Download The Musculoskeletal System: Structure, Function, and Injuries and more Exams Nursing in PDF only on Docsity! 1 BOC Prep and NATA-BOC Exam Secrets Study Guide Questions and Answers 2024 When did was the NATA formed? - 1950 What are the 5 steps in Evidence Based Practice? - 1. develop a clinical question2. Search the literature3. Appraise the evidence4. apply the evidence5. assess the outcome What is a PICO question? - Patient Intervention Comparison Outcome What are the 5 BOC Domains? - 1. Injury prevention2. Examination, assessment and diagnosis3. immediate and emergency care4. therapeutic interventions5. health care administration What are the personal qualities of an Athletic Trainer? - Stamina and ability to adapt,empathy, sense of humor, communications, intellectual curiosity, ethical practice,professional membership. BOC Domain: 1. Injury and illness prevention and wellness promotion: - promotinghealth lifestyles behaviors with effective educational and communication to enhancewell ess and minimize the risk of injury. BOC Domain: 2. Examination, assessment and diagnosis - implementing system,evid nc - based examinations and assessments to formulate valid clinical diagnosisand determine patients plan of care. BOC Domain: 3. Immediate and emergency care - integrity best practice in immediateand mergency care for optimal outcomes. BOC Domain: 4. Therapeutic Interventions - rehab an reconditioning injuries, illness,and general medical conditions with the goal of achieving optimal activity level based oncor concepts using the applications of therapeutic exercise, modality devices, andmanual techniques. BOC Domain: 5. Healthcare administration and professional responsibility - integratingbest practice in policy construction and implementation, documentation, basic businesspractice to promote optimal patient care and employee well-being. Licensure - limits AT to those who have met minimal requirements established by stateboard . 2 State certification - restricts the performance of AT functions to only those certified Registration - paid fee for being placed on an existing list of practitioners exemption - state realizes that AT perform functions similar to those of other licensedprofession al Vision statement - a concise statement that describes the ideal statement to which anorgan zation aspires mission statement - a written expression of an organizations philosophy, purpose, andcharacteristi cs WOTS UP analysis - a data collection and appraised technique designed to determinean o ga ization's ( weakness, opportunities, threats, and strengths underlying planning) Opperational planning - defines organizational activités in the short term, usually nolonger than 2 years policies - express an organization intended behavior relative to a specific programubdu tio n processes - a collection of steps designed to direct the most important task of anorganiz tio n procedure - provides specific directions for members of an organization to follow practice - the action that takes place in response to administrative problems (i.e.cedures that state that machines should be calibrated once a year) PERT (Program Evaluation and Review Techniques) - a method of graphically depictingthe time line for and interrelationship of different stages of a program. Gannt Chart - a graphic planning and controlled technique that maps discrete tasks on ac lenda r OSHA - Occupational Safety and Health Administration Budget: spending-ceiling model - requireds justification only for those expenses thatc ed those of the previous budget cycle (aka incremental model) often rests in fallingbehind due to prices of supplies rising faster than inflation Budget: Spending-reduction model - financial crisis model: requires reallocation ofinstitutional funds, resulting in reduced spending levels of some programs. shouldidentify areas that could be cut without serious impact. 5 Documentation: Computerized documentation - difficult to maintain confidential ( harder to safeguard digitally stored data) Documentation: Narrative charting - method of recording the details of a patients assessment and treatments using a detailed, prose- based format. what are the role of the skeletal system? - 1. support the body weight2. transfer body weight3. body movement4. muscle and ligament attachment5. organ protection6. bone marrow storage7. min ral storage diaphysis (shaft) - 1. cylinder2. wall (cortex) is composed f cortical (compact) bone tissue3. Inner s rface is lined with cancellous (spongy or trabecular) bone4. contains medullary (marrow) cavity epiphyseal (growth) plates - 1. cartilaginous2. separate epiphysis and diaphysis early in life3. both ends of the bone grow from this plate4. replaced by bone (closed) as skeleton matures.5. some do not close completely until age of 25 epiphyses - 1. proximal and distal ends f a long bone 2. compo ed primarily of cancellous (spongy or trabecular) one that is surround d by alayer of cortical bone.3. wider surface area increases joint stability4. art cular (hyaline) cartilage covers the articular surface of the epiphysis Articular (hyaline) cartilage - 1. covers articular surface of bones2. prot cts from joint "wear and tear"3. provides shock absorption4. p or blood supply periosteum - 1. fibrous membrane that surrounds the diaphysis2. attachement site for tendons and ligaments3. contains bone forming/ repairing cells and blood vessels endosteum - 1. fibers membrane that lines the walls the medullary (marrow) cavity 2. contains bone forming/ rearing cells Medullary (marrow) cavity - 1.tube like space located within the diaphysis2. contains bone marrow 6 osteoblast - builds bone osteoclasts - breakdown or reabsorbs bone tissue osteocytes - located within the lacunae (small cavities within a bone) fibrocartilage - 1.it has greater amount of collagen fibers2. examples- interpubic disc and meniscus central nervous system (CNS) - brain and spinal cord Peripheral nervous system (PNS) - all nerves outside the CNS somatic nervous system - - voluntary- effector- skeletal muscle- motor nerve travels from spinal cord skeletal muscle autonomic nervous system - - involuntary- effector- glands, cardiac, muscle and smooth muscle- subdivisions:* sympathetic nervous system* parasympathetic nervous system Neuron Structure: dendrites - - tree like appearance- impulse to cell body- receptor receive stimuli Neuron Structure: axon - - impulse away form cell body- single fiber with end branch Neuron Structure: myelin sheath - - insulation around some nerves- produced by Schwann cells in the PNS- fatty material- sp eds up conduction of action potential Neuron Structure: neurilemma - - outer membran Schwann cells- not found in CNS cells Types of neurons: afferent (sensory) neurons - towards CNS Types of neurons: efferent (motor) neurons - aways form CNS liability - is being legally responsible for the harm one causes another person. negligence - is the failure to use ordinary or reasonable care. 7 malpractice - liability- generating conduct associated with the adverse outcome of patient treatment. standard of reasonable care - assumes that an individual is neither exceptionally skillfulnor extraordinar y skillful nor extraordinarily cautious, but is a person of reasonable andordinary prudence. torts - a legal wrong, other than breach of contract, for which a remedy will be provided, usually in the form of monetary damages. Type of Torts: nonfeasance act of omission - when an individual fails to perform a legal duty Type of Torts: malfeasance act of commission - when an individual commits an act that is not legally his to perform misfeasance - when an individual improperly does something they have legal right to do sovereign immunity - states that neither the government nor any individual that is employed by the government can be held liable for negligence Good Samaritan law - provides limited protection against legal liability to any person who voluntarily chooses to provide first aid A plaintive must prove the following 5 components to prove an act of negligence: - 1. condu ct2. existence of duty3. breach of duty4. causation5. damage how many years does a plaintiff have to file for negligence under the statutes oflimitations? - 1-3 years, (some states allow an injured person file a suit up to 3 yearsafter the minor turns 18 ) statute of limitations - set aa specific length of time that individuals may sue for damages form negligence comparative negligence - the degree to which a plaintiff contributed to the harm caused by a defendant. Example: failing to follow instructions, failing to perform rehabilitation. Courts determine the degree (%) to which the AT and plaintiff contributed to the harm. 10 services are coordinated by a primary care physician, who acts as a gatekeeper to specialty services. Preferred provider organization (PPO) - type of insurance plan that provides financialincentives to encourage policyholders to use medical vendors approved by thecompan y Point-of-service plan (POS) - similar to PPOs, except that primary care physicians are assigned to patients to coordinate their care medicare - government sponsored program for elderly people medicaid - government sponsored for the needy CHAMPUS - government sponsored for members of the armed forces and their dependents Fraud - criminal misrepresentation for the purpose of financial gain ICD-9-CM (international classification of diseases) - coding systems applied to illness,injures, and other medical conditions to standardize the language associated with thirdparty reimbursement CPT ( current procedural terminology) - coding systems applied to specific medicalpro edures to standardize the language associated with third party reimbursement CMS 1500 - form that private-practice