Techniques of AthleticTraining exam II (and final) study guide

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Exercise Science and Sport Studies
Sara Campbell

1 Athletic Training Exam II Chapter 25: TEMPERATURE RELATED INJURIES I. Homeostasis- controlled by the hypothalamus, achieved when internal heat production and external heat loss are properly balanced ■ thermoregulation- process by which the body maintains internal body temp ■ two mechanisms for maintaining homeostasis 1. sweating- water evaporation cools the body 2. shivering- increase in blood flow increases body temperature ■ homeostasis mechanisms are activated in two ways 1. stimulation of peripheral thermal receptors in the skin 2. changes in blood temperature as it flows through the hypothalamus ■ effect of exercise on body temperature ○ heart rate increases and respiratory rate increases which stimulates an increase in blood flow and an increased temperature ■ four ways the body maintains a constant internal temperature 1. evaporation- cools skin surface and temperature of blood circulating the body which decreases the core body temperature, three factors influence the total sweat that is vaporized from the skin a) the skin surface exposed to the environment b) the temperature and humidity of the air *humidity is the most important factor in determining the effectiveness of evaporation and heat loss c) the convective air currents around the body 2. convection- air flow over body because of movement decreases the body temp 3. conduction- direct heat transfer from one object to another, heat moves from the hotter to cooler object, requires direct contact (ex sitting on a chair) 4. radiation- heat transfer from one object to another without direct contact between the objects ■ types of heat loss ○ talking- mucus membranes are exposed and water evaporates ○ the body naturally gives off water II. athletics and the environment ■ heat stress index- measure of relative humidity, air temp, and solar radiate energy ■ women typically begin to perspire at higher temperatures than men and sweat less than men do ○ womens body responses are the same as mens therefore women rely on radiation and conduction more than evaporation ○ women do not dehydrate as quickly as men ■ climatication: adapting to an environment by gradually increasing the level of exercise ○ NCAA recommends this process to occur over a 7-10 day period (varies depending on how in shape athlete is to begin with) ○ primarily athletes heart rate and breathing have to adjust III. pre existing risks to temperature related injuries ■ overweight athletes- because of muscle mass or fat ○ typically out of shape athletes with large amounts of fat are at higher risk of the two ■ clothing athlete is wearing including equipment ■ a pre existing dehydrated state- AT’s measure the weight of athletes before and after 2 practice, if the athlete lost a significant amount of weight then they have to hydrate more ■ illness- may prevent the body from adapting to climate change effectively ■ abusers- both alcohol and drugs put the body in a weakened state and and affect its ability to adapt ■ poor nutrition ■ poor sleeping habits and routine ■ elderly adults and children- do not have enough strength ■ athletes on diuretics ○ example: creatine causes muscle cramping because it pulls water out of the cells IV. heat illnesses ■ hyperthermia- elevated body temperature occurs when internal heat production exceeds external heat loss ■ heat syncope- (orthostatic dizziness) ○ symptoms: dizziness, nausea, low bp, hypoglycemia ○ occurs when individual is exposed to high environmental temperatures and is self correcting ○ non life threatening ○ after 10-15 min of treatment individual should be okay ■ muscle heat cramps ○ non life threatening and non emergency ○ painful and involuntary muscle spasm caused by excessive water and electrolyte loss during or after exercising in the heat, also caused by sodium depletion ○ most commonly in the calves, hamstrings, abdomen, and lower back ○ symptoms: thirst, sweating, and fatigue, body temp is not elevated and skin remains moist and cool ○ treat by replacing sodium fluid past the point of satisfying thirst, ice massage, stretching ○ can treat with an IV in worst case scenario and an IV can also be used to prevent cramping before practice ○ may precipitate heat exhaustion and heat stroke ■ heat exhaustion ○ usually occurs in individuals who are not acclimatized to the heat ○ it is a “functional illness” and non life threatening but can be life threatening in athletes with a pre-existing illness such as sickle cell ○ caused by ineffective circulatory adjustments and depletion of extracellular fluid (especially plasma vol) as a result of excess sweating ○ symptoms: HA, thirst, dizzy, anxiety, fatigue, excessive sweating, weak and rapid pulse, low bp, ashen grey cool clammy skin, uncoordinated gait ○ the sweat mechanism is still active in the early stages and the skin will be moist and cool, eventually the body starts shutting down at the core to conserve water resulting in perspiration stopping, lack of energy, dry skin, and temperature increasing ○ treat by placing individual in cook place, remove unnecessary clothing and equipment ○ place cold packs in high blood flow