Female Athlete Injuries and Biomechanics
86 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is a common cause of Osgood-Schlatter's Lesion during rapid growth?

  • Tightening of the quadriceps muscles due to femur growth (correct)
  • Increased flexibility of the patellar tendon
  • Weakening of the quadriceps muscles
  • Increased circulation to the epiphyses

    • Which factor is primarily associated with developing osteochondrosis in young athletes?

  • Frequent swimming
  • Low-impact exercises
  • Usage of supportive footwear
  • Rapid child growth or trauma (correct)

    • What is a defining characteristic of spondylolysis?

  • Fracture due to acute trauma
  • Stress fracture of the pars interarticularis (correct)
  • Bilateral fracture of the pars interarticularis
  • Anterior slippage of the vertebra

    • What hormone is most likely linked to increased vulnerability to injuries in female athletes?

    <p>Estrogen</p> Signup and view all the answers

    Which of the following conditions is associated with the inferior pole of the patella?

    <p>Sinding-Larsen Johansson</p> Signup and view all the answers

    Which of the following conditions is most closely associated with hormonal influences that affect tissue remodeling in female athletes?

    <p>Amenorrhea</p> Signup and view all the answers

    In female athletes, what biomechanical factor contributes to an increased risk of knee injuries compared to male athletes?

    <p>Higher Q-Angle</p> Signup and view all the answers

    What is a common misconception regarding the incidence of anterior cruciate ligament (ACL) injuries in females compared to males?

    <p>ACL injuries occur more frequently in females due to structural differences.</p> Signup and view all the answers

    Which of these factors is NOT typically a predisposition for stress fractures in female athletes?

    <p>Adequate nutrition</p> Signup and view all the answers

    How does the variation in hormone levels during the menstrual cycle primarily affect female athletes?

    <p>Leads to tissue degradation and increased injury risk.</p> Signup and view all the answers

    What aspect of the female athlete triad is most directly related to hormonal changes and their impact on physical performance?

    <p>Menstrual dysfunction</p> Signup and view all the answers

    What role does Q-Angle play in the predisposition of female athletes to knee injuries?

    <p>Excessive Q-Angle can lead to greater stress on medial structures.</p> Signup and view all the answers

    Which of the following is considered a societal factor that could impact female athletes' health and wellbeing?

    <p>Body image pressures related to fashion</p> Signup and view all the answers

    What is a potential risk factor for Testicular Cancer?

    <p>Cryptorchidism</p> Signup and view all the answers

    Which condition is characterized by the twisting of the spermatic cord?

    <p>Testicular Torsion</p> Signup and view all the answers

    What is the most prevalent type of arthritis?

    <p>Osteoarthritis</p> Signup and view all the answers

    What commonly occurs as a result of inactivity in mature athletes?

    <p>Decreased strength and flexibility</p> Signup and view all the answers

    What is a common symptom of testicular cancer?

    <p>Fluid collection in the scrotum</p> Signup and view all the answers

    What happens to the safety of joint function as humans age?

    <p>Degeneration of joint tissue begins to occur</p> Signup and view all the answers

    Which type of hernia is more common in women?

    <p>Femoral</p> Signup and view all the answers

    What age group is most at risk for developing hypertension?

    <p>40 and above</p> Signup and view all the answers

    What characterizes inflammatory arthritis compared to osteoarthritis?

    <p>It involves an immune system attack on the body</p> Signup and view all the answers

    What is a common consequence of aging on the integumentary system?

    <p>Wrinkles and dryness of skin</p> Signup and view all the answers

    Which of the following factors is NOT typically associated with the Female Athlete Triad?

    <p>Excessive hormone production</p> Signup and view all the answers

    What is a primary difference in the newly recognized RED-S compared to the old Female Athlete Triad?

    <p>It addresses energy deficiency in both genders.</p> Signup and view all the answers

    What injury could most likely be caused by penile trauma?

    <p>Hematocele</p> Signup and view all the answers

    Which biomechanical change is commonly experienced by pregnant athletes?

    <p>Increased lordosis</p> Signup and view all the answers

    Which condition can result from energy deficiency as described in RED-S?

    <p>Osteoporosis</p> Signup and view all the answers

    At what age does spermatogenesis begin?