clinics should use when filing a claim; originally developed for medicare UB-92/CMS 1450 - insurance claim form that hospitals should use Electronic data interchange (EDI) - system whereby insurance claims can be submitted electronically; also known as paperless claims system what is a normal pulse ? - 80-100 bpm what is a normal respiration rate? - 12- 20 bpm what is normal blood pressure? - 120/80 mm Hg what is considered high blood pressure? - 140/90 what is normal body temperature? - 98.6 degrees if a patient presents with rapid and weak pulse this may indicate ? - shock, bleeding , or heat exhaustion 11 if a patient presents with a rapid and strong pulse this may indicate? - heatstorke or fear profession - a commitment to certain characteristics that set professionals apart fromnonprofessional groups code of ethics - a systemized set of standards or principles that define ethical behaviorappropriate for profession; moral values determine the standard or principles ethical design making: ethical egoism - make decisions that result in greater benefit toyours lf ethical design making:utilitarianism - choosing a course of action that benefits thegreatest number of people ethical design making:formalism - most likely to followed by ATs who see a clearprofessional duty that they believe should be implemented universally exercise is an essential factor in fitness for? - conditioning, injury prevention and injuryrehabilitati on what should an athlete engage in to minimize injury and maximize performance? -conditioni ng what does the term therapeutic exercise indicate? - excersises that are used inrehabilitation program what are the ten principles of conditioning? - 1. safety2. warm up/ cooldown3. motivation4. overload5. consistency6. progression7. intensity8. specificity9. individuality10. minimal stress The SAID Principle - Specific Adaptation to Imposed Demands- when the body issubject to stress and overloads of varying intensities, it will gradually adapt over time toco t whatever demands are in place What is the function of a Warm Up? - to prepare the body physiologically for upcomingphysical work by gradually stimulating the cardiorespiratory system to a moderatedegree to increase blood flow to muscles and increase muscle temperature 12 Increase in muscles temperature results in? - ^ elasticity (degree muscles can be stretched), ↓viscosity (rate which muscles can change shape) Total warm up should last about? (dynamic) - 5-20 mins * should not be started within the next 15 mins after Cool Down - is a period that enables the body to cool and return to a resting state ( should last 5-10 mins) Flexibility - the ability to move a joint or series of joints smoothly and easily throughout full range of motion Factors limiting flexibility: bony structures - usually bony prominences stop movements at normal endpoint (or OCD in elbow limits ROM) Factors limiting flexibility: fat - may act ad a wedge between two lever arms, restricting movement (i.e abdomen fat and trunk flexion) Factors limiting flexibility: skin - inelastic scar tissue may form at the site of a tearing incision or laceration , which does not stretch wellFactors limiting flexibility: muscles and their tendons (and fascial sheaths) - most oftenresponsible for limiting ROM; over time it is possible to increase the elasticity, or theleng h hat a given muscle can be stretched Factors limiting flexibility: neural tissue - morphological changes in neural tissue mayres lt from acute compression, chronic repetitive micro trauma, muscle imbalance jointdysfunction, or poor posture (causes irritation, inflammation) AROM/ dynamic flexibility - degree to which a joint can be moved by a muscle contraction (usually midrange) PROM/ static flexibility - degree to which a joint may be passively moved to the endpoints in the ROM agonist muscle - the muscle that contracts to produce the movement antagonist muscle - muscle being stretched in response to contraction of agonist dynamic and ballistic stretching - involves a bouncing movement in which repetitivecontractions of agonist muscle are used to produce quick stretches of the antagonistmuscl e static stretching - passively stretching a given antagonist muscle by placing it in am ximal position of stretch and holding it there for an extended period of time (30-60sec, 3-4 mins) 15 Sugars - should account for less than 15% of total caloric intake Sugars: monosaccharides - found in fruits, syrup, and honey ( ex- glucose) Sugars: disaccharides - milk sugar (lactose) and table sugar (sucrose) are combinationsof monosaccharides Starches: complex carbohydrates - made up of long chain of glucose units (rise,Potatoe , bread) fiber - forms the structural parts of plants and is not digested by humans Fiber: soluble - includes gums and pectins( oatmeal , legumes, some fruit) Fiber: insoluble - primarily cellulose (whole grain breads, bran cereals) what is the recommended dietary amount of fiber? - 25 g/day* aver ge intake is 10-15 g/day fats - most concentrated source of energy; some dietary fat is. needed to make foodor flavorful and for fat- soluble vitamins. what is the recommended dietary amount of fats? - less than 30% of total caloriesshould be from fat ( less than 10% should be saturated fat) unsaturated fatty acids - usually from plants and are liquid at room temperature(GOOD! ) Saturated fatty acids - are usually from animals (bad!) trans fatty acid - have physical properties resembling saturated fatty acids; increase riskof h rt d ease by boosting levels of bad cholesterol (Should be avoided) omega 3 fatty acids - reduce the likelihood of diseases ( heart disease, stroke,hypert n io n) proteins - are major structural components of the body ( intake should be 15-20% oftotal cal ric intake) amino acids - are basic units that make up proteins; most proteins are made up ofapprox 20 amino acids Vitamins: fat soluble - vitamine A,K,D,E ( found in fatty portions of foods and in oils;poss ble to consume excess amounts and show the effects of vitamin poisoning 16 Vitamins: water-soluble - vitamin C and B- complex vitamins what are benefits of vitamins c? - building bone, teeth, maintaining connective tissue,and strengthening the immune system. what are the benefits of vitamin Folate and B12 ? - they are important for normal bloodfl w With water soluble vitamins are used to regulate metabolism of CHO, proteins and fats?- thiamin, riboflavin , niacin, biotin, and pantothenic acid. Vitamins: Antioxidants - vitamin C, Vitamin E, and beta- carotene what are benefits of antioxidants? - may prevent premature aging, certain cancers,h art diseas s, and other health problems. Vitamin Excess: vitamin A - headache, nausea, loss of hair, dry skin, diarrhea Vitamin Excess: Vitamin D - appetite loss, weight loss, failure to grow Vitamin Excess: Vitamin E - nausea, and diarrhea, interferes with vitamin K absorption minerals - are stored in the body ( especially liver and bones) what is the mineral magnesium needed for? - energy-supplying reactions what are the minerals sodium and potassium important for? - the transmission of nerveimpulse s Water - most essential nutrient; accounts for 60% of bodyweight. what is water needed for? - for energy production, and normal digestion, temperaturecontrol, elimination of waste products how much water does an average adult require? - 2.5L/10 gasses of water per day hyperthermia - elevated body temperature metabolic heat production: - normal metabolic function causes production of radiation ofheat; level of increase in body heat depends on intensity of physical activity conductive heat exchange - physical contact with other objects can result in a heat gainor loss (i.e. a football player standing on turf will experience an increase in bodytemperatur e) 17 convective heat exchange - heat loss or gain depending on temperature of circulating medium (cool breeze versus circulating air being hotter than body temperature) radiant heat exchange - from sunshine (effects greater in sunlight than in shade); on acloudy day, the body emits radiant heat energy (thus radiation may result in decreasedbody temp) evaporative heat - water is transported to surface via sweat glands, where it evaporates,taking large quataties of heat with it ( body highly dependent in sweat if air temperature> body temperature) when is heat loss evaporation impaired? - when relative humidity reaches 65%, it is virtually impossible when the humidity reaches 75% dry bulb temperature (DBT) - records from standard mercury thermometer wet bulb temperature (WBT) - uses wet wick or piece of gauze wrapped around end of thermometer that is swung around in the air globe temperature - measures the sun's radiation and has black metal casing around the end of a thermometer heat rash - red, raised rash with sensation of prickling and tingling during sweating;usu lly occur when skin is continuously wet with unevaporated sweat; generallylocalized to areas covered by clothing; continually toweling body can help prevent rashfrom developing. heat syncope - associated with rapid physical fatigue during overexposure to heat.