EXNS 200 Exam 2
Steps of rehab
1. providing correct 1st aid and controlling swelling 2. reducing pain 3. restoring full range of motion 4. restoring muscular strength, endurance, and power 5. reestablishing neuromuscular 6. maintaining cardiorespiratory fitness 7. Functional progression 8. Criteria for return to play
Possibility of death is significantly reduced if the body temperature is lowered to___________ within _____________
102°F / 30 minutes
Can be fatal if temperature rises to _______ or drops to between _______ and ______
107°F/ 77°F/85°F
Sutures should be put in within _______ hours following injury
12
The optimal level of carbohydrates is ______ grams per ______ ounces of water
14/ 8
Those who develop AIDS generally die within _________ years after the symptoms appear
3
What is the recovery time for HPV
6-8 weeks
Stimulates shivering that ceases below a body temperature of _______ to _________
85°F/ 90°F
Skin is scraped against a rough surface wearing away skin and exposing numerous blood capillaries
Abrasion *Foreign materials scraping against skin increases possibility of infection • Wound must be debrided and cleansed*
• One of the most common mental and emotional stress producers• Reflected by a vague fear, a sense of apprehension, and restlessness • Athlete may feel inadequate in a certain situation but is unable to say why • May cause heart palpitations, shortness of breath, sweaty palms, constriction in the throat, and headaches
Anxiety
•Skin is torn from the body •Associated with major bleeding
Avulsion wounds *•To reattach the torn tissue, the avulsed tissue should be placed on moist gauze, preferably saturated with saline solution • Should be taken along with the athlete to the hospital for reattachment*
Pathogenic microorganisms that can potentially cause disease
Bloodborne Pathogens
• Syndrome related to physical and emotional exhaustion leading to negative concept of self and sports attitudes and loss of concern for the feeling of others • Stems from overwork and can affect both the athlete and the coach • Detrimental to athletes' general health as they may:
Burnout
Symptoms include skin redness, swelling, tingling, and pain in the toes and fingers • Caused by problems of peripheral circulation • Can be avoided by preventing further cold exposure
Chill Blain
Results from prolonged and constant exposure to cold for more than 60 minutes with the temperature at 50 degrees or less
Chillblain
Activities that maximize performance while minimizing the possibility of injury
Conditioning exercise
Heat can be dissipated from the body through four mechanisms
Conduction Convection Radiation Evaporation
What emotion occurs when an athlete feels an overwhelming feeling of hopelessness or loneliness
Depression
What is most effective means for the body to dissipate heat when the temperature and radiant heat of the environment are higher than the body temperature?
Evaporation
• Sweat glands in the skin allow water to be transported to the surface, where it evaporates • While evaporating, water takes heat with it • When radiant heat and environment temperature are higher than body temperature, loss of heat through evaporation is key
Evaporative Heat Loss
• *Profuse sweating*, pale skin, mildly elevated temperature, dizziness, hyperventilation, and rapid pulse • Affected individual may develop heat cramps or become faint/dizzy • Decline in performance Results from inadequate fluid replacement
Exertional Heat Exhaustion
• Ingesting too much fluid before, during, and after exercise • Sodium deficiency in the diet or in ingested fluids over a period of prolonged exercise
Exertional Hyponatremia
• Sudden collapse with loss of consciousness; flushed, hot skin; *absence/minimal sweating*; shallow breathing; strong, rapid pulse; and a core temperature of 105°F
Exertional stroke
T or F Seek shelter in large trees, flag/light poles, standing water, telephone poles, pools, showers, and metal objects if lightening is around
False Avoid
T or F Core stability is not important for rehabilitation of any part of the body
False Dynamically stabilizes the entire kinetic chain during functional movements
T or F In case of an exertional heatstroke, the replacement of fluids is a critical step in initial first aid.
