KINS 2100 Exam 1 Study Guide
KINS 2100 Exam 1 Study Guide BIOL 1107
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This 25 page Study Guide was uploaded by Bridget Ochuko on Friday January 29, 2016. The Study Guide belongs to BIOL 1107 at University of Georgia taught by Armstrong in Fall 2015. Since its upload, it has received 65 views. For similar materials see Principles of Biology I in Behavioral Sciences at University of Georgia.
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Date Created: 01/29/16
KINS 2100 Unit 1 01/12/2016 ▯ Introduction to Athletic Training ▯ History: Greeks and romans Became a profession in collegiate athletics first o Mid to late 20 century Terminology: “Athletic Trainer” or “Certified Athletic Trainer” (ATC) ▯ Definitions and mission: Health care professionals who specialize in : o Prevention o Recognizing athletic injuries o Manage athletic injuries o Rehab/assisting in rehab of injuries that result from physical activity Works under the direction of a licensed physician and in cooperation with other health care professionals o Doesn’t necessarily have to be in the same room but must go over specific protocols and signing off on any other skills they have Able to recognize injuries way before they occur or before they get to the point where the injury needs surgery o Saves a lot of money Professional organization: National Athletic Trainers’ Association o Provides how to act in the clinic, funds, research, etc. ▯ Sports Medicine Umbrella Performance Enhancement: anyone who works with the physician to achieve better performance o Exercise physiology o Biomechanics o Sports Psychology Injury Care and Management: anyone who practices medicine o Practice of Medicine o Athletic Training Primary Players of Sports Medicine team: o Athlete—Coach—Physician—Athletic Trainer All must get along and work together in order to make sure the athlete is as healthy as can be o Same team for a minor (high school/junior) but includes a parent ▯ Domains (which Athletic Trainers also specialize in) Injury/illness prevention and wellness protection o Ex. Surveying the field before a game begins; instructing individuals how to land correctly to prevent injury o In order to minimize amount of injury occurring with athletes Clinical evaluation and diagnosis o Special tests Immediate and emergency care Treatment and rehab Organizational and professional well-being o Must be able to manage financial matters: insurance, large supply orders, designing facility o Must make sure to practice ethically and to stay healthy ▯ Professionalism Personal Qualities o Stamina and ability to adapt to change o Empathy o Sense of humor o Ability to communicate o Intellectual curiosity o Ethics ▯ Importance of Engaging in Evidence Based Practice Develop a clinical question o Must prove what we’re doing is doing what we’re supposed to do o PICO: Identify patient condition Intervention Comparison to other individuals who don’t do intervention Outcome: does the education program affect the athlete in any way Search the literature Appraise evidence Apply evidence Assess the outcome—determines whether or not it will be used in the future ▯ Organizations (know what each organization stands for) NATA AMA: recognized athletic training as an allied health field (1990) BOC: responsible for the certification examination for athletic trainers CAATE: comes up with the education program that all of the programs across the country must do at the minimum ▯ How to Become an Athletic Trainer A bachelor’s degree from CAATE accredited institution (min 2 years) OR a master’s degree from CAATE accredited institution with prerequisites AND pass the national Board of Certification Exam Once certification is obtained depending on state must get license or registration o Licensure is the most restricted and the best certification you can obtain as an athletic trainer Clinical Experiences o Equipment intensive sport (ex. Football at UGA) o Upper extremity and lower extremity o Male and female sports o Out of season Experience up to 25 hours per week 100 hours per month from first to last day of classes Certification Exam o Sets the standards for the practice of athletic training; only accredited certifying body for ATC’s o Proof of degree, courses, clinical experience, and endorsement of Program Director o Completely computerized exam Combines practical skills, theoretical knowledge, and situational knowledge When practicing must be under the supervision of a physician and be in accordance with state acts; liability insurance for mistakes o Must continue education units; be up to date with all current research Required every 