KIN 3100 exam 1

Team Coach certifications

coaching credentials, CPR/FA certified

Strength and Conditioning coach duties and education/certifications

athletes adequately fit to preform, need Bach degree, cscs, personal training cert. and CPR/FA

AT education education/certifications

master’s, licensure exam, pass BOC, CPR/FA

Team Physisian

usually have final say in decisions on return to play. medical degree, pass board exam for specialty

sports nutritionist education/certifications

bach or masters, pass CDR, CSSD

Sports psychologist education/certifications

master’s + state licensure

emt education/certifications

must be 18+, high school diploma, training through state, national exam

inflammation phase of healing

aka acute phase: first 72 hours, swelling, vascular response (redness/temp/loss of function), cellular response (swelling), chemical response (pain)

• pain meds hinder this part bc decreasing swelling

• primary cell death due to blood vessels bringing oxygen to tissues but aren’t in tact=hypoxia

• compression allows nutrients to go back into body and continue circulating

Fibroblastic/Repair phase 2

aka subacute phase: 3 days-6 weeks. swelling + inflammation clear out

• once cellular debris has been removed, next step is to regain adequate B.F. (capillary budding)

• fibroplasia= scar formation

• load (body weight) can start to be introduced

Maturation - remodeling phase 3

up to a year. fibroblast realign with collagen fibers to strengthen + align existing fibers

• remodeling of scar tissue according to load

Wolff’s Law

osteoclasts absorb the old bone, osteoblasts (b=build) deposit new bone

• hypertrophy (when we come back stronger than before)+atrophy(when we don’t move) can occur

Perren’s strain theory

the greater the strength of the load, the less you get bone forming. the less strain, faster bone formation

Indirect healing (bones)

non-displaced fractures reasonably healed with callus formation—a critical temporary stage in secondary bone healing where the body bridges a broken bone with fibrocartilage and woven bone to stabilize the injury

• stress fracture

Direct healing (bones)

usually an open fracture: healing a displaced fracture by putting it together using pins, screws, plates

Ligaments

repair or degenerate, healed with scar tissue

• immobilization encouraged in the first few days

• capillary budding: capillary repair needs a clean area

• can take up to 2 weeks to a year to heal

Tendons

take a long time to heal: can regenerate tissue

• 4 months to a year (bigger=longer time than ligaments)

cartilage

tissue has a low turnover rate due to low blood supply

• depending on type, recovery time varies

• certain amount of load the right way for treatment

Muscle

high healing rate due to blood flow

• muscle strains, regenerates, heals patching lesion with scar tissue, myostis ossificans (when muscle has poor healing)—generally associated with muscle contusions

  • muscle gurading+cramping are common

battle sign

Bruising behind the ear over the mastoid process, indicating a fracture in the middle cranial fossa

Hyphema

Blood pooling in the front (anterior chamber) of the eye, typically resulting from direct blunt force trauma to the face or orbital area

Nystagmus

Involuntary, rapid eye movements resulting from damage to the brainstem, cerebellum, or vestibular nerve structures that control balance and eye tracking.

Concussion/TBI (traumatic brain injury)

MOI: trauma induced alteration in mental status that may or may not involve loss of consciousness

• Direct blow: when in motion, causing a deceleration of the brain within the skill resting injury at the cellular level

Coup injury

(in TBI’s) injury at the point of contact (hits front side of skull)

Countercoup-injury: to the opposite side of the contact (whiplash) –hits back of skull

Decorticate posturing:

sign of TBI: bring hands up like a cat, rigid

Deceberate posturing:

sign of TBI: bring hands down to their sides, flexed wrists, fingers fisted

second impact syndrome

• MOI: another blow that increases chance of brain death

• S+s: may seem normal at worst but quickly worsen. May lead to dialed pupils, loss of eye movement and respiratory failure

  • Mortality rate 50%

• POC: emergency: prevent it! By not letting play or play early in return to play protocol

Post concussion syndrome (PCS):

 symptoms that last longer than 3 months

• Probs a need for referral and need to see specialist

Mandible fracture

• MOI: often from collision sports, lower jaw is prone to direct blow due to not much padding

• S+S: deformity, loss of normal occlusion of teeth, pain biting down, bleeding around teeth

• POC: requires temporary immobilization followed by reduction and fixation of jaw

Zygomatic complex fracture

• MOI: direct blow

• S+S; obvious deformity

• Vision Changes: Double vision (diplopia) or sunken eye appearance (enophthalmos) if the orbital floor is fractured

