Ch 1 The injury evaluation process
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| Def. Of Anatomy | Structure Of Human Body
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| Function of Knowing the Anatomy | Helps with understanding the Physiology and Biomechanics of human body
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| In Evaluation we must understand what? | Structure and function of Individual Body parts.
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| Def. Of Biomechanics | Relationship between individual body parts and movement.
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| Def. of Pathomechanics | Abnormal movements that are produced by individual body parts when an injury occurs.
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| Def. Of Pathology | Abnormal physiology that occurs due to illness.
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| 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.
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| What is key when doing the History? | Communication with the injured athlete
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| Better communication with injured athlete ='s what? | Better quality of information gained from patients responses to your questions.
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| Open-ended questions Do what? | Allow the patient to describe the nature of the complaint in detail. Don't want Yes-No answers!
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| 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
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| What is the first step to injury assessment? | History
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| What is the second step to injury assessment? | Inspection
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| When inspecting what do we need to compare? | Involved vs. the uninvolved side
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| Inspection starts when? | As soon as the patient walks into the facility
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| What three things can you inspect without talking to the patient? | Gait pattern
posture
Functional movement
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| Visually inspect the are for what? | gross deformity or other obvious injury
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| Inspection should include looking for what 6 things.... | Swelling
gross deformity
skin color and texture
infection
muscle tone
bilateral symmetry
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| What is the third part of the assessment process? | Palpation
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| 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
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| Palpation is a process of what? | Touching and Feeling
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| When we are palpating we are trying to detect ________ _________ that cant be _________ __________. | tissue damage:observed visually
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| When palpating we must always compare what? | bilaterally
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| We should always palpate in a specific what? | sequence
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| When palpating we should begin with the structures ___________________________? ( long answer) | Away from the site of pain and progressively move toward the damaged tissue.
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| List the order of the structures that should happen during palpation? | 1.Bones and ligaments
2.Muscles and Tendons
3.Pulses
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| What is the fourth part of the evaluation process? | Range of motion Testing
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| Def. of Range of Motion | Ability to move the limb through the correct or applicable planes of movement associated with that joint.
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| What are the three types of ROM | 1. Active
2. Passive
3. Resistive
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| ROM Testing should always include all motions for involved joint but also possibly what? | All joints Proximally and distally to involved joint.
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| What is an important tool when assessing ROM. | Goniometer
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| What are the four parts to the Goniometer? | 1. Protractor
2. Movement Arm
3. Fulcrum
4. Stationary Arm
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| What needs to be taken into account when selecting a Goniometer? | Appropriate size and shape for joint being tested.
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| What type of ROM should be eval. first? | Active Range of Motion
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| What are the contraindications of evaluating Active Range of Motion first? | Immature fracture sites or recently repaired soft tissues.
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| Def. of Active Range of Motion? | Patient actively contracts muscles while going through a particular movement.
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| What four things are we evaluating during AROM? | Quality of : 1. Motion 2. Total Range 3. Location of pain $. Painful Arcs
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| During AROM what four things can limit ROM? | 1. Swelling
2. capsular tightness
3. agonist muscle weakness
4.
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| 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.
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| Why is PROM assessed? | To assess the quantity of available movement and the end feel of tissues as they reach limit of available ROM.
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| Deficiencies in PROM may be the result of what five things? | 1. spasm
2. contracture
3. weakness
4. muscle pain
5. neurological deficits
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| What feeling also may be illicited when doing PROM? | Crepitus
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| What would you call normal end feels and what are the types? | Physiological //// 1. soft 2. firm 3. hard
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| What would you call abnormal end feels and what are the types? | Pathological //// 1. soft 2. firm 3. hard 4. empty
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| Def. of Resisted Range of Motion? | Used to asses the strength of muscle groups when resistance is applied.
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| When doing Break testing you should look for what? | compensatory motion (compensation)
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| What are the two commonly used techniques to asses RROM strength | Break Test and Manual Muscle Tests
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| Break tests asses motion based on what four levels? | 1. strong
2. weak
3. painful
4. painless
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| Manual muscle testing assesses what? | Strength and integrity of specific muscles
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| When doing Manual muscle testing you should always do compare _________ and Grade ________. | Bilaterally:numerically
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| 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
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| What two things should be taken note of while doing RROM? | Compensation movements and muscular substitution.
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| What muscle groups usually attempt to overcome weaknesses of the muscle being tested? | The proximal group.
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| what is the 5th step to the assessment process? | Ligamentous testing
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| What are we trying to achieve with ligamentous testing? | evaluate the structural integrity of the nocontractile structures surrounding the involved joint.
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| Def. of Laxity? | clinical sign that describes the amount of give within the joints supportive tissue.
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| Def. of Instability? | symptom of a joints inability to function under the stresses during functional activity.
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| What are the three grades for Ligamentous laxity? | Grade 1 Firm; Grade 2 Soft; Grade 3 Empty
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| What is the 6th step in the assessment process? | Special Tests
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| What are special tests? | Specific procedures applied to a joint to determine the presence of pathomechanics.
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| What is the 7th step in the assessment process? | Neurologic testing
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| What are the three types of Neurologic Testing? | 1. Sensory
2. Motor
3. Reflex
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| When doing deep tendon reflex grading what are the specific grades? | 0 No flex elicited////
1 Hyporeflexoria/////
2 Normal response////
3 Hyperflexoria
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| What is functional testing? | Usually activity specific testing that assesses the patients function and progress.
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| What type of stuff should be included when doing functional testing? | Should reflect types of stress that a patient will experience during normal activities.
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| 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.
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| On field evaluations or divided into what two categories? | Ambulatory and Athlete-Down
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| 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.
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| 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.
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| 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
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| After triage for on-field eval what must be determined immediately? | Disposition
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| 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
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| 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.
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| What needs to be established prior to actual emergency situation? | Clear communication and evaluation protocol must be established.
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| What should the coaching staff have on a regular basis? | CPR/AED Training
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| What is one thing to consider before acting in an emergency situation? | Rules of the sport regarding injury eval.
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