3 years Can be done by going to: conventions, workshops, self- study, research, etc. ▯ Basic Review of Anatomy Anatomical position: palms out, standing erect, facing forward o Anything in the body is referenced to this Fundamental position: palms facing the body, standing erect, facing forward ▯ Planes Three different planes used to cut the body o Sagittal (median) Plane- runs front to back, slice the body in half, dividing it into right and left halves o Frontal (coronal) Plane- runs from right to left, slice the body into a front and back o Transverse Plane- slice body in the middle to give her a top and bottom half It doesn’t matter where you put the plane on the body, only the orientation matters ▯ Axes: points where planes revolve around Frontal axis: plane runs vertical (sagittal plane) Vertical axis : transverse plane Sagittal axis: frontal plane ▯ Terms of Relationship and Comparison (reference point) Superior: anything above Inferior: anything below Posterior: back/butt Anterior: front side Medial: towards the midline Lateral: away from midline Dorsum: foot, hand o Palmar surface is facing up Internal: in towards body rotation, any rotation moving medially External: away from body rotation, lateral rotation Proximal: close to reference point Distal: far away from reference point, anything away from medial or superior ▯ Terms of Laterality Bilateral- two sides, comparing to both sides Unilateral- one side, only looking at injured side, injury only on one side Ipsilateral- same side Contralateral- opposite sides ▯ Terms of Movement Plantar flexion: pointing foot down (ankle) Dorsiflexion: pointing foot up (ankle) Ulnar deviation: medially (wrist) Radial deviation: laterally (wrist) Pronation: hands face down, happens at elbow Supination: hands faced up, happens at elbow, anatomical position Elevation, depression, protraction, retraction happen at shoulder Opposition: thumbs in Reposition: thumbs out, anatomical position Valgus: knee going more medially than normal; blow to lateral side o Can do stretches in each direction Varus: knee going more laterally than normal; bow-legged ▯ Overview ▯ Planes: Sagittal Plane: o Description of Plane- divides body into right and left halves o Axis of Rotation- frontal o Description of Axis- runs medial to lateral o Common movements- flexion and extension Frontal Plane: o Description of Plane- divides body into anterior and posterior halves o Axis of Rotation- sagittal o Description of Axis- runs anterior to posterior o Common movements- abduction and adduction Transverse Plane: o Description of Plane- divides body into superior and inferior halves o Axis of Rotation- vertical (longitudinal) o Description of axis- runs superior to inferior o Common movements- internal and external rotation ▯ Chapter 7: Protective Equipment (Injury Prevention) ▯ Safety Standards for Equipment and Facilities Concerns relative to materials, durability, establishment of standards, manufacturing, testing methods, and requirements for use Maintenance: how often do we check, what are we looking for, possibility of being sent back Reconditioning: mainly happens with football helmets (high school level)- strip the paint and check material, breakdown every piece and run tests, wash the padding; measure how the helmet holds up to certain forces o Only take a portion of helmets to be tested- means not all are proven safe before season starts Concern should be protective ability not appearance of equipment ▯ Legal Concerns Increasing amount of litigation regarding equipment The only time the manufacturer is liable is if equipment is used in the state it’s received and is used for what it’s meant for If equipment is modified, modifier is now responsible ▯ Equipment Reconditioning and Recertification NOCSAE: National Operating Committee on Standards for Athletic Equipment that set guidelines that manufacturers must meet o Indicated by a sticker on any helmet manufactured o Helmet standard: Just because it’s certified doesn’t mean there is a warranty, it merely means it meets the standards when manufactured o Should undergo regular recertification and reconditioning ▯ Head Protection Direct collision sports require head protection due to impacts, forces, velocities, and implements o Helmets, face mask, head gear, mouth guards, goggles, etc. Football Helmets o NOCSAE develops standards for football helmet certification o Must be certified, but may not always be fail-safe: if fail-safe, when the helmet cracks the athlete would not also get injured This can never be guaranteed o Athletes and parents must be aware of inherent risks Each helmet must have visible exterior warning label (NOCSAE) Athletes must be aware of risks and what label indicates o Label is important for manufacturers for liability ▯ Soccer Headgear Designed to reduce incidence of concussions due to heading ball o Technically doesn’t prevent the movement of brain inside of skull o Strengthening your neck would help more because your brain would move less in your skull ▯ Face Protection Five categories o Face Guard: has reduced the number of face injuries (poking eyes out, mouth injuries) All mountings must be flushed to the helmet: must feel like it is a part of the helmet, smooth finish o Throat Protection: if you get hit hard enough in the throat, the trachea could collapse, and the athlete could stop breathing Fatal o Mouth Guards: most dental injuries can be prevented; protect teeth, minimize lip lacerations Should fit comfortably, not impede speech or breathing Important to extend past last molar to decrease chances of it coming out and choking Three types: Stock- can’t be customized Commercial- dip in hot water and put in mouth to form to teeth Custom- fabricated from dental mold o Ear Guards Most sports do not use Wrestling, water polo, boxing o Eye Protection Highest percentage of eye injuries are sports related Generally blunt trauma ▯ Trunk and Thorax Protection Essential in many sports Must protect regions that are exposed to the impact of forces o External genitalia, bony protuberances, shoulders, ribs, and spine Risk compensation: identify the risk and adapt to change the likelihood of getting the injury- implementing a technique or using some type of equipment to prevent the injury Sports Bras o Designed to minimize excessive vertical and horizontal movements to prevent premature sagging ▯ Hips and Buttocks Required in collision and high-velocity sports Girdle and belt types Boxing, snow skiers, equestrians, jockeys, water skiers ▯ Groin and Genitalia Sports involving high velocity projectiles Require cup protection for male participants Stock item that fits into athletic supporter ▯ Lower Extremity Protective Equipment Socks Shoes: proper type to help prevent injury depending on how your foot is shaped o Wear and longevity Cushion takes at least 24 hours to rise back up to current state, important to alternate shoes o Proper fit Foot Orthotics: device for correcting biomechanical problems that exist in foot that can cause injury o Plastic, thermoplastic, rubber, sorbethane, leather support, or ready-made products o Can also be customized by physician Ankle Braces o Alone or with tape; with tape doesn’t necessarily make it more effective o Significant debate over efficacy o Little or no impact on performance o Compared to tape, the device will not loosed significantly with use o Evidence to support use for prevention Shin and Lower Leg- shin guards are used in field hockey and soccer Knee Braces o Used prophylactically (used without injury) to prevent injuries to MCL (particularly linemen) o AOSSM has expressed concerns to efficacy in doing so o May positively influence joint position sense ▯ Types of Braces Rehabilitative: useful after surgery can be adjusted Functional: used at the end of rehab when trying to get athlete back into play Neoprene: provide extra support ▯ Elbow, Wrist, and Hand Protection Often trivialized Susceptible to fracture, dislocation, sprain o Goal is to reduce these Dynamic Splints: used for injuries in hand and fingers o Keep you in a certain locked position which provides the ideal environment for ligaments and tendons to heal o Combo of plastic, elastic, and velcro ▯ Construction of Protective and Supportive Devices An athletic trainer should be able to design and construct protective devices o Heating and molding a device Must have knowledge of theoretical basis in order to make the best device Use a combination of materials ▯ How else can we prevent injuries? Being in shape, conditioning Strengthening correctly Warm up, cool downs Good form Making sure athletes are educated to do things correctly ▯ Chapter 9: Mechanisms and Characteristics of Musculoskeletal and Nerve Trauma ▯ Mechanical Injury Trauma: physical injury or wound produced by internal or external force o The external force results in trauma Results from force or mechanical energy that changes state of rest or uniform motion of matter o Example: collision from other player changes state of bone from whole to pieces ▯ Tissue Properties- In order for an injury to happen the force must break the tissue Load: application of force that causes stress Stiffness: ability of tissue to resist load force o The greater the stiffness, the greater the magnitude a load can resist Stress (internal resistance to a