Term
|
Definition
-largest organ of body
-integumentry system
-Epidermis is composed of EPITHELIAL tissue
-DERMIS = connective tissue
-22ft
1-2mm thick
10lbs |
|
|
Term
|
Definition
-sense organ (touch, thermal, chemical)
-Protection (UV rays, bacteria, mechanical forces)
-Temperature regulation
-vit D synthesis |
|
|
Term
| Types of Superficial Skin Wounds |
|
Definition
1.Blisters
2.Abrasions
3.Incisions
4.Lacerations
5.Avulsions
6.Burns |
|
|
Term
| Superficial skin wounds: wound care |
|
Definition
-Control bleeding (direct pressure)
-Cleansing and debridement (running water/soap and detergent)
-Prevent infection
-Antispetic solution (hydrogen peroxide is best)
-Aseptic technique (apply HP on margin and work out0
-Antibiotic ointment(topically)
-bacitracin (neosporin)
-sterilze dressing (gauze) |
|
|
Term
| Superficial skin wounds: wound care: Preventing Infection |
|
Definition
-Antiseptic solution
-Hydrogen peroxide is best
-Aseptic technique= apply hydrogen peroxide to margin and work out
-Antibiotic ointment (topically)
-Bacitracin (neosporin)
DON'T USE ALCOHOL |
|
|
Term
|
Definition
Aseptic technique= apply hydrogen peroxide to margin and work out
Used when preventing infections for superficial skin wounds |
|
|
Term
Blisters
(MOI and management) |
|
Definition
Blisters are caused by friction or rubbing forces
-develop pocket of fluid (serous or blister water) in epidermal layers)
-Dermal layer creates blood blister
Management:
-Sterilize area
-Penetrate the margin with sterile needle
-Squeeze out fluid
-Keep skin flap (do not remove)
-Apply compression bandage (keep fluid out and skin on) |
|
|
Term
|
Definition
Abraion- rubbing or scraping of the epithelium
Same MOI as blisters
-Friction (shear)
-May reach dermal layers
-when dermis is exposed it takes longer to heal and typically it will scar
-epidermis heals quickly with no scar |
|
|
Term
Superficial skin wounds:
Incisions vs Lacerations |
|
Definition
Incision:
-Sharp object
-Clean cut
-Usually 2cm or less
Laceration
-Blunt force
-Jagged edges
-Dermal layer
-Bigger/longer than incision |
|
|
Term
| Superficial skin wound: Avulsion |
|
Definition
Avulsion: full thickness skin loss
-Gouging or pulling away of a skin section
-Skin flap (like blister, don't remove flap, you'll expose tissue) |
|
|
Term
|
Definition
-Approximate the ends = better healing
-Derma-bond glue or adhesive
-Sutures if wound is >3cm in length
-Precaution is facial tissue involved |
|
|
Term
| Wound healing: Epidermis vs Dermis |
|
Definition
Epidermis is better for healing
-Superficial wound
-Epithelium regenerates quickly
Deep = dermal layers
-connective tissue
-Repair = scar tissue
-approximation of margins helps limit scarring |
|
|
Term
|
Definition
Myofibroblasts pull ends together
(closes up wound)
Dictates extent of scar |
|
|
Term
|
Definition
Keloid scar: grows beyond boundaries of wound and can form a nodule or tumor-like appearance
-Formation of keloid is genetic
Hypertrophic- nice clean scar with fibers running the same way, just fills in, does not grow beyond boundaries |
|
|
Term
|
Definition
UV light exposure:
Ultra violet rays are the damaging rays from the sun
Three types:
-UVC: shortest, never makes past ozone
-UVB: occasionally makes past ozone
-UVA: has the longest wavelength and causes the most damage to skin |
|
|
Term
|
Definition
-Overexposure of UVA & UVB radiation causes sunburn and premature aging of the skin
-UVA appears to be related more to skin cancer
-both cause damage to celluar DNA, can be life threatening
Melanin: Natural "dark" pigment that protects skin
-absorbs UV radiation
-The more melanin you have = more protection
-Melanocytes increase when exposed to sun |
|
|
Term
| Which UV radiation is most related to skin cancer |
|
Definition
UVA appears to be related more to skin cancer
-both cause damage to celluar DNA, can be life threatening |
|
|
Term
|
Definition
Melanin: Natural "dark" pigment that protects skin
-absorbs UV radiation
-The more melanin you have = more protection
-Melanocytes increase when exposed to sun |
|
|
Term
Erythematic phase
vs
Pigmentation phase |
|
Definition
Erythematic phase: reddening of the skin during a sunburn
Pigmentation phase: develops within a few hours peaking at 72hours |
|
|
Term
|
Definition
Erythematic phase: reddening of the skin during a sunburn
Pigmentation phase: develops within a few hours peaking at 72hours
-Severe forms include blister formation, chills and GI distress
-Chronic overexposure leads to premature aging of skin, drying and wrinkling
-Also increases risk of skin cancer:
-Basal/Squamous cell carcinoma
-Malignant melanoma |
|
|
Term
|
Definition
1 million cases diagnosed per year
three common types
1. Basal cell carcinoma (rarely metastasize(spreads))
-Basal layer of hair follicles
2.Squamous cell carcinoma (may metastasize)
-Epidermal keratinocytes
3. Malignant Melanoma (metastasize rapidly)
-Most common cancer in young women
-Arise from melanocytes = life threatening
-Key is early detection (watch for change in shape, color or size)
-Risk factors: pale skin, sun exposure, family history, age, immune status (antibiotics) |
|
|
Term
|
Definition
Basal cell carcinoma (rarely metastasize(spreads))
