Final Exam Study Guide - KINE 232 PDF

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KINE 232 Final Exam Study Guide

Chapter 1 – Intro to Injury Care 1. True/False. A certified personal fitness trainer is responsible for the immediate care and treatment of injuries in the athletic setting.

2. What roles and responsibilities fall under the title of “Coach” as it pertains to healthcare? First person at the scene of an injury (typically at high schools). Immediate reaction and decisions are critical and any inappropriate actions may jeopardize the athletes’ health.

3. Who is primarily responsible for maintaining and fitting protective equipment? Athletic trainers

4. What healthcare professionals are part of the sports medicine team? Physician, coach, athletic trainers Exercise physiologist, nurse, certified athletic trainer, nutritionist, strength and conditioning coach

5. What member of the sports medicine team holds the ultimate responsibility for the total or overall healthcare of the student-athlete? Physician

6. What healthcare professional would assist athletes with coping mechanisms and stress following an injury? Sport psychologist

Chapter 2 – Legal Liability and Insurance 1. What is the purpose of Good Samaritan Laws? Provides limited protection against legal liability to one that provides care should something go wrong

2. True/False. Sport and fitness coordinators cannot release any medical information about an injured individual without that person’s written consent if the person is older than 18 years of age.

3. Define negligence. Occurs as a result of an action, or lack of action, by a professional who had a legal duty of care. Nonfeasance: individuals fails to perform a legal duty of care (act of omission) Malfeasance: an individual commits an act that is not their responsibility to perform (act of omission) Misfeasance: using the wrong procedure in performing a responsibility

4. What conditions must be met/broken in order for negligence to occur? Duty, breach, causation, and damages/harm 5. A coach suspects his star player has suffered a lower leg fracture due to the visible angulation of the involved bones. The coach decides to straighten out the limb and immobilize the leg in a splint. What legal tort might this coach have broken? Malfeasance

Chapter 4 – Injury Mechanism and Classification of Injury 1. Define the different types of bone fractures. Page 59 Acute fractures: partial or complete disruption that can either be closed or open. Presents with deformity, point tenderness, swelling, pain on AROM or PROM Open: a portion of a broken bone breaks through the skin Closed: little or no displacement of broken bones Stress fractures: calcium formation found in muscle tissue due to repetitive trauma. Begins with a dull ache but worsens over time,

2. What is the difference between a dislocation and subluxation? Subluxation: partial or incomplete dislocation Dislocation: bones that compromise a joint are forced beyond their normal position

3. Define the different grades of injuries, i.e, Grade 1, Grade 2 and Grade 3. Grade 1: fibers have been stretched or torn resulting in tenderness, soreness, and pain for ROM Grade 2: number of fibers have been torn and active contraction is painful, swelling and discoloration occur Grade 3: complete rupture of a muscle or junction, significant impairment occurs, pain, discoloration, lumps/bulges, bruises

4. Define the different types of forces acting on the body, i.e, compressive, shear, tensile, etc. Axial force: force acting along the long axis of a structure (body weight on legs when standing) Compression force: axial loading that produces a squeezing or crushing affect (body constantly compresses bones) Tensile force: axial loading in the direction opposite to that of compression (muscle contraction) Shear force: force that acts parallel or tangent to a plane passing through an object, cause one part of the object to interact with another part (squatting and the knee joint)

5. What injury may be caused by repeated blows to the same area resulting in bone formation? Ossifican

Chapter 5 – The Healing Process 1. Define hypoxia Disruption of the oxygen supply

2. What is the difference between a closed and open wound/fracture? Closed wound involved an injury to the soft tissue WITHOUT breakage of the skin while an open fracture involves breakage of the skin.

3. What are the signs/symptoms of inflammation? Rubor, calor, tumor, dolor, and loss of function

4. How should you properly irrigate a wound? Pressure at 4-15 psi

5. What is the difference between primary and secondary injury? Primary: initial injury Secondary: any additional injuries that may have occurred from the primary injury

Chapter 6 – Injury Management/Wound Care 1. True/False. The best practice in the event of a blood spill, is to treat the blood of any individual as if it is infected with a bloodborne pathogen.