    <p>13 years</p> Signup and view all the answers

    What is the primary cause of bone health degradation during menopause?

    <p>Decreased hormone production</p> Signup and view all the answers

    What type of injury involves superficial wounds or lacerations to the penis?

    <p>Penile trauma</p> Signup and view all the answers

    Which of the following statements regarding concussions is true?

    <p>They are evaluated under the RED-S CAT.</p> Signup and view all the answers

    Which condition refers specifically to swelling caused by blood in the tunica vaginalis?

    <p>Hematocele</p> Signup and view all the answers

    What is one potential consequence of a Type V epiphyseal injury?

    <p>Premature closure of the growth plate</p> Signup and view all the answers

    What increases the susceptibility of young athletes to overuse injuries?

    <p>Muscle-tendon tightness due to slower bone growth</p> Signup and view all the answers

    How does the growth plate's strength compare to the strength of joint capsules and ligaments?

    <p>It is approximately 1/5 as strong as joint capsules</p> Signup and view all the answers

    Which type of injury involves the separation of the growth plate and a portion of the metaphysis?

    <p>Type II Injury</p> Signup and view all the answers

    What contributes to the predisposition of female athletes to stress fractures?

    <p>Lower estrogen levels leading to reduced bone density</p> Signup and view all the answers

    What is a characteristic symptom of the Female Athlete Triad?

    <p>Disordered eating patterns</p> Signup and view all the answers

    What hormonal effect can increase injury risk in female athletes?

    <p>Estrogen fluctuations affecting ligament properties</p> Signup and view all the answers

    In relation to growth, what major difference exists between male and female youth athletes?

    <p>Males tend to have greater overall muscle mass</p> Signup and view all the answers

    Which type of fracture is commonly associated with maturation issues in the growth plate?

    <p>Epiphyseal Fractures</p> Signup and view all the answers

    What is a common complication of apophyseal injuries in young athletes?

    <p>Ongoing growth issues in the affected area</p> Signup and view all the answers

    What potential consequence can arise from an injury to the growth plate?

    <p>Stunted growth due to compromised blood flow</p> Signup and view all the answers

    Which zone in the growth plate is primarily involved in the process of cartilage ossification?

    <p>Calcification Zone</p> Signup and view all the answers

    What is the strength of the growth plate compared to the joint capsule and surrounding ligaments?

    <p>1/5 of joint capsule strength</p> Signup and view all the answers

    What type of injuries can occur if the metaphyseal area is impacted?

    <p>Compromised blood flow affecting growth</p> Signup and view all the answers

    Which type of epiphyseal injury is characterized by crushing of the physis with no displacement?

    <p>Type V</p> Signup and view all the answers

    What factor contributes to the increased risk of overuse injuries in young athletes during growth periods?

    <p>Muscle growth outpacing bone growth</p> Signup and view all the answers

    Which classification of epiphyseal injuries usually involves a fracture of the physis and a part of the metaphysis?

    <p>Type II</p> Signup and view all the answers

    How do the growth plate injuries impact the overall growth of young athletes?

    <p>They can stunt growth if growth plates are damaged</p> Signup and view all the answers

    Which symptom is NOT typically associated with testicular torsion?

    <p>Lump in the scrotum</p> Signup and view all the answers

    What is a common risk factor for developing testicular cancer?

    <p>Cryptochidism</p> Signup and view all the answers

    What describes the difference between osteoarthritis and inflammatory arthritis?

    <p>Osteoarthritis results from the breakdown of cartilage, while inflammatory arthritis involves immune system attacks on the joints.</p> Signup and view all the answers

    Which factor contributes to the decline in maximal oxygen consumption ($VO_{2}$) with aging?

    <p>Decreased physical activity levels</p> Signup and view all the answers

    Which type of hernia is characterized by a protrusion into the femoral canal?

    <p>Femoral hernia</p> Signup and view all the answers

    Which condition is characterized primarily by irregular menstrual cycles and low bone density in female athletes?

    <p>Female Athlete Triad</p> Signup and view all the answers

    Which hormonal change is most commonly associated with the onset of menopause?

    <p>Decrease in estrogen production</p> Signup and view all the answers

    What condition results from an energy imbalance leading to decreased hormonal levels in athletes, particularly affecting bone density?