False Immediately immerse the athlete in a cold water bath up to his or her neck
T or F taping should be used as a substitute for rehab
False never
T or F There is a vaccination for HCV
False no vaccine
T or F An athlete's physician does not have final say in whether the athlete can return to full competition and practice
False physician does have final say
T or F HIV is most common bloodborne infection in the United States
False HCV/ Leading indication for liver transplant
T or F These is a vaccine for HIV
False no vaccine
What is the single most important step taken by a coach to minimize the chance of heat illnesses
Fluid replacement *only 50% of fluid is ever replaced and should therefore be replaced before, during, and after exercise*
•Involves ears, nose, cheeks, chin, fingers, and toes •Occurs with high wind and/or severe cold •Causes skin to appear firm with cold, painless areas that may peel and blister in 24-72 hours
Frost Nip
• Superficial frostbite involves only skin and subcutaneous tissue • Skin appears pale, hard, cold, and waxy • When rewarming, the area will first feel numb, then sting and burn • Affected area may blister and be painful for several weeks
Frostbite
In situations in which thunder or lightning may be present and you feel your hair stand on end and skin tingle, you are in imminent danger.... you should _______
Get down on the ground and assume a crouching position
___________ are an effective motivator for compliance to rehabilitation of an athletic injury, as well as for reaching goals in a general sports setting
Goals
• Flulike symptoms such as fatigue, weakness, nausea, abdominal pain, headache, fever, and possibly jaundice • It is possible that the individual will not exhibit signs and symptoms
HBV
•80% of those infected have no signs or symptoms •Symptoms include jaundice, mild abdominal pain, loss of appetite, nausea, fatigue, muscle or joint pain, and/or dark urine
HCV
Traditionally attributed to excessive water loss and electrolyte imbalance due to profuse sweating Painful muscle cramps Recent evidence suggests muscle fatigue that alters neuromuscular control facilitates a reflex contraction or cramp of the muscle
Heat Cramps/ Exercise-Associated Muscle Cramps
Physiological processes in the body will continue to function if body dissipates heat and the body temperature is maintained within a normal range
Heat Stress
• Associated with rapid physical fatigue during overexposure to heat • Caused by peripheral vasodilation, hypotension, or a pooling of blood in extremities
Heat syncope
Major cause of viral infection that results in swelling, soreness, and loss of normal function in the liver
Hepatitis B Virus (HBV)
Acute and chronic form of liver disease
Hepatitis C Virus (HCV)
Used postacutely (after swelling stops) • Increase blood and lymphatic flow • Facilitate reabsorption of by-products of injury process into the lymphatic system
Hot Packs
Where are Bloodborne Pathogens found
Human Blood, semen, vaginal secretions, cerebrospinal fluid, synovial fluid, and any other fluid contaminated with blood
Caused by a family of complex viruses that invade normal healthy cells, thus decreasing the effectiveness of the host cell in preventing disease Virus that destroys cells of the immune system
Human Immunodeficiency Virus (HIV)
Refers to an increase in body temperature
Hyperthermia
• Failure to warm up sufficiently or becoming chilled because of inactivity for varying periods • Low temperatures in conjunction with wind chill and dampness or wetness
Hypothermia
When does rehab process start
Immediately after injury
Wound with smooth edges that appears where a blow has been delivered over a sharp bone that is poorly padded
Incision
Incorporated in the later phases of the rehabilitation program Use fixed speed with accommodating resistance to provide maximal resistance throughout R O M
Isokinetic Exercises
Performed in the early phase of rehabilitation when a joint is immobilized for a period of time Increase static strength, assist in decreasing the amount of atrophy, and reduce swelling
Isometric exercises
Sharp, pointed object or direct blow tears the skin giving the wound appearance of a jagged - edge cavity
Lacerations
Return the injured athlete to practice or competition as quickly and safely as possible
Long - Term Goal
What are the at risk sports for transmitting HIV
Martial arts, wrestling, and boxing
Systematic manipulation of the soft tissues of the body
Massage
• Direct result of graded pressures and movements of the hand on the body • Encourage venous and lymphatic drainage and mildly stretch superficial and scar tissue
Mechanical response
Useful in restoring or developing an athlete's ability to produce dynamic movements associated with muscular power
Neuromuscular control
________________ provide a complete barrier around and over a wound and are air-tight and water-tight
Occlusive dressings
Result of imbalances between a physical load being placed on an athlete and his or her coping capacity Can lead to staleness and eventual burnout
Overtraining
• Increase circulation which in turn increases metabolism and aids in the removal of metabolites such as lactic acid • Aids in removing edema by increasing circulation at and around injury site
Physiological Response
Incorporated into the later stages of a rehabilitation program Use a quick stretch of a muscle to facilitate a subsequent concentric contraction
Plyometric Exercises
Useful in restoring or developing an athlete's ability to produce dynamic movements associated with muscular power
Plyometric Exercises
• Utilize isotonic contractions to generate force against resistance while the muscle changes length • *Concentric and eccentric strengthening exercises should be used*
Progressive resistance exercises (PRE)
Relaxation can be induced by slow, superficial stroking of the skin that is beneficial for tense, anxious athletes
Psychological Reponses
Direct penetration of tissues can introduce the tetanus bacillus into the bloodstream, possibly making the athlete a victim of lockjaw
Puncture wounds
Signs of Wound Infection
Same as those for inflammation Pain, heat, redness, swelling, and disordered function Pus may form due to accumulation of white blood cells Fever may occur as immune system fights bacterial infection
• Providing correct immediate first aid and management following injury to limit and control swelling • Reducing or minimizing pain • Restoring full range of motion • Reestablish core stability
Short - Term Goals
How is HCV transmitted?