2. True/False. If external support personnel (i.e EMTs, Athletic Trainers, parents) are used in the implementation of the emergency action plan, their roles, responsibilities and protocols should also be defined in advance.

3. True/False. Cleansing is the delivery of solution or fluid to the wound surface by a mechanical force to remove foreign bodies and debris.

4. True/False. The exposure control plan should be developed with input from the personnel at the facility, higher authorities to which the institution reports, medical personnel and legal personnel.

Chapter 7 – Injury Assessment 1. Define Active, Passive, Resistive and Assistive range of motion. AROM: ROM performed voluntarily by the patient PROM: physician/medical professional leading the patient in assisted ROM (patient does not move with the professional but rather allows the professional to do the work) RROM: asses the strength and muscle function for specific movements by a medical professional applying force against a patient’s AROM AsROM: ?

2. What are you looking for when palpating? Examines the size, consistency, texture, location, and tenderness of an organ or body part

3. What is the difference between a sign and symptom? A sign is something the physician can see or test A symptom is something that patient feels

4. Define Primary and Secondary survey.

The primary assessment first looks at any life-threatening conditions or injuries that may need medical attention immediately. It also looks at the responsiveness of the patient. The secondary assessment looks at vitals, any other injury that needs to be managed, and other decisions needed to be made after the primary injury is under control. 5. What is meant by “mechanism of injury?” The physical cause or circumstance under which the injury occured

Chapter 10 questions - Head 1. Define Anterograde and Retrograde memory Antegrade: unable to recall events after a concussion (make new memories) Retrograde: unable to recall events from before concussion (old memories)

2. What is the difference between Coup and Contrecoup injuries? Contrecoup: moving head (brain) strikes a stationary object Coup: moving object impacting stationary head

3. How is the BESS test performed?

4. List the 12 cranial nerves and their functions. (Page 118)

Olfactory nerve-smell optic nerve-vision oculomotor nerve-eyelid and eyeball movement trochlear nerve-innervates superior oblique turns eye downward and laterally trigeminal nerve-chewing, face/mouth touch & pain abducens nerve-turns eye laterally facial nerve-controls most facial expression, secretion of tears and saliva, taste vestibulocochlear nerve-hearing, equilibrium sensation glossopharyngeal nerve-taste, senses carotid blood pressure vagus nerve-senses aortic BP, slows HR, stimulates digestive organs, taste spinal accessory nerve-controls trapezius and sternocleidomastoid, controls swallowing movements hypoglossal nerve-controls tongue movement

5. What is a Halo Sign? CSF mixes with blood on an absorbent surface, forms a spot in the center and a lightly stained ring forms a halo around it

6. What are Racoon Eyes? Severe ecchymosis and swelling

7. What is a Battle Sign? Bleeding or swelling behind the ear

Chapter 12 – The Shoulder Complex 1. What muscles make up the Rotator Cuff? Teres minor: used in rotation Infraspinatus: rotate and extend shoulder Supraspinatus: hold Humerus in place and keeps your upper arm stable and assists in lifting the arm

Subscapularis: used for rotation

2. What is the actual name for the shoulder joint? Glenohumeral joint

3. What is the acronym for a common mechanism of injury for the shoulder joint and what does it stand for? FOOSH: fall on the outstretched hand

4. What bursa is the one most commonly irritated in the shoulder joint? Subacromial

5. Why is a posterior dislocation of the clavicle deemed a medical emergency? Because of all the vital structures posterior to the medial clavicle (innominate artery, innominate vein, brachial plexus, trachea, superior lung, esophagus, thoracic duct)

6. This bone is the weakest of the shoulder complex and the site where most fractures of the shoulder occur. Clavicle?

Chapter 13 – The Elbow, Forearm, Wrist and Hand 1. Define boxer’s fracture Fracture involving the distal metaphysis or neck of the fourth or fifth metacarpals, commonly seen in young males involved in punching activities

2. Name the ligaments of the elbow and their subparts if applicable. Where is each located? What are their functions? Medial collateral ligament (MCL, ulnar): 3 oblique bands denoted by anatomical position