* caused by peripheral vasodilation of superficial vessels, hypotension, or a pooling ofbl d in extremities, which result in dizziness, fainting, and nausea how do you treat heat syncope? - cool the athlete and hydrate heat cramps - muscle spasm related to excessive loss of water and several electrolytes ( sodium, chloride, potassium, magnesium, and calcium) but especially sodium. who is most likely to suffer form her cramps? - fairly fit athlete who is not acclimated to the heat what is the immediate treatment for a heat cramp? - ingestion of large quantities of fluids, mild prolonged stretching with ice massage. exertional heat exhaustion - occurs from environmental heat stress and strenuous physical exercise with what rectal temperature is mild hyperthermia? - < 104 degrees F 20 Common Cold Injuries: Frost Nip - commonly occurs when there is a high wind, severe cold, or both; most often affects ears, nose, cheeks, chin, finger and toes. Common Cold Injuries: Frost Nip- TX - affected areas can be treated with earlysustained pressure of hand (without rubbing), by blowing hot breath on the spot, or byplacing fingers in armpits Common Cold Injuries: Frost Nip- S/S - Skin appears very firm with cold, painless areas that may peel, and blister in 24-72 hours. Common Cold Injuries: Frostbite- chilblains - result for prolonged and constant exposureto c ld for many hours. Skin redness, tingling, swelling, and pain in toes and fingers.Caused by problems of peripheral circulation. Common Cold Injuries: Superficial Frostbite - involves only the skin and subcutaneoustissue. Skin appears pale, hard, cold, and waxy; palpating will reveal a sense ofhard ess but with yielding of underlying deeper tissue structures.- when rewarming: the area will feel numb; the will sting and burn; may later produceblisters/pain Common Cold Injuries: Deep frostbite - deep tissue are also frozen; medical emergencyrequiring prompt hospitalization. Tissue is initially cold, hard, pale, or white and numb.- rapid rewarming ( hot drinks heating pads, or hot water bottles at 100-110F)(during the process, tissue will become blotchy red, swollen, and very painful (laterinjury may become gangrenous, causing a loss of tissue) Altitude Illness: Acute mountain sickness - 33% chance for individuals who go toaltitudes of 7,000-8,000 ft. Caused by tissue disruption in the brain that affects sodium/potas ium balance- can cause excess fluid retention within cells and subsequentoccurrence of abnormal pressure. Altitude Illness: Acute mountain sickness S/S - S/S- headaches, nausea, vomiting, sleep disturbance , and dyspnea (unpleasant breathing) for up to 3 days. Altitude Illness: Pulmonary Edema - at altitudes of 9000-10000 ft. lungs accumulate asmall amount of fluid w/I alveolar walls. Most individuals: fluids absorb in a few days (or some, continue to collect and forms pulmonary edema) Altitude Illness: Pulmonary Edema S/S - dyspnea (shortness of breath), cough, headache, weakness, sometimes unconsciousness. Altitude Illness: Pulmonary Edema TX - move to lower altitude ASAP and give oxygen (rapidly resolves) Altitude Illness: Sickle-cell trait reaction - 8-10% of AAs have sickle- cell trait- abnormality of structure of RBCs and Hb content. when abnormal Hb molecules 21 become deoxygenated as a result of high altitude, cells tend to clump (this processcau es an abnormal sickle shape to RBC, with can be destroyed easily) Can cause anenlarged spleen, which in some cases has ruptured at high altitudes. Flash to Bang: - count # of seconds from sighting of lightning to hearing the thunder,divide by 5.- flash to bang count 30: lightning 6 miles away (inherit danger)- count of 15: lightning is 3 miles away ( everyone should leave and seek shelter)* 30 mins must pass since last lightning strike before resuming play. cardiac dysrhythmia - jet lag In the cervical spine what is considered the atlas? - C1 In the cervical spine what is considered the Axis? - C2 what makes up the Atlantoaxial joint? - C1 and C2 what motions occur in the Atlantoaxial joint? - rotation what is a pivot joint? - a pivot joint is (uniaxial), a round process of bone that fits into a bony ligamentous socket allows rotation. (atlantoaxial joint) what is a ball and socket joint? - a ball and socket joint is ( multiaxial), rounded head and fits into a concavity, which permits movement on several axes (hip, shoulder) what is a condyloid joint? - bondyloid joints are (biaxial) permits flexion and extension, abduction and adduction, and circumduction ( metacarpalphalangel)what is s ddle joint? - in saddle joints (biaxial), saddle shaped heads hermit moc ment in two different planes ( the thumb- carpometacarpal joint, trapezium and thefirst metacarpal) what is a hinge joint? - hinge joints (uniaxial) petit flexion and extension only (elbow) whats is a plane joints? - plane joints ( usually uniaxial) permit gliding or sliding movements what is Klenbocks disease - vascular necrosis or osteocondritis of the lunate what is Epstein Barr Virus? - this is a member of the herpes group and causes infectious mononucleosis Unhappy/Terrible Triad - MOI: valgus force with foot planted in slight ER Damage: MCL , ACL, and medial meniscus 22 screw home mechanism - 5 degree of tibial external rotation that occurs during terminal knee extension Ribs 1-7 are classified as? - true ribs ribs 8-12 are classified as? - flash ribs ribs 10-11 are classified as? - false ribs how many ribs are there total? - 12 how many cervical vertebrae are there? - 7 (c1-c7) how many thoracic vertebrae are there? - 12 (T1-T12) how many lumbar vertebrae are there? - 5 (S1-S5) how many sacral vertebrae are there? - 5 (S1-S5) how many coccygeal vertebrae are there? - 4 (Co1-4) cryotherapy - use of cold (usually between 32 F and 70 F; 0C and 21 C examples of cryotherapy - ice massage, ice packs, ice slashes/ ice immersion, part go contrast therapy, cold whirlpool and vapocoolant spray thermotherapy - uses of superficial and deep heat (usually between 98.6F and 109.4 F; 37 C and 43C examples of thermotherapy - moist heat packs, warm. whirlpool, paraffin wax path, ultrasounds, pulsed shortwave diathermy and ultraviolet. hydrotherapy - application of water examples of hydrotherapy - whirlpool and aquatic therapy pools, and ice slush/ ice immersion electrotherapy - the use of electricity examples of elector therapy - EMS, iontophoresis, TENS, and diathermy light therapy - use of electromagnetic radiation mechanotherapy - use of motion, force or pressure examples of light therapy - laser, light therapy, infrared 25 smaller inner pouch is broken leaking fluid into the larger, outer pouch is broken, leaking its fluid into the larger, outer pouch. length of application if RICES on a finger - 20 mins length of application if RICES on a ankle or arm - 30 mins length of application if RICES on a thigh - 45 mins frequency of application of RICES - initial application: 5-10 mins right after the injury Second application: 30-60 mins later RICES - rest, ice, compression, elevation, stabilization proper crutch fitting - First: 2-3 inches between the axillae and the axillary pads.Second: adjust the hand piece to ~30 degrees and the wrist is in a comfortable weight-bearing position. the three pint giant is preferred. the phases of repair (4) - 1. Hemostasis and inflammation2. Epithelialization3. Proliferation4. Remodeling Phases of Repair: hemostasis and inflammation - this phase is the same ashe odynamic, leukocyte migration, and phagocytosis pages of the inflammationresponse. Hemostasis is the arrest or stoppage of bleeding. Phases of Repair: Epithelialization - the process of developing a membranous tissue covering (epithelium) over exposed tissue or organs is called epithelialization. closing laceration protocol - must be sutured or steer-stripped to close the wound gap,thus allowing healing by primary union. For best results, these procedures should bedone within 4- 6 hours after the wound occurs. Phases of Repair: Proliferation - consist of three major events: angiogenesis ( growth ofnew blood vessels), collagen synthesis (also known as collagenization), and woundcontraction (the drawing together off new wound edges) Stages of Proliferation - Angiogenesis: is a transiet phase during which lots of newblood vessels are formed (which later diaper)Collagen Synthesis: collagenization is the process of manufacturing and laying downcolla en in the wound space.Wound contracture: pulls the sides of the wound together in an attempt to close it. Phases of Repair: Remodeling - consist of twi processes the cause the scar to become smaller, more pale (in light-skinned people), and stronger: contraction and restructuring. 26 Phases of Repair: Phases of Remodeling - Contracture: is the first process, is thecollap ing of the capillary arcade.Restructuring: the second process,the collagen itself is restructured. This occursconcurrently with contraction. The collagen fibers are reorganized form the haphazardw y the were laid down to parallel arrangement. smog - produced by combination of carbon monoxide and sulphur dioxide (emanates from combustion of fossil fuel such as coal) sulfur dioxide (SO2) - colorless gas that is component of burning coal or petroleum,lungs to rid themselves of foreign matter, shortness of breath, coughing, fatigue, andincreased susceptibility to lung diseases. carbon monoxide poisoning (CO) - colorless, orderless gas; reduced Hb ability totransfer oxygen and restrict release of oxygen to the tissue; interferes with performancein exercise and also virus psychomotor, behavioral and attention- related activities Carcadian dysrhythmia (jet lag) - desychronization of the athletes biological andphysiological time clock. Refers to the physical and mental effects caused by travelingrapidly across several time zones. T/F: traveling north to south has no effects on the body? - True Minimizing the effects of jet lag: - 1. readjust by setting up and going to bed one hourlater for each time zone crossed.2. drink plenty of fluids to avoid dehydration3. traveling west: light meals early, heavy meals late; consume caffeine; exercise/ trainlat n day.4. traveling east: heavy meals earlier; avoid caffeine; exercise/ train earlier in day. Equipment reconditioning and recertification: - national operating committee on standards for athle cs equipment (NOCSAE) has estab ish d voluntary test