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Chapter 13

KINE 3575 Chapter Notes - Chapter 13: Bone Pain, Sagittal Plane, Palpation


Department
Kinesiology & Health Science
Course Code
KINE 3575
Professor
Kelly Parr
Chapter
13

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CHAPTER 13 OFF FIELD INJURY EVALUATION
`four main evaluations done routinely in athletic training: 1) preparation examination is done prior to the start of
season , 2) initial on-field-injury assessment done after acute injury, 3) detailed off-field-injury-evaluation in
athletic therapy clinic, hospital, ER etc.., 4) progress evaluation is done throughout rehab state of athlete
CLINICAL EVALUTATION AND DIAGNOSIS
Diagnosis to establish cause or nature of the injury and functional impairement
Diagnosis forms basis for patient care
Athletic therapist can only make clinical diagnosis and not medical, clinical identifies pathology of injury, the
limitations and possible disabilities associated with condition
Diagnosis is what an athletic trainer actually does when evaluating an injury or illness
SURFACE ANATOMY: key surfaces provide examiner with indications of normal or injured anatomical structures
lying underneath the skin
BODY PLANES planes and anatomical directions are very important, they are used as reference points
Sagittal plane runs vertically front to back and divides body left and right halves
Coronal runs vertically right to left dividing the body into front and back
Transverse runs horizontally dividing body into upper and lower parts
ABDOMINOPELVIS QUADRANTS AND REGIONS four corresponding regions of the abdomen divided for
diagnostic reasons and diagnosis
Serve as reference points for underling organs and structures
MUSCOSKELETAL SYSTEM structural and functional anatomy, major joints and bony structures neural anatomy
also a big part in this for movement control and sensation, superficial and deep pain
STANDARD TEMINOLOGY terminology used to convey accurate and precise info to easily work with other
professionals
BIOMECHANICS
Biomechanics is application of mechanical forces which may stem from within or outside the body
Pathomechanics refers to mechanical forces that are applied to body bc of structural body devitions leading to
faulty alignment , cause overuse syndromes
Understanding activity that injured person is involved in is critical if AT is effective in determining mechanism of
injury
Overseeing wrong movements made in biomechanical aspects of every activity performed
Must understand erogonomics of repetitive activity example; working with a ballerina must understand
dancecrs needs o understand physical demand of performing artistic activity
DESCRIPTIVE ASSESSMENT TERMS
Etiology cause of an injury or disease (mechanism of injury)
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Mechanism mechanical disruption of cause
Pathology structural and functional changes that result from injury process
Symptoms change n patients body or its functions that indicate an injury or disease , sypmtoms are subjective
Signs are objective a definitive and obvious indicator of specific condition; more determined when patient is
examined
Diagnosis denotes name of specific condition, differential diagnosis is a systematic method of diagnosing a
disorder that lacks unique symptoms or signs; is a list of possible injuries that cannot be ruled out until more
information is obtained typically through diagnostic tests; most serious injurie are taken care of first
prognosis is a prediction of the course of the condition so the outcome of the injury
patient is told what to expect as injury heals and length of time required for injury to heal completely
sequela refers to condition following and reslting from injury ; complication of an existing injury
syndrome a group of symptoms and signs that together indicate a particular injury
OFF-FIELD INJURY EVALUTATION
detailed evaluation performed on side line, clinic, ER etc
can be evaluated same day, few hours or even days after initial trauma
HOPS: history, observation, palpation, and number of special tests
HISTORY
Mechanism of injury, listening to complaints, provide clues to nature of injury
Be calm and reassuring while asking about previous medical history
Ask open ended questions so patients can add anything relevant to the inof given
Listen carefully to complaints
Maintain eye contact see what patient is feeling
Record exactly what is said without interpretation
Try and obtain history directly after injury
Present injuries should try and be described in detail
MECHANISM OF INJURY
If they did not see the injury happen ask following questions;
What is the problem
How did it occur when did it occur
Did you fall, how did you land etc…
INJURY LOCATION
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Ask patient to locate the area of complaint by pointing with one finger , probably localized injury if the patient is
able to pinpoint exactly problematic area
If problem site cannot be indicated it is probably a generalized injury
PAIN CHARACTERISITICS
What type of pain is it? ; nerve pain is sharp, bright, or burning, bone pain localized and piercing, pain in vascular
system is poorly localized, aching and referred from other area, muscle pain is dull and referred to other area
Where is the pain? ; deeper injury site makes it difficult to match the pain with trauma site, can cause treatment
to be performed at wrong site, closer injury is to surface the better elicited pain corresponds with site of pain
stimulation
Does pain change at different times? Pain can subside with a activity meaning it is chronic inflammation; pain
tha increases throughtout the day indicates a progressive increase in edema
Does the patient feel sensations other than pain? For example pressure can cause pins and needles sensation
called paresthesia
JOINT RESPONSES
Instability in joint? Does joint feel as is will give away? Does joint lock or unlock ?
Determining wether injury is acute or chronic ; ask patient how long he or she has had symptoms and how often
they appear
HISTORY OF INJURY
Previous or pre-existing injuries has this ever happened before type of deal
OBSERVATION
Look for obvious deformity, how patient is moving, limp, movements that are slow or abnormal, unable to move
certain body parts, body stiffens to pain, facial expressions, lack of sleep, asymmertries, swollen or red skin,
unnatural lumps, postural malalignment, abnormal sounds, inflammation, swelling or heat ?
PALPATION
Two areas of palpation are bony and soft tissues and must be performed systematically
Light pressure followed by more and more added gradually
Usually begin away from the site of injury
BONY PALPATION
Injured and non injured sites should be palpated and compared
Touch may reveal abnormal gaps or swelling on bone, misalignment or protrusions associated with joint or bone
SOFT TISSUE
Patient should be relaxed as possible
Deviations, swelling, lumps, gaps, abnormal muscle tension, temperature variations
Torn ligaments and tendons can be identified
Variations In shapes and structures of tissue can be felt
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