-Basal layer of hair follicles |
|
|
Term
|
Definition
Squamous cell carcinoma (may metastasize)
-Epidermal keratinocytes |
|
|
Term
|
Definition
Malignant Melanoma (metastasize rapidly)
-Most common cancer in young women
-Arise from melanocytes = life threatening
-Key is early detection (watch for change in shape, color or size)
-Risk factors: pale skin, sun exposure, family history, age, immune status (antibiotics) |
|
|
Term
| Prevention of skin cancer |
|
Definition
-Sun protection factor (SPF)
-SPF #30 blocks 97% of UV radiation
-contains chemicals which absorb or reflect UVA/UVB
-Avoid exposure at peak hours
-Inspect body for lesions (newly developed)
-Protection (clothing, hats, glasses)
Be cautious if: light skin tone or on prescription drugs |
|
|
Term
|
Definition
1. Bacterial
-Staph or strep
2. Viral
-Herpes simplex 1 or 2
3. Fungal
-Dermatophytes |
|
|
Term
|
Definition
Single celled micro-organisms
Staph = clumps
strep = chains
Pyroderma= pus producing
-abcess (cystic)
-Cellulitis
-Folliculitis
-Furuncles/Carbuncles
-Impetigo Contagiosa
-MRSA or ORSA |
|
|
Term
Cellulitis
-cause
-symptoms
-treatment |
|
Definition
Bacterial Infection caused by staph or strep
-typically caused by open wound, infected hair follicule
Affects dermis and subQ of legs and skin; swollen lymph nodes (groin region/back of knee)
Develop flu-like symptoms (fever,chills)
Spreads very quickly, especially if not recognized early
Treated easily with antibiotic |
|
|
Term
Folliculitis
-type of infection
-causes
-symptoms
-treatment |
|
Definition
Folliculitis is a staph bacteria infection
-Infected hair follicule (usually due to shaving or skin irritation)
-Develop pustules
-Treatment: Topical ointments, antiseptic washes and oral antibiotics |
|
|
Term
Furuncles or Carbuncles
-type of infection
-symptoms
-treatment |
|
Definition
Furuncles/carbuncles (aka boils) are caused by staph bacteria
S/S: red swollen, inflamed lesion, pus-filled center, extremely tender, may develop fever, or swollen lymph nodes
-Treatment: warm soak or compress, antibiotics(oral/topical) and/or surgical drainage |
|
|
Term
Impetigo Contagiosa
-type of infection
-causes
-symptoms
-treatment |
|
Definition
Impetigo contagiosa is a step infection (sometimes staph)
Usually transmitted by direct contact with open wound on skin or insect bites
incubation period is 1-3 days (EXTREMELY CONTAGIOUS)
S/S: itching, red oozing pustules(sores), crusty (honey-colored), tender to touch, usually in nasal or mucosa area, can be on torso
Treatment: topical and/or oral antibiotic |
|
|
Term
MRSA or ORSA
-type of infection
-symptoms
-treatment |
|
Definition
MRSA or ORSA
Methicillin/oxicillin resistant staphyloccus
Worst case staph infection
presents as folliculitis, insect bite or infected pimple
transmitted via direct contact, infected clothing or hygiene products (outbreaks in sports teams)
Treatment: oral antibiotics (both are resistant to antibiotics and are difficult to treat) |
|
|
Term
|
Definition
Ultramicroscopic organisms; different from bacteria because it requires a host
Requires a host cell to survive (usually nerve cells and then travels through axons)
Herpes Simplex (HSV)
HSV 1: mouth and nasal mucosa
HSV 2: genitalia
(same virus just different area)
Transmitted through direct contact with open wound or mucosal membranes |
|
|
Term
| Muscles of the hip and thigh |
|
Definition
Quadriceps (4)
Hamstrings (3)
Abductors/Adductors
Quads(front) and Hamstrings(back) counter each other. Quadriceps are stronger than hamstrings, see a lot of hamstring strain |
|
|
Term
|
Definition
Quadriceps
Rectus femoris
hip flexor strain = rectus femoris; see strains in upper 1/3 of muscle
caused by eccentric loading
Management:
Strengthen and stretch
wrapping |
|
|
Term
|
Definition
Acute strains occur in the middle
-Forceful contraction or overstretching; combination of eccentric loading while lengthening
Chronic strains occur above(ischial tuberosity) or below tibia
-tendinitis over biceps tendon
Biceps femoris is the most often strained of the three because it is the shortest of the three muscles
high recurrence rate, because it decreases critical force level |
|
|
Term
| Thigh: Quadriceps Contusion |
|
Definition
Direct blow to muscle
Localized hematoma (collection of blood)
-mild, moderate, severe
-Limited ROM
Can result is myositis ossfificans if not treated properly
Muscle relaxed or contracted? If muscle is relaxed force will penetrate deeper(possibly to bone). If muscle is contracted force won't penetrate muscle
Calcium develops in spikey formations, extremely painful
Treat with ice with leg in flexed position; once ice has taken care of inflammation, use heat to break up calcium |
|
|
Term
| What are the joints at the knee? |
|
Definition
3 Joints at the knee
Tibio femoral is primary joint
Patello-femoral is secondary (smaller, less injuries)
Proximal tibio-fibular (no movement, rare injuries) |
|
|
Term
| What is the primary joint of the knee |
|
Definition
|
|
Term
|
Definition
Quadriceps angle
difference between a line drawn from the center of the patella to the ASIS compared with a line drawn from the center of the patella through the tibial tubercle