standardst re uc head injuries by establishing minimum safety requirements for helmets andface masks.Followed by the NCAA and NFSHSA Equipment reconditioning and recertification: Condition of helmet determined by- - type of helmet, amount, and intensity of usage. Equipment reconditioning and recertification: Recommendations of NOCSAE -recommendations periodically reconditioning and rectifying used helmets (every 2 yearsif no warranty) football helmets - all helmets must have NOCSAE certification (not necessarily fail-safe, however- exterior warning label) 27 Football helmets warning - players must be read the warning label aloud but the equipment manager and athlete has to sign a form Fitting of a football helmet - 1. wet players hair to simulate playing conditionFitting Standard:1. helmet should fit sung: no gaps between pads and head/ face.2. cover base of skull; pads placed at back of neck should be snug, not uncomfortable.3. helmet should not come down over eyes front of eyes ( front edge 3/4 inch/ 2 inchfinger widt above eyebrows)4. a holes should match5. should not shift when annual pressure is applied; should not recoil on impact6. the chin strap should be an equal distance from the center of the helmet; straps mustkee helmet form moving up and down side to side.7. cheek pads should fit snugly against face8. face mask should. be attached securely to helmet; positioned 3 finger- width fromnose. Chinstraps - 2-snap, 4 snap, 6 snap 4- snap: preferred because it keeps helmet form timing forward and back Jaw pads - essential to keep helmet from racing laterally (fitting singly against cheeks) Ice Hockey Helmets - -they must withstand high-velocity impacts (hits by sticks orpucks) but also high-mass-low-velocity forces (produce by running into boards or fallingon ice)- needs to have a hard exterior shell and energy-absorbing liner Ice Hockey Helmets: stamp of approval - they must have a stamp of approval from the Canadian Standards Association (CSA) Baseball/ Softball helmet (batting) - -ear flap can provide additional protection -each batter on deck must have a helmet with a NOCSAE stamp Cycling helmets - designed to protect the head during one single impact (football, hockey, and baseball helmet are more durable) - many states require cycling helmets, especially by adolescents. Face Guards: Football - -↓ face injury (lacerations, nose fx, eye injuries, etc)-Atleast 2 bars; bar attachments should be flush with helmet; 3- inch space b/w top offace guard and lower edge of helmet; more than drilling on each side (drilling by factory-authorized reconditioned) 30 Cohesive Elastic Bandage: - exerts constant, even pressure (2 layers of nonwovenrayon, s parated by strands of spandex material)- coated with a substance that makesbandage adhere to itself ( nothing needed to hold in place) ankle of foot spica bandage size? - 2 inch - 3 inch spiral spica bandage size? - 3 inch - 4 inch groin support spica bandage size? - 6 inch shoulder spica bandage size? - 4 inch- 5 inch what is an elbow figure 8 bandage spica? - used to secure a dressing in cubital fossa or prevent full extension; 3 inch wrap; athlete flexes elbow b/w 45-90 ° of flexion. Tissue properties: Load - the outside force or forces acting on tissue Tissue properties: stress - the internal reaction or resistance to an external load Tissue properties: strain - extent of deformation of tissue under loading Tissue properties: viscoelastic - both viscous and elastic properties, allowing for deformation Tissue properties: yield point - elastic limit of tissue Tissue properties: mechanical failure - elastic tissue is exceeded, causing tissue to break. Tissue Stress: Tension - force which pulls or stretch tissue ( muscle strain and ligaments) Tissue Stress: Stretching - beyond yield point leads ti ruoture of soft tissue or fx ( sprains, strains, avulsion fx) Tissue Stress: compression - with enough energy, crushes tissue (force can no longer be absorbed) ex: contusion Tissue Stress: Shearing - force that moves across the parallel organization of tissue ( blisters, abrasion, vertebral disk injury) Tissue Stress: bending - force on a horizontal beam/bone that places stress within structures causing it to bend or strain inert ( non-contractile) - skin, joint capsule, ligaments, facia, cartilage, dura mater, and nerve roots 31 contractile - structures of muscle, tendon, or bony insertion contusion - occurs from sudden traumatic blow to body strain - stretch, tear, or rip in muscle, fascia, or tendon Grades of Strains - Grade 1- some fibers stretched/ torn; some TTP and pain withAROM; painful movement but ROM WNL Grade 2- several fibers have been torn, active contraction is very painful, palpable divot/depression; swelling and possible discoloration due to capillary bleeding. Grade 3- complete rupture of muscle; significant impairment or total loss of movement;pain quickly subsides T/F Tears most commonly occur in muscle belly, musculotendinous junction, or bonyattachment. - true Muscle Spasm: reflex - reaction caused by trauma of the musculoskeletal system Muscle Spasm: tonic - rigid muscle contraction that last a period of time Muscle Spasm: clonic - alternating involuntary muscular contraction and relaxation inquick succession acute-onset of muscle soreness - transient, develops during/ after exercise, andaccompanies fatigue delayed-onset muscle soreness (DOMS) - pain becomes most intense 24-48 hours afterand then gradually subsides so that muscle is pain free by 3-4 days after (leads toincrease muscle tension, swelling, stiffness, and inflexibility) muscle stiffness - fluid that collects in muscle during and after exercise are absorbedinto the blood stream at a slow rate (muscle becomes swollen, shorter, and thicker; thusresists stretching)Tx: lite exercise, massage , passive mobilization muscle cramps - painful involuntary skeletal contractions Myofascial Trigger Points - hypersensitive nodule found within a taut band of skeletalmuscle and/or fascia (found most commonly in muscles involved in postural support;may also be caused by acute or repetitive trauma that stresses fibers) Myofascial Trigger Points: Latent - does not cause pain unless pressed upon, but mayrestrict movement or cause muscle weakness 32 Myofascial Trigger Points: Active - causes pain at rest; firm pressure usually elicits a"jump sign", tender to palpation with a referred pain pattern similar to patient's paincomplaint (referred pain differentiates trigger point from tender pt) Myofascial Trigger Points: Tender point - pain only at a site of palpation myositis - inflammation of muscle tissue (more specifically, fibrositis or connective tissue inflammation) fasciitis - chronic inflammation of fascia that supports and separates muscle tendinitis - has a gradual onset, diffuse tenderness because of repeated microtrauma, and degenerative changes (swelling, pain) tenosynovitis - inflammation of synovial sheath surrounding a tendon acute tenosynovitis - rapid onset articular crepitus, and diffused swelling chronic tenosynovitis - tendons become locally thick-end, with pain and articular crepitus present during movement ectopic calcification (myositis ossificans) - can occur in a muscle that directly overlies abone 9quad iceps and brachial muscles) osteoid material that resembles bone rapidlyaccumulate s.ubside complete in 9-12 months or may mature into classified area. atrophy - wasting away of muscle tissue ( main cause is immobilization, inactive, or loss of nerve stimulation) contracture - abnormal shortening muscle tissue (great resistance to passive stretch). Associated with a joint that develops unyielding scar tissue because of muscle injury synarthrotic - classified as immovable amphiarthrotic - slightly movable diarthrotic - freely movable diarthrotic joints/ synovial joints - - presence of capsule or ligaments- c psule is lined with synovial membrane-opposing bone surface contains hyaline or articular cartilage- presence of a joint space (cavity) containing synovial fluid. intrinsic ligaments - occur where the articular capsule has become thickened in some places 35 osteoblast - cells forming bone together medullary (marrow) cavity: - hollow tube in the long bone diaphysis; contains a yellow,fatty marrow endosteum - lies the medullary cavity Wolf's law - bone in a healthy person will adapt to the load under its placed osteoclast - the break down of bone where is the bone the weakest? - where the long bone suddenly changes shape anddirectio n periostitis - inflammation of the periosteum (often contusions) manifest as skin rigidityover un erlying muscles depressed fx - often in flat bones; caused by falling and striking body part on unyieldingsurface or by being hit with hard object greenstick fx - incomplete break in bone that have not completely ossified; often occursn convex bone surface while concave surface remain intact. impacted fx - caused from fall of height (force directed up long axis). Requiresimmediate splinting by athletic trainer and traction by physician to ensue normal lengthpf injured limb. longitudinal fx - bone splinting along its length, often result of jumping and stress directsup long axis spiral fx - s- shaped separation , common in football and skiing sudden rotation of thebody with foot planted) oblique fx - occur when one end of the bone receives sudden torsion while other is fixedr stabilized (angle) serrated fx - two bony fragments have saw- tooth, sharp-edged fx line; usually causedby direct blow. transverse fx - occur in a straight line nat right angles to the bone shaft; caused bydirect blow commuted fx - ≥3 fragments at fx site. caused by hard blow or fall in awkward position.Difficult healing situation because of displaced bone fragments (soft tissue