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University at Buffalo
Exercise Science
ES 300

ES 300 Exam 1 Sports medicine Domains: • Prevention • Clinical education and diagnostic • Immediate care • Treatment, rehab and reconditioning • Organizations and admin • Professional responsibility Safety and facility management How do injuries occur? • Cumulative stress that exceed the capacity of the body to heal and doesn’t adapt to the load • Trauma • Improper equipment Safety: employee training • OSHA • First aid • CPR/AED • Emergency training Facility dangers • Floor coverings • Outside facilities and property • Improper instruction • Equipment’s use and design • Inside facilities o Temperature o Disease transmission What is an Emergency? An urgent, unexpected occurrence that may cause injuries that requires immediate action. Major concerns in emergencies o Maintain CV function o Maintain CNS function o Initial evaluation o TIME is critical o 4 minutes until irreversible brain damage Legal implications o Law of torts: when someone’s actions cause harm on another. A tort is not necessarily a illegal crime but the actions have caused harm on another. This a duty of obligation the participant makes. o Duty of care: Doctor to patient, to take proper care o Good Samaritan o Negligence o Reasonable care Post emergency o Notification -parental, supervisor, medical staff o Documentation -procedures, incident report, safety training The Downed Athlete: o Identification o Primary survey actions Downed athlete Thoughts Note body position determine level of consciousness Consider neck/spine injury establish a b c (A-airway open B-breathing: face up or face down, C-circulation: do they have a pulse) o Secondary survey Non-life threatening Vital signs musculoskeletal elevation Mechanism (How did this occur) Physical inspection o Ambulation: -Spine board: only if absolutely necessary. -Ambulatory aid: ability to walk short distances -Manual conveyance: inability to walk, athlete in a seated position supported from two sides o Post trauma Hemorrhaging: o Internal o External o Treatment Direct pressure, elevation, pressure points: Arm=brachial artery, thigh=femoral artery Knee=popliteal artery Shock: signs: cold skin, rapid pulse, weak pulse, shallow breathing, low BP Treatment: call EMS! Maintain temperature, elevate legs and feet, handle with care, keep others away, nothing by their mouth. ALWAYS MONITOR PATIENT AFTER AN INJURY, NEVER REMOVE A HELMET UNLESS CERTIFIED Exercise screening and Contraindications Purpose for screening: Identification of risk factors and contraindications to exercise. (Congenital, Acquired, Disabilities, diseases) Procedures: o Medical history (diabetes, heart problems, family history) o Body composition o BP o HR o Height weight (BMI) o Orthopedic Wellness screening: Tobacco use, Alcohol use, caffeine use, eating habits, Exercise fitness, Stress, Personal Safety. Sudden Death syndrome: Happens within 1 hour of activity. More common in men. Etiology: Hypertrophic cardio myopathy Anomalous origin of coronary arteries Marfan’s syndrome Coronary artery disease Right ventricular dysplasia Dilation of the aorta Wolff-Parkinson-White (WPW) Drug use (caffeine, amphetamines etc) Sudden blow to the chest Other heart valve abnormalities Arachnodactyly (large fingers) Pectus excavatum (caved in chest) Aortic stenosis- narrows aorta which decreases cardiac output Larger right ventricle messes up the heart beat Signs and symptoms: No signs prior to death, Sudden chest pain, nausea, shortness of breath, profuse sweating, fever. Management and prevention: Counseling and screening are critical Orthopedic concerns: o Acute & Chronic Back Pain o Osteoarthritis (improper movement of bone. Bone spurs) o Rheumatoid Arthritis/Joint Pain (Body attacks itself at the wrists, feet, fingers. Always on both)  Atlantoaxial instability o Osteoporosis (female athlete triad) o Muscle Tendon Inflammation o Low Back Pain o Screening is a way exercise professionals can enhance the safety of participants and reduce their own risk by identifying potential risks for injury or sudden death. o Screenings MUST include the identification of musculoskeletal, respiratory, metabolic, and cardio vascular risks Mechanisms and Etiology Load: external forces acting on an internal tissue Stiffness: ability of a tissue to resist a LOAD Stress: Resistance to a LOAD, Internal response is a deformation or change in dimension Strain: Extent of deformation under LOADING conditions Tissue failure Plasticity: beyond the yield, Deformation persist after Removal of the load, Permanent changes. CREEP: deformation of a Tissue with a constant LOAD over time Five Stresses Leading to Injury:  Tension  Compression  Shearing  Bending  Torsion 4 point 3 point tension compression Tension compression Classification of injury:  Contusion: compression injury  Strains: stretch/tear to fascia, muscle tendons. Separation to rupture.  Sprains: Traumatic joint twist. Injury to ligaments  Muscle spasm/cramps: Involuntary contraction. -Clonic: contraction/relaxation. Nerve irritation. -Tonic: Rigid contraction, Depletion of electrolytes, interruption of synergism  Muscle soreness: Acute soreness, DOMS (delayed onset muscle soreness)  Dislocations and subluxations(incomplete or partial dislocation) Other fractures: Depressed, impacted, longitudinal, serrated, contrecoup, avulsion, stress. Abrasion: - Infection - exposure to infection - clean and debride - keep moist: heal from inside out Laceration: - Rough edges - Avoid contamination - Possible sutures Incision: - Smooth edges - Sharp objects (scalpels, bones) - Avoid contamination and possible sutures Puncture: - Highly infected - Tetanus shot Avulsion: - tissue is torn away - Must save tissue! Clean the wound: sterile saline solution, Germicide, Medication- Bacitracin, Triple A. only if not referred out by MD. Place medicine on the bandage and not the wound Tissue Healing Phases of healing: Phase 1: Inflammation Phase 2: Proliferation Phase 3: Remodeling Phase 1: Inflammation: - Acute primary healing - Designed to protect and localize the injury - Initial injury and trauma - Cellular death - Initial Vasoconstriction then Vasodilation Vasodilation – A closer look  Edema  Exudate  Polymorphonuclear Leukocytes (PMN’s)  Neutrophils  Basophils  Mononuclear Phagocytes
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