HTHS 1120 Module 2 Torn ACL

What are the steps to evaluating an unconscious athlete?

Do not move the athlete.
Do not remove the helmet.
Do not use ammonia inhalants, which may cause the head to jerk from the noxious stimulus.
Do not give liquids or food.
Do not rush the evaluation.
Do not worry about delaying the game.

If the athlete is unresponsive, alert other medical personnel and coaches, and call for an
ambulance. The medical staff should then proceed with CPR steps as necessary. If the athlete is not breathing, start rescue breathing.

What are the steps to evaluating a conscious athlete?

Evaluate mental status, symptoms, mechanism of injury, rule out neck injury, give a physical exam of injured area, slowly have athlete sit up, reevaluate, help athlete walk to sidelines.

What are the responsibilities of a first responder at the scene of an athletic injury?

The first responder at the scene of an athletic injury needs to be able to recognize a life-threatening condition, provide emergency care, and facilitate transportation to a medical facility when indicated. An orderly, logical primary assessment on the field can help identify serious conditions promptly and guide further evaluation and treatment.

Be familiar with the anterior cruciate ligaments (ACL) location and list 2 functions.

Functions of ACL:
a. Prevents tibia from sliding forward on femur
b. Prevents undue internal rotation of the tibia related to the femur.

What is an MRI scan?

An MRI scan is a radiology techniques using magnetism, radio waves, and a computer to produce images of body structures.

What health professional would perform an MRI scan?

A radiology technician with a specialty in magnetic resonance imaging

What is an arthroscope?

The arthroscope is a small fiber-optic viewing instrument made up of a tiny lens, light
source and video camera.

What are some advantages of arthroscopic surgery?

Arthroscopic surgery makes it easier to examine, diagnose, and treat joint problems. Surgery is less extensive, enables small incisions, shorter recovery time, and shorter hospital time.

Describe the surgical method used to replace a torn ACL.

Reconstruction of the ACL begins with a small incision in the leg where small tunnels are drilled in the bone. Next the new ACL is brought through these tunnels, and then secured. As healing occurs, the bone tunnels fill in to secure the tendon.

What is electrical muscle stimulation (EMS)?

Electronic impulses stimulate the nerve axons signaling muscles to contract and relax.

How can EMS prevent or reduce muscle atrophy?

EMS increases blood flow to muscles, increases range of motion, increases muscle strength, as well as enhances muscle endurance.

no synovial cavity. Bones held together by dense irregular connective tissue. Skull bones

fibrous

no synovial cavity. Bones held together by cartilage. pubic symphases

cartilaginous

has synovial cavity. United by dense irregular connective tissue of articular capsule. Accessory ligaments

synovial

immovable joint

synarthrosis

slightly movable joint

amphiarthrosis

freely movable joint

diarthriosis

space between articulating bones filled with synovial fluid

synovial cavity

hyaline cartilage covering bones at synovial joint, provides a smooth, slippery surface, reduces friction and absorbs shock

articular cartilage

2 layers: outer fibrous and inner synovial

articular capsule

bundles of fibrous membranes, connect bone to bone

ligaments

connect bone to muscle

tendon

movement of flat bone surfaces back and forth or side to side in respect to another

gliding

decrease in angle between articulating bones

flexion

increase in angle between articulating bones

extension

continuing extension beyond anatomical position

hyperextension

movement away from midline

abduction

movement toward midline

adduction

movement of the distal end of a bony part in a circle

circumduction

movement of bone around its own longitudinal axis

rotation

what is the function of the articular capsule

unites articulating bones

what is the function of synovial fluid

reduce friction, absorb shock, supply o2 and nutrients, remove wastes

what is the function of hyaline or fibrocartilage that covers the articulating surfaces

cover the articulating surfaces of the bones to cushion shock and reduce friction during movement

extends from the patella to the tibia. strengthens the anterior surface of the joint

patellar ligament

broad, flat ligament that extends from the femur to the tibia. the ligament and tendon strengthen the posterior surface of the joint

oblique popliteal ligament

extends from the lateral femur to the head of the fibula. it strengthens the lower lateral part of the posterior surface of the joint

arcuate popliteal ligament

extends from the medial femur to the medial tibia. it strengthens the medial aspect of the joint

tibial collateral ligament

extends from the lateral femur to the lateral side of the fibula. it strengthens the lateral aspect of the joint

fibular collateral ligament

ligaments within the capsule that connects the tibia and femur

ACL and PCL

this ligament limits hyperextension of the knee and prevents the anterior sliding of the tibia on the femur

ACL

this ligament is stretched or torn in 70% of all serious knee injuries

ACL

this ligament prevents the posterior sliding of the tibia when the knee is flexed.

PCL

two fibrocartilage discs between the tibia and femur

interarticular discs

help compensate for the irregular shapes of the bones and circulate synovial fluid

interarticular discs

allowed movements of the knee

flexion, extension, slight medial rotation, and lateral rotation (when leg is flexed)

blood that has accumulated in a joint

hemarthrosis

Which of the following is NOT an effective surgical repair for an ACL tear?
- Achilles tendon allograft
- Hamstring autograft
- Patellar tendon autograft
- Suturing of torn ACL

suturing of torn acl

athletic trainer

First responder. Treatment and assessment

physical therapist

Strengthening knee joint before and after surgery

Anesthesiologist

Administers medications causing a loss of consciousness during surgery

Radiology tech

performs MRI scan for assessment of knee injury

Surgeon tech

preparing operating room and patient for surgery

Radiologist

Interprets results of diagnostic imaging exams

OR nurse

selects and handles instruments and supplies used for the operation

Orthopedic surgeon

performs surgical repair of ACL tear

What is the purpose of a field exam by an athletic trainer?

rules out injuries that would prevent the athlete from being moved

What criteria needs to be met before an athlete can be moved to the sidelines

back, head injuries or fractures

Define the following test: carried out on a knee which is just slightly flexed. A full examination must of course include testing of other structures around the knee some of which are commonly injured simultaneously (e.g. the menisci

Lachman

knee is at 90 degree angle. pull forward from behind the knee.

Anterior Drawer

Define the following test: let leg hang down and extend. turn in foot and attempt to shift the knee against the femur

Pivot Shift

Define the following test: normal scan results in appearance of a dark black filament intersecting the femur and tibial. An absence of this ligament presents for damage

MRI

The distal position of a body part that is bent outward

valgus

The distal position of a body part that is bent inward

varus

The act of bending the knee, in contrast to the act of extending the knee

knee flexion

Severe bleeding, either internally or externally

hemorrhage

What are 3 graft options for replacing a torn ACL

Achilles tendon allograft, Hamstring autograft, Patellar tendon autograft

bursa

fluid-filled sac that allows for easy movement of one part of a joint over another