Injury Nomenclature

1
Injury Nomenclature

• Important to use proper terminology with other
  health care professionals
• Begin using in athletic training room today

2
Types of tissue

• Tendon
• attaches muscle to bone
• very strong
• assists in joint mobility

3

• Ligament
• Attach bone to bone (ACL, MCL, etc)
• Provide joint stability

4

• Cartilage
• Articular- covers the end of bones
• Menisci-improves joint congruity and acts as
  shock absorption

5

• Bone
• Hard calcified connective tissue
• Primary structural support system in the body

6

• Skeletal Muscle
• Produces joint movement
• Part of musculotendinous unit(contractile unit)

7

• Bursa
• Fluid-filled sacs that serves to decrease
  friction between tendon and bone

8
Classification of Injuries

• Acute
• Chronic
• Catastrophic

9
Strains

• 1st degree
• limited tearing

10
Strains

• 2nd Degree
• fibers are torn
• ecchymosis

11
Strains

• 3rd degree
• Complete rupture
• Palpable defect

12
Clinical Finding of Muscle Strains

• History
• Onset
• Location of Pain
• Mechanism
• Inspection
• Palpation
• Functional Tests

13
Tendinitis

• Microtrauma
• Tenosynovitis

14
Clinical findings of tendinitis

• History
• Onset
• Location of Pain
• Mechanism
• Inspection
• Palpation
• Functional Tests

15
Myositis Ossificans

• Formation of bone in muscle bellys fascia
• Fibroblast transform osteoblasts and
  chrondroblasts to form immature bone
• Occurs after 3 weeks

16
Clinical Myositis Ossificans

• History
• Onset
• Location of pain
• Mechanism
• Inspection
• Palpation
• Functional Tests
• Special Tests

17
Clinical findings of bursitis

• History
• Onset
• Location of pain
• Mechanism
• Inspection
• Palpation
• Functional tests

18
Joint Structures

• Sprains
• Joint subluxation
• Dislocation
• Synovitis

19
Sprains

• 1st Degree
• Little tearing
• Endpoint is felt
• Local pain
• Mild point tenderness
• Slight swelling of joint

20
Sprains

• 2nd Degree
• Partial Tearing
• Endpoint still present
• Moderate pain and swelling
• Loss of joints function

21
Sprains

• 3rd Degree
• Complete rupture
• No endpoint
• Swelling
• Complete loss of function

22
Clinical Findings of Ligament Sprains

• History
• Onset
• Location of pain
• Mechanism
• Inspection
• Palpation
• Functional Tests
• Ligamentous tests
• Special test

23
Joint subluxation

• Partial or complete dislocation of joints
  articulating surfaces which may or may not
  spontaneously return to normal alignments
• May have bony/soft tissue injury
• Progressive

24
Clinical Findings of Joint Subluxations

• History
• Onset
• Location of pain
• Mechanism
• Inspection
• Palpation
• Functional Tests
• Ligamentous Tests
• Special tests

25
Joint Dislocation

• Complete dislocation
• Obvious deformity
• Risk to bony, soft tissue, and neurovascular
  structure

26
Clinical Findings ofJoint Dislocations

• History
• Onset
• Location of pain
• Mechanism
• Inspection
• Palpation
• Functional tests
• Neurological tests

27
Synovitis

• Inflammation of joint capsule that spreads to
  synovial membrane

28
Clinical Findings ofCapsular Synovitis

• History
• Onset
• Location of pain
• Mechanism
• Inspection
• Palpation
• Functional
• Ligamentous tests
• Special tests

29
Articular Surface Injuries

• Osteochondral Defects
• Osteochondritis Dissecans
• Osteoarthritis

30
Osteochondral Defects

• Fractures and progressive softening of this
  cartilage (OCD)

31
Clinical Findings of Osteochondral defect

• History
• Onset
• Location of pain
• Mechanism
• Inspection
• Palpation
• Functional Tests
• Special Tests

32
Osteochondritis Dissecans

• Dislodged fragments of bone within joint space
• Lesion of bone and articular cartilage resulting
  in delamination of subchondral bone

33
Clinical Findings of Osteochondritis Dissecans

• History
• Onset
• Location of pain
• Mechanism
• Inspection
• Palpation
• Functional Tests

34
Osteoarthritis

• Articular surfaces degenerate and regeneration
  causes a bony outgrowth

35
Clinical Findings of Arthritis

• History
• Onset
• Location
• Mechanism of Injury
• Inspection
• Palpation
• Functional tests
• Ligamentous Tests
• Special Tests

36
Bony Injuries

• Pediatric
• Exostosis
• Apophysitis
• Fractures
• Avulsion Fractures
• Stress Fractures

37
Clinical Findings ofExostosis

• History
• Onset
• Location of Pain
• Mechanism
• Inspection
• Palpation
• Functional Tests

38
Apophysitis

• Inflammation condition involving the growth plate
• Due to recent, rapid growth
• E.g. osgood-schlatters, Severs disease

39
Fractures

• Location
• Severity
• Shape
• Onset

40
Avulsion Fracture

• Tearing away of ligament or tendons bony
  attachment
• Often missed because of small fracture site

41
Stress Fracture

• Repetitive stress
• Bones osteoclastic activity is greater than
  osteoblastic activity causing a weakened area
  along the line of stress

42
Clinical Findings ofStress Fractures

• History
• Onset
• Location of pain
• Mechanism
• Inspection
• Palpation
• Functional tests
• Special tests

43
Neurovascular Pathologies

• Peripheral Nerve Injury
• Entrapment
• Neuropraxia
• Reflex Sympathetic Dystrophy (RSD)

44
Imaging Techniques

• Radiographs
• Computed Tomography
• MRI
• Bone Scan
• Ultrasound

45
Radiographs (X-Ray)

• Ionizing Radiation
• Interpretation
• Stress X-Ray

46
Computed Tomography (CT)

• X-ray detectors rotate around the body
• Improved soft tissue viewing
• 2D image

47
Magnetic Resonance Imaging(MRI)

• Detailed picture of soft tissue
• Great visual details of soft tissue injuries
  including inflammation

48
Bone Scan

• Use to detect bony abnormalities not detected on
  XRay
• Injected with radionuclide tracer element that is
  absorbed by areas of bone undergoing remodeling
• Hot spot vs. cold spot

49
Ultrasound

• Soft tissue
• Less than .8 MHZ