Fundamentals of Sports Injury Management TEST 3 (Chapter 7&9)

Define signs of an injury
Things individual can hear, feel, see, or smell.
Define symptoms of an injury
Subjective feelings, such as blurred vision, ringing in the ears, fatigue, dizziness, nausea, headache, etc.
Acute injury
Resulting from a specific event leading to a sudden onset of symptoms.
Chronic injury
Characterized by slow, insidious onset of symptoms that culminates in a painful inflammatory condition.
Injury Evaluation Process
Includes, taking a history of current condition, visually inspecting the area for noticeable abnormalities, physically palpating the region for abnormalities, and completing functional stress, stress, or special tests.
Injury Assessment
Should follow a consistent, sequential order to ensure that as much information as possible is obtained.
HOPS Format
Uses both subjective and objective information to recognize and identify problems contributing to the condition.
History
A complete history includes information on the primary complaint, cause or mechanism of injury, characteristics of the symptoms, and related medical history that may affect specific condition.
Primary complaint
Explored in detail to discover the evolution of symptoms, including the location, onset, severity, frequency, duration, and limitations caused by the pain.
Mechanism of Injury
The physical cause under which the injury occurred.
Characteristics of Symptoms
Somatic pain (deep, superficial), visceral pain, and referred pain.
Related Medical History
Scenarios involving acute conditions, obtaining information regarding other problems or conditions that may affect the current condition.
Observation
Focuses on individuals state of consciousness, and body language, which may indicate pain, disability, fracture, dislocation, or other conditions.
Palpation
Involves the healthcare provider physically touching and feeling the body of the injured individual.
Testing
Includes functional tests, stress tests, special tests, neurologic testing, and sport or activity-specific functional testing.
Functional tests
Identify patients ability to move a part through the range of motion actively, passively, and against resistance.
Active Range of Motion (AROM)
Joint motion performed voluntarily by the individual through muscular contraction. Indicates individual’s willingness and ability to move the injured body part.
Passive Range of Motion (PROM)
Distinguishes injury to contractile tissues from non-contractile or inert tissues.
Resisted Range of Motion
Assess muscle strength and detect injury to the nervous system. Performed by applying an overload pressure in a stationary or static position.
Stress tests
Occur in a single plane, and graded accordingly to severity. Specifically, sprains of ligamentous tissue are generally rated on a three-degree scale
Special tests
Occur across planes and are not graded. (Speed’s tests, assessing pathology and Thompson’s test, assessing potential rupture to Achilles tendon)
Neurological tests
1. Somatic portion; provides sensory input from the skin, fascia, muscles, and joints.
2. Visceral component; supplies the blood vessels, dura mater, periosteum, ligaments, and intervertebral discs.
Activity-Specific Functional testing
Involve the performance of active movements typical of the movements executed by the individual during sport or activity participation.
Injury Assessment and the Coach
The coach should be prepared to assess a range of acute conditions as the first respondent. It is not within the duty of care to of a coach to assess and manage post-acute, chronic, or stress-related injuries.
Primary Survey
Determines the level of responsiveness and assesses airway, breathing, and circulation. (ABC’s)
Assessment of Unconscious Individual
1. Do not move individual if possible spine injury,
2. Call their name loudly and gently touch the arm,
3. If no response, pinch soft tissue in armpit,
4. If still no response, immediately initiate the primary survey,
5. If individual isn’t breathing and there is no pulse, activate EMS, and perform CPR,
6. If individual is breathing and has a pulse, activate emergency plan and monitor the condition through assessing their vital signs.
Secondary Survey
Performed to identify the type and extent of any injury, and the immediate disposition of the condition.
Vital Signs
Assessed to establish a baseline of information, and indicate the status of cardiovascular and CNS.
Pulse
Assessed by counting the carotid pulse rate for a 30- second period and then doubling it.
Respiration
Breathing rate is assessed by counting the number of respirations in 30 seconds and then doubling it.
