Conditions Quizzes PDF

Quiz 1 Kamille is doing a sideline assessment on Payton. Which of the following would be included in a sideline assessment, but NOT an on-field assessment? Select all that apply. - Looking for deformities - Palpating the suspected injury - sport-specific functional testing...

Quiz 1 Kamille is doing a sideline assessment on Payton. Which of the following would be included in a sideline assessment, but NOT an on-field assessment? Select all that apply. - Looking for deformities - Palpating the suspected injury - sport-specific functional testing - Passive ROM Madison has sustained an injury to her foot while hiking (she rolled her ankle). Thankfully, you are hiking with her and know how to manage it. She is experiencing pain, decreased ROM and you note there is swelling and some heat around the injured site. What will you do to help manage Madison's injury? Select all that apply. - apply heat to the area - elevate her foot above her heart - massage the area of pain - apply pressure - apply ice - apply a heat rub, like A535 to the injured area - Get her to rest the area Recently, Jade and Ebony were making some crafts for her upcoming party in the sandbox. Ebony asked Jade to pass her the scissors, but unfortunately she handed Ebony the sharp end accidently cutting Ebony. Jade felt horrible for creating this laceration, (not to mention there is now blood all over the crafts!). Thankfully you were there and you quickly sprung to your feet and began inspecting the wound. Unfortunately, you need to search around for gloves as there is none in sight. What should you get Ebony to do now? - Ask Jade to apply pressure to the wound - Ebony should apply manual pressure on the open wound - You should give Ebony ice to ease her pain and slow the bleeding - You should test for a fracture You are covering a soccer tournament, and McKenzie is carried over to your tent. The coach thinks they have a 3rd degree quad strain. Which of the following would be some signs and symptoms that would indicate that McKenzie has a 3rd degree quadriceps strain? - The athlete has some pain with moving the knee. The knee extension strength is full or graded at 5/5 or 100% compared to the uninjured leg. - The athlete has some tenderness and pain when they flex (or bend) the knee, but they have full range of motion (ROM). - You would note some swelling, a hematoma that is palpable and the muscle contraction is extremely painful and weak. They also are unable to fully flex their knee (bring their foot to their butt) due to the pain (decreased range of motion (ROM)).  - The athlete has significant swelling and a hematoma has developed. They are unable to extend their knee, and the pain initially was intense, but is now absent with movement. There is a significant divot or depression in the muscle. Kelsey was playing ultimate and fell awkwardly. She is complaining of pain in the mid foot zone and at the head of the 5th metatarsal. As well, she has an inability weight bear. You perform a tuning fork and percussion test and find these to be positive. What should be your course of action for Kelsey? Select all that apply. - tape her with an ankle support (closed Gibney) so she can return to play - splint using the R.I.C.E. principle - refer to ER - Do nothing now, but advise she make an appointment with her physician tomorrow - Utilize P.I.E.R. Your textbook classifies pain into 2 categories: somatic and visceral. Somatic pain arises from skin, ligaments, muscles, bones and joints whereas visceral pain results from disease or injury to an organ in the thoracic or abdominal cavity. Is this true or false? To test specifically for contractile tissue strength, you perform passive range of motion. Is this true or false? Amanda is at softball practice and is experiencing a cramp in her calf and asks you for assistance. She is frustrated because she wants to begin the strength training program tonight and is concerned the cramp may interfere with her training. Which of the following can you do and/or advise her on to manage her cramp? Select all that apply. - advise her to increase her fluid consumption especially fluids which contains electrolytes - stretch her calf - advise her that it is best to strength train when the muscle is fatigued - advise her to strength train at night Eric was running through his house practicing for an upcoming cross-country meet when he kicked the chair leg with his hallux (big toe). The hallux was extended at the time when he made contact with the leg. Based on the mechanism of injury, which of the following would be part of your indices of suspicion? Hint: think about the mechanical properties of tissue, loading, and Newton's 3rd law of motion. - Contusion - dislocation/subluxation - fracture - sprain Katie was cooking and cut herself (there is no bone or tendon exposed). Thankfully Hayden was there to help her! Hayden fills up the syringe with hydrogen peroxide to clean Katie's wound. Hayden feels that hydrogen peroxide is the best way to clean out a cut. Is this true or false? Which of the following tests would rule out a fracture? Select all that apply. - Resisted ROM (RROM) - tuning fork test - Active ROM (AROM) - percussion test - Passive ROM (PROM) Krissie's dog ran by tripping Ruby causing her to roll her ankle. You spring into action to do an on-field assessment. Ruby tells you that there is mild to moderate pain, and localized joint stiffness and you can see slight swelling, however, there is no instability, lack of AROM, or weakness. What would you grade this sprain as? - grade 1 - grade 2 - grade 3 Levi has sustained a blister on his heel from his new shoes that he is breaking in for his upcoming cross-country meet. He knows he shouldn't wear new shoes for a meet, but his old shoes are beyond repair. He believes that the blister is caused by rubbing his heel against