b/w them -incomplete healing) 36 blowout fx - occur to the wall of the eye orbit as a result of a blow to the eye. avulsion fx - separation of a bone fragment at an attachment of ligament or tendon.Usually occur as a result of a sudden, powerful twist or stretch of a body part. slater harris fx - Type 1: separation of the phys plateType 2: s paration of the growth plate and small part of metaphysisType 3: fx of the physType 4: fx of prtion of physis and metaphysisType 5: crushing force (growth deformity) apophyseal injury - are traction epiphyses in contrast to the pressure epiphyses of thelong bones(severs disease, Osgood-Schlatter's disease) neuritis - inflammation of the nerve referred pain - pain that is felt at one point of the body other than its origin how long is the inflammatory response? - 4 days what are the 5 sings of inflammation? - redness (rubor), swelling (tumor), pain (dolor),increased temperature (calor), and loss of function (functio laesa) Healing response: Inflammatory response phase - cellular injuries result in alteredmetabolism and liberation of materials of materials that initiate the inflammatoryrespons e. what is released in the inflammatory response phase? - leukocytes and otherphagocytic cells and exudates are delivered to injured tissue- ten s to localize or dispose of injury byproducts (blood and damage cells) throughphagocyt s is Healing response: vascular reaction - -immediate vasoconstriction (5-10 mins)-vascular dilation- transitory increased in blood flow- initial effusion of blood and plasma last for 24-36 hrs Healing response: vascular reaction- Chemical mediators - -histamine- released frommast cells; vasodilation, increased cell permeability, sensitize pain receptors.-leukotaxin- margination (leukocytes line up along cell walls), increase cell permeabilitylocally to allow for diapedesis (transfer WBC through cell walls)- necrosis- phagocytic activity; amount of swelling that occurs directly related to extentof vessels damage-leukocytes release- bradykinin( ^ permeability, pain, stimulates release ofprostaglandins) and prostaglandin( ^ permeability of blood vessels and tissue (^ spacefor WBC to move) 37 Healing response: Formation of Clot - -Release of thromboplastin (protein) from injuredcel l-Thromboplastin causes prothrombin to be changed into thrombin- thrombin causes conversions of fibrinogen into a sticky fibrin clot that shits off bloodupply to area- clot formation begins 12 hours post injury, completed with in 48 hours Healing response: Phagocytosis - PMNs (polymorphonuclear neutrophils) are first onsc ne- g od at killing bacteria, but not good at dealing with interstitial debris; eventuallyie off and cre te a toxic environment.-Mon uclear phagocytes/ Macrophages are next-Once debris is removed:- blood coagulates, exudates coagulates to form a network of fibrin to localize injury- epith l al cells migrate align edges of wound/ injury and fibroblast enter to regrowcapillarie s Healing response: Chronic Inflammation - involves replacement of leukocytes withmacrophages, lymphocytes and plasma cells; these cells accumulative in a highlyvascularized and innervated loose connective tissue matrix ini the area of injury how long is the fibroblastic repair phase - day 4- week 6 fibroblastic repair phase: revasculariation - growth of capillary buds into wounds is stimulated by lack of oxygen (after which wound can heal aerobically) What are the three types of heat-related illnesses? - Heat stressHeat exhaustionHeat stroke What are the symptoms of heat stress? - swollen hands and feet, itchy skin, sunburn, heat syncope (pale moist skin, hypotension) and heat cramps What is the treatment for heat stress? - remove from heat, cool, hydrate, and replacelost sodium What are the symptoms for heat exhaustion? - flu-like aching, nausea, and vomiting,headaches, dizziness, and hypotension with cold clammy skin and diaphoresis.excessive weating and temp <106 degrees What is the treatment for heat exhaustion? - cool the body and replace sodium andfluids, must be prompt in order to prevent heat stroke. careful monitoring (reactions mayb delayed) What are the symptoms for heat stroke? - temperature greater than 106. may result in seizures, neurological damage, multiple organ failures and death. 40 Callus formation (keratoderma) is formed by: - hypertrophy of the stratum corner layer of the epidermis How can you prevent callus formation? - soaking feet and using callus files to reducehicknes swearing double socks to cushion the sole of the footw aring properly fitted shoesapplying emollients to feet and hands to prevent friction and keep skin supplewearing rotective gloves, tape, or moleskin to protect palms from friction infestation with lice is known as: - pediculosis what are symptoms of lice? - persistent itch, irritation, excoriation, and sometimes secondary infection What is the treatment of choice for lice? - Permethrin 1% (Nix) indicates failure to acclimatize, may be mild to severe and often presents withheadache, lethargy, nausea, confusion, unsteady gait, and dyspnea.occurs 6 - 24 hours after ascent - acute mountain sickness (AMS) can lead to acute neurological damage, causing seizures, coma and death - high- altitude cerebral edema (HACE) can lead to acute respirator distress and death - high-altitude pulmonary edema (HAPE) What are the different types of eating disorders? - anorexia nervosabulimia nervosabinge eating Characterized by a profound fear of weight gain and severe restriction of food intake.Often accompanied by abuse of diuretics and laxatives. Can cause a delay or cessationof menses. - anorexia nervosa binge eating followed by vomiting, often along with use of diuretics, enemas and laxatives. gastric acids can damage throat and teeth - bulimia nervosa affects 2-5% of females and includes grossly overeating, often resulting in obesity, depression and shame - binge eating caused by the spirochete Treponema palladium. has an incubation period of 3 weeks - Syphilis What are the three phases of syphilis? - primary secondary 41 tertiar y what are the treatment options for syphilis? - primary, secondary, early tertiary:benzathine penicillin G 104 million units IM in one dosetertiary: benzathine penicillin G 2.4 million units IM weekly for three weeks what is the most common STD in the US - chlamydia what is the treatment for chlamydia? - azithromycin 1 g orally in one dose ORdoxycycline 100 mg orally twice daily for 1 weekavoid sexual contact for 1 week caused by Neisseria gonorrhoeae and should be suspected with urinary infections -Gonorrhe a An infectious disorder caused by the Epstein-Barr virus - mononucleosis How is mononucleosis spread? - saliva and airborne droplets (occurs most often inteenagers a d young adults) What is the incubation period for mononucleosis? - 4 - 6 weeks What symptoms may a person with mononucleosis present with? - weakness,h dache fever, persistent sore throat, enlarged lymph nodes in neck and axillae,e larged tonsils, generalized red macular rash, enlarged spleen T/F: Treatment for mononucleosis is mcnally supportive as there is no treatment for thevirus - Truet eatment includes rest, acetaminophen or ibuprofen, and adequate fluid intake tinea cruris is commonly referred to as: - jock itch what are symptoms of tinea cruris? - scaly, itching, erythematous rash that may containpapule or vesicle ad is usually bilateral and symmetrical What is the treatment for tinea cruris? - topical antifungal ointment 2x daily for 4 weeks tinea pedis is commonly referred to as: - athletes footfungal in ec ion of the feet and toes symptoms of tinea pedis include: - severe itching with vesicles or erosion of instep andwith eeling maceration and fissures between toesdry, scaly, mildly erythematous patches on plantar and lateral foot surfaces this drug is commonly referred to as the date rape drug or roofie - rohypnol 42 This drug is a CNS depressant that causes muscle relaxation, slurred speech andredu es i hibitions. The effects occur within 20 - 30 minutes of ingestion but may persistfor 8 - 12 hours - Rohypnol Who are the most common victims of the date rape drug? - females How is the diagnosis made that a person has been drugged with rohypnol? - history and clinical examination the form of alcohol found in alcoholic beverages, flavorings and some medications. It is a multi system toxin and CNS depressant - Ethanol How much of ethanol is metabolized in the liver? - about 90% When should emergency medical treatment be initiated for a person who has ingestedetha ol? - when the person exhibits an altered mental status, nausea and vomiting,semi-conscious or unconscious used to increase muscle mass and improve athletic performance - anabolic steroids what are negative side effects of anabolic steroids for men - liver disorderscardiovascular disordersincreased aggressiveness and libidodecreased sperm countgynecomastia (breast development) what are negative side effects of anabolic steroids for women? - liver disorderscardiovascular disordersincreased aggressiveness and libidoinhibition of formation of follicles and irregularities of menstrual cycle, includingamenorrh eahypertrophy of the clitorisacn ehair loss and male pattern balding with increased facial hairbre st atrophymasculinization of body, features, and lowering of voice what is the leading preventable cause of death? - tobacco use should be the first part of any training exercise, performed for 15 - 30 minutes to increase circulation and muscle elasticity and prevent injury - warm-up exercises what are the macronutrients and their calorie equivalents - fats = 9 cals/gram (30% of the diet)rbohydrates = 4 cals/gram (55% of the diet)prote ns = 4 cals/gram (15% of the diet) 45 full-contact martial