    <p>RED-S</p> Signup and view all the answers

    Which biomechanical change is commonly experienced by pregnant athletes?

    <p>Increased spinal curvature</p> Signup and view all the answers

    What is a characteristic sign of stress on the bones during menopause?

    <p>Bone health degradation</p> Signup and view all the answers

    Which of the following best describes spermatogenesis?

    <p>Generation of spermatozoa in seminiferous tubules</p> Signup and view all the answers

    What condition is characterized by swelling caused by fluid accumulation in the scrotum?

    <p>Hydrocele</p> Signup and view all the answers

    Which type of injury results from superficial wounds or contusions to the penis?

    <p>Penile trauma</p> Signup and view all the answers

    What is a common long-term consequence of low back or pelvic girdle pain experienced during pregnancy?

    <p>Chronic pain beyond one year</p> Signup and view all the answers

    Which factor does NOT typically contribute to the degradation of bone health during menopause?

    <p>Increased physical activity</p> Signup and view all the answers

    What mechanism primarily contributes to Osgood-Schlatter's lesion in young athletes?

    <p>Tightening of the quadriceps muscles due to femur growth</p> Signup and view all the answers

    Which type of injury involving the growth plate is categorized as physeal?

    <p>Sever's lesion</p> Signup and view all the answers

    What is a potential consequence of osteochondrosis during a child's rapid growth phase?

    <p>Aseptic necrosis due to disrupted circulation</p> Signup and view all the answers

    What is the main consequence of a stress fracture in the pars interarticularis of the spine?

    <p>Spondylolysis leading to vertebra slippage</p> Signup and view all the answers

    In which region of the body does Sheuermann's lesion primarily occur?

    <p>Thoracic spine</p> Signup and view all the answers

    Which muscle group is primarily involved in the pathology of Osgood-Schlatter's lesion?

    <p>Quadriceps</p> Signup and view all the answers

    What common sports activity is most closely linked to the onset of osteochondrosis?

    <p>Running with pivots</p> Signup and view all the answers

    Which of the following lesions is considered a non-articular type of osteochondrosis?

    <p>Osgood-Schlatter's lesion</p> Signup and view all the answers

    What structural weakness leads to spondylolysis in the lumbar spine?

    <p>Congenital weakness of the pars interarticularis</p> Signup and view all the answers

    Which type of osteochondrosis is characterized by a condition in the femoral head?

    <p>Perthes disease</p> Signup and view all the answers

    What specific knee injury is significantly more common in female athletes due to anatomical and hormonal factors?

    <p>Anterior cruciate ligament (ACL) injury</p> Signup and view all the answers

    Which biomechanical factor contributes to increased stress on the medial knee structures in female athletes?

    <p>Increased femoral obliquity (Q-Angle)</p> Signup and view all the answers

    Which type of menstrual irregularity is characterized by a period that stops after previously being normal?

    <p>Amenorrhea</p> Signup and view all the answers

    What is the primary anatomical difference in the Q-Angle between male and female athletes?

    <p>Higher Q-Angle in females</p> Signup and view all the answers

    What biomechanical feature is most likely to contribute to instability in female athletes?

    <p>Reduced hamstring activation</p> Signup and view all the answers

    Which factor is most closely associated with the predisposition of female athletes to stress fractures?

    <p>Poor biomechanics</p> Signup and view all the answers

    What commonly held societal belief may impact the health and physical well-being of female athletes?

    <p>Idealization of thin body types</p> Signup and view all the answers

    Which condition indicates irregular menstrual cycles without amenorrhea commonly found in female athletes?

    <p>Oligomenorrhea</p> Signup and view all the answers

    What factor is a significant contributor to the increased risk of overuse injuries in female athletes?

    <p>Low levels of estrogen</p> Signup and view all the answers

    What is the primary implication of having an increased Q-Angle in female athletes?

    <p>Increased lateral patellofemoral contact</p> Signup and view all the answers

    Study Notes

    Female Athletes

    • Females and males have equal rates of injury incidence, but female athletes are more likely to experience structural injuries.
    • Common structural injuries in female athletes include ACL tears, PFS and Patella Subluxation, Spondylolysis and Spondylolisthesis, and Stress Fractures.
    • Hormonal and menstruation factors contribute to Spondylolysis and Spondylolisthesis in females.
    • The knee is particularly vulnerable to injuries in females due to pelvic differences, specifically the Q-Angle.

