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evaluation of athletic injuries..sec1 LE

Purpose of evalto determine what injury ath has, severity of the injury and or the priority of the injury, appropriate course of treatment
Principles of injury eval test uninvolved side 1st to get a baseline, increase pt confidence, decrease pt apprehension, apply over pressure with care, w/ PROM & ligamentous testing both degree & quatlity, w/ ligament testing repeat increasin stress, myotome testing hold for 5 sec
importance of non injured side provides immediate ref to relative dysfunction, used to demonstrate mechanism of injury, provide regerence of symmetry of bone, tissue, tissue color/temp, swelling/inflammation, ROM, strength, ligamentous laxity, neurovascular tests
Primary survey ABCD Airway-chin tilt/jaw thrust Breathing-look listen feel Circulation-carotid pulse Disability-wiggle fingers/toes, flex/ext arm, move foot
Secondary survey (head to toe exam) vital signs:level of consciousness, pulse respiration, BP, skin color/temp, ability to move, pupil reflexes, reaction to pain
Localized Swelling superficial structures, bursitis, contusions, strains, sprains
diffuse swelling severe hematoma, dislocation, fractures
intramuscular swelling swelling within a muscle
intermuscular swelling swelling between the muscles
immediate swelling within 2 hrs severe injury, hemarthosis or damage to a structure with a rich blood supply,
delayed swelling 6-24 hrs synovial irritation, bone chips, capsular/ligament sprain
delayed swelling post activity only busitis, chronic synovial irritation
Normal end feels bone on bone-hard unyeilding painless soft-tissue approximation-yeilding compression that stops further movement tissue stretching-hard, firm, or springy w/ a slight give/elastic resistance
Abnormal end feels muscle spasm, capsular, bone to bone, empty spring block
muscle spasm abnormal end feel sudden & hard, sudden, dramatic stoppage of movment accompanied by pain
Capsular decrease ROM
Bone to Bone restriction occurs before the normal end ROM
Empty movement is impossible due to pain
Spring block similar to tissue streatch. rebound effect, decreased ROM
Stress Tests evaluates the structural integrity of ligament & joint capsules, determines the amount of laxity in a specific ligament and/or the amount of instability in a specific joint
Special Test specific procedure applied to a body part to determine the amount of damage done (ie fracture tests, muscle-tendon function tests. etc)
Loose packed position position of joing in ROM wher ejoint under least amount of stress & joint capsule has greatest capacity-pos of minimal congruency btween articular surfaces & joint capsule- ligaments are in greatest pos. of laxity
Resting position of Hip 30* of flex, 30* of abduction, slight ER
Resting position of knee 25 degrees of flex
Resting position of patella femoral full flex
Distal Tib-fib PF 10*, 5* of inversion
Talocural PF 10*, midway between inv/ev
Subtalar Pf 10* midway between inv/ev
Closed Packed Position avoid as much as poss during assessment, 2 joint surfaces fully congruent &compressed, ligament and joint capsule completely taut, joint surfaces cant b serperated w/ distraction, if injured p! increases when reaching this position. w/ swelling cant reach
Closed packed position of hip Lig-full ext, abduction, IR Boney- flexed 90*, slight abduction, ER
Closed packed position of knee full flex and ER
Closed packed position of patella femoral full ext
closed packed distal tib-fib none
Closed packed talocural full dorsiflexion
closed packed of subtalar full inversion/supination
Created by: jwebst1