battle sign

What is the primary cause of cervical fractures, dislocations, and subluxation?

Headfirst contact; compresses and buckles the cervical spine

What is the temporal lobe responsible for?

Hearing and speech

What is hyphema?

Hemorrhage into the anterior chamber of the eye caused by a blow

What are treatments for cauliflower ear?

Ice and compression with moldable material; may lance (drain) ear to reduce swelling and use steroid medication to keep hemorrhage under control

What is the computerized concussion test that Lyon uses?

ImPACT

What are some steps to prevent poor postural habits?

Imagining balloons attached to your head that are pulling you up straight, alternate carrying your book bag/gym bag on opposite shoulders, staying fit and exercising regularly

What are signs and symptoms of traumatic fractures to the lumbar spine?

Immediate pain, direct tenderness over the vertebral segment, referred pain along nerve distribution, crepitus, decreased ROM, unwillingness to move

What can cause compression of nerve structures?

Injuries associated with the cervical spine are typically caused by bone or soft tissue encroachment into the spinal canal or intervertebral spaces

What is an inguinal hernia?

Intestine protrudes through a weak spot in the adductor muscles; causes a bulge in the groin or scrotum in males; may cause pain or burning; more common in males

What is an umbilical hernia?

Intestine protrudes through the umbilical opening in the abdominal muscles; very common and typically harmless

What is the nucleus pulposus part of disks?

Jellylike core

What is the proper lifting technique that prevents spinal injuries?

Keeping the head up, feet in wide stance, and spine in a neutral position; keeping load close to the body to reduce stress on back

What are some theories as to why side stitch pain occurs?

Lack of oxygen getting to the abdominal muscles, improper breathing techniques, eating food before exercising, air trapped in the abdominal organs, muscle spasm

What does the left ventricle do?

Largest chamber of the heart; receives blood from the left atrium and pumps it throughout the body

What are the four chambers of the heart?

Left and right atria (upper chambers) and the left and right ventricles (lower chambers)

How many lobes to the left and right lungs have?

Left lung has 2, right lung has 3

What is the right upper quadrant of the abdominal cavity?

Lies just below the ribs of the athlete's right side; contains the liver, portion of the pancreas, right kidney, gallbladder, large and small intestines

What is the left upper quadrant of the abdominal cavity?

Lies just below the ribs on the athlete's left side; contains the stomach, portion of the pancreas, left kidney, spleen, large and small intestines

What are signs and symptoms of the thoracic spine?

Localized pain and discomfort, tenderness with palpation over the spinous process of the involved vertebra, muscle spasm and guarding, increased pain with forward flexion and other movements of the thoracic spine

What are signs and symptoms of rib contusions?

Localized pain, swelling, discoloration, periosteal irritation, point tenderness, pain over impact site but not on compression away from site

What are signs and symptoms of spinous process fractures?

Localized pain, tenderness to palpitation, pain with extreme flexion and extension movements

What is the lens?

Located in the anterior portion of the eye; focuses light entering the eye on the retina; can be dislodged by a poke to the eye, causing blurring and changes in an athlete's vision

What are symptoms of spondylolysis and spondylolisthesis?

Lower back pain that worsens during hyperextension, radiating pain to the butt and upper thigh, swelling, muscle spasms, straightening of lordotic curve

What are alveoli?

Lung tissues that perform oxygen/carbon dioxide exchange

What is the only moveable bone in the skull?

Mandible

What are the major bones of the face?

Maxillae (2 bones of upper jaw), mandible (lower jaw), zygomatic (cheekbones)

Who experiences degenerative bony changes due to traumatic or repetitive injury?

Most commonly seen in older adults; commonly seen in athletes involved in contact and collision sports, such as rugby and football

Who experiences spinal stenosis?

Most often seen in older adults; can be disabling for anyone but is of particular concern in contact sports and may disqualify athletes from competition because of the greater risk of spinal cord injury

What are signs and symptoms of strains?

Muscular pain, point tenderness, spasm, decreased ROM

What can posterolateral osteophytes do?

Narrow the intervertebral foramen, resulting in nerve root compression and increased susceptibility to brachial plexusneuropraxia

What are signs and symptoms of concussions?

Nausea, headache, dizziness, vomiting, ringing in ears, vacant state, delayed verbal and motor responses, confusion and inability to focus attention, disorientation, slurred or incoherent speech, gross observable coordination issues, emotions out of proportion to circumstances, memory deficits, any period of loss of consciousness brief or prolonged

What causes vascular injuries?

None or soft tissue encroachment that results in compression of various vascular structures in and around the neck

What does neutral spine mean?

Normal alignment of the spine

What keeps the spinal segments aligned properly?

Normal anatomical alignment and muscular strength

What causes sternal fractures?