Spread by contact with blood of infected person •Sharing needles or syringes •Sharing personal care items that may have blood on them tattoo
• Numerous reasons including training too hard and long without proper rest • Attributed to emotional problems stemming from daily worries, fears, and anxiety
Staleness
If exposed to HIV what is the testing procedure
Testing should occur at six weeks, at three months, and at one year after exposure
• Bacterial infection that may cause fever and convulsions • Occurs most often with a puncture wound
Tetanus
Exercises used in a rehabilitation program
Therapeutic exercise
Incorporated into rehabilitation programs • Cryotherapy and thermotherapy • Ultrasound and electrotherapy • Light therapy and massage • Traction and intermittent compression
Therapeutic modalities
T o F People with HIV may go as long as 8 to 10 years before developing any signs or symptoms
True
T or F All wounds should be treated as though they have been contaminated with microorganism
True
T or F If thunder and/or lightning can be heard or seen, stop activity and seek protective shelter immediately
True
T or F Infected person's blood may test positive for the HBV antigen within 2 to 6 weeks after symptoms develop
True
T or F Isokinetic measures are used as criteria in making decisions for athlete's return to functional activity following injury
True
T or F Replacing fluids with sports drinks is more effective than replacing fluids with water alone
True
T or F Deep lacerations, incisions, or occasionally puncture wounds may require some sort of manual closure using sutures
True
T or F Injury prevention is physiological and psychological
True Athletes under stress emotionally are more prone to injury than those who are adjusted emotionally
T or F In cold disorders is fluid replacement critical
True Dehydration decreases blood volume, which reduces the amount of fluid available for tissue warming
T or F Single negative test does not prove that a person is not infected.
True initial test is negative, the test should be repeated
T or F Injury to a joint is always followed by some associated loss of motion
True • Resistance of the muscle and its tendon to stretch • Contracture of the ligaments and capsule around a joint
Dangerous therapeutic modality if not administered by professional
Ultrasound
Most individuals who test positive for HIV will eventually develop ______________.
acquired immunodeficiency syndrome (AIDS)
What are the reaction to injury and rehabilitation for chronic rehab
anger, frustration dependence, independence, apprehension
Ability to _____________ and maintain ______________ stability is essential to reacquiring athletic skills
balance/postural
what is the most neglected component of a rehabilitation program
cardiorespiratory fitness
recurring
chronic
Convection
contact with cool air or water mass
Conduction
direct contact with a cooler object
During progressive resistance exercise, both _________________ and _____________ contractions are incorporated
eccentric and isotonic contractions
What are the reaction to injury and rehabilitation for long term
fear, anger loss of vigor, irrational thoughts, alienation
what is the goal for rehab
for the injured athlete is to return to activity as quickly and safely as possible
Series of gradually progressive activities designed to prepare an individual for return to a sport Sport-specific skills are broken into components
functional progressions
Involves a single maximal effort to gauge how close the athlete is to a full return to activity
functional testing Agility runs, side stepping, vertical jumps, hopping, and co-contraction tests
Radiation
heat generated from metabolism
Used for minimizing swelling and providing analgesia following injury
ice bags
What are the reaction to injury and rehabilitation for termination rehab
isolation, grief process loss of athletic identity
greater than 4 weeks
long term
Bacteria is known as _____________ is more difficult to treat
methicillin-resistant Staphylococcus aureus (M R S A)
____________ lead to lack of attentional focus and muscle tension, which in turn leads to the stress-injury connection
negative stressors
factors that influence reactions to injury and rehabilitation are
past history, coping skills, social support, and personality traits
Stress may be _______ or ________
positive or negative
Neglecting balance issues may predispose athletes to ______
re-injury
What are the reaction to injury and rehabilitation for short term
shock, relief impatience
less than 4 weeks
short term
Formula for disinfectant
solution of one part bleach to ten parts water
Evaporation
sweat evaporating from the skin surface
First-aid management should be directed toward controlling __________
swelling
career ending
terminating
Decision about how to progress the rehab program should be based on ______________.
