288 final exam

acute injury

mechanical failure of soft tissue due to excessive force occurring in a single bout

chronic injury

mechanical failure of soft tissue due to repeated micro trauma occurring over an extended period of time

chronic injury is a …

gradual onset of prolonged during

open injury

exposed and breaks the skin surface

closed injury

unexposed and does not involve disruption of the skin surface

load and stress

external or internal force acting on the tissue

strain of a mechanical stress

the extent of deformation that might occur

yield point of the stress-strain (load deformation) curve

the load is greater than mechanical capabilities of the tissue

Mechanical failure begins to occur during this part of the stress-strain curve

after the yield point

6 primary mechanical forces that cause injury

tension, torsion, compression, shear, bending, combined

tension

creates a pulling action trying to elongate the structure

compression

creates a pushing action tending to shorten the structure

a shortstop is hit in the shin by a batted ball that took a bad hop, what type of force?

compression

shear force

forces that act parallel in opposite directions to the cross section or surface of body

bending

loading about an axis for a combination of tension and compression

torsion

load applied causing structure to twist around an axis

combined loading occurs when

the body part is subjected to multiple minor loads

the two main mechanical properties of bone

shape and size

more bone mass is correlated to an increase in

bone strength

where are mechanical stresses most concentrated

in places of sudden shape changes

what type of fracture?

incomplete

what type of fracture?

transverse

what type of fracture

displaced

what type of fracture

open

what type of fracture

comminuted

what type of fracture

spiral

what type of fracture

oblique

what type of fracture

depression

what type of fracture?

stress

what type of fracture?

avulsion

3 types of chronic muscle injury

myositis, fasciitis, myositis ossificans

what does the body do while a fracture is healling?

osteoblasts extra bone called callus

osteoclasts will reshape the bone

where is dislocation more common?

upper extremities

dislocation

bone is completely out of the joint

sublaxation

a partial dislocation

what symptom is always present with a dislocation?

deformity

how to treat a dislocation when one occurs

it should be treated as a fracture until ruled as a dislocation by an xray

healing of a fracture typically requires

immobalization by casting or splinting the bone

soft tissue types

tendon, ligament, muscle, bursa

the tendon functions to

Execute joint motion by transmitting forces from muscles to bones

A ligament functions to

Join bones and provide stability to joints

ligaments and tendons are _______ meaning that they do not contract or create force

inert structures

the left foot injury in the image is ________, the right foot is a ________

sprain, strain

sprain

disruption of a ligament

strain

disruption of muscle or tendon

what does it mean for the tendon to be highly collagenous in composition (what its made up of)?

they have high resistance to tension forces

what soft tissue is highly collagenous in composition?

tendon

where are the tendons strongest at?

in the middle of the tendon

where are the tendons weakest at

myo-tendinous and osteo-tendinous junctions

acute inflammation of the tendon

tendinitis

inflammation of the synovial fluid surrounding a tendon

tenosynovitis

chronic degenaration of the tendon due to injury failing to heal

tendinosis

bruising of the tendon that causes a direct blow

contusion

Mild overstretching, no tissue disruption, firm feeling, no instability

first degree ligament sprain

Partial disruption or macrotearing of the ligament, soft feeling, slight instability

second degree ligament sprain

Complete disruption of the ligament with nothing to feel and severe instability

third degree ligament sprain

skeletal muscle injury caused by neurological, repetitive trauma, other injury

Muscle guarding (spasm)

skeletal muscle injury caused by eccentric muscle contraction

Muscle Soreness (DOMS)

skeletal muscle injury caused by dehydration, electrolyte imbalance, fatigue

Muscle Cramping (Heat Cramps)

sudden traumatic blow that can affect superficial or deep tissue and rated by ROM

muscle contusions

stretch or tear in the muscle that makes the muscle contract abnormally

muscle strains

Overstretching or microtearing of muscle or tendon

first degree muscle injury

Stretching and partial tearing of muscle or tendon fibers with severe symptoms and loss of muscle function

second degree muscle injury

complete rupture of the muscle

third degree muscle injury

3 types of chronic muscle injuries

myositis, fascitis, myositis ossificans

chronic myositis

inflammation of muscle

chronic fasciiitis

inflamation of fascia within the muscle

chronic myositis ossificans

repeat trauma your muscle can ossify

bursitis

inflammation in fluid filled sac in places where friction occurs between bony surfaces and tendons

compression of a neural structure occurs

when a direct blow occurs causing acute swelling

no sensation nerve injury

anesthesia

tingling, burning, numbness as symptoms of nerve injuries

paresthesia

hypersensitivity from this type of nerve injury

hyperesthesia

combined loading

multiple intermediate loads because the body rarely undergoes one mode only

A football player suffers repeated blows to his left quadriceps. What type of injury could be sustained?

contusion has occured, could lead to myocitis

A basketball player steps on another player’s foot and

sustains a lateral ankle injury

• What forces are applied?

• What type of injury has occurred?

force: ankle torsion

injury: lateral ankle sprain

menengitis

infection of the membranes that cover your brain and spinal cord

dura mater spaces

epidural and subdural space

where is Cerebrospinal fluid

between arachenoid and pia mater membranes

concussion

An injury caused by a direct blow to the head, neck, or body that causes an impairment of neural function

is a concussion a functional or structural injury?

functional

coup

in the front when your head strikes the object

contracoup

after your head strikes the front, it strikes the back causing confusion and swelling

assesing head injuries for an unconscious person

suspect a cervical neck injury, if no life threatening conditions then stabilize spine and wait for EMS

when you palpate the skull and cervical spine, look for:

points of tenderness and deformities

PEARL

pupils are equal and reactive to light

balance error scoring system

quantifiable tool of balance with 6 total trials

three different stances

two different surfaces

athletes can return to play after concussion when…

all symptoms are resolved

second impact syndrome

rapid swelling of the brain following a second head impact occuring before the symptoms of a previous concussion are resolved

what is the mortality rate of second impact syndrome

50%

intracerebral hematoma impact

the head hits a stationary object

care for intracerebral hematoma

hospitalization and diagnostic imaging

epidural hematoma impact

blow to the head that results in a tear of meningeal arteries

subdural hematoma

involves venous bleeding

mandible fracture mechanism of impact

direct blow

orbital fracture mechanism of impact

direct trauma to the eyeball

retinal detachment mechanism of injury

blow to the eye