Not very common; impact to sternum can be expected to cause internal injuries

What are motor responses and their grading according to the Glasgow Coma Scale?

Obeys commands for movements (6), purposeful movement to painful stimulus (5), withdraws in response to pain (4), flexion in response to pain aka decorticate posturing (3), extension in response to pain aka decerebrate posturing (2), no response (1)

What causes rib fractures?

Occur at weaker, posterior angle; caused by direct impact or chest compression, sudden violent muscular contraction, blows to front and back of ribs

What is an epigastric hernia?

Occurs in the midline of the belly between the sternum and navel; typically small and painless

What is second impact syndrome?

Occurs when athlete receives more than one concussion or blow to the head in a relatively short time

What is degenerative disk disease?

Occurs with recurrent sprains and chronic joint dysfunction; annulus fibrosis can be weakened or damaged with repetitive injury or stress, reducing disc height and shock absorbing capability

What are verbal responses and their grading according to the Glasgow Coma Scale?

Oriented (5), confused conversation able to answer questions (4), inappropriate words (3), incomprehensible speech (2), no response (1)

What is the incus (anvil)?

Ossicle found in the middle ear; the bridge between the malleus and stapes

What are stapes (stirrup)?

Ossicle found in the middle ear; the footplate that transitions pressure waves to the inner ear; the smallest bone in the human body

What is the malleus (hammer)?

Ossicle found in the middle ear; the long handle attached to the eardrum

What are signs and symptoms of facet syndrome?

Pain and decreased motion at facet joints; pain is exacerbated with extension and rotation to involved side

What are signs and symptoms of myocardial contusions?

Pain in chest especially over sternum, neck vein dissension, possible arrhythmia, muffled heart tones, shock, respiratory or cardiac arrest

What are signs and symptoms of rib fractures?

Pain, difficulty breathing, point tenderness, swelling, discoloration, crepitus, muscle guarding, increased pain with inhalation but not exhalation

What are signs and symptoms of abdominal muscle strains?

Pain, muscle spasm, palpable tenderness, swelling and discoloration may or may not be present

What are signs and symptoms of hyperflexion and hyperextension mechanisms?

Pain, point tenderness over cervical musculature, spasm, restricted movement

What are signs and symptoms of sprains or separation of the constochondral joint?

Pain, point tenderness, increased pain with deep respiration, crepitus/clicking, increased prominence of joint, swelling, discoloration

What are signs and symptoms of strains in the thoracic and lumbar spine?

Pain, point tenderness, muscle spasm, possible swelling in and around the involved musculature

What are signs and symptoms of a detached retina?

Pain, see sparks, lights, and flashes, difficulty seeing, foggy vision; can result in blindness

What are signs and symptoms of degenerative disk disease?

Pain, spasm, motion restriction, bony changes

What are signs and symptoms of cervical whiplash?

Pain, spasm, restricted ROM

What are signs and symptoms of spinal cord injuries?

Paresthesia, paralysis, numbness, burning, tingling, atrophy

What is the oval window (vestibule)

Part of the inner ear; connects the middle ear with the inner ear

What is the Eustachian tube?

Part of the inner ear; connects the middle ear with the nasopharynx that aerates the middle ear and clears mucus

What are semicircular ducts?

Part of the inner ear; fluid filled arches involved in both hearing and equilibrium

What is the cochlea?

Part of the inner ear; spiral shaped organ of hearing that transforms sound into signals that get sent to the brain via the auditory nerve (cochlear and vestibular nerves)

What are the functions of the bony spinal column?

Protecting the spinal cord, holding the body upright for walking, serving as a site for muscle attachments

What are femoral hernias?

Protrusion that follows the path of the femoral canal; occurs more frequently in females than males, but are less common than inguinal hernias

What does the lumbar spine do?

Provides both mobility and stability for the upper extremity and torso movements and effectively absorbs and transmits forces between the upper and lower extremities

What's involved in the rehabilitation objective of preventing deconditioning?

Provides exercises for cardiovascular system, the uninvolved area of the injured extremity or segment, the uninvolved extremities

What do the ventricles do?

Pumps blood throughout the body

How quickly do symptoms occur of oxygen deprivation?

Pupils dilate within 60 sec; 4-6 min without oxygen, biological brain death occurs

What's caused by contact or impingement of adjacent spinous processes?

Push off fractures with hyperextension mechanisms

What are signs of intracranial hemorrhage?

Rapid shallow breathing, hypotension, pupil on the same side as head injury will be enlarged, athlete may have difficulty speaking, using extremities on the opposite side of injury, stiffening of posture, rapid eye movements, unconsciousness or coma, lack of coordination

What causes fractures of the thoracic spine?