the shoe, but you indicate that rubbing is not the cause. Which of the following statements could you use to explain the development of a blister? - The cause of the blister is a shear force. It is caused by the stretching of the internal tissues due to a parallel force - The cause of the blister is due to friction. It is the force that resists motion when the surface of one object comes in contact with the surface of another. - The cause of the blister is due to torsional forces. As the foot moves within the shoe, torsion occurs creating tension, which elongates the internal tissue essentially tearing it creating the opportunity for a blister to develop. - The cause of the blister is a combination of moisture and compression. The "water" increases the friction coefficient thereby creating "stickiness" which will increase the compressive forces on the underlying tissue. Quiz 2 Joaquin is playing soccer and inverts his ankle. You are called out onto the field and you begin your on-field assessment. Based upon your history, objective ROM tests and palpation, you feel he has a lateral ligament sprain. Which of the following tests should you do which will isolate injury to a Anterior Talofibular ligament? - Thompson Test - Tinel sign - Anterior Drawer - Kleiger test Stephanie comes to see you on the sideline with pain in her lower leg that has been gradually increasing in intensity. Her mom is a nurse and thinks it may be compartment syndrome. Which of the following are some signs and/or symptoms associated with compartment syndrome. Select all that apply - Pallor - pain with passive stretching - paresthesia - Lack of a plantar reflex Marissa has hurt her ankle and you feel that ice would be appropriate to manage her injury. You want to rule out contraindications to ice. Which of the following would be a contraindication to ice application? - Raynaud’s phenomenon - Open wounds - Metal implants - Hyperhidrosis - Impaired circulation Josh was playing tiddlywinks with his toes and sat on his 1st toe forcing the distal phalange in a valgus direction. He is in pain, but thankfully you are there to do a “field Ax”. You are observing to see if inflammation is present in his toe. Which of the following should you look/feel for? - Deformity - Contusion - Redness - Swelling - Abrasions - Heat Ella has a suspected fracture to her tibia (bone in the shin). You want to splint her using a rigid speed splint. The suspected fracture is in the middle of the tibia. Other than the tibia, what else should you immobilize? - Pelvis - Toes - Femur - Foot - Ankle joint - Knee joint Amelia was dancing in “A Midsummer Nights Dream” and landed awkwardly on her foot. She managed to pull herself off the stage to you, who is waiting in wings. You perform an on field assessment and test for a fracture. Based on the Ottawa ankle rules, which of the following painful sites would warrant a trip to the ER or emergency clinic? - Bone pain at the cuboid bone - Bone pain at the calcaneus - Bone tenderness at the navicular - Bone tenderness at the posterior or tip of the lateral malleolus - Bone tenderness at the base of the 5th metatarsal Ben was playing Texas Hold’Em and reached across the table to gather his winnings, however, Alex thought he was reaching for her winnings and subsequently hit his hand with her “coffee” mug. He was in significant discomfort and wanted his hand injury managed so he could play in the next tournament. Which of the following methods of acute care management are the top two choices for limiting swelling? - Ice - Optimal loading - Elevation - Compression - Protection When deciding whether to return an athlete back to their sport. There are certain “rules of thumb” that apply. Which of the following are these rules? - Athlete must be able to stand on one leg for greater than 30 sec  - Must have at least 80% strength of the uninjured limb - Athlete needs full ROM of the injured joint - Athlete must always be taped prior to RTP Graham had a nightmare. He dreamt he was playing basketball with his grandkids. He pushed off his right foot while his knee was extending and then heard and felt a pop in the posterior aspect of his ankle. Graham thought someone shot him in the leg. He wants to know if his dream is a predicting a potential rupture of his Achilles tendon? True = yes it is predicting, False= no its not predicting Natalie is preparing for an upcoming figure skating competition. She has been doing a lot of jumping and is now experiencing pain over the calcaneus where the Achilles tendon attaches. Upon examination, she feels pain on the soft tissue just anterior to the Achilles tendon. You also note that there appears to be swelling where the Achilles attaches to the calcaneus. It bothers her especially when she is toeing off preparing for her jump. (In jumping, the calcaneus compresses against the boot of the skate). Which of the following would be an appropriate index of suspicion? Hint, think about the big 7 injuries. - Fracture of the calcaneus - Retrocalcaneal bursitis - Sprain of the Achilles tendon - Achilles tendinopathy Midterm Stephanie was at a martial arts event and hurt her ankle. You assess it and feels she has a 1st degree lateral ankle sprain. You tape the ankle and begin your figure 8 strips. Stephanie inquires as to the purpose of the figure 8 strips. What is your response to her? - the figure 8 limits eversion - the figure 8 limits plantarflexion - the figure 8 limits dorsiflexion - the figure 8 limits inversion At an AT party the first week of September, Kristen pulled out her harmonica and began playing and dancing on the amp and got so excited that she jumped off it, injuring her ankle. Graham assessed her ankle and indicated that she had a 1st degree lateral ankle sprain. At their next gig (they are a duo now; Graham plays bagpipes), Kristen asks you to tape her ankle