load; force) vs. Strain (change in shape tissue) o The beginning of the graph is the elastic region- the ability of the tissue to be stretched to a certain point and then go back to normal o The second part of the graph is the plastic region- the tissue being stretched past the certain point where the tissue doesn’t go back to it’s complete normal state Where injury begins to happen o If the force gets past the yield point, the tissue will fracture Tissue Loading o Compression: force coming from both sides so that whatever is in the middle is crushed = tissue crush o Tension: a force applied at both ends which stretches the tissue o Shearing: force that moves across (perpendicular) to the parallel organization of tissue Bending- can occur when forces are applied at different points of the tissue o Two force pairs act at opposite ends of a structure: 2 point bending o Three forces causes bending: 3 point bending Torsion: twisting in opposite directions from opposite ends ▯ Injury Classification Primary injury: direct result of a force Secondary injury: delayed injury some time after initial trauma o An accommodation to the primary injury Acute injury: something that happens immediately after sustaining a blow o Load (force) was applied and the immediate result was an injury Chronic injury: failure of tissue that is a result of repeated trauma over a period of time o Example: tendinitis o Gradual onset and prolonged duration ▯ Muscle Strains Fibers are stretched passed a certain point which causes a tear in the muscle o Damage to muscle that results from over stretching Difficult to identify cause of muscle strains Graded based off of severity Grades of Muscle Injuries o First Degree: result of slight over stretching, not very significant, won’t affect patient to severely Results in bruising, mild loss of strength, swelling, etc. o Second Degree: further stretching, more severe, worse symptoms than above (depends on individual) o Third Degree: complete rupture, severe symptoms, lose function of muscle, tendon will shift proximally Avulsion- tendon comes away from attachment sight Other Muscle Injuries Muscle cramps: involuntary contractions Muscle guarding: muscle contraction in response to pain Muscle spasms: o Clonic- involuntary o Tonic- constant contraction for long period of time ▯ Tendon Injuries Attaches muscle to bone Usually double the strength of the muscle it serves o Based off orientation of fibers, characteristics of tendon Injury types o Tendinitis: inflammation of tendon o Tenosynovitis: inflammation of sheet around tendon o Strain/Rupture Mechanisms o Strain/Rupture- high magnitude, single load, often times tendon is on a stretch Common in older people who continue to play sports and people who have sustained many tendon injuries o Tendinitis/Tenosynovitis- repetitive, low magnitude forces, occur over time o Compressive forces o Friction: constant rubbing that can occur Repetitive stress results in microtrauma and elongation The constant state of inflammation leads to increased collagen production which results in weakening of tendons ▯ Contusions Results from a sudden blow to the body Leads to formation of hematoma: blood and lymph flow into surrounding tissue As swelling accumulates, it affects the way the brain communicates with the area, which results in change of function Chronically inflamed and contused tissue can lead to calcium deposit buildup (bone) in the area to protect the area from blows to the area = Myositis Ossificans ▯ Mechanical Properties of Ligament (connects bone to bone) Frequency of Loading: repeated loading leads to weakening of ligament The ability to resist tension depends on how the load is applied Can be injured the same way tendons are o High magnitude- ACL tears o Low magnitude- causes change in ligament properties Graded the same way muscles are ▯ Dislocations and Subluxations Subluxation- the ability of bone to go out of contact but come back together immediately o Muscle guarding begins to happen the instance bones are not touching each other’s surfaces anymore Dislocation- if someone has to physically put the bone back into place it becomes this ▯ Bone Injuries Anatomical Characteristics: o Divided into epiphysis, diaphysis, epiphysis from top to bottom o Epiphyseal plate- growth plate, stops extending when you stop growing o Metaphysis o Spongy bone close to articulating surface The center of the bone is less spongy like Fractures o Classified as either closed (little to no movement in bone that has fracture) or open (a broken fragment ends up coming out and breaking through the surrounding tissue) An open fracture doesn’t necessarily have to