Anterior: Inferior surface of the medial epicondyle to the medial aspect of the coronoid process; taut throughout the full ROM, primary valgus restraint Transverse (oblique): medial epicondyle to the coronoid process; provides little to no joint stability Posterior: fan-shaped capsular thickening; taut when the elbow is flexed beyond 60 degrees Lateral collateral ligament (LCL, radial): Lateral ulnar (LUCL): middle of the lateral epicondyle to tubercle of the ulna; important stabilizer and independent of the other lateral ligament Radial collateral (RCL): located in the thickened area of the lateral joint capsule between the lateral epicondyle and annular ligament; resist varus force, maintains a relationship between the humeral and radial articulation surfaces Annular: fits tightly around the radial head; permits supination/pronation, in extreme supination the anterior fibers are taught, in the end of pronation the posterior fibers are taut Accessory collateral lateral (ALCL): a superficial layer of fibers blending with the annular ligament and assists the annular RCL in preventing the radius from separating from the ulna

3. What is the difference between a Colles’ and a Smith’s fracture? Smith’s: falling on the flexed wrist, less common Colles’: FOOSH forcing radius and ulna into hyperextension

4. If a person has a fractured scaphoid, where might the pain be located? Anatomical snuff box; pain with radial deviation, flexion, and extensions

5. What muscles flex the wrist? Flexor carpi radialis, palmaris longus, and flexor carpi ulnaris

6. What is a common MOI for olecranon bursitis? Direct blow or overuse, superficial location makes it extremely susceptible to injury

7. What position is meant by “anatomical position?”

Body is upright, facing observer, feet flat and forward, upper limbs extended with palms forward

8. What muscles act to extend the elbow? Triceps brachii

9. What is a Tommy John injury? Injury to the ligament on the medial side of the elbow, commonly occurs in overhead throwing athletes (baseball pitchers)

10. What is the difference between Golfer’s elbow and Tennis elbow? Golfer’s: overuse injury affecting the flexor-pronator muscle origin at the anterior medial epicondyle of the humerus; repeated forceful flexion of wrist and extreme valgus torque of the elbow Tennis: resistive microtrauma to insertion of extensor muscles of lateral epicondyle (backhand in tennis); painters, plumbers, and carpenters are particularly prone to developing this 11. In what positions are the brachialis, bracioradialis and biceps brachii the most efficient elbow flexors respectively?

12. Where might you experience paresthesia if injury to the ulnar nerve is suspected? Fingers?

Chapter 14 – The Thigh, Hip, Groin and Pelvis 1. What muscles make up the quadriceps muscle group? Rectus femoris, vastus lateralis, vastus medialis, vastus intermedius

2. What bones make up the sacroiliac joint? Sacrum and inner side of the ilium

3. Why is a femoral fracture considered a medical emergency?

Surgery may be needed to fix the injury (such as screws to hold fracture in place). It is also one of the most used bones in the body and will require therapy to regain normal ROM.

4. Describe the capitis femoris ligament (AKA ligamentum teres). Where is it located? What is its function? Runs from the femoral fovea (hole in the head of the femur) to the transverse acetabular ligament, helping to attach the femur head to the acetabulum and assisting with blood supply to that region

5. How is the FABER test performed? Just google it bro

6. What muscles make up the hamstrings muscle group? Semitendinosus, semimembranosus, biceps femoris

Chapter 15 – The Knee 1. What are the functions of each of the ligaments of the knee? (ACL, PCL, MCL and LCL) ACL: normally undergoes less than 2.5mm length change over full ROM PCL: primary stabilizer resisting posterior displacement of the tibia on a fixed femur, acts as a drag during the gliding phase of motion, controls and imparts rotational stability to the knee, prevents hyper extension of the knee and femur MCL: prevent valgus and external rotational forces LCL: primarily responsible for varus forces when the knee is between full extension and 30 degrees of flexion

2. If damage to the peroneal nerve was suspected, what motion(s) might the patient be weak in? Lifting of ankle/toes

3. What is a common mechanism of injury for the ACL? Athlete decelerates with foot planted and turns in the direction of the planted foot forcing tibia into internal rotation