Normal is 15-20 degrees
Wider hips = bigger Q angles |
|
|
Term
| Patello-Femoral Conditions |
|
Definition
Tendinitis (jumpers/runners knee)
Chondromalcia (break down of cartilage)
Dislocation/subluxation |
|
|
Term
Patellar Tendinitis
-MOI
-S/S
-Management |
|
Definition
"jumpers/runners knee" (not actually an itis b/c of the lack of blood supply)
MOI: Jumping/landing activity
S/S: point tender; pain upon loading
(quad weakness; people neglect quads which leads to more issues)
Treatment: Strengthen quadriceps; Cho-pat strap |
|
|
Term
Chondromalacia
-what is it
-MOI
-S/S |
|
Definition
Degenerative softening or
wearing away of the articular
cartilage
causes irritation and exposure of free nerve endings on the lateral undersurface of the patells
MOI: excessive Q-angle; abnormal tracking of the patella
S/S: pain during patellar motion (quad activity) |
|
|
Term
Dislocation/Subluxation
-MOI
-S/S
-Management |
|
Definition
MOI:
-Direct blow to the knee
-Quick start or cutting motion when running
Tear of medial retinaculum or medial patello-femoral ligament
-may become chronic
S/S:
-Pain and abnormal movement about
the patella
-Patella may be obviously out of place
-Extreme pain along the medial aspect
of the patella
-Athlete may report that the knee "gave out"
Managment:
-STRENGTHEN THE QUADS!!
-PRICE
-Immobilze leg
-refer for x-ray
-Patellar brace |
|
|
Term
|
Definition
Medial Collateral ligament; one of the tibio-femoral joint injuries
MOI: Valgus loading of the knee or ligament; contact and non-contact mechanisms (usually non-contact)
S/S:
-Point tenderness and pain over MCL upon palpation or hyperextension
-Swelling around the medial knee
-Athlete will state the knee feels
"stiff"
-Felt and/or heard a snap or pop
at the time of injury
Managment:
-treat conservatively
-place on crutches
-PRICE
-Lateral knee brace (prophylatic)
May also affect ACL
MCL has the highest frequency of tears. Has the highest incidence of injury, but its not the most severe!
Skiing is the number one cause of ACL tears |
|
|
Term
|
Definition
Lateral Knee Brace for MCL
A: person recieves blow to the knee
B: Stresses are absorbed and taken away
C. no strain on MCL
MCL brace was developed for the protection of ACL
Loses effectiveness when knee is bent |
|
|
Term
ACL
-MOI
-S/S
-Management
-ETC |
|
Definition
Anterior crucio ligament; "watchdog of the knee"
MOI:
-Hyperextension
-Tibial rotation with valgus load
-Anterior tibial displacement
(contact and non-contact mechanisms) (Typically its tibia rotating on femur)
S/S:
Heard/felt pop
Hemarthrosis
“Golden period”
Chronic ACL deficiency
Management:
-surgery using patellar tendon or hamstring
-de-rotational brace
Not the most common knee injury but the most devastating |
|
|
Term
|
Definition
tearing of the
MCL
ACL
Medial meniscus |
|
|
Term
| Special test for ACL Tear |
|
Definition
Lachmans test
Must be done before hemarthrosis |
|
|
Term
|
Definition
ACL Tears: Golden period is 5min to an hour
-Hemarthrosis - Joint inflammation followed by muscle gaurding
(protective spasm)
-affects evaluation and obscures special tests (Lachman test)
Golden period is time in between injury and when knee fills up
with fluid and it is difficult to do test |
|
|
Term
| Functional (AKA De-roatational) knee brace |
|
Definition
ACL tears
Functional knee braces (AKA derotational)
Designed to protect the ACL &
MCL ligaments
Control valgus, hyperextension,
tibial displacement and rotation
Not much scientific support for
their effectiveness
The decision to use such a brace
is generally made by the
physician and athlete |
|
|
Term
| Three types of knee braces |
|
Definition
| Three different types of braces: Patellar, Prohylactic, ACL(de-rotational or functional knee brace) |
|
|
Term
Tears of the meniscus
-location
-MOI
-S/S
-Tests |
|
Definition
Location of most tears: : Posterior horn of medial meniscus
MOI: Tears occur when knee is flexed and rotated
Medial meniscus is less mobile and more often torn
S/S:
-point tender in the back back of the knee
-slow effusion
-limited ROM
-popping,clicking sound
-McMurrays is the good test; appleys is bad |
|
|
Term
|
Definition
Two common tears:
1. Radial tears(inside to outside)=parrot beak tear
2. Bucket handle tear
Only the outer third of the meniscus receives blood flow, thats why its so difficult to heal, b/c tears usually happen toward outside |
|
|
Term
| Compartments of lower leg and major muscles |
|
Definition
Anterior: Tibialis anterior
Lateral: Peroneal muscle
Deep Posterior: Tibialis Posterior
Superficial Posterior: Gastrocnemius and soleus muscle |
|
|
Term
|
Definition
Distal tibio-fibular
-syndesmosis (not really any motion)
Talo-crural(true ankle joint)
-dorsi/plantar flexion
Sub-talar
-Inversion/eversion |
|
|
Term
| Which malleolus is higher; what does the lower prevent |
|
Definition
| Medial malleolus is higher than lateral. Lateral prevents eversion ankle sprains |
|
|
Term
| Functional Segments of Ankle/Foot |
|
Definition
Hindfoot/rearfoot: Talus & Calcaneous
Midfoot: Tarsals, navicular, cuniforms and cuboid
Forefoot: Metatarsals and Phalanges |
|
|
Term
Ankle ligaments
-superior
-lateral
-Intra |
|
Definition
Superior:
-Anterior tib-fib
-Posterior tib-fib