areas such as the neck (carotid artery), under arm (brachial artery), and groin (femoral artery) *arteries are high blood flow areas ○ remove player from activities- like shock cannot reverse the effects of heat exhaustion with basic AT first aide they need to be in a controlled environment such as a hospital 3 ■ heat stroke ○ after the sweat mechanism has stopped and the body begins shutting down *the hypothalamus shuts everything down ○ person is unconscious and the risk of cardiac arrest and seizures ○ provide emergency care as soon as possible V. preventing heat related illnesses ■ educate athletes ■ monitor environment ■ monitor athletes weight charts ■ proper hydration before during and after practice ■ early recognition of illness VI. cold illnesses ■ raynaud's- cold allergy reaction in extremities and fingertips NUTRITION AND THE ATHLETE ■ balanced meal/ portion plate has replaced the food pyramid ■ athletes plate: ○ bulk is made up of meat, grains, and veggies ○ additional portions of: healthy fats, fruit, and dairy I. carbohydrates: 65-70% ■ primary fuel for cells ■ required for aerobic and anaerobic activity ■ source of energy is stored in muscle glycogen ■ carbo-loading: (glyco supercompensation) maximizing glycogen stores in preparation for activity ■ glucose and sucrose: twice as effective in restoring muscle glycogen ■ fructose: avoid II. fats: 20-25% ■ greatest source of potential energy ■ turns to glycerol and free fatty acids (FFA) ■ 0.45 g per 1 lb of body weight ■ excess intake of fats can increase fat stores and cause intestinal discomfort prior to exercise ■ inadequate intake can decrease serum testosterone, cause menstrual dysfunction, and may make a person hungrier III. proteins: 15-20% ■ energy source for sustained activity ■ important for muscle growth and repair ■ 0.5 to 1 gram of protein per 1 lb of body weight (ex 3 oz of chicken, tuna, or beef is 21 g protein) IV. fuel during exercise Intensity (VO2 Max) Energy Source 30% predominantly muscle fat stores 40-60% predominantly fat and carbohydrates (CHO) 4 75% predominantly carbohydrates >80% 100% carbohydrates V. breakfast ■ best meal to consume high carbohydrate foods ■ avoid breakfast meats ■ fruits, bagels, muffins, juices VI. lunch ■ emphasize that bread in sandwiches is the filling ■ avoid fried foods: fish, chicken, fries, large burgers ■ baked potato, plain burger, salad, plain taco/burrito, chili VII. snacking ■ wna to eat four to five times a day and replace fluids frequently ■ high level athletes burn a lot of calories VIII. pre-event meals (3 to 4 hrs) ■ stick to a high carb low fat and low protein meal ■ avoid sugary sweets ■ moderate portions ■ one to two hours before event stick to fruits and juices ■ what an athlete eats can make a difference in their performance especially in average athletes IX. post event meals ■ increase carb intake within 4 to 5 hours or more ideally 1 to two hours after activity ■ post meal determines an athletes energy level the next day ■ 1-2 g carbohydrates (insulin is anabolic) food is broken down for energy ■ include more protein and fat with meal to enhance muscle growth ■ should be a 2:1 ratio between carbs and protein content in meal, same goes for meals during recovery the next day X. early morning workouts ■ presents the challenge to find a good energy source early in the AM ■ liquid nutrition is ideal because it is easy/quick to eat and digest ■ bars are less ideal because they are heavier which can cause gastric distress (if going to eat a bar make sure you combine it with hydrating) ■ plan meal ahead the night before XI. fluid requirements ■ 60-65% of total body weight is fluids ■ fluid loss leads to loss of Na and K ■ dehydration can diminish energy and impair performance (as little as 2% water loss can decrease performance by 6-7%) ■ an athlete should not rely on the thirst mechanism XII. baseline examination ■ determine needs of the athlete (time in season, how fit they are) ■ develop realistic goals: weight loss, gain, or maintenance ■ determine where their food source is coming from ■ estimate their daily resting metabolic rate ■ create a food diary ■ may refer to a registered dietician or MD when necessary 5 ■ be aware of possible eating disorders XIII. ergogenic aids A. micronutrients (1 a day vitamins) ■ magnesium, zinc, copper ■ used for energy, metabolism, enzyme activity, and antioxidant defense ■ lost in sweat and urine ■ most people ingest adequate amounts of vitamins in diet but those people with deficiencies may benefit B. protein supplements ■ theory is that increasing protein intake will improve strength, endurance, and power ■ reality is that excess amino acids are excreted and burned off during activity ■ theory may apply to heavy weight lifters and high endurance athletes ■ the impact on kidneys is over exaggerated ■ NCAA restrictions: institutions cannot provide products containing more than 30% of its calories from protein, higher than 30% is considered an ergogenic aid ■ obtaining protein in a normal diet is more realistic and more cost efficient C. creatine monohydrate ■ five day method: increase dosage over a short period of time (shown to be more effective) ○ daily requirement is 2-5 g loaded with 20-25g for five days ■ gradual method: gradually increase