break through the skin entirely o Can become serious if not managed appropriately o Signs and symptoms: Deformity Pain, point tenderness, swelling False joint Crepitus: crunching on bone X-ray is necessary o Types: Greenstick- typically happens in children; one side of the bone is bent and the other is broken Pott’s- only occurs in ankle Colle’s- frequent in children, falling on an outstretched hand: fracture both radius and ulna Open, displaced- piercing through skin Comminuted- fracture causes many tiny fragments Linear- break along the long axis of bone Transverse is perpendicular These can become displaced Oblique, Spiral- break resulting from some type of rotational force Depressed- fracture in the skull, bone is pushed down into cranial cavity Epiphyseal Conditions: 3 different injuries can occur here in adolescents o Injury to growth plate- happens at the growth plate line o Injury to articular epiphysis- happens at the top of the bone o Apophyseal injuries- happens where tendons attach to the bone Apophyseal Injuries o Sever’s disease o OSD- tibial tuberosity Salter-Harris Classifications: o Type 1- separation, injury happens at growth plate o Type 2- part of the growth plate experiences separation and the beginning of metaphysis o Type 3- fracture in the epiphysis o Type 4- fracture through epiphysis, growth plate, and metaphysis o Type 5- crushing growth plate between epiphysis and metaphysis ▯ Nerve Injuries Injury of ulnar nerve and get tingling sensations o Compressing the nerve makes the symptoms happen for longer o Severing the nerve completely ends all communication in that nerve Nerve response to stress: o Anesthesia- loss of sensation o Paresthesia- altered sensation o Hyperesthesia- increase in sensitivity Compression and tension are primary nerve mechanisms Neuropraxia: interruption in conduction of the nerve fiber ▯ Chapter 10: Tissue Response to Injury The ability to understand how your body will respond to a certain injury ▯ The Healing Process Healing is a continuum Must create a conducive environment for healing Healing is different depending on how many injuries the individual has had before Certain factors can slow down/impede the healing process ▯ Cardinal Signs of Inflammation (within 5 minutes): Redness- rubor Swelling- tumor Tenderness- dolor Increased temperature- calor Loss of function- function laesa ▯ Phases of Inflammatory Response Inflammation Phase- healing begins immediately because the body recognizes that there is an injury o The goal is to protect injured area, localize injury, decrease other agents that might cause injury, and begin preparation for healing and repair o Injury to cell—chemical mediators liberated—vascular reaction: vasoconstriction in order to control the area of injury, vasodilation to bring more things to help the area heal) —platelets and leukocytes adhere to vascular wall— phagocytosis—clot formation o Chemical Response: Derived from anything foreign in the area- invading organisms, damaged tissue, etc. 3 chemical mediators: Histamine- causes vasodilation after vasoconstriction; allows more things to come into area Leukotrienes- assist in permeability Cytokines- attract phagocytes to help keep the are clean o Vascular Response Vasoconstriction happens in first 5-10 minutes of injury Chemical mediators (histamine and leukotriene) trigger vasodilation to fix the area o Clot formation: platelets have to adhere to the area in order for clot to form Helps to localize injury Begins within 12 hours and complete within 48 hours o Chronic Inflammation: if you stay in the inflammatory phase for a long period of time, your tissue will never go back to normal Results in tissue abnormalities or tissue death Fibroblastic Repair Phase- blast the injured area with fibers o Fibroplasia = scar formation Begins within the first few days and lasts 4-6 weeks As collagen keeps laying down, it starts to get stronger, which decreases the fibroblasts to avoid too much tissue build up Maturation and Remodeling Phase (rehab very important in this phase)- goal is to realign randomly laid collagen in previous phase into organized fibers o Realignment of collagen increases the strength of the tissue o Will begin to appear more normal with stress in orientation of the way that we want the tissue to lay ▯ Soft Tissue Healing Each cell structure within our body does different thins Tissues of the Body (Bone is not classified as soft tissue) o Epithelial tissue o Connective tissue o Muscle tissue o Nerve tissue Adaptations o Metaplasia- conversion of one tissue type into the next o Dysplasia- abnormal development of tissue o Hyperplasia- too much development of