because she will dance a highland fling while her and Graham play. Prior to taping Kristen, you need to get a baseline of her neurovascular system to ensure that the tape will not cause any issues. What do you check prior to taping her ankle? Select all that apply. - Reflexes by tapping the Achilles tendon - Circulation by checking for capillary refill of the big toe - Circulation by checking it at the posterior tibial artery which is located behind the medial malleolus - Sensation, by scraping something sharp (like your fingernail) close to her toes - Motor, by asking her to wiggle her toes Rocking Ruby is at an ACDC concert and in the pit. She is wildly dancing to Graham's solo (Graham was asked to fill in for Angus Young) and ended up tripping on Joaquin's foot (who was also rocking out to Graham's solo). Thankfully you hate ACDC and were not dancing so you went to assess Ruby. You conduct your assessment and want to rule out a fracture of the tibia (shin bone). Ruby is reporting pain in the mid shaft of the tibia (approximately 7 cms superior to the medial malleolus). Unfortunately with all the dancing, your tuning fork fell out of your pocket and you elect to use a percussion test to rule out a fracture. How would you perform this test to maximize its effectiveness? - Tap on the painful area (7 cms superior to the medial malleolus) - Tap the medial malleolus with your knuckle - tap the lateral malleolus - Compress the tibia and fibula (the lower leg bones) together Luca was petting Buddy the cat when you, Kayla and Levi come over to visit. Levi unfortunately trips over Buddy the cat causing Luca to become upset because he is afraid that Buddy may be really hurt. You take charge of the situation because you believe Levi has a fracture of his ankle due his obviously angulated joint. You send Kayla to comfort Luca and see if Buddy is okay and you assist Levi. You believe that Levi has to be splinted. What is involved in splinting? - Add intermittent compression - Elevate the leg - Tightly wrap a tensor around the ankle to immobilize - Immobilize in the position found - Reduce the fracture - Rest - Apply something cold Garett was bowling for millions and inverted his ankle tripping over the arrows. He is reporting pain around the lateral malleolus, but wants to continue to play as he is one of the top money earners! You, coach Shanyn and Garett feel he needs to play based upon your assessment (Shanyn wants to go to Cancun for the international bowling championships). Garett asks to be taped to prevent any further damage to the ankle so he can keep playing. For an inversion ankle sprain, which direction would the stirrups go? Check all that apply. - stirrups would go from the toes to the shin  - stirrups go from lateral to medial - stirrups go from medial to lateral - stirrups would go from the shin to the toes Sara is the head chef for J Cole and tripped over rocking Ruby who was dancing in the kitchen. You suspect that Sara has fractured her ankle joint. You elect to splint her with Ruby's help and refer her to the hospital for further evaluation. Which of the following areas must you splint for a suspected ankle joint fracture. Select all that apply. - lower leg bones (tibia and fibula) - femur - ankle joint (subtalar and talocrural) - knee joint (tibiofemoral) - foot bones (metatarsals) - toes (phalanges) Hayden really wants to make the national pickle ball team, but unfortunately just sprained their ankle. They are desperate to maintain a training schedule and thinks they can begin doing light weight squats when the ankle is inflamed. Is this true or false? - True - False Sara was playing ultimate and was thrown a bad pass from Souad. Sara, in her athletic prowess, jumped for the frisbee in a full out superwoman pose landing awkwardly on her wrist (but she caught the frisbee in her other hand!) causing a 1st degree wrist sprain. You are the therapist covering the event and elect to use acute care management pressure, however Sara wants to know what is the purpose of pressure. What do you tell her? - increases venous flow - approximates the ends of the torn ligament - causes cutaneous vasoconstriction - Decreases the release of chemical mediators to lessen vasodilation When testing ROM for a sideline assessment. You should begin with Active Range of Motion (AROM) first. True or false. - True - False Keysha is playing pick up basketball with Mackenzie in her bare feet. Keysha went up for a rebound landing on Mackenzie's shoe forcing her big toe into valgus, so much so that there is an obvious angulation of the hallux. Keysha is in lots of pain and you decide to splint her. Based on your observations, you suspect a dislocation and want to splint it in the position found. You remember the acronym R.I.C.E. when splinting the ankle. What does R.I.C.E. stand for when it comes to splinting? - Compress - Reduce - Cold - Ice - Immobilize - Rest - Educate - Elevate Josh is breaking in a new pair of soccer cleats and is developing a "hot spot" on his heel. What can you do to help Josh manage the hot spot. Check all that apply. - See if you can fix the cause of the blister - apply skin lube over the hot spot - recommend he change into cotton socks - Add a hood onto the inside of the cleats where the hot spot is beginning - put a donut and hood over the hot spot You are grocery shopping and hear someone crying out in pain in the cereal isle. You rush over to help and see Mackenzie covered in cereal boxes clutching her ankle (she had to stand on the shelf to get the Count Chocula cereal and the shelf fell). You know this isn't an emergency so you begin your on field assessment. What questions should you ask Mackenzie to determine some indices of suspicion. Select all that apply. - Active Range of Motion - Special tests - Deformities - Mechanism of Injury - Onset of Pain - Chief Complaint - Severity