Lateral:
-Anterior talofibular(ATFL)
-Calcaneofibular(CFL)
-Posterior talfibular(PTFL)
Lateral are most often sprained
ATFL and CFL are most commomly injured
Intra-articular ligaments
Cruciates of the ankle
Interosseous talo-calcaneal
Cervical |
|
|
Term
|
Definition
Deltoid
Primary stabilizer of the
medial side of the joint
-Rarely injured in sports
-Eversion with dorsiflexion |
|
|
Term
|
Definition
Longitudinal and Transverse Arches
Navicular is keystone in medial longitudinal arch
Both are important for absorbing forces |
|
|
Term
|
Definition
Pes Planus (flat feet)
-overpronation
-stresses medial ankle
Pes cavus (high arch)
-stresses midfoot region |
|
|
Term
| Pronation and Supination of the feet |
|
Definition
Pronation:
-heel contact with weight transfer
across foot
-Dorsiflexion, eversion & abduction
-Tibia rotates internally
Supination
-Heel-off
-Plantarflexion, inversion & adduction
-Tibia rotates externally |
|
|
Term
|
Definition
Plantar fasciitis
Tarsal tunnel syndrome
Medial tibial stress syndrome (shin splints) |
|
|
Term
Plantar fascitis
-MOI
-S/S
-Management
-Complications |
|
Definition
Overpronation from worn shoes or bad
mechanics
Plantar fascia becomes inflamed and painful
S/S
-painful in morning
-point tender on calcaneal tuberority
-Hot spot in the back of foot
Management:
Stretching of the Achilles
and fascia
Arch taping
Orthotics
-Night brace (keeps foot in neutral position)
Complication: Heel spur (traction apophysitis) |
|
|
Term
Tarsal Tunnel Syndrome
-Cause
-S/S |
|
Definition
Caused by over pronation; Compressive mechanism from overpronation; overuse injury; orthotics or new shoes usually correct the problem
-Numbness and tingling "foot falling asleep"
-Neurovascular impingement of tibial nerve and posterior tibial artery |
|
|
Term
| Medial Tibial Stress Syndrome |
|
Definition
Shin splints
Overpronation coupled with overuse; tensile loading mechanism
-Pulls on tibials posterior tendon and medial tibia |
|
|
Term
Achilles Tendon/Calf Strain
-MOI
-Acute/Chronic
-Managment |
|
Definition
MOI: Eccentric loading- lengthening and contracting at the same time
Acute mechanism: jumping/landing/taking off
Chronic: overuse; microtrauma over time
Managment: stretching |
|
|
Term
Lateral Ankle Sprains
-types
-MOI |
|
Definition
80-85% of ankle sprains are to the lateral ligaments
Single, double or triple ligament injury (ATF, CF and
Tib-Fib)
MOI:
Hyper-plantarflexion (ATFL)
Hyper-inversion (CFL)
Internal rotation/adduction of foot (High ankle sprain; syndesmosis) |
|
|
Term
|
Definition
-Forced eversion
-Foot Abducts
-Stress on deltoid ligament
-Sprain/separation of distal tib-fib joint
-syndesmosis
-high-ankle sprain |
|
|
Term
| Lateral Ankle sprain special tests |
|
Definition
Anterior drawer: Anterior talo-fibular ligament
Talar tilt: Calcaneo-fibular ligament |
|
|
Term
| Pain above or below maleolus indicates what and what |
|
Definition
| Pain below maleolus is typically a sprain, pain above the maleolus is typically a fracture, must have x-ray to confirm |
|
|
Term
| Characteristics of Tibio-fibular fractures |
|
Definition
Mid-shaft fracture
Gross deformity
Splint
Check neurovascular function
Fall on outside of lower
leg or hyper-inversion |
|
|
Term
|
Definition
| requires intramedullary rod for stability |
|
|
Term
| Where do distal tibio-fibular fractures occur |
|
Definition
| just above the ankle joint |
|
|
Term
|
Definition
Avulsion fracture - proximal
-Styloid process
-Peroneous brevis attachment - traction force
-tarso-metatarsal joint
Jones Fracture - Middle(dancers fracture; requires surgery)
-Inversion or twist
-inter-metatarsal joint
Stress fracture - Distal
-Shaft
-Overuse - fatigue |
|
|
Term
Morton’s Neuroma
-MOI
-S/S
-Special test
-Management |
|
Definition
MOI: Transverse arch collapse
-Between MT (base, shaft or heads)
-Neural impingement due to fallen arch
during activity
Usually between 2nd/3rd and/or 3rd/4th MT
S/S: burning pain, tingling sensation
Special test: Mulder's sign; grasping foot toward end to elicit pain
Management: orthotic |
|
|
Term
Big toe sprain
-MOI
-S/S
-Comlication |
|
Definition
“Turf Toe”
MOI: joint capsule is damaged
-Hyperextension (dorsi-flexion) of 1st metatarsal-P joint
-1st MT is driven down as toe is forced into hyper-extension
-Capsule is torn
S & S
-Debilitating injury
-decrease ROM (flexion)
-extreme pain upon weight bearing
-lack of push off strength
Long term complication: hallux rigidus; limited extension
Managment: Taping |
|
|
Term
Herpes simplex
-type of infection
-S/S
-Treatment |
|
Definition
Viral infection
Signs/symptoms
-Brought on by emotional or physical stress
-predromal period (1-3 days)
-tingling sensation later painful
-Vesicles highly contagious
HSV 1: coldsore on lips, face, torso
Treatment: topical or oral medicine (can only manage, not cure)
originally looks like impetigo but anti-biotics won't work |
|
|
Term
| Viral infections (not herpes) |
|
Definition
Papilloma Virus
-HPV (aka genital warts)
-Can cause cervical cancer
Verruca virus
-Warts (epithelial tumor)
Pox Virus
-Molluscum contagiosa
-Itchy bumps or arms and legs
transmitted by contact |
|
|
Term
|
Definition
Dermatophytosis
Yeats and molds
-"skin plants"
