KNES 315 exam 2
dermatomes
"do you feel this?" 'does it feel different on the other side?'
SAID principle
- Specific Adaptations to Imposed Demands - The body will gradually, over time, adapt very specifically to the various stresses & overloads to which it is subjected
frost nip
- involves ears, nose, cheeks, chin, fingers, and toes - occurs when there is a high win, severe cold, or both - skin initially firm but then blisterse 24-72 hours after
sequence for palpations
-bones and ligaments first- because they do not spasm and they are obvious landmarks -muscles and tendons -pulses
criteria for progression to phase 4
1. bilateral ROM and flexibility restored 2. muscular strength, endurance, and power equal or near equal to those of the unaffected limb 3. cardiovascular endurance and general body strength 4. sport-specific functional patterns completed using mild-moderate resistance 5. individual psychologically ready to return to protected activity
criteria for progression to phase 2
1. control of inflammation with minimal edema, swelling muscle spasm and pain 2.ROM, joint flexibility, muscular strength maintained 3. cardiovascular fitness maintained as close to pre injury level as possible
criteria to move to phase 3
1. inflammation and pain under control 2. ROM within 80% of normal 3.bilateral joint flexibility restored 4. proprioception improving or restored 5. cardiovascular endurance and general body strength maintained at pre-injury level
how much water loss from the body weight causes someone to feel thirsty
2%
How to find max HR
220-age
how many oz of water should be replenished per pound of water loss
24 oz
how soon to the season should you get a PPE exam
4-6 weeks prior to allow time to correct minor problems and be referred to medical specialists
stages of tanner test
5 stages females: pubic hair and breast development males: pubic hair and genital
how much water should you drink after 2-3 hours of exercise
7-10 oz
what does the different times for stretching do?
8-10 section warms up muscle 30 sec-2 mins is for long term changes
types of closed wounds
Bruises and contusions Hematomas treatment-PRICE
closed kinetic chain
Distal segment of the extremity cannot move independently Weight bearing
Hypermobility vs hypomobility
Extreme mobility of a joint vs not flexible -more muscle strains
t or false: HR goes down with immobilization
False- it goes up
heat exhaustion vs heat stroke
Heat Exhaustion=Will continue to sweat when dried off Heat Stoke=Will stop sweating when dried off (Medical Emergency)-Temp 105-106. Unable to regulate heat, brain problem not fluid loss
nystagmus
Involuntary rapid eye movements
active ROM
Is movement initiated and completed by the athlete without assistance.
passive ROM
Movements that are performed by the examiner with the athlete relaxed.
kinetic chain
The combination and interrelation of the actions of the nervous, muscular, and skeletal systems to create movement.
arthokinematics
The motions of joints in the body-between two bones
convection
The transfer of heat by the movement of a fluid
t or f: athletes have the legal right to play a sport regardless of physicians recommendations
True
t or f: increasing strength decreases muscular endurance
True (typically)
t or f: evaporation causes heat loss
True, it causes heat loss, not the sweating
ballistic stretching
a technique in which muscles are stretched by the force generated as a body part is repeatedly bounced, swung, or jerked -detrimental,
agility
ability to change directions rapidly when moving at a high rate of speed
speed
ability to move body mass over time, assessed by timed sprints
endurance
ability to produce force for a sustained length of time
power
ability to produce force in a given time
for suspected fracture where do you pslint
able and below fracture site in the position the limb was found
hypothermia
abnormally low body temperature
types of open wounds
abrasion- scraping away of layers of skin blisters-accumulation of fluid between epidermis and dermis incisions- clean cut lacerations-irregular tear avulsions- complete separation of skin punctures-penetration of skin and underlying tissue
isokinetic advantages/disadvantages
advantages- 100% loading throughout ROM, pain disengages mechanism disadvantages- as muscle fatigues, resistance decreases, most machines only permit concentric contraction
isotonic -advantages -disadvantages
advantages- permits exercise of multiple joints simultaneously, allows both eccentric and concentric contraction, permits weight bearing exercises disadvantages-when load is applied, the muscle can only move that load through the ROM with as much force as the muscle provides at its weakest point
where do you palpate