• Swelling and Bruising: Periorbital ecchymosis (black eye) and tenderness around the cheekbone

Laceration

S+S: obvious deformity, open wound, and/or bleeding

POC: apply direct pressure to control edema, steri strips or butterfly stitches. Cover with telfpad, bigger that ½ inch= need stitches

Tooth fracture

• MOI– impact to upper or lower draw or direct trauma to tooth

  • Uncomplicated: fracture to dentin and enamel

  • Complicated crown fracture fracture in pulp

  • Root fracture: fracture line through root

  • S+S: uncomplicated: small portion is broken, but no bleeding and pulp chamber is not exposed

    Complicated: pulp chamber is exposed with increased pain

    Root fracture: occurs below gum line and may need xray

    Tooth may appear normal by bleeding from gum

    May lead to concussion

    POC: uncompliicated/complicated require immediate treatment. Broken oeices can be saved, need mouth guard

    
    

Tooth subluxation, luxasion, avulsion (pulling out)

• S+S: tooth slightly loose or dislodge, little pain but diff than tooth fracture

• POC: partially dislocated=not immediate treatment needed

• Luxation: try to put into place and refer

Nasal fracture and chondral separation

MOI: most common fracture in face, lateral force cause more obvious deformity

• S+S: separation of maxilla and/or lateral cartilages. Hemorrhaging is profuse, swelling is immediate. Deformity, crepitus when palpated possible, bruising under eyes

• POC: control bleeding, refer to phys for x-ray, protect before return to play

Epistaxis (nosebleed)

Direct blow or history of nosebleeds

S+S: hemorrhages arise from high vasculature in the anterior aspect of nasal septum. Usually resolve immediately but not than may need medical attention

Use universal precautions when dealing with blood

\POC: sit upright with cold compression over nose and carotid artery for 5 mins. Felt plug or gauze can help encourage blood clotting

Don’t let them blow their nose or put their head back

Auricular hematoma (cauliflower ear):

hematoma caused when athlete does not wear head gear and compression. Trauma may tear tissue from cartilage causing bleeding and fluid acumination

• S+S: coagulation (lines disappear)

• POC: surgery, head gear, cold compress, pressure bandage to reshape ear

Otitis externa (swimmers ear)

• MOI: bacterial infection in ear canal from trapped water due to obstruction

• S+SL itching, discharge, dizziness, loss of hearing

• POC: dry ear thoroughly after water, ear drops

Orbital hematoma (black eye)

• Bruised from direct contact to eye 

• S+SL bruising around orbital region, potential form bloody vision

• POC: cold application, do not blow nose or bleeding will increase

Acute conjunctivitis (pink eye)

• MOI: bacteria, allergens, irritation: can be bacterial or vial infection

• S+SL eyelid swelling, discharge around eye in morning, itching, burning

• POC: high contagion and should be referred to physician

Corneal Abrasion

• MOI: cutting, scratching, or abrasion to cornea, usually from sand dirt or contact

• S+S: feeling like sand/dust in eye, watering eyes

• POS: wear sunglasses, treat symptoms, refer if doesn’t heal

Retinal detachment

• MOI: blunt trauma or jarring motion common in MARfan’s patients

• S+SL flashes of light, blind sports, halos, curtains

• POC: refer. Damage between retina and choroid can disrupt optic nerve

What level of schooling does an athletic trainer require?

Master's

Which profession is responsible for educating and training athletes in proper weight-lifting and conditioning practices?

Certified Strength and Conditioning Coach

Ligament holds _____ to ______. 

 Bone to bone

Tendon holds ____ to ____. 

Muscle to bone

Who is most likely to experience a greenstick fracture?

9 year old soccer male player

T/F Wolff's law states that osteoclasts absorb the old bone​ and osteoblast deposit new bone​. 

true

T/F Muscle contusions can lead to myositis ossificans​

True

(t/f) A strain is a stretch, tear, or rip in the muscle tendon

True

neuropraxia

temporary block in nerve signa transmission: can come to full recovery

axonotmesis

damage to axon, but schwann cells in tact

neurotmesis

complete disruption of both the axon and all surrounding connective tissue layers: usually needs surgery and results in only partial recovery—usually wont re-align

referred pain

you dont feel pain in the injury spot, you feel it somewhere else

radiating pain

often has something to do with nerves

subjective

tests: ROM, palpation

ligament sprains

often occurs by a joint/joint capsule—common in both hyaline and fibrocartilage

tendon/muscle strain

muscles are too tight, overstretched, and/or forced to contract

• active ROM=pain

myositis ossificans

occurs often from bad contusion to muscle. repeated blows make calcium deposits accumulate to create a bone spur