-parastiic molds or yeast
-trichophyton or microsporum
Tinea: Ringworm
-Capitus, unguium, corporis, pedis, cruris, and versicolor
Thrive on skin, especially keratinized tissue (hair, nails skin) |
|
|
Term
|
Definition
-scalp lesions
-infect hair follicles
-Hypopigmentation (for people with dark skin) hyperpigmentation (for light skinned people) |
|
|
Term
|
Definition
Affects the torso, arms and legs
-Characteristic circular wheel pattern with red raised patched inside
-Single or multiple lesions |
|
|
Term
|
Definition
"Athlete’s Feet” same mold as ringworm
Starts in the web spaces between toes
Progresses beyond toes to plantar and
dorsal surfaces of foot
Cracks in skin can allow for bacterial
infection to occur secondary to fungus |
|
|
Term
|
Definition
(under the nail bed)
Onychomycosis
Fungi are embedded within nail bed or plate
Mainly toenails
Hard to treat; doesn't go away
-can treat with oral medication or nail lacquer |
|
|
Term
|
Definition
Anti-fungal agents
Topical applications in spray, powder, cream or gel
Daily application for 1-2 weeks |
|
|
Term
|
Definition
"Sun fungus"
Yeast, NOT A DERMATOPHYTE
-feeds on skin oils
Thrives in warm and humid conditions
Hypo-pigmentation
-white patches
-scaling
Shampoo or ointment |
|
|
Term
| Allergic reactions are a... disorder |
|
Definition
Hypersensitivity disorder of the immune system
-super sensitive mast cells |
|
|
Term
|
Definition
Classic S/S:
-Local skin reaction: hives(wheal and flare), redness, swelling and
itching
-Runny nose, watery eyes
-Airway constriction: dyspnea, wheezing
Systems involved include digestive, respiratory
and circulatory
-Ingested: abnormal abdominal pain, bloating, vomiting and
diarrhea
-Inhaled/injected: asthma, sneezing and bronchospasm (tight chest)
Management
-Anti-histamines: topically or systemic
-benadryl and anti-itch medicines
-Steroids (prednisone) |
|
|
Term
| Sensitization Process of Allergies |
|
Definition
Allergies are aquired
Initial exposure: sensitizing dose
Second exposure: shock dose |
|
|
Term
|
Definition
Severe, life threatening allergic reaction
Immune system response: Systemic
-Skin reaction: hives, itching
-Airway constriction: dyspnea, wheezing
-Angio-edema: generalized swelling of face, lips, throat and neck region
-Hypotension: drop in blood pressure
-Seizure and schock
Immediate care – epi-pen or auto-injector |
|
|
Term
|
Definition
Urticaria
Chilblains (exposure to wind and/or cold
contact)
S/S
Raised, red, itchy patches
Management: anti-itch or anti-histamines |
|
|
Term
|
Definition
Thermoregulation - body's ability to maintain
or regulate core temperature at a safe level |
|
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Term
| HOW THE BODY GAINS & LOSES HEAT |
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Definition
Gain:
-Solar radiation
-Ambient temperature
-Metabolic functions (BMR)
-Exercise/physical activity (work)
Loss
-K=conduction
-Cv=Convection
-R=Radiation
-E=Evaporation**
Evaporation is the most important for cooling down body. Sweat must be evaporated to cool body |
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Term
| Describe How the body LOSES heat |
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Definition
Conduction
-Direct contact between hot object and cooler object
-must be thermal gradient
-Wet towel or ice pack
Convection
-Cool breeze (wind)
-Cutaneous (thermopane)
Radiation
-Cool room: air condtioning
Evaporation
-Liquid to gas
-Most efficient |
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Term
| Sweat Mechanism and Evaporation |
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Definition
-Internal thermostat(hypothalamus) detects > Core temp and if above set point will activate sweat mechanism
-Superficial blood vessels dilate and blood is shunted to the skin
-Heated fluid (H2O) and salt) diffuses from vessels to sweat gland
-Sweat gland contracts(myo-epithelial cells)
-Sweat is squeezed to surface via pore
-Water vaporizes (Latent heat effect)***
-Uses heat as energy (endothermic) for converting water to gas state
-Evaporation is severely limited when high heat is coupled with high humidity
Latent heat describes the amount of energy in the form of heat that is required for a material to undergo a change of state (liquid to gas) |
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Term
|
Definition
| Latent heat describes the amount of energy in the form of heat that is required for a material to undergo a change of state (liquid to gas) |
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Term
| Hormonal effects on the sweat mechanism |
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Definition
Epinephrine (adrenergic) -Sweating is enhanced when circulating levels of epinephrine (adrenergic) rise during exercise (adrenal medulla)
Aldosterone-Adrenal cortex secretes aldosterone which helps reabsorb NaCl in kidney and sweat gland (sweat is diluted)
Vasopressin (ADH)-Posterior pituitary gland secretes vasopressin(ADH) to help retain water at kidney (makes urine more concentrated or dark) |
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Term
Exertional Hyperthermia
-primary and secondary cause |
