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2 nd Quarter Notes. What is an athletic injury?. A damage to the musculoskeletal structures brought about by forces (i.e. acute or repetitive) during athletic performance. Compression. Forces that act along the long axis of a structure which produces a crushing effect. Tension.
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What is an athletic injury? A damage to the musculoskeletal structures brought about by forces (i.e. acute or repetitive) during athletic performance.
Compression Forces that act along the long axis of a structure which produces a crushing effect.
Tension A pulling force that acts along the long axis of the structure which stretches the tissue.
Shear Forces that act at opposite directions at different points causing one part of the structure to move away from another part of the structure.
Acute Injury • Injury with a sudden onset brought about by large forces • Overuse Injury • Injury that developed over time as a result of repetitive microtrauma
Neurological Emergencies • Concussion • Temporary disturbance in brain function brought about by a blow or jolt to the head • Symptoms include headache, balance problem, confusion, and dizzy • Signs include unconsciousness, amnesia, and clumsy
Neurological Emergencies • Skull Fracture • Trauma to the bony structure that protects the brain • Could be linear, comminuted, depressed, or basilar • Watch out for complications!! • Signs and symptoms include cushing’s triad, nausea, and CSF leak
Neurological Emergencies • Intercranial Hematoma • Symptoms include headache, dizziness, and vomiting • Signs include HR decrease, BP increase, raccoon eyes, battle’s sign, and CSF leak
Neurological Emergencies • Spinal Cord Injury • Trauma to the spinal cord leading to temporary or permanent paralysis • C1-C4 paralysis from neck • C5-C7 paralysis from chest • T1-T9 paralysis of lower extremities
Management • Steps to Spinal Injury Management • Check consciousness (AVPU) • Manage airway • Perform neurological tests • Apply cervical collar • Log roll into spine board
Fractures • Disruption in the continuity of a bone • Type of fracture depends on mechanical load and bone maturity • Several types of fractures include . . . • Simple • Compound • Greenstick • Comminuted • Spiral
Signs and Symptoms • Signs • Deformity • Weakness • Bruise • Swelling • Positive X-ray • Symptoms • Pain • Grating sensation
Evaluation Palpation – deformity, tenderness, indentation Percussion – pain during tapping Compression – distal to proximal Distraction – apply traction
Treatment Cast? Internal Fixation? External Fixation?
Dislocations Bone is pushed out of the joint capsule Signs and symptoms are similar to fracture Treat like fracture!!!
Immobilization Anatomical – fingers Rigid - wood Soft - bandage
Guidelines for Splinting • Support the injured area above and below the site of the injury, including the joints. • If possible, splint the injury in the position that you find it. • Don’t try to realign bones or joints unless . . . • Before and after splinting, check for proper circulation (warmth, feeling, and color). • Immobilize above and below the injury.
Triangle and Cravat Bandages • Cotton cloth that can be substituted if roller bandages not available • First aid device, due to ease and speed of application • Primarily used for arm slings • Cervical arm sling • Shoulder arm sling • Sling and swathe
SPRAINS vs. STRAINS NOT INTERCHANGEABLE!! Both injuries are caused by abnormally high tensile forces which tears the tissue but damaged tissues are different . . . Which is Which?!?
SPRAINS vs. STRAINS • Shoulders • Elbow • Wrist • Knee • Ankle • Lower Back • Hamstrings • Gastrocnemius
SPRAINS vs. STRAINS 1st Degree (Mild) No loss of function 2nd Degree (Moderate) Unstable / Weak 3rd Degree (Severe) Loss of function Dependent on the number of torn fibers . . .
Control Inflammation What is inflammation? Is it bad? P – protect R – rest I – ice C – compression E – elevation
Elastic Bandage Application • Hold bandage in preferred hand with loose end extending from bottom of roll • Back surface of loose end should lay on skin surface • Pressure and tension should be standardized • Anchor at the distal end
Elastic Bandage Application • Body part should be wrapped in position of maximum circumference • More turns with moderate tension • Each turn should overlap by half to prevent separation • Circulation should be monitored when limbs are wrapped
The Skin • Epidermis • Dermis • Hypodermis Function?!?
Common Emergencies • Wounds • Break in the skin and underlying tissues • Open • Closed • Burns • Injury caused by heat, cold, chemical, electricity, etc.
Common Emergencies Bites Wound caused by teeth or mouth Stings Small puncture wounds with chemical injected
Wounds and Bleeding Types of Wounds • Incision Clean, sharp edge • Laceration Irregular, tearing • Abrasion Friction, scrape • Puncture Pointed object • Avulsion Partially ripped
!DANGER! • Hemorrhage • 1 glass (250cc) – normal • 2 to 3 glasses – casualty becomes anemic and predisposes to infection • 4 to 6 glasses – fatal • Infection – gangrene may develop, amputation may be necessary • Shock – circulation is compromised and may lead to death
Capillary bleeding – oozing flow of blood Venous bleeding – even flow of blood, dull color Arterial bleeding – irregular spurting of blood, bright red color Kinds of Bleeding
Wounds and Bleeding • Proper Care • Protect self • Control bleeding • a. direct pressure** • b. elevation • c. pressure points • Use sterile dressing • Prevent shock • a. raise legs • b. prevent heat loss • Irrigate wound • Change dressing regularly
SUTURES are needed for deep cuts as well as cuts more than an inch long. Interrupted or Subcuticular?