arts what injuries of the lower extremity are most common? - injuries to the knees anda kle s what equipment is required for baseball? - batting helmets, mouth guards, shin guards,c est protector, and protective mitt what equipment is required for football? - football helmet, mouth guard, shoulder, hipand tailbone padding, thigh guards what equipment is required for soccer? - shin guards, cleats This committee researches and establishes standards regarding protective equipment. -National Operating Committee on Standards of Athletic Equipment (NOCSAE) Sets the standards for eye protection for racquet sports as well as non- racquet sports toeduc the risk f eye injury. - American Society for Testing and Materials (ASTM) what is most eye protection made out of? - polycarbonate plastic Most good running shoes support - miles of running - 350 - 550 The medial aspect of the ankle is stabilized by the: - deltoid ligament the distal tibia and fibula is stabilized by the: - anterior and posterior tibiofibularligamen ts Most sprains are injuries with tearing of the lateral ligaments - inversion Breast protective devises should support: - Cooper's ligaments % of genital injuries result in permanent damage - 20% T/F: The athletic trainer should ensure that a procedure is in place to check the fieldbefore use - True kills about 100 people per year, and injuries 400-500 - lightning count the seconds from the lightning to the sound of thunder an divide by 5 - flash-to-bang method If you are stuck in an open area during lighting, what position should you take? - crouchlow with nly feet touching the ground 46 open spaces surrounding areas of sports activity within a facility. needed because athletes leave the playing area at high speed - buffer zone Divides the body or parts into anterior (front) and posterior (rear) sections - example: arm during backstroke in swimming - Frontal (coronal) Divides the body or parts into superior (upper) and inferior (lower) sections - example: bat swing in baseballmov ment of criterion arm in bball jump sho t movement of criterion arm in forehand drive(tennis) - Transverse (horizontal) divides the body or parts into right and left sections- xample: movement of criterion arm during serve in tennispulli g arms upward - Median (mid- sagittal) Contractions involve movement of the muscle when pushing or pulling. Usually balance concentric and eccentric contractions - isotonic causes the muscle to shorten, as occurs when the muscle is used to lift a weight, as with a bicep curl - concentric contraction cause the muscle to lengthen, as occurs when lowering the weight - eccentric contraction occur without muscle movement, as when attempting to push or pull an immovableobject, tightening the muscle, or holding an object out in front of the body so that theweigh pushes down but the muscles' opposing force keeps the object stable - isometric a type of training utilized to increase the production of energy to meet demands of athletic activities, such as running, swimming and cycling - aerobic endurance training what determines the VO2 max? - genetics the point at which aerobic activity becomes anaerobic - lactate threshold damage to superficial layers of skin, such as with road burn or ligature marks - abrasion occurs when friction or pressure causes damage to underlying vessels - contusion tear in the skin resulting from blunt force - laceration tissue that is separated from its base and lost without adequate base for attachment - avulsion 47 using a stethoscope to listen to movement of air or fluid within the body andcharacterizing the sound according to intensity, frequency, and quality. Commonly usedto assess heart and lung function, circulatory impairment and bowel sounds -Auscultatio n What can you feel for when palpating a patient? - hardnesstemperatu reswellin gsiz emobility a technique in which fingers of one hand are laid flat against the skin and tapped with the finger tips of the opposite hand, causing sound to resonate. - percussion localized response to contact with an allergen, resulting in a rash that may blister and itch - contact dermatitis bacterial infection of the hair follicles, often on the face, resulting in pustules, erythema, and crusts that are painful and itchy - folliculitis what is the treatment for folliculitis? - antibacterial soaps and topical and oral antibiotics contagious itchy bacterial infection of the skin, commonly on the face or hands causing clusters of blisters or sores - Impetigo overstitching of a part of the musculature that causes microscopic tears in the muscle or tendon, usually resulting from excess stress or overuse - strain damage to a joint, with a partial rupture of the supporting ligaments, usually caused by wrenching or twisting, related to a fall - sprain these fractures involve the cartilaginous epiphyseal plate near the ends of long bones in children who are growing - Salter-Harris fractures What are the classifications of Le Fort Fractures? - Le Fort I - horizontal (low downwardforce )Le Fort II - pyramidal (low or mid maxilla force)Le Fort III - transverse (force to bridge of nose or upper maxilla) most often occur with blunt force against the globe causing a rupture through the floor or the orbital bone or a direct blow to the orbital rim - orbital fractures this injury occurs in runners who push off the foot or athletes who jump frequently, engage in martial arts or play on artificial turf - turf toe What are symptoms of turf toe? - stiffness 50 This nerve branches from the brachial plexus and travel down the arm from theshoulder, raveling along the anterior forearm beside the ulna, to the palm of the hand. -Ulnar nerve Occurs when the median nerve is compressed within the compartment formed by ligaments and bones, between the forearm and the hand. - carpal tunnel syndrome Initial symptoms of carpal tunnel syndrome include: - numbnesstingling/burning (esp palm/thumb/index/ iddle fingers)eventual weakening/inability to gripCompression increases when wrist is flexedsymptoms may worsen during sleep What special tests would be positive if a person is suffering from carpal tunnelsyndrome? - Tinel's signPhalen's testOriental Prayer test This ligament connects the femur to the fibula - lateral collateral ligament what test would be positive for a LCL injury? - varus stress test This muscle originates below the iliac crest and inserts at the top of the greater trochanter - Gluteus medius this muscle controls abduction of thigh and allows the hip to rotate internally and externally; during running, it stabilizes the pelvis - gluteus medius What special test evaluates for weakness of the gluteus medius? - Trendelenburg test What are the causes of a ruptured achilles tendon? - blunt trauma to the tendonexcessive forced dorsiflexion of the ankleinjury to a taut tendon Where does the achilles tendon injury usually occur? - 2-3 cm above the area where the tendon attaches the gastrocnemius to the calcaneus This condition can be induced by sitting for long periods of time without activity. - Deep Vein Thrombosis symptoms of a DVT include: - pain or aching in the calf, especially on activity swelling What positive test identifies a deep vein thrombosis? - Homan's sign What is the most common running-induced bursitis? - trochanteric bursitis 51 characterized by pain in the lateral hip that radiates down the lateral thigh. - trochanteric bursitis symptoms of iliotibial band syndrome include: - diffuse burning pain at lateral knee(usu lly after running or cycling for a few minutes)pain occurs earlier when inflammation increases what test identifies a positive it band friction syndrome? - Ober's test Noble's test what are symptoms of tendinitis? - pain with movement edem adysfunctio ndecreased range of motion what is the common name for inflammation of the medial epicondyle on the inside of theelbow? - Golfer's elbowlittle leaguers elbowthr er's elbow inflammation of the lateral epicondyle is known as and affects the extensor carpi radialis brevis muscle - Tennis elbow The Occupational Safety and Health Administration (OSHA) mandates that anyemployee who is at risk for exposure to blood-borne pathogens must be offered avaccination for which of the following conditions? - Hepatitis B Which of the following is TRUE regarding the National Collegiate Athletic Association(NCAA)-mandatory medical examination of student athletes? - mandates that all studen t thletes undergo a complete medical examination within six months of starting any typeof required pres ason conditioning, practice, or competition. Which of the following would NOT contribute to the development of a heat-related illness during exercise? - Frequent water breaks Which of the following best describes the recommended percentage of total caloriesfrom protein, fat, and carbohydrates for most physically active adults? - 10- 15% protein,30 fat, 55-65% carbohydrates An athlete who is trying to gain weight should consume how many additional calories per day? - 500 calories A basketball player who weighs 250 pounds (114 kg) is eating a regular, balanced diet. He is trying to build muscle and has started supplementing his diet with a commercial 52 protein shake. What is a good range of daily total protein intake for this athlete? - 135- 195 grams per day Which of the following findings on a female student athlete's pre- participationexamin i would most likely impact her ability to begin training with the cross-countryteam? - A hemoglobin level of 25% During a high school basketball training camp, a young boy complains of knee pain afterlanding from a jump shot. He reports hearing a popping sound when the injury occurred.Which of the following is the most likely explanation? - Anterior cruciate ligament (ACL)te r Which of the following is an indication that an athlete is suffering from a chronic injury instead of an acute injury? - Dull ache when the body is at rest What is the medical term that describes a dangerous increase in pressure within the muscles? - Compartment syndrome Which of the following is NOT an appropriate step to take when initiating treatment forcold injury to the feet? - Have the individual place the feet near a space heater to helpgradually thaw the feet During soccer practice, a player falls against the goal post and has a large laceration onhis arm that is bleeding. Which of the following is the most appropriate immediatetreatment of the injury? - Have the goalie apply pressure to the wound using a cleancloth whi retrieving a pair of gloves If an athlete with sickle cell disease experiences chest or abdominal pain and pain in thejoints, he or she may be at immediate risk for which of the following complications? -rhabdomy ly sis What piece of equipment is most likely to be carried by an athletic trainer to be used in conjunction with cardiopulmonary resuscitation (CPR)? - Pocket mask An athlete with known diabetes mellitus has a hypoglycemic reaction during an athleticevent. What should be done to begin treatment? - Have the athlete drink 4 ounces ofjuice or soda, then reassess in 15 minutes What foods have a low glycemic index (less than 55)? - Milk and grapefruit Which of the following is an intrinsic risk factor for injury? - Age What is the maximum heart rate for an athlete who is 25 years old? - 195 When wrapping a hip flexor strain, what is the position of the patient who is being wrapped? - Involved leg is in a neutral position with the knee slightly bent 55 A patient with a suspected eating disorder comes to the athletic trainer for assistance.What is the best course of action to care for this patient? - Refer the patient to adisordered-eating specialist for assessment. Which type of glenohumeral shoulder stabilizer is best for a football player in hot, humid weather? - Cuff-type stabilizer Which of the following strengthening exercises requires a spotter? - Overhead triceps extension During the pre-participation physical examination, which of the following patients would the athletic trainer suspect has decreased joint stability? - An ectomorph A patient with limited range of motion in the hamstring muscle needs a stretch to perform at home to improve flexibility. Which of the following best escribes an effectivehamstring stretch? - Standing with affected leg on a table that is hip height, then leaningforward toward elevated leg Which muscle fibers experience adaptation in response to resistive exercise? - Only those involved in the resistive exercise What is the best way to prevent hyponatremia? - Eat foods with sodium. Which of the following is a sociocultural factor for disordered eating? - Sport type During exercise what is the best-absorbed fluid and energy replacement formula? - 6% carbohydrate-electrolyte solution with fructose and sucrose A patient with iron-deficient anemia will require what form of nutrition? - Taking oral iron supplements with vitamin C For which of the following sports does NATA neither endorse nor discourage use of helmets or headgear? - Soccer What professional can be involved in medical history review for the PPE? - Nurse How can the distance of a lightning strike be determined if a lightning detector is notavailable? - Count the number of seconds from the strike to the sound of thunder. Thenumb of seconds divided by 5 equates to the number of miles. A pre-participation exam should occur no more than how many weeks before the start of the season? - Six weeks before the start of season training 56 A patient asks the athletic trainer to modify a piece of equipment that does not fitproperly. What should the athletic trainer do to limit liability? - Do not modify theequipment and do not allow the patient to play with the improperly fitted equipment. When is the best time for an athlete to exhale during weightlifting? - When the athlete is in the concentric phase of the lift How long after a patient had failed a urine-specific gravity test can the patient retest? - 24 hours In a clinical setting, when can a client be billed for reimbursement? - When the athletic trainer corrects the form of the client doing exercise How often should an athlete who participates in wrestling have weigh-ins in the off- season? - No more than once per week When is heat syncope most likely to occur? - Within the first five days of practice before acclimatization occurs How often should the athletic trainer educate tackle football players on the risks ofhead-down contact in a season? - Twice: once at the beginning and midway through theseaso n To prevent the spread of infectious disease, what type of cleaning agent should be used on wrestling mats? - Hospital broad-spectrum disinfectant Which nutritional factor positively influences bone density? - Vitamin D intake Which heat-loss mechanism is the most effective in warm, humid weather? - Evaporation An athletic trainer may have been exposed to a bloodborne pathogen. How long mustdocu en ation of this exposure be kept? - Thirty years from the date of the end ofemployme nt Who must be educated regarding infection-control policies and procedures? - Administration, coaches, athletes, and custodians Which medical conditions are exacerbated by cold environments? - Anorexia, exercise- induced bronchos Which of the following types of skin is most likely to be sunburned? - Thin and white in color Which of the following is an example of a complex carbohydrate? - Sweet potato 57 Which athlete is most likely to suffer a heat-related illness? - An overweight athlete whouses a wheelchair (from a spinal cord injury) wearing a cotton shirt and taking laxatives What is the proper technique for cleaning medical instruments? - Place instruments inapp oved instrument-cleaning solution for a minimum of 10 minutes. When can the athletic trainer breach confidentiality? - When another person is in clearand imminent danger Which of the following is considered an open kinetic chain exercise? - Leg (knee)extension on a machine What is the CPT code for an evaluation? - 97005 By sport-specific rules, which sport(s) have bleeding time-outs? - Tennis and wrestling What is the NOCSAE standard for football helmets regarding eye protection? - Wireface mask and a polycarbonate eye shield If a person were to represent herself as an athletic trainer before passing her BOCcertification examination, what national standard has this person violated? - Both theBOC Standards of Professional Practice and NATA Code of Ethics According to the NATA position statement on safe weight loss, how many pounds canbe safely lost in a week? - 1 to 2 pounds per week Weight-bearing forces on bone cause which type of cells to activate to increase bonesize? - Osteoblasts Which of the following best describes the areas of a female's body that are used duringskinfold measurement? - Chest, thigh, abdomen, triceps, suprailium, midaxilla,subscapula, and calf When can a multiple adaptor be used safely with electrical modalities? - Never According to the BOC Standards of Professional Practice, under whose medicaldirection is an athletic trainer? - Physician Which of the following football players should wear cantilevered shoulder pads? -Defensive linemen Which condition is likely to result from a sedentary lifestyle along with high intake ofsugar? - Gallbladder problems 60 competition? - Cut a felt piece the size of the contusion. Heat the thermoldable plastic,place the malle ble plastic over the felt, and wrap in place. Once it cools, remove thef lt and cut a doughnut hole of softer foam; place it over the edges of the contusion. Cutfoam to cover the plastic shell. Which is the best timing and composition for a pre-competition meal? - A bowl of wheat pasta with meat sauce, low-fat milk, and orange juice four hours before the game Which sport, if any, should an athlete with an active case of herpes be disqualified from? - No sports with mats or contact sports until not contagious In training room design, it is important to have signage. Which of the following signs need to be in the training room? - Location of the AED At what age is peak strength most likely attained in untrained males and females? - Males between 20 and 30 and females by 20What is the best way to determine maturation of pediatric patients? - Puberty Which form of stretching has been found to improve running performance? - Dynamic A patient needs a diet to prevent the trigger of diarrhea. What substances and foods should be eliminated from the patient's diet? - Caffeine, fructose, lactose, and sorbitol Of the following, which is most likely to cause an increased frequency of muscle twitches to potentially cause muscle cramps? - Diuretics How can athletic trainers assist in reducing the risk of overuse injuries in youth? - Encourage youth to participate in a variety of sports. What is the role of nutrition in tissue synthesis? - Proteins are basic building blocks of bones, muscles, and skin. Which of the following is most likely to contribute to hypothermia? - Alcohol A coach has requested information about the status of an athlete's injury. What shouldthe athletic trainer do with such a request? - Obtain written authorization from thethlete to disclose information. Patients with large waist circumference are at a higher risk for what type of disease? - Cancer What is the primary method for developing both speed and agility? - Proper mechanics Which of the following provides the most cost-efficient and reliable support for an athlete with a history of ankle sprains? - A verified commercial ankle brace 61 Which