LE: Examination and Clinical Diagnosis

Exam 1

What is the difference between sports medicine and regular medicine?

Time

What is the sports medicine team?

• Who is on the sports medicine team?

• What are their roles?

• What is the AT role?

Anybody who would need to work on/with the athlete

AT, Team Physician, Psychologist, etc.

The AT role is to be the link between all sports medicine team.

SOAP Notes

Subjective - symptoms

Objective - signs

Assessment - determination of injury

Plan - keep the athlete motivated and engaged

Long Bone

Epiphysis - end of the long bone

Diaphysis - shaft of the long bone

Metaphysis - flare of the bone

Physis - growth plate

Periosteum - covering of the bone

Traction Epiphysis

Where a tendon applies force (knee)

Pressure Epiphysis

At the end of long bones

Open Fracture

A fracture that also has any break in the skin

Closed Fracture

A fracture where the skin does not have a break

What are the different types of fractures? (12)

Transverse - straight through the bone

Greenstick - incomplete fracture

Oblique - diagonally across the bone

Spiral - fracture line wraps around the bone

Spiral Oblique - fracture line is at an oblique angle and wraps around the shaft of the bone

Impacted/Compound - jamming and shattering at the fracture site

Comminuted - several separate bone fragments

Line/Stress - incomplete fracture involving a crack in the bone without displacement

Avulsion - an attached ligament or tendon pulls away a bone fragment

Chondral / Osteochondral - articular cartilage or the articular cartilage and the underlying bone

Epiphyseal - involves the epiphyseal plate

Intraarticular - fracture that enters the joint space

Ways to identify a fracture?

• Observe it happen

• Tap test/ Percussion test

• Palpation

• Tuning fork

• Ultrasound

• Athlete feels it

Typical Bone Fractures

• Greenstick

• Spiral

• Comminuted

• Transverse

• Compound

Articular or Hyaline Cartilage

Covers the ends of the bones

Fibrocartilage

Shoulders, knees, vertebrae

• Meniscus, labrum

5 Open Wounds

1. Abrasion - scraping

2. Laceration - tearing with irregular wound margins

3. Incision - a cut with smooth, straight wound margins

4. Puncture - penetration of the skin

5. Avulsion - a pulling away of the tissue

3 Closed Soft Tissue Wounds

1. Contusion - a bruise

2. Strain - stretching or tearing of a muscle or tendon

3. Sprain - stretching or tearing of a ligament

Dislocation

Complete separation of the joint capsule

Subluxation

Incomplete separation of the joint capsule

Injury Cycle

5 Cardinal Signs of Inflammation

1. Redness

2. Swelling

3. Heat

4. Pain

5. Loss of function

R.I.C.E

Rest - Non weight bearing, slow down activity

Ice - 15 - 20 minutes (depends on location), while the injury is still producing heat

Compression - Trying to remove the swelling

Elevation - helps with removing the swelling

Soft Tissue Management (PEACE and LOVE concept)

Let pain guide your return, incorporate earlier activity, optimal loading

Abduction

Away from midline

Abrasion

Scrap

Acclimatization

Adjusting to conditions

Acute

Of sudden onset

Active Range of Motion

Range of motion provided by the patient

Adduction

Toward the midline

Aerobic

With oxygen

Alienation

Disuse of an injured body part

Anerobic

Without oxygen

Anastamosis

A group of blood vessels

Anatomical Postion

Standing with the arms supinated and to the sides

Antalgic

Painful (gait)

Anterior

Toward the front

Aponerosis

A fascia

Apophysis

A traction epiphysis

Arrythmia

Abnormal heart rythmn

Atrophy

Wasting away of a muscle

Avulsion

Tearing away

Axilla

Arm pit

Bilateral

On both sides

Bursa

A fluid filled sac

Chondro

Cartilage

Chronic

Injury over time

Circumduction

Circular range of motion

Concentric

Muscle contraction with muscle shortening

Congenital

Present since birth

Contusion

A bruise

Coxa

Hip

Crepitus

Creaking or grinding

Crus

Lower leg

Cubitus

Elbow

Cyanosis

Bluish skin from lack of oxygen

Deformity

Abnormal anatomy

Diagnosis

A doctor’s opinion of an injury

Diaphysis

The shaft of the bone

Dislocation

Disruption of the joint capsule

Distal

Further from the body

Dorsal

Back

Dorsiflexion

Movement of the foot toward the shin

Eccentric

Muscular contraction with muscle lengthening

Ecchymosis

Bruising and discoloration

Edema

Swelling

Effusion

Swelling

Endurance

Resisted range of motion over several repetitions

Epiphysis

The end of long bones

Epistaxis

Nosebleed

Eversion

Rolling of the ankle to the medial side

Extension

Increasing the angle of a joint

External Rotation

Rotaion of motion away from the midline

Etiology

Cause of an injury

Fascia

Broad, strong connective tissue

Flexibility

Ability to go through a full range of motion

Flexion

Decrease in the joint angle

Gait

Walking pattern

Genu

Knee

Hallux

Big Toe

Hemarthorsis

Bleeding in the joint

Hematome

Bleeding in the tissueHe

Hemmorrhage

Bleeding

Homeostasis

The body’s desire to maintain equilibrium

Horizontal Abduction

Movement away from the midline in the horizontal plane

Horizontal Adduction

Movement toward the body in the horizontal plane

Hyper

Excessive

Hypertrophy

Increase in size

Hypo

Low or beneath

Idiopathic

Of unknown origin

Incontinence

Inability to control bowel or bladder

Infection

The invasion of the body by a foreign substrance

Inferior

LowerIn

Inflammation

The body’s response to irritation

Inversion

Ankle movement to the lateral side

Internal Rotation

Rotation towards the midline

Isokinatic

Movement with accommodating resistance

Isometric

Strength training with no joint movement

Isotonic

Strength training with movement

-itis

Inflammation

Kyphosis

Abnormal curvature of the thoracic spine (hunch back)

Lateral

Towards the ouside

Laxity

Increases movement in a joint