• needs surgery to remove, but not super common

• protect athlete from developing through padding

muscle soreness—muscles arent used to load

DOMS: delayed onset muscle soreness (24-48 hours after)

• PNF stretching, static stretching, ice (within first 3 days)

muscle guarding

muscle seize up/involuntarily contract to protect muscles

• muscle cramps: often result from muscle guarding

tendinopathy

(tendinitis, tendinosis, tenosynovitis) clinical conditions caused by chronic or acute injury to a tendon

• all treated with ice, NSAIDS, and time

tendinosis

failed tendon healing

tenosynovitis

inflamed tendon sheath

stress fractures

fatigue: bone is strong—caused by strain that bone cant withstand=begins to break

insufficiency fracture: bone is weak: osteoarthritis/porosis, calcium deficiency

• common: 5th med, fibula, ulna

• fatigues bone under periosteum

signs+ symptoms of stress fracture

• pain worsens when activity stops

• can be extremely hard to see on x-ray

• can happen from not getting enough calories

• Reds/female athlete triad

• replace shoes/cleats is usually a fix

Tib-Fib fracture

looks like dislocated ankle

retrocaneal bursitis (MOI, POC)

normally chronic, can be acute

POC: donut pad to take pressure off, alter shoe heel

Metatarsal fracture (MOI, S+S, POC)

MOI: (usually acute, chronic if stress fracture) direct force (being stepped on), twisting, torsion

S+S: pain while walking, selling, bruising, deformity (while palpating normally), point tender

POC: x-ray, control swollinhg cast/boot 2-6 weeks

jones fracture (MOI, S+S, POC)

a break in the fifth metatarsal bone of the foot: acute (a little lower than a med. fracture), can be chronic through overuse

MOI: acute inversion, high velocity rotating force,

S+S: sharp pain outside foot, point tenderness,

POC: surgery if no union of blood supply, immobile for 6-8 weeks if not

plantar fasciitis (MOI, S+S, POC)

MOI: tight arc/calf, insufficient arch support, leg length discrepancy

S+S: heel pain at origin of fascia, increased pain with first step in morning, pain with dorsi flexion, crepitus feeling on bottom of foot

POC: tape, inserts, etc

longitudinal arch strain (MOI, S+S, POC)

chronic, caused by over pronation (weight on medial side)

MOI: high stress to plantar muscle, acute muscle strain depressing arch

S+S: pain with running and high impact, tenderness, big toe compensation

POC: reduce weight

Morton’s neuroma (MOI, S+S, POC)

always between 3rd and 4th metatarsals

MOI: irritation, pressure, injury to plantar nerve, causing a mass

S+S: interment pain from weight bearing to NWB, burning or numbness (numb=nerves)

POC: pad placed between 3rd and 4th med to sperate and decrease pressure

• if it does not resolve, surgery is needed

Turf toe (MOI, S+S, POC)

acute or chronic

MOI: hyperextension of big toe causing sprains of surrounding ligaments

S+S: pain of big toe joint increased pain with toe extension

POC: shoe +support to decrease big toe extension

ankle sprain: inversion/lateral (MOI, S+S, POC)

MOI: joint forced into plantar flexion + inversion

S+S: redness, swelling, pain

POC: RICE, higher grade=longer recovery

eversion ankle sprain: less commo, can have avulsion fracture involved

High ankle sprain (MOI, S+S, POC)

MOI: forced hyperdorsi flexion

S+S: pain with tibia+fibula forced apart, decreased pain when compressed together

POC: same recovery as both other ankle sprains

ankle fracture (MOI, S+S, POC)

MOI: can happen with ankle sprain

S+S: unable to bear weight, extremely point tender, swelling

POC: splint, x-ray, etc.

tendinopathy (general term for tendon injuries)—(MOI, S+S, POC)

MOI: faulty foot mechanics

S+S: pain, swelling, crepitus, stiffness after no use

POC: rest, modalities, orthotics, NASIDS

• important to heal bc tendon will start to break down

navicular drop test

arch height

helps to understand arch: positive if medial arch drops > 10mm when put weight on

• test navicular bone to see how much it drops

long bone compression test

stress fractures/metatarsal fractures: grip at base and head of meds and compress together—looking for pain between your fingers on their med bone