tissue o Atrophy- a decrease in the size of tissue due to cell death and re-absorption or decreased cell proliferation o Hypertrophy- an increase in the size of tissue without necessarily changing the number of cells ▯ Cartilage Healing Cartilage lines the epiphysis of the bone—protective layer that protects the underlying bone If damaged, less likely to heal because of lack of blood flow to area ▯ Ligament Healing Ligaments are the next least likely to heal Vascular supply: get blood from surrounding capillaries but doesn’t get as much so it takes longer to heal Repair phase: stretch ligament within a certain range in order to reorder the fibers o Makes ligament stronger May take up to 12 months to heal and will never go back to it’s original state ▯ Skeletal Muscle Healing Has the most ability to heal within a short period of time Healing could last 6-8 weeks Tendon Healing Abundance of collagen is required for good tensile strength in order for the tendon to heal o Too much collagen being laid down causes it difficult for the fascia around the tendon to glide = restriction in range of motion ▯ Nerve Healing Least likely to regenerate after injury The axon can regenerate but is extremely slow o Long part attached to nerve cell The nerve cell cannot regenerate, once injured it is gone The closer the injured part of the axon is to the nerve cell, the longer it will take to regenerate ▯ Bone Healing 5 stages: o Hematoma formation- skin expands because blood from vessels that are injured go into the surrounding area o Cellular proliferation- after the clot, the necessary things needed to help heal the area begin to form callus o Callus formation Formed by chondroblasts o Ossification- callus hardens Balance of osteoblasts (fill the bone) and osteoclasts (remove excess) o Remodeling of new bone- important to load tissue the way we want it to be remodeled Periosteum- the outer layer of the bone o Whenever this layer is injured, the surrounding soft tissue is also injured Very important to set the bone in proper alignment or else bone will grow back with a deformity ▯ Acute Fracture Management Important to stabilize as soon as possible to prevent more injury to the area Make sure: o The patient has blood supply to distal extremities o Be aware of infection if anything were to break through to skin Avascular necrosis: lack of blood supply that leads to tissue death o Bone looks black on an x-ray Immobilization: splint proximal and distal to injury site Infection: everything in environment and what you’re putting on patient must be sterile ▯ Healing of Stress Fractures Constant stress put on bone can impact bone resorption (more bone is being reabsorbed-osteoclasts than bone being laid down- osteoblasts); can lead to microfracture Must restore balance: do this by telling athlete to rest ▯ Pain Multiple sources: o Cutaneous- happens on the skin o Deep somatic- muscular injury o Visceral- organ, within abdominal cavity o Psychogenic- pain associated with the mind Acute vs. Chronic o Feeling pain immediately vs. pain felt over time Referred: pain that results due to an injury in another part of the body o Ex. Kidney stones causes pain in lower back Nociceptors = Pain receptors o Mechanical: any type of defamation of a structure o Thermal: in response to a change in temperature o Chemical: pain due to chemical alteration Afferent and Efferent o Afferent- stimuli arriving to the brain from the periphery Brain understands what is happening in the body o Efferent- stimuli leaving the brain down to the extremity Brain tells body what to do Neurotransmitters: chemicals that stimulate feeling pain ▯ Mechanisms of Pain Control Gate Control Theory: distracting the brain from feeling the pain at the moment of injury o Uses two pathways- the sensory path is bigger so the gate opens and allows you to feel the distraction as opposed to the pain o Know what SC stands for on the slide o Eventually the pain stimuli will catch up and overpower the sensory stimuli Release of endorphins o Analgesic- pain reliever ▯ Pain Assessment Visual Analog Scales- used over time to see if treatment is effective Pain Charts Questionnaires Numeric rating scale ▯ Psychological Aspects of Pain If an individual is in chronic pain, it will affect them psychologically ▯ Treatment NSAIDs: anti-inflammatory drugs o Inflammation is good and if someone continually takes these on a regular basis it prevents the body from healing Modalities TherEx: exercises to restore movement patterns in the body ▯ ▯ Exam 41 questions: multiple choice and true/false 3 short answers Some bonus questions ▯ ▯ ▯ ▯
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