the limitations of the healing process
T or F Certain combinations of various antiviral drugs, which have been labeled "cocktails," can slow replication of the virus and improve prospects for survival
true
T or F Gloves and bandages should be placed in sealed white bags prior to disposal in regular trash containers
true
T or F Some strains of Staphylococcus aureus have become resistant to some antibiotics
true
T or F First-aid techniques can be considered the most critical part of a rehabilitation program
true Initial management of an injury critically influences the rehabilitative process
T or F Heat illness can still occur in a cold environment
true Occurs when the body is dehydrated and unable to dissipate heat through sweating
T or F Avoid using hydrogen peroxide and bacterial solutions initially when cleaning a wound
true the wound should be cleaned with copious amounts of soap and water
T or F sharps should be disposed of in a leakproof and puncture-resistant container
true Container should be red or orange and labeled as a biohazard
Criteria for return to play
• Athlete is fully reconditioned • Athlete has regained full ROM, strength, neuromuscular control, cardiovascular fitness, and sports-specific functional skills • Athlete is mentally prepared
Biohazard warning labels should be fixed to:
• Containers for regulated waste • Refrigerators containing blood • Containers used to store or ship potentially infectious materials
Treatment of frostbite
• Deep frostbite indicates frozen skin requiring hospitalization • Gradual rewarming is required, including hot drinks, heating pads, or hot water bottles that are 100°F to 110°F • Tissue will become blotchy red, swollen, painful, and possibly gangrenous
Phases of an injury
• Denial • Anger • Bargaining • Depression • Acceptance
symptoms of overtraining
• Deterioration in the usual standard of performance • Chronic fatigue and apathy • Loss of appetite, indigestion, and weight loss • Inability to sleep or rest • Increased risk for acute and overuse injuries and infections
Treatment for Heat Exhaustion
• Fluid ingestion in a cool environment • Intravenous replacement of large quantities of fluids • Returning the patient's core temperature to 102°F
symptoms of burnout
• Have headaches, gastrointestinal disturbances, sleeplessness, and chronic fatigue • Experience feelings of depersonalization, increased emotional exhaustion, reduced sense of accomplishment, cynicism, and depressed mood
Treatment of Exertional Hyponatremia
• If hyponatremia is suspected and blood sodium levels cannot be determined on-site, the athlete should be transported immediately to a medical facility • Delivery of sodium, certain diuretics, or intravenous solutions may be necessary
What are some stress management techniques
• Imagery • Relaxation strategies • Cognitive restructuring • Thought stoppage
Exertional Heatstroke Treatment
• Immediately immerse the athlete in a cold water bath up to his or her neck • Remove equipment and clothing • Sponge him or her down with cool water and fan with a towel • Ice bags may be placed at the neck and over other major arterial vessels
Treatment for Heat Illness
• Lay the athlete down in a cool environment • Elevate lower extremities • Replace fluids
Signs and symptoms of Exertional Hyponatremia
• Progressively worsening headache; nausea and vomiting; swelling of the hands and feet; lethargy, apathy, or agitation; and low blood sodium • Very low concentration of sodium can compromise the central nervous system, creating a life-threatening situation
Wrapping and taping techniques are routinely used for various reasons including
• Providing compression to minimize swelling in the initial management of an injury • Reducing the chances of injury by applying tape prophylactically (for prevention) before an injury occurs • Providing additional stability to an injured structure
Reactive phases to the injury process
• Reaction to injury • Reaction to rehabilitation • Reaction to return to play or termination of career
Treatment for chillblain
• Remove wet or constrictive clothing • Cover with warm, loose, dry clothing or blankets • Do not disturb blisters • Apply friction massage, apply creams or lotions, or use high levels of heat • Continually monitor the affected area for return of circulation and sensation
Signs if HIV
• Transmitted by exposure to infected blood or other bodily fluids or by intimate sexual contact • Fatigue, weight loss, muscle or joint pain, painful or swollen glands, night sweats, and fever
Treatment for Heat Cramps
• Treat with fluid ingestion and light stretching with an ice massage • Avoid fatigue and overexertion during exercise to reduce the likelihood of altered neuromuscular control • Return to play is unlikely because of continued cramping
Treatment for Frost Nip
•Apply firm pressure to the affected areas *(without rubbing)* •Blow hot breath on the spot •Place hands in armpits if the fingertips are affected
HPV Prevention
•Good hygiene and avoid high - risk activities •Survives up to 1 week in dried blood or contaminated surfaces •Vaccine to prevent contracting virus•3 shots over 6 months • OSHA - Occupational Safety and Health Administration •Mandated that employer must offer vaccination to any employees exposed to blood or other bodily fluids at no cost
Extent of pain is partly dependent on the following:
•Severity of the injury •Athlete's response to pain •Athlete's perception of pain •Circumstances under which the injury occurred
Define Flash bang method
•Sight lightning and start counting until the thunder is heard •Divide the number of seconds by 5 to determine the number of miles away the lightning is *Lightning--> 20 seconds counted--> Thunder --> 20/5 = 4 miles away