of Pain Carsen was playing pickleball and fell against the post causing a laceration on his thigh. He wants to know if you think he needs stiches. Which of the following would be an indication that he needs stitches? Select all that apply. - The wound is longer than.5 inch or 1.3 cms. - You are unable to approximate the wound when you apply steri strips - The wound is over a large muscular area (e.g. thigh muscle) - wound is over a highly mobile area (e.g. elbow). - You can see yellowish, fatty tissue Summer hurt her ankle playing squash. She heard a pop when she was backpeddling to go to the back of the court. You are called out onto the court to assess her injury and you proceed with a HOPS assessment. As part of your specials, you elect to do a Thompson test. Summer asks you what a positive Thompson test mean. What should be your response to her athlete? i.e. which of the following structures does the Thompson test assess? - damage to the Anterior Talofibular ligament - injury to the syndesmosis of the leg - fracture of the tibia - integrity of the Achilles tendon Kristen cut herself while making dinner and is bleeding profusely. Shanyn (who is a dinner guest) tells you it is imperative that you apply ice to the wound to stop the bleeding immediately. True or False? - True - False You are covering a rugby game and Alex falls to the ground clutching his ankle. The coach of the team asks you to go attend to him. You are a good therapist and already have your gloves on, however, before stepping onto the field what should you do first? - Gather all your equipment that you will need to help your athlete  - Grab your blood towel in case there is blood to manage - Flag the coach to substitute another athlete - Ensure the scene is safe before you to enter onto the field Marissa has injured her knee during an on-ice collision playing broom ball. You've assessed her knee and have determined that she can't go back to play. You choose to fit her for crutches to minimize her weight bearing. Which of the following landmarks would you use to help fit her for crutches? Select all that apply - Position the tip of the crutch 2 inches (5 cms) in front of the great toe - Position the tip of the crutch 10 inches (25 cms) away from the lateral side of the foot. - Position the tip of the crutch 5 inches (13 cms) in front of the great toe - Position the axillary (underarm) pad 3 inch (8 cms) below the anterior fold of the axilla - Position the axillary (underarm) pad 1 inch (2.5) cms below the anterior fold of the axilla - Position the tip of the crutch 6 inches (15 cms) away from the lateral side of the foot. Madison comes to you wanting a bag of ice for her knee. You ask her if she has had ice on before, to which she answers "no". You want to educate her about ice application and tell her she will feel certain sensations with ice application. What are those sensations that they will feel and place them in the order that the sensation will be felt? Answer for blank # 1: Cold Answer for blank # 2: Burning Answer for blank # 3: Aching Answer for blank # 4: Numbness Joshua has hurt leg after getting off the Leviathan roller coaster, lost his balance balance, and landed awkwardly on his ankle. Thankfully you were waiting in line and rushed over to conduct a HOPS assessment. During your assessment, Joshua complains of pain along the distal 1/3 of the fibula (bone on the outside of the leg). You want to check for a fracture with your tuning fork. If the fracture test is positive, Cade would experience which of the following symptoms with the application of the tuning fork? - sharp, shooting pain to where the suspected fracture site is located - dull, achy pain on the fibula - tingling where her suspected fracture is located - burning pain along the fibula Luca fell out of his chair during a lecture, cut his arm and comes to see you to ask if he needs stitches. You know there are certain rules for whether you should refer to a health care provider for stitches. Which of the following would be an indication that you should refer Luca to the health care provider? Check all that apply. - if the cut is longer than.5 cms - if the athlete has not had a tetanus shot within the last 5 years - If the athlete has managed diabetes - If the athlete is prone to keloid scars - if it is on the face - if there is uncontrollable bleeding You begin your on field assessment of Madison's ankle. You know that you will need to do a HOPS assessment. Which of the following are components of the H portion of the HOPS assessment? Select all that apply.  - Severity of Pain - Onset of Pain - Chief Complaint - Mechanism of Injury - Special tests - Deformities - Active Range of Motion Katie was dancing to a tik tok video and fell hurting her wrist. You are there and begin an on field assessment. You ask Katie some pain related questions, and she describes the pain as bright and burning and radiating down his hand. From the following list, which of the following structures may be effected? - Vascular - Muscle - Nerve - bone Carsen, recently got a small tattoo on his torso. His tattoo artist indicated that he should cover it because it is a "wound" but didn't provide him any additional information. He asks you what would you recommend to cover it to facilitate healing. What is your response to him? - occlusive dressing as in Tegaderm - Non-occlusive dressing as such as a band-aid - Non-occlusive dressing as in a non-adherent pad secured with ultralight - Non-occlusive dressing as in non-sterile guaze secured with ultralight tape Anna has just come back from her shift at the IHOP and immediately goes to her basketball game. It is now the 3rd quarter and she has been playing most of the game. She is really tired and jumps for a rebound, landing awkwardly and in obvious pain. You are summoned out onto the court whereby you begin your onfield