1
Q
Important parts of the spine
A
- facet joints
- vertebral body
- disc
- spinous process
- transverse process
2
Q
Cervical vertebrae
A
C1-C7
3
Q
Thoracic vertebrae
A
T1-T12
4
Q
Lumbar vertebrae
A
L1-L5
5
Q
Structures of the right upper quadrant
A
- liver
- gallbladder
- duodenum
- head of pancreas
- right kidney and adrenal gland
- hepatic flexure of colon
- part of transverse and ascending colon
6
Q
Structures of left upper quadrant of abdomen
A
- stomach
- spleen
- left lobe of liver
- body of pancreas
- left kidney and adrenal gland
- splenic flexure of colon
- parts of transverse and descending colon
7
Q
Structures of right lower quadrant of abdomen
A
- caecum
- appendix
- right ovary and tube
- right ureter
8
Q
Structures of left lower quadrant of abdomen
A
- part of descending colon
- sigmoid colon
- left ovary and tube
- left ureter
9
Q
What is a fascial chain?
A
- fascia runs from quads to psoas to quadratus lumboroum and travels over posterior aspect of the kidneys to cover the diaphragm
10
Q
Palpation of the abdomen
A
- palpate the 4 quadrants
- start superficial and gradually increase pressure
11
Q
What is a sports hernia (athletic pubalgia)?
A
- fascial weakness in abdominal wall where abdominals and adductors attach to pubic bone
12
Q
Mechanism of injury of sports hernia?
A
- repetitive strain in the area
13
Q
What sports is a sports hernia common in?
A
- hockey
- football
- soccer
- sprinters/hurdlers
- rugby
14
Q
Signs and symptoms of sports hernia
A
Pain with:
- sitting up
- quick cutting
- sprinting
- coughing
15
Q
Special test for sports hernia
A
- resisted sit up
16
Q
Acute management for sports hernia
A
- PIER
- adductor wrap
- sequential RTP
*easily re-irritated
17
Q
Conservative treatment for sports hernia length
A
- 4-6 weeks
18
Q
Visceral structures potentially affected in sport
A
- kidney contusions
- spleen rupture (mono?)
- lungs (pneumothorax)
- bladder rupture (empty bladder)
- testicular contusions
- heart
19
Q
Abdominal injuries MOI
A
- direct blow
- fall from height
20
Q
Signs and symptoms of abdominal injuries
A
- pain
- rigidity in abdomen
- feeling unwell
- shock
- Cullen sign (umbilicus discoloration)
- Grey Turner sign (flank discoloration)
21
Q
Acute management of abdominal injuries
A
- quadrant palpation
- call 911
- rest comfortably
- treat for shock
- reassure
22
Q
Kidney injuries MOI
A
- blow to back
23
Q
Signs and symptoms of kidney injuries
A
- pain in low back
- peeing blood
- feeling unwell
- shock
- refer
24
Q
Causes of sudden death of athletes
A
Usually due to cardiac disease:
- congenital abnormalities of coronary arteries
- hypertrophic cardiomyopathy
25
Hypertrophic cardiomyopathy
- genetic condition causing thickening of heart muscle
- leading cause of sudden death in athletes
- altered rhythm = reduced/blocked blood flow
26
Warning signs of hypertrophic cardiomyopathy
- fainting or seizure
- dizziness or light headedness
- chest pain
- palpations (quick/fluttering/irregular/pounding heart beats)
- shortness of breath
27
Emerging causes of acquired heart disease in young athletes
- anabolic steroids
- peptide hormones
- stimulants (ie. energy drinks)
28
What is a blow to the solar plexus (ie. "wind knocked out of you")
- spasm of diaphragm muscle
29
MOI of a blow to the solar plexus
- blow to abdomen or chest
- fall on buttocks or back
30
Signs and symptoms of a blow to the solar plexus
- pain
- difficulty breathing
- panicky
31
Acute management of a blow to the solar plexus
- bring athlete's knees gently towards chest
- guided breathing
- diaphragmatic breathing
- RTP once symptoms resolve
32
Facet joint sprain MOI
- forced rotation
33
Signs and symptoms of facet joint sprain
- hear/feel pop
- sharp localized pain
- pain with motions that open the joint
- muscle guarding
34
What sports are facet joint sprains common?
- contact sports such as from an unexpected hit
35
What level of the spine are facet joint sprains common?
- c-spine due to large ROM
36
Special tests for facet joint sprains
- quadrant test (positive if pain on the opp side or joint that you are opening)
37
Acute management of facet joint sprain
- PIER
- refer
38
What is facet joint effusion?
- irritation of the facet joint
39
MOI of facet joint effusion
- sudden episode of extreme ROM
40
Signs and symptoms of facet joint effusion
- click or sharp pain
- localized pain
- spasm around inflamed joint
- nerve root irritated
- closing joint painful
41
Special test for facet joint effusion
- quadrant test (positive if pain on same side)
42
Acute management of facet joint effusion
- PIER
- refer
43
Disc protrusions MOI
- acute or chronic compression through disc, often in flexed position
44
What does a disc protrusion result in?
- bulge in disc resulting in changes to myotomes & dermatomes
45
Signs and symptoms of disc protrusion
- pain with repeat forward bending
- relief with extension
- pain with cough/sneeze
46
Management of disc protrusion
- refer for conservative treatment
47
If inert structures are damaged, what are some goals of treatment?
- dynamic stability
- strong core, strengthening contractile tissues around injury
48
What are dermatomes?
- sensory areas of skin that are innervated by specific nerve roots
49
Sensations of dermatomes
- pain
- tingling
- numbness
- pressure
50
Special tests for myotome testing
- cervical nerve root involvement
- lumbosacral nerve root involvement
51
Cervical nerve root involvement test
- resisted tests are performed 5x bilaterally
- look for weakening over the 5 reps
52
Which resisted motion is associated with nerve root C1?
- cervical flexion
53
Which resisted motion is associated with nerve root C2?
- cervical rotation
54
Which resisted motion is associated with nerve root C3?
- cervical side bending
55
Which resisted motion is associated with nerve root C4?
- shoulder elevation
56
Which resisted motion is associated with nerve root C5?
- shoulder abduction
57
Which resisted motion is associated with nerve root C6?
- elbow flexion
58
Which resisted motion is associated with nerve root C7?
- elbow extension
59
Which resisted motion is associated with nerve root C8?
- thumb extension
60
Which resisted motion is associated with nerve root T1?
- hand intrinsics (spread fingers)
61
Which resisted motion is associated with nerve root L1,L2?
- hip flexion
62
Which resisted motion is associated with nerve root L3?
- knee extension
63
Which resisted motion is associated with nerve root L4?
- foot dorsiflexion & inversion
64
Which resisted motion is associated with nerve root L5?
- hallux extension
65
Which resisted motion is associated with nerve root S1, S2?
- plantarflexion in sitting
66
Which resisted motion is associated with nerve root S1?
- knee flexion
67
Which resisted motion is associated with nerve root S2?
- hallux flexion
68
Nerve root C5 test
- biceps reflex
69
Nerve root C6 test
- brachioradialis reflex
70
Nerve root C7 test
- triceps reflex
71
Nerve roots L4,L5 test
- patellar tendon reflex
72
Nerve root S1 test
- achilles tendon reflex
73
Muscle strains of the neck and back MOI
- overstretch or eccentric load (loading muscle while forward bending)
- rotation at high velocity
- may have external force
74
What sport are neck and back strains common?
- tennis
- golf
- baseball
75
Signs and symptoms of muscle strains of the neck and back
- abrupt pull
- pain
- protective spasm
- divot
76
Acute management of muscle strains of the neck and back
- PIER (but never to anterior neck to major vessels)
- altered activity
77
Rib and scapula fracture MOI
- direct blow
- compression
78
Signs and symptoms of rib fracture
- pain with deep breath (shallow breathing)
- pain with compression
- TOP area of fracture
79
Signs and symptoms of scapula fracture
- TOP
- pain with movement of shoulder
80
Acute management of scapula fracture
- stabilize the segments with padding and tensor
- tube sling
- send for imaging
81
Ideberg classification of scapular fractures
- type 1a
- type 1b
- type 2
- type 3
- type 4
- type 5a
- type 5b
- type 5c
- type 6
82
What are the 4 spondy's of the spine?
1. Pars interarticularis
2. Spondylolysis
3. Spondylolisthesis
4. Spondylitis
83
Spondylolysis
- stress fracture in pars interarticularis
84
Spondylolisthesis
- stress fracture and sliding vertebra (dislocation)
85
Spondylitis
- inflammation in vertebra that could lead to fusion
86
Spinal fractures MOI
- axial load
- compression through spine
87
Signs and symptoms of spinal fractures
- central pain
- tingling
- numbness
- unwillingness to move
- spasm
88
What is there a potential for with a spinal fracture?
- displacement of segments can put pressure on spinal cord or nerve roots resulting in paralysis
89
Paralysis of C-spine
- paraplegia
90
Paralysis of T-spine
- quadriplegia
91
Acute management of spinal fracture
- stabilize
- call 911
92
How to break pain-spasm cycle
- find and treat the cause
93
Special test for rib compression
- positive test: pain at suspected fracture site
- pain with inspiration or cough
94
Special test: Quadrant test of lumbar spine joint effusion vs ligament sprain
- athlete extend backwards, side bend & rotate in same direction
- pain on same side = facet joint effusion
- pain on opp side = facet sprain
95
Special test: stork stance
- athlete stand on one leg on side of pain & extend backward through lumbar spine
- positive test = pain localized to affected segment
96
What might stork stance special test indicate?
- if positive test is coupled with history of repeat backbending may indicate spondylolysis or spondylolythesis
KNPE331
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