always palpate, but start distally and work towards injury
thermotherapy
applying heat to the body for therapeutic purpose during the second phase of rehab . timing is KEY
when does injury management start
as soon as injury occurs (the cell death)
length of application of cryotherapy
asap after injury, 15-30 minutes one, 1-2 hours off during the first 48-72 hours
what are they checking in a cardiovascular examination
auscualation of heart sounds, check for cardiac abnormalities, and history of chest pains, LOC and dizziness
what do they check in a pulmonary exam
auscultate for breath sounds, coughing, difficulty breathing, asthma, ear nose throat exam
check for consciousness
avpu a-alert v-verbal p-pain u-unresponsive if conscious check ABC's a-airway b-breathing c-circulation (pulse)
stretching techniques
ballistic, static, dynamic
secondary defecits
based off primary defecit because of pain they cant walk, combined issues compared to primary
hypomovile
below normal laxity
osteokinematics
bone (osteo) kinematics (movement), what we can see preformed
Etiology
cause of an injury (different forces, how injury is described by patient)
laxity
clinical sign of the amount of "give" within a joint; identified by stress testing
3. resistive phase
coincides with conversion from type 111 collagen to type 1 collagen development and increased tensile strength from late proliferation to late remodeling healing phases- close to full ROM
common modes of heat transfer with cold application
conduction- cold object in contact with warm evaporation-sweat
respiration rate
count for 30 seconds then double it- 10-25 breaths per min for adult 20-25 in children bp- 120/80 for adults
pulse rate
count for thirty seconds then double it 60-100 bpm for adults 120-140 for children higher for both when actively in a game etc.
how to determine how far a thunderstorm is
count from when you see the flash to the sound of thunder and divide by 5 within 6 miles away seek shelter must wait 30 mins before resuming activity
frost bite
damage to tissues as the result of exposure to cold, frozen body parts medical emergency
visceral
deep nagging and pressing, often accompanied with nausea and vomiting, internal organ is injured
special tests
designed to detect specific pathologies and substantiate what has been learned through history, observations and palpations -targets specific structures and tissues to try and determine what is involved and what the patient is suffering from
open kinetic chain
distal segment of the extremity is free to move without causing motion at another joint non weight bearing
aggressive phase
during late remodeling phase, goal is to restore patient to optimal performance , multiplanar, increase speed over time, low-to no contact practice skills
primary defecits
factors that are caused by specific issues caused by the pathology or injury -pain,ROM
heat stroke
failure of body's thermoregulatory system, prolonged strenuous physical exercise in people who are poorly acllimatized Treatment-immediate emergency, activate EAP and EMS, move to cool area and remove clothing
t or f: phase 3 is is the direct link of proprioception
false, its phase 4
Hypermyopia
farsightedness; inability to focus on close objects
hyperthermia
high body temperature
musculoskeletal exam
history of previous injury (nature and when it occurred, who evaluated it), orthopedic screening
what part of HOPS is the foundation for the rest of the assessment
history, sets the tone for all of the assessment to know what to expect or to evaluate.
thermoregulation is done by the ___?
hypothalamus
stitches
if the wound is deep enough that the subcutaneous fat is visible or wide enough that it cannot be easily closed- need to be applied within 6 hours of injury to avoid contamination of the wound
wolfs law
if you dont use it you lose it
four phases of rehab
inactive, active, resistive, aggressive
return to sport/activity criteria
individual can return to their sport activity as soon as muscle strength, endurance, and power are restored
heat exhaustion
ineffective circulatory adjustments compounded by depletion of extracellular fluid, prolonged sweating treatment- rest in cool area, remove equipment and clothing, fluids
strength gains depend primarily on the ____ of the overload
intensity
endurance improvement will be determined by the ___ and the ____ of exercises
intensity and duration
instability
joint's inability to function under the stresses of function activity
MMT
manual muscle testing- isolate a specific muscle or muscle group to determine if that actual tissue or structure has a deficit in strength: isometric contraction
MOI
mechanism of injury- how did the injury occur. were there relevant sounds or sensations (a pop, snap?)