assessment. Provide Anna with written home program that uses an acute care management plan. Feel free to add additional information if you feel it is pertinent. - Uses PIER - Pressure, Ice, Elevate, Rest - Give them crutches - Refer to a Medical Doctor Kelsey has sustained a laceration to his forearm during an axe throwing event. You want to stop the bleeding so you can properly assess it. Other than apply direct pressure, what else can you instruct your athlete to do? - only time will stop the bleeding - elevate his forearm above his heart - keep the forearm level with the heart - place the forearm lower than his heart Eric has a blister on his finger from typing so many applications to get into the AT program and asks that you break it. You do break it believing that you, as a 2nd year student AT, can pierce the skin to break a blister for their athlete. Is this True or false. Abdel is taking part in a mountain biking race and fell off his bike sustaining some road rash. You happen to be at an aid station and are called to attend him. You want to clean out his wound because it is filled with debris. Which of the following are appropriate to clean the abrasion out? Select all that apply. - tap water  - hydrogen peroxide - Betadine - normal saline - soap and water Ethan has cut his hand while trying out for the Real Canadian Cooking show. You are the AT at the event and are asked to look at his hand. He is quite upset in thinking that his chances to win are over and asks you if you think he needs stitches. Which of the following would indicate that he may need stitches? Select all that apply. - You can see yellowish, fatty tissue - wound is over a highly mobile area (e.g. elbow). - You are unable to approximate the wound when you apply steri strips - The wound is longer than.5 inch or 1.3 cms. - The wound is over a large muscular area (e.g. thigh muscle) When deciding whether to return Rebekah, the soccer star, back to the game, there are certain "rules of thumb" that apply. Which of the following are these rules? Select all that apply. - Must have at least 80% strength or 4+/5. - Athlete is willing to play - Athlete needs full ROM of the injured joint. - Athlete must be able to stand on one leg for greater than 30 seconds. - Athlete must always be taped prior to RTP. You are covering a soccer tournament and Bayly is carried over to your tent. The coach thinks they have a 3rd degree quad strain. Which of the following would be some signs and symptoms that would indicate that Bayly has a 3rd degree quadriceps strain? - The athlete has significant swelling and a hematoma has developed. They are unable to extend their knee and the pain initially was intense, but is now absent with movement. There is a significant divot or depression in the muscle. - You would note some swelling, a hematoma that is palpable and the muscle contraction is extremely painful and weak. They also are unable to fully flex their knee (bring their foot to their butt) due to the pain (decreased range of motion (ROM)). - The athlete has some tenderness and pain when they flex (or bend) the knee, but they have full range of motion (ROM). - The athlete has some pain with moving the knee. The knee extension strength is full or graded at 5/5 or 100% compared to the uninjured leg. In your assessment, when you preform resisted ROM (RROM), it tests contractile tissue. - True - False Rachel was playing squash and heard a snap. She is no longer able to push off of her foot to walk. You feel she may have an Achilles Tendon Rupture. Which of the following tests will confirm the presence of a rupture? - Thompson - Anterior Drawer - Kleiger - Hallux Valgus Marissa recently had adhesive spray applied to her arm prior to being taped. She comes to you after warmup indicating that her arm itches. When you remove the tape you note the following and take a picture. What can you do next time she gets taped? - use a hypoallergenic spray instead of regular spray adherent - do nothing; she will eventually get used to it - refuse to tape her - use pro wrap under the zinc tape Ruby was bowling with Robert. Robert (who has never bowled before), got his finger caught in the ball subsequently flinging the ball toward Ruby, hitting her in the quadriceps muscle (the thigh muscle). You eagerly jumped in to assess Ruby. From your assessment, you've determined that she has a quadriceps contusion. She is in pain and you elect to put ice on her. She wants to know when to remove the ice from her quadriceps. What is your response to her? - when she experiences numbness - after 15 minutes of ice application - when she experiences achiness - after 20 minutes of ice appication In your assessment, when you perform passive range of motion (PROM) to the athlete's injured joint, you are actually testing contractile tissue. True or false. Quiz 3 Summer was multitasking. She was cleaning her apartment, dancing to Abba, cooking dinner and practicing taping ankles on Marissa. Unfortunately, she tripped over the laundry that still had to be folded and fell, injuring her knee. Thankfully you were there and you sped into action beginning with your history to develop some indices of suspicion (IOS). Based upon your history, observations and palpations, one of your IOS is an MCL sprain. Which of the following special tests will help you isolate the MCL? - Varus stress - Valgus stress - Anterior Drawer - Posterior Drawer You and Josh were invited to participate in a podcast with Dr. Andrew Huberman. However, when Josh went to sit in his chair, he tripped over the statue of Costello, the sleeping dog, injuring his knee. Based on Josh's history, observations and palpations, you feel he may have torn his ACL. Which of the following tests) would have the highest clinical relevance to help you confirm whether he has torn his ACL? Select all that apply. - Anterior Drawer - Valgus stress - Posterior drawer - Varus stress - McMurrys test - Lachman Graham was in a musical, "Singing in the Rain". He was tap dancing with his umbrella when he slipped on the water forcing his tibiofemoral joint into a valgus alignment. You rush out on the stage and believe he may have subluxed his patella based on the history. You choose to do an apprehension test. Which of the following signs/symptoms would indicate a positive test. Select all that apply. - Locking - fear on the patients face - swelling - pain Eric hurt himself on the judo mat. You go out to assess him on the mat. Is the following statement true or false with regards to the purpose of the on-field assessment? The purpose of an on-field assessment is to determine if an athlete can RTP. - True - False Hayden was running a trail race and saw a bear. The bear came out of nowhere, forcing Hayden to plant his right foot and cut to the left. He felt a "pop" in his knee and now it feels very unstable. He was able to hobble over to the med tent to see you and he is now reporting achy pain in the joint and on the medial aspect of the tibiofemoral joint (he saw the bear 15 minutes ago). He indicates it is painful to move and rates the severity at 7/10. He denies any radiating pain, but it is constant. It is now starting to swell and it feels warm to touch. Which of the following would be appropriate indices of suspicion based upon the MOI and his description of the injury? - Hamstring strain and ACL sprain - Hamstring strain and LCL sprain - MCL and LCL sprain - ACL and MCL sprain Ethan comes to see you on the sidelines. He is reporting pain in the "knee" with associated locking and giving away. He cannot remember a specific MOI, but he has been having this discomfort for a while especially when he plays soccer. Which of the following would be appropriate indices of suspicion. Select all that apply. - MCL sprain - meniscal tear - quadriceps muscle strain - LCL sprain - fat pad contusion You are covering a soccer game and are summoned onto the pitch where you see Abdel clutching his knee in pain. You rule out an emergency situation and begin your history. You remember needing to ask about pain related questions and think of the alphabet song. You come to the letters O and P and remember what they stand for with regards to pain related questions. What do those letters stand for with regards to pain related questions? Select the most appropriate responses. - Pain - Onset - Occurrence - Occasional - Provokes - Priority You want to assess for intracapsular swelling in the tibiofemoral joint. You elect to use a wipe test. What sign would you see to indicate intracapsular swelling? - a "wave" of fluid on the medial aspect of the tibiofemoral joint - you would see a "goose" egg on the anterior surface of the patella - visual inspection only - palpation would confirm a "jelly" like feel When conducting an on-field assessment, you MUST do bilateral joint range of motion. - True - False Hannah was in a wrestling match and was thrown by an opponent, landing awkwardly. When you reach her, you observe that the patella is dislocated and she is in a lot of pain. The fracture tests prove negative, however, she has an obviously dislocated patella. What should be your next course of action? - ask her to flex/extend her knee - utilize RICE - perform special tests to rule out damage to the surrounding ligaments - utilize PIER Rachel was in a car accident and Kelsey was driving. Unfortunately, Kelsey rear ended a vehicle in front of her. Even more unfortunate, Rachel was not wearing a seat belt and was "shoved" forward causing her tibial tubercle to hit the dashboard. You reach the scene and assist. Which of the following would be appropriate IOS based upon her MOl? Select all that - PCL sprain - contusion - LCL sprain - Fracture - MCL sprain - ACL sprain Bayly was jumping off the plinth and landed awkwardly forcing her knee into a varus alignment. She felt immediate pain on the lateral aspect that is provoked with knee flexion and extension. She is tender on palpation at the lateral femoral epicondyle and fibular head. She has decreased ROM of knee flexion and extension with strength at ⅘. Based upon this information, which special test would be the most appropriate for you to perform “on the field”? - Varus - Valgus - Anterior drawer - Resisted knee flexion Quiz 4 Carson is a 14 year old soccer player. He was running down with the ball and was about to do a long kick across the field to Abdel. However, before he delivered his kick, he fell to the ground clutching his right hip. The following are from his history. O=10 seconds ago P=any movement Q=sharp R=yes 5=7/10 T=constant What would be appropriate IOS based on his Hx? Select all that apply. - Bursitis - Subluxation - Contusion - Tendinopathy - Avulsion Fracture Katie plays basketball. She comes to see you reporting a snapping sensation in her groin that she hears and feels she does side to side shuffles or runs forward and backwards. There is sometimes pain in the groin, but mostly an "annoying snapping sound". She denies any MOl and indicated that this began about 3 weeks ago and is increasing with slight dull pain in the groin area. What are some probably IOS? Select all that apply. - Iliopsoas bursitis - Rectus femoris tendinitis - Legg-Calve-Perthes Disease - Greater trochanteric bursitis - Iliopsoas tendinitis - Osteitis Pubis Graham the goon was stepping out of the penalty box after serving his 16th penalty minute in his 30 minute game. As he stepped out, the ref collided with him (it looks like Graham gave him a hip check...however, it wasn't caught on video). The ref falls to the ground, curled in a fetal position. You approach the ref and ask where his pain is located to which he responds to his hip/waist. His history reveals the following: CC: hip/waist MOl: direct hit by