    Biomechanical Predisposition

    Knee Injuries

    • Females have a higher femoral obliquity (Q-Angle) which increases valgus force, leading to greater stress on medial structures like the MCL, meniscus, and ACL.
    • Female athletes have a smaller intercondylar notch, which can lead to more instability and hypermobility in the knee.
    • Females often have a weaker hamstring to quadriceps strength ratio, leading to decreased recruitment of the hamstrings and overreliance on the quadriceps.
    • Cyclical hormonal fluctuations impact collagen tissue remodeling, potentially degrading tissue during menstruation.

    Skeletal Differences

    Q-Angle

    • The Q-Angle in males is 13%, leading to increased medial tibiofemoral contact.
    • The Q-Angle in females is 18%, leading to increased lateral patellofemoral contact.

    Anterior Cruciate Ligament (ACL)

    • ACL injuries are more common in females, occurring 2-6 times more frequently than in males.
    • Mechanisms of ACL injury include valgus force, hyperextension, internal rotation of the femur, and deceleration.

    PFS and Patella Subluxation

    • Female athletes often have smaller patellas.

    Stress Fractures

    • Predisposing factors to stress fractures include overuse, poor mechanics, low bone density, nutrition deficiencies, and hormonal fluctuations.
    • Societal factors can also contribute, such as the idealization of a thin body, the pressures of working motherhood, and fashion trends like high heels which can contribute to shortened Achilles tendons and Hallux Valgus (toe inward)

    Prevention

    • Strengthening exercises for the legs.
    • Assessment of quadriceps and hamstring strength.
    • Education on posture and biomechanics.

    Hormonal Effects

    • Amenorrhea (lack of menstruation):

      • Primary Amenorrhea: No period by age 16. Stress Fractures are common in primary amenorrhea.
      • Secondary Amenorrhea: A previously regular period that has stopped. Can be pregnancy related.

    • Oligomenorrhea: Irregular menstrual cycle.

    • Anovulation: Not ovulating, leading to low estrogen levels.

    • Short Luteal Phase: The phase responsible for progesterone production after ovulation. A short luteal phase can lead to decreased progesterone levels.

    • Dysmenorrhea: Pain during menstruation, including cramps, nausea, and emotional variability.

    • All of these hormonal irregularities can lead to loss of progesterone and estrogen, resulting in bone degradation.

    Female Athlete Triad (Old)

    • Osteoporosis: Low bone density
    • Disordered Eating: Inadequate nutritional intake
    • Amenorrhea: Lack of menstruation

    RED-S: Relative Energy Deficiency in Sport (New)

    • This syndrome is caused by energy deficiency due to a mismatch between dietary intake and energy expenditure.
    • RED-S is now acknowledged in both males and females.
    • It is especially important for athletes in weight-based sports.
    • RED-S CAT is a concussion evaluation tool.

    The Pregnant Athlete

    • Competition is typically possible up to the 7th month of pregnancy.
    • Pregnant athletes often discontinue after the 3rd month of pregnancy.

    Biomechanical Changes in Pregnancy

    • Increased lordosis and upper spine extension.
    • Approximately 50% of pregnant individuals experience low back or pelvic girdle pain. 25% continue to feel pain after 1 year postpartum.

    Contraindications of Exercises During Pregnancy

    Menopause

    • Occurs between ages 40-60, on average age 52.
    • The ovaries start producing smaller amounts of hormones.

    Bone Health During Menopause

    • Decreased hormone production contributes to bone health degradation, increasing stress fractures and osteoporosis.

    Male Athlete

    Testosterone

    • Essential for fetal development.
    • Responsible for the development of primary and secondary sex characteristics.
    • Anabolic effects promote muscle growth and development.
    • Promotes and regulates spermatogenesis and maturation of sperm.

    Spermatogenesis

    • The process of generating spermatozoa.
    • Begins around age 13.
    • Occurs in the seminiferous tubules.
    • Testosterone is required for successful spermatogenesis.