sport has athletes who tend to be nutritionally compromised as a result of the need to strive for a lean body? - Wrestling and gymnastics Which of the following best describes how to fit an ice hockey helmet? - The helmet should fit snuggly on the forehead, top, and sides of the head. Which of the following training activities is the best implementation of the SAID principle(specific adaptation to imposed demands) for a high jumper? - Performing plyometricdepth jumps Which of the following diseases or conditions requires the standard precaution that the athletic trainer wear a mask covering the nose and mouth? - Tuberculosis The workspace station of the athletic trainer needs to fit the individual. Which bestdes ribes an ergonomically fit space? - The chair allows for the feet to touch the floor. When performing a peer review of a patient's medical condition, which of the following istrue regarding the patient's confidentiality? - The peer reviewers must hold allinformation derived from the medical case confidential. Which of the following conditions has a genetic component? - Substance abuse Which exposed body part is most likely to lose body heat more quickly? - Head Which best describes the female athlete triad? - Disordered eating, amenorrhea, and osteoporosis When does a football helmet need to be reconditioned? - According to manufacturer'sw rrant y What does the wet bulb globe temperature (WBGT) measure? - Ambient air temperature, humidity, and solar radiant energy What is the best plan for an athlete who has been diagnosed with overtrainingsyndrome? - The athlete can be active but not in his chosen sport, and he mustdecrease ac ivity by half. Athletes in which of the following sports are required by the NCAA and NFHS to wear mouth guards? - Field hockey, tackle football, ice hockey, and lacrosse A patient with insulin dependency is moving to a high-altitude area to exercise. Whatmust the patient know about glycemic control at high altitudes? - Glucose monitors havepr blems with reliability at high altitude. 62 Which of the following is the best description of static neck stretching of theernocleid mastoid muscles? - Sitting with the head and neck upright, turn the head toright and then left using submaximal concentric muscle action. Laundry bins with wheels are preferred over stationary baskets in facilities. What is thereason for wheeled bins rather than stationary ones? - They are more ergonomicallyo iente d What is an adverse effect of using growth hormones? - Heart disease At what point on the body mass index (BMI) scale is there often an increased risk of health problems associated with excess body fat? - More than 25 One station in the examination requires the athletic trainer to take the athletes' blood pressure. What is the correct order of steps to obtain a blood pressure measurement? - 1. Select adul cuff2. Inflat bladder to 200 mmHG3. Place stethoscope over brachial artery at cubital fossa4. Deflate bladder at 3 mmHg per second5. Listen for first sound6. Note when sound disappears7. Record blood pressure Match the skin color with the likely condition. Use each skin color only once. check youranswers when you've finished. - Bright red = Carbon monoxide poisoning or heatstrokePallor = Decreased circulationWhite ra slucent waxy = Frozen skinDark red pupil = High blood pressureJaundic = Liver diseaseCyanotic = low oxygen levels Using the abdominal quadrants shown in the photo as a guide, choose one of the fourquadrants for each of the organs listed. - Left kidney = ULQappendix = LRQgall bladder = URQstomach = ULQspleen = ULQleft ureter = LLQright ureter = LRQ Which items on a physical or health history form would be recognized as a concern for further investigation? a. Hemoglobinuria 65 b. Dumbbell alternating curld. Seated rowf. Triceps pushdown The athlete's final profile lists the following deficits in her fitness: •Lacks upper-body strength •Lacks core strength Select all the exercises recommended for increasing core strength.a. Push jerkb. Front squatc. H ng cleand. Lat pulldowne. Abdominal crunchf. Shoulder press - A, B, C, F a. Push jerkb Front squatc. H ng cleanf. Shoulder press A 25-year-old female patient has asked the athletic trainer to design a comprehensivenutrition program for maintaining good health. She weighs 175 pounds (79.3 kg) and is5 feet 10 inches (82.8 cm) tall. The client has a body mass index of 25.1. Question 13Which of the following pieces of information are additional anthropometric baselineinformation hat the athletic trainer needs in order to assess this patient? Choose all thatapply .Which of the following pieces of information are additional anthropometric baselineinformation hat the athletic trainer needs in order to assess this patient? Choose all that apply.a. The p tient's waist-to-hip ratio is .60.b. The age at which the patient had her first menstrual cyclec. The famil history of this patient includes a mother with high blood pressure and afather with diabetes.. The patient runs three miles three times per week.e. The patient does not consume alcohol.f. The patient does not use tobacco products.g. The patient does not know her current blood pressure.h. The patient does not monitor her diet.i. The patient has no health issues.j. The patient is not familiar with any of her family members' heights and weightsk. The patient's lean body mass is 122.6. 66 l. The patient's waist circumference is 36 inches (91.4 cm) - A, K, L a. The patient's waist-to-hip ratio is .60.k. The patient's lean body mass is 122.6.l. The patient's waist circumference is 36 inches (91.4 cm As the athletic trainer begins the assessment of this patient, which pieces of informationare he lth information that the athletic trainer needs to know? Choose all that apply.. The patient's goal is to be healthy.b. The age at which the patient had her first menstrual cycle.c. The famil history of this patient includes a mother with high blood pressure and afather with diabetes.. The patient runs three miles three times per week.e. The patient does not consume alcohol.f. The patient does not use tobacco products.g. The patient's current blood pressure is 136/84.h. The patient does not monitor her diet.i. The patient has no health issues.j. The patient does not take any medications.k. The patient does not use any illegal drugs.l. The patient's total cholesterol level is 220 (borderline high)m. The patient's blood glucose tolerance level is 144mgdL. - C, D, F, G, I, J, K L, M c. The family history of this patient includes a mother with high blood pressure and afather with diabetes.. The patient runs three miles three times per week.f. The patient does not use tobacco products.g. The patient's current blood pressure is 136/84.i. The patient has no health issues.j. The patient does not take any medications.k. The patient does not use any illegal drugs.l. The patient's total cholesterol level is 220 (borderline high)m. The patient's blood glucose tolerance level is 144mgdL. The patient would like some recommendations for a low-fat diet. In the following list,select the ources of fat that are best to include as regular parts of this patient's diet. Choose all that apply.. Olive oilb. Peanutsc. Salt porkd. Fish fate. Whole milkf. Egg yolk 67 g. Palm oil h. Pepperoni - A, B, D a. Olive oilb. Peanutsd. Fish fat It has been determined that this is a first-degree ankle sprain. The athletic trainer elects to use this injury as an opportunity to teach a student how to tape an ankle. For this closed basketweave ankle taping, match each pattern of tape application withthe correct number of pieces of tape and the direction in which they should be placed.Check your answers for feedback. As many strips as it takes anterior to posterior Three inferior to superior Two in a circular pattern Two laterally and anterior to posterior a. Stirrupsb. Heel locksc. Figure eightsd. Closing strips - As many strips as it takes anterior to posterior = d Three inferior to superior = a Two in a circular pattern = c Two laterally and anterior to posterior = b A wrestler has a lesion on his arm. The area around the wound is red, painful, and swollen. Question 25Select which information is important for the athletic trainer to know in order to determine the significance of the lesion. Select all that apply. Select which information is important for the athletic trainer to know in order to determine the significance of the lesion. Select all that apply.. The athlete indicates the lesion occurred a few days ago.b. The athlete is not coughing.. The athlete indicates he is feeling sick. 70 b. Those with previous cold injuryc. Youngd. Those with febrile conditionse. Those with large muscle massf. Those who weigh ing. Sleep-deprived individualsh. Those who have spinal cord injuries and are in wheelchairs - A, C, D, E, G, H a. Malesc. Youngd. Those with febrile conditionse. Those with large muscle massg. Sleep-deprived individualsh. Those who have spinal cord injuries and are in wheelchairs What types of things might the athletic trainer do to prevent hyperthermia? Select all that apply.. Have athletes wear breathable wicking fabrics.b. Monitor each athlete's body temperature periodically throughout practice.c. Have athletes eat food high in fiber.d. Have the athletes consume large amounts of protein, caffeine, and fluids.e. Sit out all athletes with prior heat or cold injuries.f. Have athletes acclimatize at least two weeks in advance of practices.g. Weigh athletes before and after practice. - A, F, G a. Have athletes wear breathable wicking fabrics. Have athletes acclimatize at least two weeks in advance of practices.g. Weigh athletes before and after practice. 71 BOC Prep and NATA-BOC Exam Secrets Study Guide Questions and Answers2024