Rare; compression of the vertebral body resulting from violent forward flexion or axial loading in forward flexed position

What are some objective and measurable goals?

Rating pain on a scale from 1-10, measuring girth/ROM/strength, ID positive gains and areas for improvement

What does the right ventricle do?

Receives blood from the right atrium and pumps it to the lungs to re-oxygenate the blood

What are the primary muscles of the abdomen?

Rectus abdominus and obliques

What causes traumatic fractures of the lumbar spine?

Relatively uncommon; transverse process injuries can result from direct trauma, violent torsional movements, avulsion of psoas major muscle following violent contraction; spinous process injuries attributed to blunt trauma but can occur from forced hyperflexion

What are treatments for sponylolysis and spondylolisthesis?

Rest, drug therapy, lumbar bracing, exclusion from certain sports, extensive rehabilitation that focuses on strengthening trunk muscles in neutral spine position, surgery

How can sprains occur in the cervical and upper thoracic spine?

Result from compression or jamming of the spine into extension; may also occur during forceful hyperflexion, hyperextension, or rotational movements

What are signs and symptoms of facet syndrome in the thoracic and lumbar spine?

Results from acute trauma or chronic repetitive insult; localized swelling, paraspinal muscle spasm, tenderness upon palpitation and movement of facet joint, increased pain with extension, compression, rotation to involved side, pain referred down leg

What are compound skull fractures?

Results in a portion of the skull sticking through the scalp and profuse bleeding

What does the retina contain?

Rods that provide vision in black and white and cones that provide vision in color

What do spinal extensors do?

Run the entire length of the spine posteriorly and attach to structures such as the pelvis, ribs, and vertebrae

What are some examples of non computerized concussion tests?

SAC, SCAT5

What causes rib contusion?

Same type of impact or compression that can cause fractures

How is cervical flexion accomplished?

Scalene muscles that attach to the cervical vertebrae and run down to the first and second ribs

What is the parietal lobe responsible for?

Sensation

What are signs and symptoms of transient neuropraxia?

Sensory changes (burning, tingling, numbness), motor changes ranging from weakness to temporary paralysis in both the upper and lower extremities; usually subside within a few minutes, but may persist for 1-2 days

What are signs and symptoms of testicular trauma, and how can you manage it?

Severe pain and swelling; use ice to reduce pain and swelling, wearing protective cup during contact sports

What are signs of cardiac tamponade?

Shock, neck vein distension, hypotension, cyanosis, severe chest pain, difficulty breathing

What do long term goals for rehabilitation do?

Show the final desired outcome

What does hematoma cause?

Significant increase in pressure on the brain; can cause rapid death

What are signs and symptoms of kidney contusions?

Signs of shock, deep aching pain in lower back and flank region, nausea, vomiting, rigidity of back muscles, hematuria (blood in urine)

How do isolated strains occur?

Single episode of mechanical overload or from violent stretching into flexion, extension, or rotation

What are examples of injuries caused by external forces acting on the spinal cord or cervical nerve roots?

Spinal cord injury, transient neuropraxia, disc herniation, branchial plexus injuries

What are eye opening responses and their grading according to the Glasgow Coma Scale?

Spontaneous eye opening (4), eyes open to speech (3), eyes open to pain (2), no eye opening (1)

Who are additional secondary rehabilitation team members?

Sport team members, equipment manager, teachers, athletic administrator

How are cervical spine bending (lateral flexion) and rotation accomplished?

Sternocleidomastoid muscle that is attached to the top of the sternum and runs up the neck attaching to the mastoid process behind the ear

What are some complications associated with degenerative bony changes?

Structural malalignment, narrowing of spinal canal or intervertebral foramen resulting in nerve compression, increased risk of nerve injury

What can cause strains in the thoracic and lumbar spine?

Sudden contraction or stretching of involved musculature, sudden eccentric loading of already contracting muscle, single episode muscle overload, cumulative stress

What is cervical whiplash and how does it occur?

Sudden forced extension followed by sudden forced flexion; can occur in sports and motor vehicle accidents ; can result in sprain-strain injuries

What causes sprains of the thoracic and lumbar spine?

Sudden loading or torsion movements, direct or indirect trauma that forces the spinal segment beyond normal ROM, compressive loading forces

What do the abdominal muscles do?

Support trunk movement, especially rectusabdominus and internal/external obliques

What are signs and symptoms of cauliflower ear?

Swelling, redness, pain caused by internal bleeding in pinna of ear

What are vertebrae?

The bones of the spine

What is the brain stem?

The center for breathing, heart rate, and other life sustaining functions

What is the cornea?

The clear center section of the eye; protects other important structures from injury; covers the iris and pupil and admits light to the interior; can be injured by wearing contacts too long or by something scratching the eye

What is the iris?