Anterior drawer test

lateral ankle sprain

tests anterior talofib ligament: grab shin+cup heel, positive sign = pain + looseness

shin contusions (MOI, S+S, POC)

shin//tibia vulnerable to blows bc no adipose tissue or muscle

• S+S: fluid filling up, intense pain, swelling, warmth

• POC: ice + compression (ACE bandage), donut pad

Med tibial stress syndrome (MOI, S+S, POC)

aka shin splints

common on both medial and lateral sides (runners esp. on lateral)

• common on apex of tibia

MOI: inflammation, irritation, bad mechanics, impact, transition of training

S+S: pain on anterior (lower 2/3rds of shin, pain during activity and increases afterward)

POC: stretch + strengthen, reduce activity, rule out stress fracture, make sure footwear is good

Compartment syndrome (MOI, S+S, POC)

can happen in any body compartment

MOI: acute=direct blow to anterior compartment causing bruising and pressure buildup that compresses vasculature + nerves

• acute exertional: occurs without trauma, chronic: occurs overtime

S+S: tingling (nerve) un anterior compartment, aching pain, pain with passive stretching, difficulty dorsiflexing foot

POC: reduce swelling ASAP without compression, elevate, send to physician

Achilles tendon rupture (MOI, S+S, POC)

MOI: tight calves and high impact when planting foot

S+S: (possibly loud) pop, weak or no PF

POC: surgical intervention which immobilizes 6-8 weeks

• rehab focus=pain free ROM

Thompson test

Achilles tendon rupture or tear: squeeze calf and have athlete plantar flex (point toe)

what to check for in knee assesments

symmetry, gait, limp, swelling, deep squats, does going up stairs cause pain

MCL sprain (MOI, S+S, POC)

MOI: valgus hit or rotation

S+S: pain on medial joint line, swelling, pain with valgus stress test

POC: control swelling, surgery, PT may be needed

LCL sprain (MOI, S+S, POC)

MOI: Varus hit or rotation

S+S: pain on medial joint line, swelling, pain with varus stress test

POC: control swelling, surgery, PT may be needed

ACL tear (MOI, S+S, POC)

females more prone

MOI: planting, deceleration, rotation and valgus force

S+S: loud pop knee feels unstable+cannot function, rapid swelling, intense amount of pain that slowly decreases

POC: control swelling, surgical intervention

• commonly also indicates MCL/LCL tear + meniscus damage

PCL tear (MOI, S+S, POC)

MOI: landing on knees, posterior translation of tibia

S+S: pop behind knee, slight tibial sag, swelling behind knee,

• can be hard to differentiate

POC: control swelling surgery may be needed

Meniscus injury (MOI, S+S, POC)

MOI: compression and rotation of femur and tibia

S+S: joint line tenderness, knee locking/clicking, knee effusion. joint line tenderness, pain with squats

POC: best to heal on own if possible—give it time if not extremely serious, surgical repair or menisectoring (surgical removal of all or part of a torn meniscus)

osgood schlaters disease (MOI, S+S, POC)

MOI: rapid growing or upward pull on patella

S+S: raised bump that increases pain when pushed on

POC: reduce activity, padding, ice

IT band friction syndrome: (MOI, S+S, POC)

MOI: overuse occurring in athletes due to misalignment, asymmetry

S+S: tenderness around + swelling at IT band insertion, pain during AROM

POC: stretching+full ROM, NSAIDS, ice massage, massage over tendon area

Patellar fracture (MOI, S+S, POC)

MOI: trauma

S+S: unable to bend and straighten, swelling

POC: immobilize

Patellar dislocation (MOI, S+S, POC)

MOI: more prone if ACL+meniscus injuries previously occurred

S+S: loss of function, pain, swelling,

POC: ice for swelling, see physician, immobilize 2-4 weeks

Patellar tendonopathy (MOI, S+S, POC)

MOI: overuse and inflammation of patellar tendon

S+S: pain during + after activity, especially explosive movements

POC: friction reduction strap, eccentric exercise, ice massage tendon

knee functional movement tests

deep squat, gait

varus stress test, valgus stress test

varus: suspected LCL: push on medial side

valgus: suspected MCL: push on lateral side

lachmens test

ACL: hand on thigh push down, hand behind knee push up

anterior + posterior drawer test

anterior = ACL: pull towards your

posterior = PCL: push down to them

apley’s test

Meniscus