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Study Guide

AT 250 Study Guide - Fall 2019, Comprehensive Midterm Notes - Range Of Motion, Muscle, Gravity


Department
Athletic Training
Course Code
AT 250
Professor
Dr. Susan Norkus
Study Guide
Midterm

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AT 250

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On field evaluation
Determines nature of injury and directs decision about emergency action
Primary survey
Determines life threatening situations
Correct first, then move to non-life threatening issues
Secondary survey
More in depth, correct injuries that were non-life threatening
Off field evaluation
More detailed, comprehensive assessment
History
Observation
Inspection
Palpation
Nerve assessment (if above steps indicate neurologic)
Fracture tests
ROM
Active, passive, resisted
manual muscle testing
Isolate muscles and test individually to find which one(s) is weak/injured
Do not do if resisted ROM comes back free
Special tests
Functional tests (only if nothing presenting themselves and patient seems okay; sport specific)
Determine differential diagnosis/assessment decision
Best educated guess based on process
Immediate treatment (action)
Progress
Focus on how injury appears now compared with last time
Limited in scope compared to off field evaluation
Based on knowledge of patient and healing process
Dictated by timelines for healing
Can’t speed it up, just provide optimal environment
Assessment decision: better or worse
Treatment
Ergonomic risk assessment
Clinic, corporate, or industrial settings
Evaluation of factors at a job that increase risk in workplace
Bad posture, vibration, repetitive movements
Reduces frequency and severity of workplace injuries
Attempts to resolve issues with intervention
Combine info from evaluations and injury stats to evaluate physical demands of each job
Treatment goals
1. Control swelling
2. Control pain
3. Establish core stability
4. Re-establish neuromuscular control
5. Restore postural control and stability (balance)
6. Restore full ROM
7. Restore muscle strength, endurance, and power
8. Maintain cardiorespiratory fitness
9. Functional progressions
Pain and swelling can impact all other goals, so they are treated primarily.
Specific Measurable Achievable Realistic Timely → SMART goals
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Treatment plan goals
Short term goal (1-2 weeks) and long term goals; mini goals (1-2 days)
Must follow SMART goal guidelines
Therapeutic intervention (tools)
Therapeutic modalities
Therapeutic medications
Therapeutic exercise
Therapeutic therapies
Functional/sport specific exercises
Healing and reevaluation → treatment and rehabilitation plan
Phases predictable
Inflammatory (acute injury phase)
Fibroblastic repair
Maturation remodeling
No definitive beginning
Create optimal environment
Documentation
Initial injury report
SOAP
Subjective → history
Objective → the evaluation (observation → special tests)
Assessment → differential dx, problem list, treatment goals
Plan → todays treatment and plan moving forward
Progress notes
Written post-progress evaluation throughout course of rehab program
SOAP format, treatment notes, weekly summaries
Type of treatment received, patients response, progress made towards STG, changes to
treatment plan and/or goals, plan for treatment for next few days (mini goals)
Off field evaluation
Need to know:
Surface anatomy
Body planes and anatomical directions
Abdominopelvic quadrants and regions
Musculoskeletal anatomy
Body position and directional terminology
Biomechanics: foundation for assessment
Application of mechanical forces, to living organisms
Pathomechanics
Mechanical forces applied that adversely change body’s structure and function
Sometimes precede injury (overuse)
Understand activity patient does
Common injuries
Mechanics
Responsibilities
Positions
Etc.
Etiology: cause of injury or MOI (mechanism of injury)
Pathology: structural and functional changes that occur from injury process
Symptom: subjective; what patient tells you they are experiencing (pain, warmth, nausea, etc)
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Sign: things you can see; objective (leaning, swelling, deformity, discoloration, etc)
Diagnosis: specific name of condition
AT’s usually make a best guess / give differentials
Physicians make diagnosis
Based on tools available
Diagnostic tests are used to confirm diagnosis
Prognosis: predicted outcome/course of healing
Sequela: development of additional condition as a complication of an existing injury or disease
Example: osteoarthritis after a severe joint sprain
Syndrome: a group of signs and symptoms that together indicate a particular injury/disease
Off field evaluation
On sideline, in ATR, ER/ED, clinic
After on-field or immediately after, possibly days/months
Detailed assessment, figure out what’s wrong
History, Observation, Palpation, Special Tests, ROM,
Page 349 Prentice figure 13-1
Systematic, sequential, comprehensive
History
As much info as possible
Calm and reassuring
Simple, not ‘leading’
Open ended ONLY
Avoid yes/no questions
Listen to the patient
Think + process
Make eye contact
Document exactly what the patient says
Determine
Primary complaint - what, how, when?
Injury location - point w one finger
Pain characteristics - 1-10, constant/intermittent
Nerve pain: sharp, bright, burning
Bone pain: localized, piercing
Vascular: poorly localized, aching
Muscle: dull, aching, cramping
Sudden or slow onset?
Exact movements that cause/help pain
Sensations → other feelings besides pain
Temp, pins/needles
Previous injury
Function
Instability? Lock, give-way, etc?
Weakness, ‘giving out’
Observation
Begins at time of injury/whenever you see patient first post-injury
Facial expressions, demeanor, mannerisms, how they move
Compare to uninjured
Can be done while doing history → practice!
How body part is held
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