evaluation of athletic injuries..sec1 LE
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| Purpose of evalto determine | what injury ath has, severity of the injury and or the priority of the injury, appropriate course of treatment
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| 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
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| 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
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| Primary survey | ABCD
Airway-chin tilt/jaw thrust
Breathing-look listen feel
Circulation-carotid pulse
Disability-wiggle fingers/toes, flex/ext arm, move foot
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| 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
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| Localized Swelling | superficial structures, bursitis, contusions, strains, sprains
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| diffuse swelling | severe hematoma, dislocation, fractures
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| intramuscular swelling | swelling within a muscle
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| intermuscular swelling | swelling between the muscles
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| immediate swelling within 2 hrs | severe injury, hemarthosis or damage to a structure with a rich blood supply,
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| delayed swelling 6-24 hrs | synovial irritation, bone chips, capsular/ligament sprain
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| delayed swelling post activity only | busitis, chronic synovial irritation
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| 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
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| Abnormal end feels | muscle spasm, capsular, bone to bone, empty spring block
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| muscle spasm abnormal end feel | sudden & hard, sudden, dramatic stoppage of movment accompanied by pain
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| Capsular | decrease ROM
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| Bone to Bone | restriction occurs before the normal end ROM
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| Empty | movement is impossible due to pain
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| Spring block | similar to tissue streatch. rebound effect, decreased ROM
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| 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
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| Special Test | specific procedure applied to a body part to determine the amount of damage done (ie fracture tests, muscle-tendon function tests. etc)
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| 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
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| Resting position of Hip | 30* of flex, 30* of abduction, slight ER
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| Resting position of knee | 25 degrees of flex
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| Resting position of patella femoral | full flex
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| Distal Tib-fib | PF 10*, 5* of inversion
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| Talocural | PF 10*, midway between inv/ev
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| Subtalar | Pf 10* midway between inv/ev
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| 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
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| Closed packed position of hip | Lig-full ext, abduction, IR Boney- flexed 90*, slight abduction, ER
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| Closed packed position of knee | full flex and ER
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| Closed packed position of patella femoral | full ext
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| closed packed distal tib-fib | none
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| Closed packed talocural | full dorsiflexion
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| closed packed of subtalar | full inversion/supination
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