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Definition
HEAT GAIN > HEAT LOSS
Primary cause: sweating during exercise without
rehydrating
Secondary cause: lack of acclimatization |
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Term
Exertional Hyperthermia
-Risk Factors (internal and external) |
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Definition
Internal:
-Age
-Somatotype (body type)
-indo is least efficient
(short and fat)
-Fitness level
-Previous history
-Post-illness
External:
-Ambient temperature &
relative humidity (RH)
-Clothing/equipment
-Activity level
-exertion
-intensity |
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Term
Exertional Heat Illness (EHI)
-what is it
-what are the grades |
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Definition
Heat – related illness is very similar to other illnesses
(e.g. flu or cold)
-S/S linger and athlete needs time to recover
-Graded continuum (mild, moderate and severe cases)
Grades:
(1) syncope & muscle cramping,
(2)exhaustion (physical shutdown), and
(3) stroke(collapse and CNS shutdown)
-Preventable
-400 deaths annually in US |
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Term
Grade 1 EHI
s/s
immediate care |
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Definition
Heat Cramps/Syncope
Syncope – feeling faint, lightheadedness, dizzy
Heat cramps -- least severe form of heat disorder
S/S:
Severe muscle cramps
Profuse sweating
Feeling faint
Immediate care
-Consumption of fluids
-Immediate cessation of exercise
-Static stretching of involved muscles |
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Term
| What is the test for dehydration |
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Definition
|
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Term
EHI Grade 2
-what is it
-S/S
-Treatment |
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Definition
Exertional Heat Exhaustion
-related to lack of acclimatization and dehydration during exercise
-can lead to exertional heat stroke
-athlete usually recovers in 30 min
Profuse sweating, Fatigue
Moist, clammy skin with fatigue
Nausea (malaise), dizziness
Rare - loss of consciousness
⇑ respiration rate and rapid pulse
Tc ranging from 101 to 104ºF (core temp is usually around 101)
Mental and neurologic status is normal
Immediate care
Immediate cessation of exercise
Move athlete to cool location and place into a supine position
If not fully recovered within 30 minutes, transport to a medical facility
-Elevate legs 8-12 inches (face is pail, raise the tail)
-Loosen clothing and cool with wet towels or ice packs
-Consumption of fluids(commercially prepared electrolye solution
or chilled water preferably) |
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Term
EHI Grade 3
-what is it
-S/S
-Treatment |
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Definition
Exertional Heat Stroke (EHS)
100% preventable!!!
Body is unable to cool itself resulting in rapid elevation of body temperature,>104°F
Profuse sweating and improper rehydration
True medical emergency (lifethreatening)
-3rd leading cause of death in athletes behind cardiac and head/neck trauma
-Athletes exercising in hot, humid, conditions with profuse sweating and improper rehydration
-Mental and neurological status are altered
-unsteady, irritable, confused, unconscious
-CNS distress!!! shutdown of systems
S/S:
Early
Profuse sweating
Mental confusion and/or loss of consciousness (seizure)
GI distress
Motor disturbances and loss of coordination
Rapid and strong pulse
Late
Sweating diminishes
Weakening of pulse
Collapse
Loss of consciousness
Immediate care
True medical emergency - death can result if not
treated correctly and promptly
Rapidly cool body any means necessary
Get Tc to 104ºF ASAP
Best way is CWI (cold wraps, ice massage or dousing, fans)
Place cold packs in/around neck, armpits, groin, and head
Summon EMS
-Move athlete to cool location
-Treat for shock and if possible, monitor temperature and vital signs
-Keep the athlete in a supine or semi-seated position if possible |
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Term
| EHI Prevention strategies |
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Definition
Monitor heat and humidity
-sling psychrometer
Gradual Acclimatization
7-21 days
Weight charts
Proper attire
Monitor ‘at risk’ athletes
Fluids "AD LIBITUM"
Rest periods
Recommendations:
1. Increase fitness level prior to heat exposure
2. Increase intensity and volume of
exercise gradually with heat exposure
3. Rehydration during exercise |
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Term
Psychrometry
-what is it
-how is it measured |
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Definition
Measures air temp (dry bulb) and %RH (wet bulb)
Heat stress index is used to assess the risk of heat injury above 70-80% humidity makes training in heat risky
Measured with sling or digital psychrometer
(best is Wet Bulb Globe Thermometer, measures humidity, temp, wind speed and solar radiation) |
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Term
Acclimatization
-What is it
-How long does it take |
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Definition
What is it?
