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Ch1 Eval Ortho. Inju

Ch 1 The injury evaluation process

Def. Of Anatomy Structure Of Human Body
Function of Knowing the Anatomy Helps with understanding the Physiology and Biomechanics of human body
In Evaluation we must understand what? Structure and function of Individual Body parts.
Def. Of Biomechanics Relationship between individual body parts and movement.
Def. of Pathomechanics Abnormal movements that are produced by individual body parts when an injury occurs.
Def. Of Pathology Abnormal physiology that occurs due to illness.
Five reasons Athletic trainer may conduct Multiple evaluations. 1.On site at time of injury. 2.On site evaluation just following injury 3.Offsite eval. involving injury assesment and rehab. 4.Follow up eval. during rehab. 5.Pre-participation Physical.
What is key when doing the History? Communication with the injured athlete
Better communication with injured athlete ='s what? Better quality of information gained from patients responses to your questions.
Open-ended questions Do what? Allow the patient to describe the nature of the complaint in detail. Don't want Yes-No answers!
What are seven points of Injury assessment? 1. history 2. inspection 3. palpation 4. Range of motion testing 5. ligamentous testing 6. special tests 7. neurological testing
What is the first step to injury assessment? History
What is the second step to injury assessment? Inspection
When inspecting what do we need to compare? Involved vs. the uninvolved side
Inspection starts when? As soon as the patient walks into the facility
What three things can you inspect without talking to the patient? Gait pattern posture Functional movement
Visually inspect the are for what? gross deformity or other obvious injury
Inspection should include looking for what 6 things.... Swelling gross deformity skin color and texture infection muscle tone bilateral symmetry
What is the third part of the assessment process? Palpation
We should identify what seven things during palpation? Areas of: Point Tenderness Crepitus Swelling Trigger Points Tissue Density Increased Tissue Temp. Malalignment of joint or bone
Palpation is a process of what? Touching and Feeling
When we are palpating we are trying to detect ________ _________ that cant be _________ __________. tissue damage:observed visually
When palpating we must always compare what? bilaterally
We should always palpate in a specific what? sequence
When palpating we should begin with the structures ___________________________? ( long answer) Away from the site of pain and progressively move toward the damaged tissue.
List the order of the structures that should happen during palpation? 1.Bones and ligaments 2.Muscles and Tendons 3.Pulses
What is the fourth part of the evaluation process? Range of motion Testing
Def. of Range of Motion Ability to move the limb through the correct or applicable planes of movement associated with that joint.
What are the three types of ROM 1. Active 2. Passive 3. Resistive
ROM Testing should always include all motions for involved joint but also possibly what? All joints Proximally and distally to involved joint.
What is an important tool when assessing ROM. Goniometer
What are the four parts to the Goniometer? 1. Protractor 2. Movement Arm 3. Fulcrum 4. Stationary Arm
What needs to be taken into account when selecting a Goniometer? Appropriate size and shape for joint being tested.
What type of ROM should be eval. first? Active Range of Motion
What are the contraindications of evaluating Active Range of Motion first? Immature fracture sites or recently repaired soft tissues.
Def. of Active Range of Motion? Patient actively contracts muscles while going through a particular movement.
What four things are we evaluating during AROM? Quality of : 1. Motion 2. Total Range 3. Location of pain $. Painful Arcs
During AROM what four things can limit ROM? 1. Swelling 2. capsular tightness 3. agonist muscle weakness 4.
Def. of Passive Range of motion? Range of motion testing when clinician takes affected body part through different planes and the muscle and patient is relaxed.
Why is PROM assessed? To assess the quantity of available movement and the end feel of tissues as they reach limit of available ROM.
Deficiencies in PROM may be the result of what five things? 1. spasm 2. contracture 3. weakness 4. muscle pain 5. neurological deficits
What feeling also may be illicited when doing PROM? Crepitus
What would you call normal end feels and what are the types? Physiological //// 1. soft 2. firm 3. hard
What would you call abnormal end feels and what are the types? Pathological //// 1. soft 2. firm 3. hard 4. empty
Def. of Resisted Range of Motion? Used to asses the strength of muscle groups when resistance is applied.
When doing Break testing you should look for what? compensatory motion (compensation)
What are the two commonly used techniques to asses RROM strength Break Test and Manual Muscle Tests
Break tests asses motion based on what four levels? 1. strong 2. weak 3. painful 4. painless
Manual muscle testing assesses what? Strength and integrity of specific muscles
When doing Manual muscle testing you should always do compare _________ and Grade ________. Bilaterally:numerically
What does the grading scale of manual muscle testing consist of? 0-5 //// Normal 5/5; Good 4/5; Fair 3/5; Poor 2/5; Trace 1/5; Gone 0/5
What two things should be taken note of while doing RROM? Compensation movements and muscular substitution.
What muscle groups usually attempt to overcome weaknesses of the muscle being tested? The proximal group.
what is the 5th step to the assessment process? Ligamentous testing
What are we trying to achieve with ligamentous testing? evaluate the structural integrity of the nocontractile structures surrounding the involved joint.
Def. of Laxity? clinical sign that describes the amount of give within the joints supportive tissue.
Def. of Instability? symptom of a joints inability to function under the stresses during functional activity.
What are the three grades for Ligamentous laxity? Grade 1 Firm; Grade 2 Soft; Grade 3 Empty
What is the 6th step in the assessment process? Special Tests
What are special tests? Specific procedures applied to a joint to determine the presence of pathomechanics.
What is the 7th step in the assessment process? Neurologic testing
What are the three types of Neurologic Testing? 1. Sensory 2. Motor 3. Reflex
When doing deep tendon reflex grading what are the specific grades? 0 No flex elicited//// 1 Hyporeflexoria///// 2 Normal response//// 3 Hyperflexoria
What is functional testing? Usually activity specific testing that assesses the patients function and progress.
What type of stuff should be included when doing functional testing? Should reflect types of stress that a patient will experience during normal activities.
Functional testing can be used as a what for return to play criteria? Can be used to establish a basline of function with continued follow-up.
On field evaluations or divided into what two categories? Ambulatory and Athlete-Down
What is an ambulatory evaluation? What can affect this type of eval? One in which the clinician is sought out whether it is on the field of play similar to the clinic setting. Time may be decreased if during competition.
What is the basis behind an athlete-down evaluation? Athletic trainer responds to the athlete and the situation and must triage injuries and rule out any life threatening situations.
The on-field eval must rule out what seven things? 1. inhibition of heart of breathing//// 2. life threatening trauma to head or spine//// 3. profuse bleeding///// 4. fractures//// 5. joint dislocation//// 6. peripheral nerve injury//// 7. other soft tissue trauma
After triage for on-field eval what must be determined immediately? Disposition
What three things does Disposition encompass having to do with on-field evaluation? 1. On-field management of the injury///// 2. Safest way to remove athlete from the field//// 3. Referral urgency
What are the roles of the two person on-field eval team? Responder 1: stabilize spine, calms and communicates with athlete and controls the scene/////// Responder 2: performs necessary evaluation.
What needs to be established prior to actual emergency situation? Clear communication and evaluation protocol must be established.
What should the coaching staff have on a regular basis? CPR/AED Training
What is one thing to consider before acting in an emergency situation? Rules of the sport regarding injury eval.
Created by: shsuman152