Temperature
Normal body temp= 98.6ºF, but can fluctuate considerably.
Skin Color
Indicates abnormal blood flow and low blood oxygen concentration in a particular body part of an area.
Pupils
Responsive to situations affecting the CNS.
Diplopia
Individual sees two images instead of one
Blood Pressure
Pressure or tension of the blood within the systemic arteries, generally the aorta.
Bones of the Skull
Protect the brain, and the facial bones provide structure of the face and form the sinuses, orbits of the eye, nasal cavity, and mouth.
The Scalp
Composed of three layers; the skin, subcutaneous connective tissue, and pericranium.
The Brain
Outermost membrane is the dura mater, and fibrous tissue containing dural sinuses.
Meninges
The entire brain and spinal cord are enclosed in three layers of protective tissue.
Dural Sinuses
Act as veins to transport blood from the brain to the jugular veins of the neck.
Arachnoid mater
Thin membrane internal to the dura mater, separated from the dura mater by the subdural space.
Bones of the Face
Provides bony framework and protection for the eyes, nose, mouth, and ears.
The Eyes
Surrounded by three protective tissue layers called, tunics.
Protective Equipment for the Head and Face
Includes, a helmet, face guard, mouth guard, eye/ear wear, and throat protector.
Scalp Injury
First area of contact in trauma. Primary concerns with any scalp laceration are to control bleeding, prevent contamination, and assess for a possible skull fracture.
Techniques to Assess Balance and Coordination
1. Finger to nose test
2. Gait
3. Romberg Test
Skull Fracture
Fracture can be linear, comminuted, depressed, or basilar.
Types of Skull Fractures
Linear (in a line)
Comminuted (in multiple pieces)
Depressed (driven internally toward the brain)
Basilar (involving the base of the skull)
Skull Fracture (Signs and Symptoms)
Complaints of severe headache and nausea, as well as changes in pupils.
Skull Fracture (Management)
1. Avoid moving individual
2. Check ABC’s, if necessary perform CPR
3. Cover any open wounds
4. Monitor individual until EMS arrives
Cerebral Injuries
Impact can cause a shock wave to pass through the skull to the brain, causing acceleration. Acceleration can lead to shear, tensile, and compression strains within the brain substance.
Coup-type Injury
Brain is traumatized at the point of impact
Contrecoup-type Injury
Force of the brains weight accelerates and hits the opposite side of the skull (Injury away from the actual impact site)
Focal Injuries
Involve localized damage
Diffuse Injuries
Involve widespread disruption and damage to the function or structure of the brain.
Focal Cerebral Injuries
Usually result in localized collection of blood or hematoma
Epidural Hematoma
Caused by a direct blow to the side of the head and is almost always associated with a skull fracture.
Epidural Hematoma (signs and symptoms)
Individual may experience an initial loss of consciousness at the time of injury, following by a lucid interval in which the individual feels somewhat normal and asymptomatic.
Subdural Hematoma
Classified as either acute, which presents 48 to 72 hours after injury, or chronic which can be simple or complicated
Complex Subdural Hematoma
Characterized by continuous of the brain’s surface and associated cerebral swelling that increase intra-cerebral pressure.
Diffuse Cerebral Conditions
Involve trauma to widespread of the brain rather than one specific site.
Concussions
A disturbance in brain function caused by a direct blow to the head or indirect force that produces a jarring of the brain.
Post Concussion Syndrome
May develop after any concussion. Cognitive impairments may extend from the time of injury to 48 hours after trauma and last for several weeks to months.
Second Impact Syndrome
Occurs when individual who has sustained an initial head injury, usually a concussion, sustains a second head injury before the symptoms associated with the first one have totally resolved.
The Coach and Concussion
The primary responsibility for the coach is to recognize potential signs and symptoms of a concussion. Also, take vital signs to establish baseline of information that can be rechecked