The contractile, colored portion of the eye with the pupil in the center; responds to light changing its size; bright light causes it to constrict, limiting the amount of light entering the eye; in a dark room it dilates to allow more light into the eye

How is spinal stenosis characterized?

The developmental or congenital narrowing of the cervical spinal canal; narrowed canal increases risk for cord compression and injuries resulting from hyperextension or hyperflexion mechanisms; when coupled with secondary complications, risk for spinal cord injury is further increased

What is dentin?

The hard, bony portion of the tooth

What is the mouth made up of?

The mandible, maxillae, temporomandibular joint, tongue, palate, teeth

What is the diaphragm?

The muscle that separates the thorax and abdominal cavity; contracts and pulls down to assist in inhalation and moves upward to push air out of the lungs on exhalation

What is the esophagus?

The passageway for food going from the mouth to the stomach; located in front of the cervical vertebrae and behind the trachea and larynx

What is the root of the tooth?

The portion of the tooth below the gum line

What is pneumothorax (collapsed lung)?

The presence of air in the pleural cavity which can occur either as a result of trauma or without trauma; injured lung moves toward the center of the chest, which puts pressure on the heart and other lung

What is the pinna?

The projecting portion of the external ear; cartilage covered by skin; catches sound and funnels it into the auditory canal

What are the main structures in the posterior chamber of the eye?

The retina and optic nerve

What is the annulusfibrosus part of disks?

The several layers of cartilage that surround the nucleus pulposus

What is pulp?

The soft portion of the tooth containing the nerve and blood supply

Where are lacrimal glands (tear glands) located?

The upper outside (superior lateral) edge of the eye

What is the crown of the tooth?

The visible portion of the tooth above the gum line; capped with a thin layer of enamel

What is the larynx?

The voice box; the modified upper part of the trachea that contains the vocal cords

What is the sclera?

The white area of the eye covered by conjunctiva; change in color indicates that the athlete has a problem or illness such as liver disease, lack of oxygen, or poisoning

What is pleura?

Thin, lubricated tissue that lines each half of the thorax and is folded back over the surface of the lung on the same side

What forms the thoracic cage?

Thoracic spine, corresponding 12 pairs of ribs, sternum

What can head trauma result in?

Tissue edema or hemorrhage particularly over the temporal or parietal regions, causing pressure to build in the intracranial space ultimately compressing the brain stem

What causes traumatic and non-traumatic pneumothorax?

Traumatic can occur from a rib puncturing a lung, gunshot wound, severe laceration; non-traumatic can occur due to weakness of lung tissue

What can a blow to the base of the neck do?

Traumatize the brachial plexus resulting in numbness and weakness in the upper extremity

What are signs and symptoms of intervertebral disc herniation?

Typically protrudes into the intervertebral foramen which compresses and irritates the nerve root, pain and discomfort that improves with cervical distraction and worsens with extension and rotation, decreased ROM, muscular splinting

Where do spinous process fractures occur?

Uncommon but can occur in the cervical and thoracic spine as a result of hyperflexion or extension mechanisms

What are signs and symptoms of cervical contusions?

Uncommon; pain, muscle spasm, decreased ROM

What's involved in the rehabilitation objective of rehabilitating the injured part?

Using good judgment, having good knowledge of the injury and the healing process, knowing methods of rehabilitation

What are confusional eye injuries?

Vary in severity from simple corneal abrasions to major injuries such as rupture of the eye, fracture of orbit, both, and detached retina

How can an AT determine if a person has normal posture?

Viewing them from the side; imagining a line dropping from the ceiling and the line would pass behind the ear, through the center of the shoulder, down through the middle of the greater trochanter hip, just behind the patella, and down to just in front of the lateral malleolus

What causes abdominal muscle strains?

Violent muscle contraction, trunk twisting, chronic or repetitive overuse

What is the occipital lobe responsible for?

Vision

What fluid fills the posterior chamber of the eye?

Vitreous humor

What is the frontal lobe responsible for?

Voluntary muscle movement, emotions, eye movement

What is a tension pneumothorax?

When air leaks out of a collapsed lung and into the chest cavity, forcing the lung to press against the other lung and heart; can observe deviated trachea; death can occur if not treated; athlete will experience respiratory distress, absent breath sounds on injured side, anxiety, bluish skin color, rapid/weak heart rate, decrease in blood pressure

What is a hemothorax?

When blood leaks into the pleural cavity secondary to a penetrating rib fracture

What is a cardiac tamponade?

When the pericardial sac fills with fluid placing pressure on the heart to the point where it may stop beating

When does inhalation occur?

When too much carbon dioxide is registered by the receptors

What type of fractures are the most common form of facial fractures?

Zygomatic fractures