neurological examination
minimal part, history of past head injury
goals of rehabilitation
minimize swelling and control pain using PRICE
what environmental temp is passive heat loss?
moderate-cool
hyopermobile
more laxity than normal
short term goals
motivational and encourage patient to work
myotomes
motor function of nerve root, MMT test
static stretching
movement is slow and deliberate, GTO override impulses from the muscle spindles, safe more effective
heat cramps
muscle spasms that result from a loss of large amounts of salt and water through perspiration treatment-large fluid intake, stretch, ice
myopia
nearsightedness; difficulty seeing distant objects when light rays are focused on a point in front of the retina
are you disqualified to play when there are red flags in your PPE examination
no, it just means lets get more tests done
what does a negative joint stability mean
normal stability
emmetropia
normal vision
do we always palpate?
not when there is an obvious deformity or an emergency. we just want determine the tissue that is involved in the injury
sign
objective and definitive (inflammation etc.)
differences in steps of the evaluations
on the field you have to be faster and figure out where to transport the patient, on the field you need to be aware of the crowd especially with different ages and genders
what kind of questions should be asked
open ended, to allow for the patient to explain what is going on and then you can ask follow up questions
propioception
perception of the body's position and posture
what are the different age groups for the PPE
pre-pubescent: 6-10 pubescent: 11-15 post pubescent: 16-30 adult: 30-65 (cardiovascular risks)
prognosis
predictive course of an injury (out for 2-3 weeks etc.)
primary and secondary survey
primary-life threatening injuries, unconsciousness secondary-non life threatening, conscious
2. active phase
proliferation healing phase with advance type 111 collagen development, start performing active exercise , patient goes through pain free movements
PNF
proprioceptive neuromuscular facilitation- exercises that stimulate propioreceptors in muscles, tendons, and joints to improve flexibility and strength
PRICE
protected rest ice compression elevation
motor control and repetition
requires repetition of the same movement until its automatic
do you preform the same evaluation on all locations?
same steps but different goals depending on pathology/where you are located
kinesthesia
sensation of joint movement
what is the best way to judge obesity
skin fold test
normal end feels
soft (muscle and fat hitting muscle and fat elbow flexion), firm (majority of joints, little bit of give), hard (bone contacting bone-elbow extension)
somatic vs visceral
somatic- deep, long lasting, injury to bone muscles or internal joint structures
SMART
specific (to primary deficit, specific joint etc) measurable (increase shoulder flexion from 170-180) attainable (something possible and realistic relevant (something that will help get to long term goal) time based (10-14 days typically its for short term goals)
dynamic stretching
sport specific, controlled functional movements, activates and stimulates tissues and increase blood flow
overload principle
standard which states that gradual increase of a physical demand on the body will improve fitness -manipulate: frequency, duration, intensity (add more reps or more weights)
symptom
subjective perception (cannot be measured or seen)
SOAP notes
subjective, objective, assessment, plan- a system to effectively document and record subjective and objective findings and develop a treatment plan subjective- history objective- observations, palpations, and special tests
maximal strength
the ability to produce force in one maximal resistance
reaction time
the ability to respond to a stimulus
balance
the body's coordinated neuromuscular response to maintain a defined position of equilibrium in response to changing visual, tactile, or kinesthetic stimuli
motor control
the brains attempt to teach the body where it is in space
Pathology
the study of cause and effects (diagnoses)
cryotherapy
therapeutic use of cold-heat is lost from skin and transferred to ice pack want to decrease pain perception and muscle spasm
inactive phase
through inflammation phase of healing PRICE, no exercise, want to relieve pain swelling and spasm
What is the goal of the PPE?
to ensure health and safety of physically active individuals, and gather information about their general health and maturity for their fitness level.
Radiation
transfer of heat from a warmer object to a cooler one in the form of infrared waves without physical contact
what bee sting is the worst
wasp, can sting multiple times
who takes longer to sweat? men or women and why
women for the higher core temp