-improved capacity to withstand heat stress
-Internal and external adjustments
-Goal: reduce physiologic (cardiovascular) strain on body while maintaining physical work capacity
-Protect internal organs(keep core temperature down)
How long does it take? 7 – 21 days of daily exposure (~2
hr) with exercise, but can take as long as 6 weeks to fully
acclimatize
-7-21 days is the minimum
-it must be DAILY for about 2hours with EXERCISE |
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Term
| Best way to prevent heat related illness |
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Definition
| Best way to prevent heat related illness is to acclimatize |
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Term
| Acclimatization: Physiological adaptations |
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Definition
Physiological adaptations?
-Increase Plasma Volume – cardiac output (reserve for sweating)
-Increase central and peripheral tolerance to heat
-Sweating
-onset is earlier (starts evaporating sooner)
-rate and volume increased
-sodium content decreases
-Increase fitness level
Expansion of plasma volume: increase hemoglobin
total blood volume for average person is 4-6 liters
when you adapt you can increase up to a liter (avg acclimatized person 6 liters) |
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Term
|
Definition
Exertional heat illness prevention strategy
Athlete weighs in before and after each practice session
Weight is closely monitored for fluctuations
2 – 5% BW loss b/t sessions- Athlete needs to be monitored during practice
>6% BW loss b/t practice sessions: athlete should be withheld until weight is gained back |
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Term
Fluid Rehydration Guidelines
Before exercise (practice)
During exercise
After exercise |
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Definition
Before exercise (practice)
-2-3 hours before: 17-20oz
-10-20min 7-10oz
During exercise
-7-10oz every 10-20minutes
-1Liter (32oz) per hour of sports drink
After exercise
-16-20oz of fluid per pound of weight loss
-UAA guide |
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Term
Sports Drinks
-what are they made of |
|
Definition
Solution of
-Water, electrolytes (Na), CHO and anti-oxidants
Maintain thirst (urge to consume fluids)
-Concentration of CHO (6%)
Gastric emptying rate
-Flavored drink for palatability (needs to taste
good) |
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Term
Hypothermia
-what is it
-important temperatures to know
-exacerbates |
|
Definition
Heat loss > heat gain
Acute or chronic cases
Temperatures < 60°
Thermoregulation failure Tc < 95°F
Coma Tc < 79°F
Exacerbates
Wet clothing
Wind chill
Immobility
Alcohol
Trauma – shock |
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Term
| Hypothermia (grades and symptoms) |
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Definition
Mild
-Shivering and goose bumps
-Numbing of extremities
-Goose bumps provide an insulation and trap heat in the body
Moderate
Apathy/disorientation
Slurred speech
Loss of fine motor control
Severe
Progressive shock
Unconscious/comatose
Deterioration of vital signs
(hard to reverse once its in the severe stage) |
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Term
Hypothermia
-management
-prevention |
|
Definition
Management
Prevent additional heat loss
Remove from environment
Remove wet clothing
Rewarm
Clothing, warm bath
Monitor vital signs
Prevention
Monitor wind chill
Proper clothing
Keep hydrated
Recognize S & S
Avoid alcohol and drugs |
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Term
URTI
-what does it consist off
-what are the infectious diseases
-S/S |
|
Definition
URTI: ear, nose, throat, paranasal sinuses
Viral – common cold (AKA rhinitis)
S/S sore throat, runny nose, fever and cough
-Typically viral infections don't spike a high fever. bacterial infections commonly spike high fevers (Fever 102-103, check for strep throat)
Considered self-limiting
-based on how much you can tolerate |
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Term
|
Definition
LRTI: Larynx, bronchi, lungs
Bronchitis
-Viral 90%, bacterial 10%
-usually viral; get antibiotics in case its bacterial
-Inflamation of mucus membranes in the bronchi
-Cough (dry or productive)
-Can accompany an URTI |
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Term
|
Definition
LRTI: Larynx, bronchi, lungs
Influenza (AKA flu)
Viral (severe)
S/S – chills, fever, sore throat, muscle & joint pain, severe headache, cough, extreme fatigue
Viruses:
-3 days coming
-3 days staying
-3 days going
-Vaccinations
-Can lead to pneumonia |
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Term
|
Definition
LRTI: Larynx, bronchi, lungs
Pneumonia (viral or bacterial)
-viral: walking pneumonia
Inflammation of alveoli
-inflammed alveoli is bad because it can impair gas exchange
Flu-like symptoms with persistent cough, chest pain and dyspnea |
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Term