4. What are the signs and symptoms of a meniscus injury? Effusion after 48-72 hours, joint line pain, loss of motion, intermittent locking and giving away, pain with squatting

5. What is the normal Q-angle degree range in men and women? Men: 13-14 degrees Women: 17-18 degrees

Chapter 16a – The Foot 1. Define pes planus and pes cavus Pes planus: flatfeet Pes cavus: high arc of the foot

2. What is the plantar fascia? Broad structure spanning between the medial calcaneal tubercle and the proximal phalanges of the toe

3. True/False. The extensor hallucis longus is responsible for movement of the great (big) toe.

4. What muscle passes behind the medial malleolus? Flexor digitorum longus muscle

5. What bones are contained in the hindfoot, midfoot and forefoot?

Hindfoot: talus (ankle) and calcaneus (heel) Midfoot: navicular, cuboid, 3 cuneiform bones Forefoot: metatarsals, phalanges, sesamoids

Chapter 16b – The Ankle and Lower Leg 1. What joint as known as the ankle joint? Talocrural joint

2. What is Medial Tibial Stress Syndrome (MTSS)? Muscle or fascia exerts excessive traction or tensile forces on the medial border of the tibia

3. What bones make up the medial and lateral malleolus respectively? Medial: end of the tibia Lateral: end of the fibula

4. Why do we have greater range of motion of inversion at the ankle than eversion?

Chapter 17 – Environmental Conditions 1. What are the signs and symptoms of heat stroke? Core body temp above 105, dehydration, weakness, hot and wet or dry skin, tachycardia, hypotension, hyperventilation, vomiting, diarrhea, dizziness, drowsiness, irrational behavior, confusion, irritability, emotional instability, hysteria, apathy, aggressiveness, delirium, disorientation, staggering, seizures, loss of consciousness, coma

2. Define the different examples of heat exchange, i.e, radiation, conduction, convection, etc. Conductive: physical contact with objects resulting in heat loss or gain Convective: body heat can be lost or gained depending on circulation of medium Radiant: comes from sunshine and will increase temperature

3. Define the different stages of hypothermia and their signs/symptoms. Mild: core temp 98.6-85, amnesia, lethargy, vigorous shivering, impaired fine motor, cold extremities, polyuria, pallor, rhinorrhea, typically conscious, BP within normal limits Moderate: core temp 94-90, depressed respiration and pulse, LOC, cardiac arrhythmias, cyanosis, cessation of shivering, impaired mental function, slurred speech, impaired gross motor, muscle rigidity, dilated pupils, BP decreased or difficult to measure Severe: core temp below 90, rigidity, bradycardia, severely depressed respiration, hypotension, pulmonary edema, spontaneous ventricular fibrillation or cardiac arrest, usually comatose

4. What is the purpose of a sling psychrometer? To measure DBT and WBT

5. How can hyperthermia be prevented? Take frequent breaks, drink water, wear cool clothing, shady area to rest

6. What is the most important factor in determining the effectiveness of evaporative heat loss? Relative humidity

Congenital Issues 1. What population of athletes is most at risk for becoming poikilothermic? Wheelchair athletes

2. Define sickle cell anemia. Autosomal recessive condition where red blood cells form an abnormal sickle or crescent shape

3. What are the signs and symptoms of Marfan’s Syndrome? Tall stature, ratio of arm span exceeds 1.0, anterior chest wall deformities, joint hypermobility, kyphoscoliosis, decrease in subcutaneous fat, narrow high arc plate with crowding teeth, long spidery fingers, reduced upper to lower body ration, flat arch, scoliosis greater that 20 degree, inguinal hernias, poor muscular development, elongated face and malocclusion

4. What is the difference between an acquired and congenital condition/disorder? Acquired: development of a condition as a result of some intrinsic or extrinsic influence that is out of the ordinary Congenital: conditions recognized at birth or is believed to have been present since birth, including conditions which are inherited or caused by an environmental factor

5. Define Hypertrophic cardiomyopathy. Autosomal dominant disorder characterized by left ventricular outflow obstruction with asymmetric septal hypertrophy and marked disarray of ventricular muscle fibers...