dosage over 30 days ■ positive effects in high resistance exercise ■ the increase in body mass is likely through fluid retention (causes increased muscle cramping) ■ not recommended for adolescents D. HMB (B-hydroxy-methylbutyrate) ■ claim is that increases muscle mass, maximizes protein synthesis, and accelerates fat loss ■ found in protein rich foods ■ expensive (over a hundred dollars a month) ■ more studies are needed on its effects, use is not very common ■ studies have shown benefits in muscle recovery and is is more commonly used in athletes post injury E. androstenedione “andro” ■ considered a “pre-hormone” ■ claim is that is a natural and legal anabolic steroid that increases muscle mass and strength, boosts libido, and enhances recovery ■ banned in NCAA ■ considered very risky- causes increase risk of cardiovascular disease, decreases HCL (good cholesterol), may lead to breast cancer, increased estrogen levels F. ephedral ma huang ■ claims that it improves athletes performance, promotes weight loss, increases energy and alertness via cardiac output increase, bronchial airways, and muscle contractility ■ often combined with caffeine for enhanced effects ■ no evidence for improvement of athletes performance ■ has negative effects on bp, heart rate, seizures, neurovascular, hypertension 6 ■ banned in the NCAA VI. the female athlete- ■ decreased energy/ decreased nutrient intake causes the following ○ bone density decrease ○ impaired immune response ○ menstrual dysfunction ○ anemia ○ poor exercise performance ○ increased recovery time from injury or has a consistent problem (stress fractures) ■ triad: disordered eating, amenorrhea, osteoporosis ○ malnourished impairs reproductive and bone health ○ menstrual irregularity and decrease bone mineral density causes an increased risk for stress fractures ○ triad occurs most commonly in sports that emphasize leanness VI. the diabetic athlete ■ disease characterized by partial or complete deficiency of insulin ■ type 1: insulin dependent, complete absence of insulin, affects about 10% of the population, causes a greater risk of ketoacidosis ■ type 2: non-insulin dependent: adult onset, caused by obesity or family history, normal or excessive levels of insulin ■ ketoacidosis: when blood glucose levels increase and excess glucose is excreted along with water and electrolytes ○ body goes from glucose metabolism to fat metabolism and the breakdown of ketones ○ causes a “fruity” breath and if no insulin is present person could fall into a coma ■ insulin shock: hypoglycemia, glucose levels fall ○ causes thirst, dizziness, nausea, hunger, cool/clammy skin, ○ fast onset ○ treat by administering glucose to increase insulin levels via gels, tablet, food source ■ diabetic coma: hyperglycemia, glucose levels increase ○ slower onset ○ if unsure give glucose ○ like ketoacidosis glucose will not help and person should seek medical attention UPPER EXTREMITIES I. the shoulder complex: four articulations SC, GH, AC, ST (false) ■ weak joint ■ ball and socket joint (but not really a socket, socket created by labrum) ■ not a weight bearing joint so weakness does not cause a problem ■ intertubercular groove: long head of the biceps II. clavicle ■ medial articulation: SC joint with the proximal upper third of sternum (manubrium) ■ lateral articulation: AC joint with the acromion process ■ muscular attachments, blood vessels, nerves ■ similar to the ribs in shape 7 ■ help function in shock absorption from the upper extremities III. scapula ■ glenoid cavity is almost flat ■ flat blade type bone ■ anterior: insertion of the subscapularis ■ posterior: scapular spine (difficult to fracture) ■ sits over top ribs 207 and provides protection for the upper back area ■ acromion forms a joint ■ coracoid processes serve as muscular and ligamentous attachments IV. GH joint ■ labrum: fx for shock absorption and deepens labrum* ■ long head of biceps attaches to superior portion of labrum ○ slap lesion injury: tear of the superior labrum anterior to posterior direction ■ most common dislocation of the labrum is in the anterior inferior direction ■ coracoacromial ligament: connects bone to bone, functions more as a boarder for subacromial region ■ the humeral head is about three times larger than the labrum which results in instability ■ most movable joint in the body therefore compromise stability with gained ROM ■ GH capsule and capsular (glenohumeral) ligament contribute to stability ■ transverse humeral ligament- holds the long head of the biceps in place V. rotator cuff ■ most strained position is abducted and ER ■ supraspinatus: abduction and elevation ○ empty can exercise (thumbs down): combines abduction and elevation to isolate muscle, if the person has pain do thumbs up ■ infraspinatus: external rotation ■ subscapularis: internal rotation ■ teres minor: external rotation ■ the RC muscles work together to pull the humeral head down and inside the glenoid fossa VI. AC joint ■ coracoclavicular ligament (conoid and trapezoid): if the AC ligaments rupture (not common) these ligaments will keep the clavicle in place ○ separated shoulder: results because of damage to the coracoclavicular ligaments VII. SC joint ■ sternoclavicular and
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