Graham to the hip/waist 0: 30 seconds ago P: breathing, lateral movement of the trunk, hip extension/abduction Q: sharp R: no S: 4/10 T: only with movement Which of the following would be an appropriate IOS? - iliac crest fracture - hip pointer - kidney contusion - gluteal muscle strain Ben was playing soccer and gradually began feeling pain in his groin that was aggravated with sit ups. The pain began a few months ago and is progressively getting worse particularly with kicking the soccer ball, running and abdominal strengthening exercises. Your history reveals the following: CC: groin MOl: Unknown 0: 2 months ago P: running, kicking the soccer ball, ab strengthening Q: sharp R: no S: 6/10 that is increasing T: only with movement Which of the following would be an appropriate IOS? Select all that apply. - avulsion fracture - osteitis pubis - quadriceps strain - stress fracture - hip pointer Shanyn was in line at Tim Horton's waiting for her sandwich. Aida, the server, laid a sandwich on the counter to which Shanyn helped herself to. Unfortunately, the sandwich actually belonged to someone else who wasn't pleased that she was eating it. A brawl broke out and Shanyn was unfortunately hit in the quadriceps by a passerby causing her to fall to the ground in pain. You assess her and determine she has a quad contusion. You encourage her to go to the AT clinic to be assessed. Shanyn hobbles to the AT clinic and Scott assesses her and determines that she indeed has a quad contusion and asks you to provide her with a home program. Which of the following should you include in your home program? ice and compress the quad with the leg fully extended fit her for crutches instruct her to massage the area weight bear as much as tolerable Luca is competing in the Cheese run in Britain. You are a little concerned because he has sustained 4 quad contusions previously while training for this (he has rolled down a hill practicing). You are concerned he might develop myositis ossificans and recommend a management technique before he competes in Britain Which of the following would you recommend for him? Select all that apply. Video for demonstration of the cheese run https://www.youtube.com/watch?v=cvuktushEhY&t=10s - compression pad - Hood - hip spica - Donut - stretching his quads pre-run A normal end feel for hip flexion is which of the following? - tissue approximation - empty end feel - bony end feel - boggy/mushy end feel Hillary was playing tag, tripped over a tree root causing her to land on her buttock with her hip flexed to 90 degrees. Thankfully she was coming to visit you later on today. When she arrives (she walked in with a slight limp), you do an assessment on her hip. Her history reveals: 0: 2 hours ago P: sitting on hard surfaces Q: achy pain over the ischial tuberosity R: no S: 3/10 T: Constant No audibles/odd sensations or significant PMH. Based on her history, which of the following would be an appropriate IOS. Hint...think anatomy! ischialgluteal (ischialtuberosity) bursitis strain to the gluteus maximus muscle iliofemoral dislocation sprain to the sacrotuberous ligament Levi and Eric were on their scooters in the skateboard park. Levi went up for a jump, landing directly on his quadriceps. He and Eric thought nothing of it and went to have an ice cream at the local DQ. Hours later Levi comes to see you with progressively increasing pain in his quad that increases when he stretches into knee flexion and finds that his knee extension is really weak. The following is what you uncover in your history. CC: anterior thigh MOl: landing a jump from his scooter and landing directly on an obstacle 0: 2 hours ago P: stretching his quadriceps into knee flexion Q: very achy and dull S: 9/10 R: No T: constant Which of the following would be an appropriate IOS? - Iliofemoral ligament sprain Myositis ossificans hip pointer compartment syndrome Joaquin has sustained a quad contusion. You've assessed it and want to manage it appropriately. You elect to use PIER while he is watching the soccer game. How would you position Joaquin's hip and knee to apply PIER? Select all that apply. - knee flexed to a tolerable position - hip extended to a tolerable position knee extended to a tolerable position - Athlete in a hook lie position - hip flexed to a tolerable position Deleshia is training for modern dance performance and asks you to look at her hip. She reports a painful snapping that occurs on the outside of the hip. There is no MOl and she feels this began approximately a month ago. She indicates that it is painful to lie on her hip at night. She also finds that pain and snapping is provoked when she moves from a flexed to an extended hip position. The pain is dull and achy and occurs only with movement. What would be an appropriate IOS? Select all that apply. - Ischialgluteal bursitis - Adductor strain - Great trochanteric bursitis - External Snapping hip - TFL strain Krissie was dancing and abducted her hip (see picture). She felt pain in her groin causing her to fall to the stage. You conduct your assessment on the stage and feel she has a strain to one of her groin muscles. As you palpate in the inguinal triangle beginning laterally and moving medially, you remember the acronym NAVEL to help you orientate to your palpation. What does NAVEL represent? - Nerve, artery, vein, empty space, lymph - Nerve, adductor muscle, vein, vastus lateralis, empty space, lymph - Neuroma, adductor muscle, vastus lateralis, external hip rotators, lateral boarder - Neuroma, artery, vastus lateralis, external hip rotators, lateral boarder Quiz 5 Bobby was playing soccer and was accidently kicked on the outside of his "knee". He falls to the ground and you run out to assess him. During your history he reveals to you that he still feels tingling down the outside of his leg, but is gradually decreasing. The tingling occurred