    Penile Trauma

    Testicle Trauma

    • Hematocele: Swelling caused by blood collecting in the tunica vaginalis cavity. 50% of hematoceles involve testicular rupture, requiring surgical repair or aspiration.
    • Hydrocele: Swelling in the scrotum due to fluid accumulation in the thin sheath surrounding the testicle. Common in newborns and often resolves on its own. In adults and older boys, hydrocele may result from inflammation or injury.
    • Varicocele: Enlarged veins within the scrotum, similar to varicose veins. Can contribute to low sperm count or decreased sperm quality.
    • Spermatocele: Cystic swelling in the epididymis or testes containing spermatozoa.

    Youth Athletes

    Injury Risk Factors in Young Athletes

    Growth and Development

    Bone Growth

    Anatomy of the Growth Plate (Epiphyseal Plate)

    Mismatched Growth

    Ligaments and Tendons

    Common Problems in Youth Athletes

    • Epiphyseal Fractures (growth plate)
    • Apophyseal Injuries (evulsion)
    • Various Osteochondroses (degenerative changes to bone)
    • Stress Fractures (Spondylolysis, Spondylolisthesis)
    • Patellofemoral Pain Syndrome

    Epiphyseal Injuries

    Classifications

    • Type I: Separation of the physis.
    • Type II: Fracture with separation of the growth plate and a small portion of the metaphysis.
    • Type III: Fracture within the physis.
    • Type IV: Fracture involving both the physis and metaphysis.
    • Type V: Crushing of the physis with no displacement, potentially causing premature closure.

    Testicular Torsion

    • A medical emergency.
    • The spermatic cord rotates and becomes twisted, cutting off blood supply.
    • Symptoms include swelling, nausea, abdominal pain, and one testicle appearing higher than the other.
    • Requires immediate medical attention, often requiring surgical correction.

    Hernia

    Testicular Cancer

    Mature Athletes

    Results of Inactivity

    Potential Problems in Inactive Mature Athletes

    Cardiovascular Effects of Aging

    Respiratory Effects of Aging

    Integumentary System

    Musculoskeletal System

    Neurological Effects of Aging

    Arthritis

    Osteoarthritis

    Inflammatory Arthritis

    Gout

    Apophyseal Injuries

    Osgood-Schlatter's Lesion

    Osteochondrosis

    Types of Osteochrondroses

    • Articular:
      • Perheses Disease (Femoral Head)
      • Kienbocks Lesion (Lunate)
      • Kohler's Lesion
      • Freiberg's Lesion (Second Metatarsal)
      • Osteochondritis Dissecans (Medial Femoral Condyle, Capitulum, Talar Dome)
    • NON-ARTICULAR:
      • Osgood-Schlatter's Lesion (Tibial Tubercle)
      • Sinding-Larsen Johansson (Inferior Pole of Patella)
    • PHYSEAL:
      • Sever's Lesion (Calcaneus)
      • Scheuermann's Lesion (Thoracic Spine)
      • Blount's Lesion (Proximal Tibia)

    Stress Fractures

    Pars Interarticularis

    Spondylolysis

    Spondylolisthesis

    Youth Athletes

    • Young athletes are at risk for various injuries due to the unique features of their growing bodies, including:
      • Bone growth: Epiphyseal plates are weaker than surrounding ligaments and are prone to injury.
      • Mismatched growth: Bone growth outpaces soft tissue growth, leading to muscle-tendon tightness and increased susceptibility to overuse injuries.

    Common Problems in Youth Athletes

    • Epiphyseal Injuries:
      • Type I: Separation of the growth plate.
      • Type II: Fracture with small metaphyseal fragment.
      • Type III: Fracture within the growth plate.
      • Type IV: Fracture involving growth plate and metaphysis.
      • Type V: Crushing of the growth plate with no displacement.
    • Apophyseal Injuries: These are traction epiphyses where muscles attach.
      • Osgood-Schlatter's Lesion: Inflammation and pain caused by the patellar tendon pulling on the tibial tubercle.
    • Osteochondrosis: Degenerative changes in the cartilage of epiphyses.
      • Articular: Affects joints like the femoral head, lunate, and metatarsals.
      • Non-articular: Found in places like the tibial tubercle and patella.
      • Physeal: Affecting the calcaneus, thoracic spine, and proximal tibia.
    • Stress Fractures:
      • Spondylolysis: Stress fracture of the pars interarticularis.
      • Spondylolisthesis: Bilateral fracture of the pars interarticularis with anterior slippage of the vertebra.