| Gastro-Intestinal (GI) Infections |
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Definition
Viral: rotavirus and norovirus (Norovirus transmitted via fecal matter)
Bacterial: parasitic (salmonella, E. Coli, clostridium)
Gastro-enteritis (stomach and small intestine),colitis (large intestine)
S/S abdominal cramping, headache (fever), dizziness and fatigue, nausea (vomiting), and diarrhea
-Risk of dehydration with vomitting and diarrhea
(vomiiting = stomach; diarrhea = intestines) |
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Term
Lyme Disease
-what is it caused by
-S/S
-Treatment |
|
Definition
Bacterial infection caused by deer tick
-Spirochete (type of bacteria)
Early S/S include red circular area around bite (bulls-eye rash)
Late S/S include flu-like symptoms with inflamed joints (arthritis)
If it becomes systemic, can cause:
-facial palsy, cognitive impairment
-cardiac arrythmia
Treated with antibiotics |
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Term
Infectious Mononucleosis
-type of infection
-how is it transmitted
-S/S
-Diagnosis |
|
Definition
Viral
Contagious (saliva)
-Prodromal period (1-2 week)
-Incubation period (4-6 weeks)
-S/s can last 6-8 weeks
S/S
Enlarged lymph nodes and flu-like symptoms
Splenomegaly – risk of spleen rupture in contact sports
(b/t 4th and 21st day) Enlarged spleen
Diagnosis – monospot (Ab) and CBC diff (WBC count) |
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Term
|
Definition
Viral infection affecting the liver (HAV, HBV, HCV)
-BBP
Incubation period
Viral and may cause liver damage
Universal precautions
Inoculations
Liver damage
Cirrhosis (scar tissue)
Jaundice (yellow skin) |
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|
Term
Exercise-Induced Asthma
-what is it
-S/S
-Treatment |
|
Definition
EIA – allergic reaction to weather (cold air) and environment (dry conditions)(during vigorous exercise)
S/S tight chest, coughing, wheezing and dyspnea
(caused by nasal to mouth breathing)
Treatment
-prescribed inhaler (albuterol)
-Proper warm-up can help manage EIA
-Affects 12-15% of population
-Airway obstruction (edema) with bronchspasm
-Inflammation with mucus secretion |
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Term
Diabetic Athlete
-types
-S/S |
|
Definition
Type I (insulin-dependent) or II (non-insulin dependent)
I. loss of insulin producing cells (pancreas)- auto immune disease, become glucose intolerant
II. decrease insulin sensitivity (down regulation of receptor sites) hyperglycemia
Diabetes – inability to regulate blood glucose levels (normal levels 100-200 mg/dl)
Excessive thirst (hunger), weight loss, lethargy
Insulin insufficiency (reduced sensitivity) leads to hyperglycemia
Exercise has an insulin-like effect on muscle |
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Term
Diabetic Athlete
Hyperglycemia S/S vs Hypoglycemia |
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Definition
Hyperglycemia
S/S
Diabetic keto-acidosis (DKA) (fruity or acetone breath)
Extreme thirst and urge to urinate
Nausea and vomiting
Loss of consciousness
Hypoglycemia
S/S
Dizzy, lightheaded
Extreme hunger
Profuse sweating
Usual behavior
Loss of motor coordination
Wrestlers breath: b/c wrestlers fast for a long time and they get acetone breath |
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Term
Exertional Rhabdomyolysis
-what is it
-S/S |
|
Definition
As a result of exertion; rhabdomyolysis is serious muscle damage
-risk is higher when dehyrated during strenous exercising
Cell components enter bloodstream
-Myoglobin provides muscles with oxygen and takes away CO2
S/S
Extreme muscle soreness and stiffness (DOMS)
Weakness
Swelling
Hematuria
-Strain on kidney: renal failure |
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Term
Exertional Rhabdomyolysis
-Complications
-Risk factors
-Diagnosis |
|
Definition
Complications
Blood
Kidney
Liver
Heart
Risk factors
Health status/fitness level
Thermal stress
Hydration status
Sickle cell trait
Diagnosis
Blood test |
|
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Term
|
Definition
Exertional Hyponatremia (low sodium condition)
-Water intoxication (sodium is diluted)
-Electrolyte imbalance
-Sweat loss with sodium
-Rehydrating with water (no sports drinks)
-Restores water levels, but sodium levels are low or diluted
S/S:
-Fatigue, nausea, vomiting, headache, cramping
-Extreme cases: cardiac arrest (can be life threatening; esp b/c it gets mistreated often, misdiagnosed) |
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Term
|
Definition
-Sickle cell trait
-as hemoglobin releases O2 during intense exercise causes RBC to change shape
-trigger is the intensity of exercise (eg: wind sprints)
-Creates log jam in major arteries
-leads to ischemia and muscle damage (rhabdomyolysis)
-Kidney strain and damage
-Exacerbates
-heat, dehydration, altitude, asthma
-Past 4 decades: 15 ES related deaths (all have been football players)
(most important: trigger is intensity of exercise) |
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