as soon as he was kicked. There is no provocation of the tingling and he feels he has full strength of his leg. Which of the following would be an appropriate IOS based off of his history? Select all that apply. - Fracture - nerve contusion - LCL sprain - Lateral quadriceps contusion Brenda and Gerdy were celebrating their 50th anniversary when an innocent bug crossed the floor. Brenda screamed out in fright! Gerdy, being the dutiful wife ran over and stomped on the innocent bug killing it. Unfortunately, karma ensued and Gerdy ended up hyperextending her knee in the process. Keith, who in his previous life was an AT, indicated that Gerdy should see the AT because that is a possible MOl for a PCL tear. Is this true or false Kamille is doing a sideline assessment on Payton. Which of the following would be included in a sideline assessment, but NOT an on-field assessment? Select all that apply. - Palpating the suspected injury - sport-specific functional testing - Looking for deformities - Passive ROM Krissie's dog ran by tripping Ruby causing her to roll her ankle. You spring into action to do an on-field assessment. Ruby tells you that there is mild to moderate pain, and localized joint stiffness and you can see slight swelling, however, there is no instability, lack of AROM, or weakness. What would you grade this sprain as? - grade 1 - grade 2 - grade 3 - unable to tell from the information provided Summer wants her ankle taped for an inversion sprain. She tells you that the stirrups involve directing the tape from medial to lateral. Is this true or false? Kelsey was playing ultimate and fell awkwardly. She is reporting pain in the mid foot zone and at the head of the 5th metatarsal. As well, she has an inability weight bear. You perform a tuning fork and percussion test and find these to be positive. What should be your course of action for Kelsey? Select all that apply. - Do nothing now, but advise she make an appointment with her physician tomorrow - tape her with an ankle support (closed Gibney) so she can return to play - refer to ER - splint using the R.I.C.E. principle - Utilize P.I.E.R. Amelia has just sprained the MCL of her knee and wants your advice on how to manage it acutely. What do you recommend? - Rest, immobilize, cold, elevate - Rest, ice, compress, immobilize - Pressure, ice, elevation, rest - Pressure, immobilize, cold, rest TQ is evaluating your Kleiger test and his daughter comes in and pronounces, "I know this test, it will evaluate an anterior talofibular ligament (ATFL) sprain." Is this statement true or false? Josh is breaking in a new pair of soccer cleats and is developing a "hot spot" on his heel. What can you do to help Josh manage the hot spot. Check all that apply. - Add a hood onto the inside of the cleats where the hot spot is beginning - See if you can fix the cause of the blister - put a donut and hood over the hot spot recommend - he change into cotton socks - apply skin lube over the hot spot Bernard and his twin brother Gerard were training to run the Boston Marathon. Bernard started experiencing pain on the lateral aspect of his tibiofemoral joint and continued to get worse. Gerard chastised Bernard for his training regime due to the fact that it could contribute to this lateral knee pain, specifically ITB syndrome. Which of the following could contribute to ITB syndrome? - running on a banked surface - supinated foot - concentric knee extension training - having a Trendelenburg gait - too much training too soon - weakness of gluteus medius You are assessing Keysha's knee for patellar subluxation and you choose to do an apprehension test. What constitutes a positive test? look of fear on their face you feel resistance to movement you note their is swelling they indicate pain Graham was in a musical, "Singing in the Rain". He was tap dancing with his umbrella when he slipped on the water forcing his tibiofemoral joint into a valgus alignment. You rush out on the stage and to help him. His history reveals sharp pain over the medial joint line that only hurts with tibial external rotation. You don't observe anything significant, but he does have tenderness with palpation over the medial joint line. What special tests) would be appropriate? Select all that apply. - Valgus - Varus - anterior drawer - posterior drawer Eric hurt his ankle. You refer him to the ER and they decide to image his ankle. Upon his return to you, he is casted and on crutches. You ask him what is wrong to which he responds that he has a "bimalleolar fracture caused by forced eversion"? How would you document this fracture in your SOAP notes? i.e., what is another name for this type of fracture? Lefranc fracture Pott's fracture March fracture  Metatarsal stress fracture Hillary was playing tag, tripped over a tree root causing her to land on her buttock with her hip flexed to 90 degrees. Thankfully she was coming to visit you later on today. When she arrives (she walked in with a slight limp), and you do an assessment on her hip. Her history reveals: 0: 2 hours ago P: sitting on hard surfaces Q: achy pain over the ischial tuberosity R: no S: 3/10 T: Constant No audibles/odd sensations or significant PMH. Based on her history, which of the following would be an appropriate IOS. Hint...think anatomy! - strain to the gluteus maximus muscle - iliofemoral dislocation sprain to the sacrotuberous ligament ischialgluteal (ischialtuberosity) bursitis You are assessing Joaquin's hip on the field. You want to ask questions to gather information in your history to establish your IOS. Which of the following questions are relevant to ask him while on the field? Check all that apply. - Can you move your hip for me? - Any significant past medical history? - What provokes the pain? - What happened? - How would you rate the severity of your pain? - Does it hurt when I move your uninjured hip?