    Female Athletes

    • Female athletes experience similar injury rates to males but have a higher risk of specific injuries.
    • Biomechanical Predisposition:
      • Increased Q-Angle: Creates valgus force on the medial structures of the knee (MCL, meniscus, ACL).
      • Smaller intercondylar notch: Can cause instability and hypermobility in the knee joint.
      • Quad-to-hamstring strength ratio: Imbalance increases stress on the ACL.
      • Hormonal effects: Estrogen and progesterone levels fluctuate during the menstrual cycle, which can affect collagen tissue and bone remodeling.
    • Skeletal Differences: Females have larger Q-angles, smaller intercondylar notches, and a greater susceptibility to ACL injuries compared to males.
    • Stress Fractures: Female athletes are prone to stress fractures due to overuse, poor mechanics, low bone density, hormonal factors, and societal pressures to maintain thinness.

    The Pregnant Athlete

    • Pregnant women can safely participate in exercise until the seventh month.
    • Biomechanical changes: Increased lordosis and upper spine extension can cause low back and pelvic girdle pain.

    Mature Athletes

    • Results of Inactivity: Decreased cardiovascular fitness, strength, flexibility, and increased risks for hypertension, osteoporosis, obesity, and coronary heart disease.
    • Cardiovascular Changes: Maximum VO2 declines with age.
    • Respiratory Changes: Decline in maximal consumption and loss of elastic recoil.
    • Integumentary System: Wrinkles, dryness, thinner dermis, reduced sebum production, and increased vascular fragility.
    • Musculoskeletal System: Decreased muscle mass and strength, increased collagen cross-linking.
    • Neurological Effects: Loss of brain weight and neurons, affecting balance and proprioceptive feedback.
    • Arthritis: Age-related degeneration of articular cartilage, causing pain and stiffness in weight-bearing joints.
      • Osteoarthritis: Most common, with bone-on-bone contact.
      • Inflammatory Arthritis, caused by the body's immune system attacking the joints.
      • Gout, characterized by crystals of uric acid forming in joints.

    Male Athletes

    • Testosterone: Hormone responsible for developing male secondary sex characteristics, promoting spermatogenesis.
    • Penile Trauma: Includes superficial wounds, contusions, lacerations, avulsions, frostbite, penetrating wounds, fractures, and priapism.
    • Testicle Trauma:
      • Hematocele: Accumulation of blood in the tunica vaginalis.
      • Hydrocele: Fluid accumulation in the scrotum.
      • Varicocele: Enlarging veins in the scrotum.
      • Spermatocele: Cyst containing spermatozoa.
    • Testicular Torsion: Medical emergency where the spermatic cord twists, cutting off blood supply.
    • Hernia:
      • Umbilical/Direct: Weakness in the abdominal fascia.
      • Inguinal: Weakness in the perineum around the inguinal ring.
      • Femoral: Protrusion into the femoral canal.
    • Testicular Cancer: Cancer originating in the testicles, more common in young men aged 15-40. Risk factors include:
      • Undescended testicles (cryptochidism)
      • Family history
      • Personal history
      • Race and ethnicity
      • HIV infection

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Lecture #6 Conditions in Specific Populations PDF

    Description

    Explore the unique injuries faced by female athletes and the biomechanical factors contributing to these issues. This quiz covers common structural injuries, hormonal impacts, and the implications of anatomical differences such as the Q-Angle. Test your knowledge on this important topic in sports medicine.

    More Like This

    The Historic 1984 Women's Marathon
    3 questions

    The Historic 1984 Women's Marathon

    DelightedMajesty avatar
    DelightedMajesty
    Cuestionario sin título
    1 questions

    Cuestionario sin título

    PlushForsythia avatar
    PlushForsythia
    Female Athlete Triad and Its Health Consequences
    12 questions

    Female Athlete Triad and Its Health Consequences

    LuxuriousMeitnerium avatar
    LuxuriousMeitnerium
    Female Reproductive System Flashcards
    10 questions

    Female Reproductive System Flashcards

    CompliantMemphis avatar
    CompliantMemphis
    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser