Examination Of Musculoskeletal Injuries

by Shultz, Sandra J.; Houglum, Peggy A.; Perrin, David H.

• ISBN13: 9780736051385
• ISBN10: 0736051384
• Edition: 2nd
• Format: Hardcover
• Copyright: 2005-05-01
• Publisher: Human Kinetics

Summary

Become proficient in the recognition of musculoskeletal injuries, know when to refer clients to physician care, and grasp all the National Athletic Trainers' Association (NATA) Athletic Training Educational Competencies related to injury and general medical condition recognition with the completely revised second edition of >Examination of Musculoskeletal Injuries.> Formerly known as >Assessment of Athletic Injuries,> this revised textbook gives you all the tools you need in one comprehensive and logical resource.The text, part of Human Kinetics' Athletic Training Education Series, is an indispensable reference for athletic trainers and other health professionals who spend much of their time caring for injuries related to physical activity and must have a solid background in recognition and examination to do so effectively. Significantly expanded, the new edition now contains 23 chapters, ten more than the first edition, that provide a broad and firm understanding of general examination principles and techniques, recognition and examination of injuries and conditions specific to each body region, and general medical conditions that you will likely encounter in the physically active.>Examination of Musculoskeletal Injuries, Second Edition,> is divided into three well-organized parts. The first part reviews in detail the general principles and foundational skills for each component of the injury examination. In addition, it includes new content related to general evaluation techniques for goniometric measurement, manual muscle testing, upper and lower quarter screens, posture, and gait.The second part considers examination strategies for the various regions of the body, including each major joint (e.g. elbow, knee, etc); cervical, thoracic, and lumbar spines; head and face; and abdomen and thorax. Each chapter is devoted to a specific body region and is broken down into four segments: functional anatomy and biomechanics; injuries specific to that body region; objective tests including structures for palpation, range of motion testing, strength testing, and special tests; and assessment strategies focusing on acute versus chronic injuries.In the third part, three chapters address general medical conditions that allied health professionals are likely to see in physically active clients and patients. The topics are discussed according to the body systems presented in >Athletic Training Educational Competencies> (National Athletic Trainers' Association, 1999). Because examinations of these conditions usually are the physician's responsibility and require diagnostic tests to identify, the text prepares readers to make appropriate referrals based on a patient's history and their own observations.The new edition includes many additional features for students, professionals, and instructors:--More than 150 illustrations, 500 photographs, and 110 tables that enable the reader to correctly comprehend the material-A student Web site that includes printable checklists for every phase of injury examination, along with superb full-color photographs of skin ailments that will enhance the reader's ability to correctly identify the disorder-Pedagogical aids that will assist in learning and retention of crucial material, including chapter objectives and summaries; "warning boxes" and "reminder boxes" highlighting techniques and knowledge crucial to avoiding further injury, permanent disability, or even death; key terms; review and critical thinking questions; a glossary; and references and bibliographical material-An instructor guide and test bank with case studies, course projects, chapter worksheets, sample test questions, and a sample course syllabus to help teachers prepare lectures and exams and organize courses and-A presentation package, heavily weighted toward photographs of objective tests and easily adapted to each instructor's lecture content and style.Human Kinetics' Athletic Training Educ

Table of Contents

Introduction to the Athletic Training Education Series	xiii
Preface	xv
Acknowledgments	xviii
Credits	xix
Part I PRINCIPLES OF EXAMINATION	1	(188)
Anatomical Nomenclature and Injury Classifications	3	(16)
Anatomical Reference Terminology	4	(2)
Physical Maturity Classifications	6	(1)
Injury Classifications	6	(2)
Sign Versus Symptom	6	(1)
Acute Versus Chronic	6	(2)
Closed (Unexposed) Wounds	8	(4)
Closed Soft Tissue Injuries	8	(1)
Bone and Joint Articulations	9	(3)
Nerve Injuries	12	(1)
Open (Exposed) Wounds	12	(2)
Learning Aids	14	(5)
Summary	14	(1)
Review Questions	15	(1)
Critical Thinking Questions	16	(1)
Cited References	17	(1)
Additional Resources	17	(2)
Principles of Examination: An Overview	19	(18)
Proper Use of Terminology	20	(1)
Examination Components	21	(9)
Injury Survey	21	(1)
SINS	22	(1)
Subjective and Objective Segments	23	(1)
Testing During the Objective Segment	24	(6)
Documenting the Examination	30	(3)
Soap Notes	31	(2)
Learning Aids	33	(4)
Summary	33	(1)
Review Questions	34	(1)
Critical Thinking Questions	35	(1)
Cited References	35	(1)
Additional Resources	35	(2)
Taking a History	37	(10)
Information to Seek	38	(2)
Information Categories	38	(1)
Signs and Symptoms	39	(1)
Situation-Specific History and Depth of Inquiry	40	(2)
Essential History (Emergent Examination)	41	(1)
Focused History (On-Site Examination)	41	(1)
Detailed History	41	(1)
Examples of Leading and Nonleading Questions	42	(3)
History of Previous Injury or Illness	42	(1)
Questions for Specific Injury Situations	43	(2)
Learning Aids	45	(2)
Summary	45	(1)
Review Questions	46	(1)
Critical Thinking Questions	46	(1)
Additional Resources	46	(1)
Observation	47	(18)
System of Observational Examination	48	(4)
Global Observation	48	(1)
Specific Observation	49	(3)
Details of Specific Observation	52	(9)
Examination of Posture	52	(2)
Examination of Gait	54	(7)
Specific Observation of the Injury	61	(1)
Learning Aids	61	(4)
Summary	61	(2)
Review Questions	63	(1)
Critical Thinking Questions	63	(1)
Cited References	64	(1)
Additional Resources	64	(1)
Palpation	65	(12)
General Principles	66	(2)
Foundational Skills	66	(1)
Palpation Technique	67	(1)
Structures to Palpate	68	(5)
Skin	68	(1)
Fascia	68	(1)
Myotendinous Unit	69	(1)
Bone	70	(1)
Joint Structures	71	(1)
Neurovascular Tissue	72	(1)
Lymph Nodes	72	(1)
Palpation Strategies	73	(1)
Learning Aids	74	(3)
Summary	74	(1)
Review Questions	74	(1)
Critical Thinking Questions	75	(1)
Cited References	75	(1)
Additional Resources	75	(2)
Examination of Motion	77	(18)
Goals and Purposes	78	(1)
Normal Range of Motion	78	(3)
Prerequisites for Successful ROM Examination	81	(3)
Physiological Motion	81	(1)
Accessory Motion	82	(2)
Measuring Range of Motion	84	(3)
Positioning	84	(1)
Patient Stabilization and Substitution	85	(1)
Measurement Technique	86	(1)
Accessory Movement Examination	87	(3)
Joint Accessory Movement Rules	87	(1)
Joint Accessory Examination Technique	87	(2)
Recording Results	89	(1)
Special Tests: Ligament and Capsule Stress Tests	90	(1)
Indications for Ligament Stress Tests	90	(1)
Grading of Ligament Laxity	90	(1)
Stress Test Technique	90	(1)
Learning Aids	91	(4)
Summary	91	(1)
Review Questions	92	(1)
Critical Thinking Questions	92	(1)
Cited References	93	(2)
Examination of Strength	95	(22)
Muscle Contraction	96	(1)
Functional Neuromuscular Anatomy	96	(1)
Review of Excitation---Contraction Coupling	97	(1)
Goals and Purposes	97	(1)
Manual Strength Examination	98	(4)
Break Tests	98	(2)
Manual Muscle Testing	100	(2)
Instrumented Strength Examination	102	(11)
Isometric Strength Examination	104	(2)
Isotonic Strength Examination	106	(1)
Isokinetic Strength Examination	107	(6)
Learning Aids	113	(4)
Summary	113	(1)
Review Questions	114	(1)
Critical Thinking Questions	114	(1)
Cited References	115	(1)
Additional Resources	116	(1)
Examination of Neurological Status	117	(30)
Functional Neuroanatomy	118	(2)
Nerve Plexuses	118	(2)
General Principles of the Neurological Exam	120	(4)
Goal and Purpose	120	(1)
Sensory Function Testing	120	(1)
Motor Function Testing	121	(1)
Reflex Testing	122	(2)
Region-Specific Neurological Examination	124	(17)
Cervical Plexus	126	(1)
Brachial Plexus	127	(6)
Lumbar and Sacral Plexuses	133	(8)
Learning Aids	141	(6)
Summary	141	(3)
Review Questions	144	(1)
Critical Thinking Questions	144	(1)
Cited References	145	(1)
Additional Resources	145	(2)
Examination of Cardiovascular and Respiratory Status	147	(18)
Functional Anatomy and Physiology	148	(5)
Lungs	148	(1)
Heart	149	(1)
Peripheral Circulation	149	(4)
Examination of Cardiovascular and Respiratory Status	153	(4)
Systemic Perfusion (Vital Signs)	153	(3)
Peripheral Circulation	156	(1)
Cardiovascular Compromise	157	(4)
Causes and Types of Cardiovascular Collapse (Shock)	158	(2)
Recognition of Shock	160	(1)
External Bleeding	161	(1)
Learning Aids	161	(4)
Summary	161	(2)
Review Questions	163	(1)
Critical Thinking Questions	164	(1)
Cited References	164	(1)
Additional Resources	164	(1)
Putting It All Together: General Examination Strategies	165	(24)
On-Site Examination	172	(7)
Coals and Purposes	172	(1)
On-Site Examination of the Unconscious Athlete	172	(4)
On-Site Examination of the Conscious Athlete	176	(2)
Communicating On-Site Examination Results	178	(1)
Acute Examination	179	(2)
Subjective Segment	179	(1)
Objective Segment	180	(1)
Clinical Examination	181	(4)
General Principles of the Clinical Examination	181	(1)
Subjective Segment	182	(1)
Objective Segment	182	(3)
Learning Aids	185	(4)
Summary	185	(1)
Review Questions	186	(1)
Critical Thinking Questions	186	(1)
Additional Resources	187	(2)
Part II REGION-SPECIFIC EXAMINATION STRATEGIES	189	(398)
Cervical and Upper Thoracic Spine	191	(36)
Functional Anatomy	192	(2)
Cervical and Upper Thoracic Spine Injuries	194	(9)
Acute Soft Tissue Injuries	195	(1)
Chronic or Overuse Soft Tissue Injuries	195	(1)
Bone and Joint Pathologies	196	(3)
Nerve and Vascular Injuries	199	(3)
Structural and Functional Abnormalities	202	(1)
Objective Tests	203	(10)
Palpation	203	(1)
Range of Motion	204	(2)
Strength	206	(2)
Neurological Examination	208	(1)
Special Tests	208	(5)
Injury Examination Strategies	213	(10)
On-Site Examination	213	(1)
Acute Examination	214	(4)
Clinical Examination	218	(5)
Learning Aids	223	(4)
Summary	223	(2)
Review Questions	225	(1)
Critical Thinking Questions	225	(1)
Cited References	225	(1)
Additional Resources	226	(1)
Shoulder and Arm	227	(46)
Functional Anatomy	228	(4)
Injuries of the Shoulder Complex and Upper Arm	232	(10)
Acute Soft Tissue Injuries	232	(3)
Chronic or Overuse Soft Tissue Injuries	235	(2)
Traumatic Fractures	237	(1)
Bony or Cartilaginous Lesions Secondary to Repetitive Stress	238	(1)
Dislocation and Subluxation	239	(1)
Neurovascular Injuries	240	(1)
Structural and Functional Abnormalities	241	(1)
Objective Tests	242	(18)
Palpation	242	(1)
Range of Motion	243	(5)
Strength	248	(3)
Neurovascular Examination	251	(1)
Special Tests	251	(7)
Joint Mobility Examination	258	(2)
Injury Examination Strategies	260	(9)
On-Site Examination	260	(2)
Acute Examination	262	(3)
Clinical Examination	265	(4)
Learning Aids	269	(4)
Summary	269	(2)
Review Questions	271	(1)
Critical Thinking Questions	271	(1)
Cited References	271	(1)
Additional Resources	272	(1)
Elbow and Forearm	273	(36)
Functional Anatomy	274	(2)
Elbow and Forearm Injuries	276	(13)
Acute Soft Tissue Injuries	276	(3)
Chronic or Overuse Soft Tissue Injuries	279	(2)
Traumatic Fractures	281	(1)
Bony Lesions Secondary to Repetitive Stress	282	(1)
Dislocation and Subluxation	283	(2)
Neurovascular Injuries Secondary to Trauma	285	(1)
Nerve Compression Syndromes	286	(2)
Structural and Functional Abnormalities	288	(1)
Objective Tests	289	(8)
Palpation	289	(1)
Range of Motion	289	(3)
Strength	292	(1)
Neurovascular Examination	293	(1)
Special Tests	294	(2)
Joint Mobility Examination	296	(1)
Injury Examination Strategies	297	(7)
On-Site Examination	297	(1)
Acute Examination	297	(3)
Clinical Examination	300	(4)
Learning Aids	304	(5)
Summary	304	(2)
Review Questions	306	(1)
Critical Thinking Questions	307	(1)
Cited References	308	(1)
Additional Resources	308	(1)
Wrist and Hand	309	(40)
Functional Anatomy	310	(2)
Wrist and Hand Injuries	312	(8)
Acute Soft Tissue Injuries	312	(3)
Chronic or Overuse Soft Tissue Injuries	315	(1)
Bony Pathology	316	(2)
Nerve and Vascular Injuries	318	(2)
Structural and Functional Abnormalities	320	(1)
Objective Tests	320	(17)
Palpation	320	(1)
Range of Motion	321	(4)
Strength	325	(4)
Neurovascular Examination	329	(1)
Special Tests	330	(4)
Joint Mobility Examination	334	(3)
Injury Examination Strategies	337	(8)
On-Site Examination	337	(1)
Acute Examination	337	(4)
Clinical Examination	341	(4)
Learning Aids	345	(4)
Summary	345	(1)
Review Questions	346	(1)
Critical Thinking Questions	346	(1)
Cited References	347	(1)
Additional Resources	347	(2)
Lower Thoracic and Lumbar Spine	349	(32)
Functional Anatomy	350	(3)
Lower Thoracic and Lumbar Spine Injuries	353	(7)
Acute and Chronic Soft Tissue Injuries	353	(1)
Bone and Joint Pathologies	354	(4)
Nerve Compression	358	(1)
Structural and Functional Abnormalities	359	(1)
Objective Tests	360	(9)
Palpation	361	(1)
Range of Motion	361	(1)
Strength	362	(1)
Neurological Examination	362	(4)
Special Tests	366	(2)
Joint Mobility	368	(1)
Injury Examination Strategies	369	(8)
On-Site Examination	369	(2)
Acute Examination	371	(2)
Clinical Examination	373	(4)
Learning Aids	377	(4)
Summary	377	(2)
Review Questions	379	(1)
Critical Thinking Questions	379	(1)
Cited References	380	(1)
Additional Resources	380	(1)
Leg, Ankle, and Foot	381	(48)
Functional Anatomy	382	(4)
Leg, Ankle, and Foot Injuries	386	(14)
Acute Soft Tissue Injuries	386	(3)
Chronic or Overuse Soft Tissue Injuries	389	(2)
Traumatic Fractures	391	(2)
Bony Defects Secondary to Repetitive Stress	393	(1)
Dislocation and Subluxation	394	(1)
Nerve and Vascular Injuries	394	(2)
Structural and Functional Abnormalities	396	(4)
Objective Tests	400	(15)
Palpation	400	(1)
Range of Motion	401	(3)
Strength	404	(2)
Neurovascular Examination	406	(1)
Special Tests	407	(5)
Joint Mobility Tests	412	(3)
Injury Examination Strategies	415	(9)
On-Site Examination	415	(1)
Acute Examination	416	(3)
Clinical Examination	419	(5)
Learning Aids	424	(5)
Summary	424	(2)
Review Questions	426	(1)
Critical Thinking Questions	426	(1)
Cited References	427	(1)
Additional Resources	427	(2)
Knee and Thigh	429	(46)
Functional Anatomy	430	(4)
Knee and Thigh Injuries	434	(13)
Acute Soft Tissue Injuries	434	(6)
Chronic or Overuse Soft Tissue Injuries	440	(2)
Traumatic Fractures	442	(2)
Dislocation and Subluxation	444	(1)
Bony and Articular Defects Secondary to Repetitive Stress	444	(2)
Nerve and Vascular Injuries	446	(1)
Structural and Functional Abnormalities	446	(1)
Objective Tests	447	(13)
Palpation	447	(1)
Range of Motion	448	(1)
Strength	449	(3)
Neurovascular Examination	452	(1)
Special Tests	453	(6)
Joint Mobility Tests	459	(1)
Injury Examination Strategies	460	(10)
On-Site Examination	460	(2)
Acute Examination	462	(3)
Clinical Examination	465	(5)
Learning Aids	470	(5)
Summary	470	(2)
Review Questions	472	(1)
Critical Thinking Questions	472	(1)
Cited References	473	(1)
Additional Resources	473	(2)
Hip, Pelvis, and Groin	475	(38)
Functional Anatomy	476	(3)
Hip, Pelvis, and Groin Injuries	479	(10)
Acute Soft Tissue Injuries	479	(2)
Chronic or Overuse Soft Tissue Injuries	481	(1)
Traumatic Fractures and Hip Dislocation	482	(1)
Defects and Abnormalities Secondary to Repetitive Stress	483	(4)
Nerve and Vascular Injuries	487	(1)
Structural and Functional Abnormalities	487	(2)
Objective Tests	489	(11)
Palpation	489	(1)
Range of Motion	490	(1)
Strength	490	(5)
Neurovascular Examination	495	(1)
Special Tests	495	(5)
Joint Mobility Tests	500	(1)
Injury Examination Strategies	500	(9)
On-Site Examination	501	(2)
Acute Examination	503	(2)
Clinical Examination	505	(4)
Learning Aids	509	(4)
Summary	509	(2)
Review Questions	511	(1)
Critical Thinking Questions	511	(1)
Cited Reference	512	(1)
Additional Resources	512	(1)
Head and Face	513	(46)
Functional Anatomy	514	(3)
Head and Face Injuries	517	(10)
Head Injuries	517	(5)
Eye Injuries	522	(2)
Ear Injuries	524	(1)
Nasal Injuries	524	(1)
Face and Jaw Injuries	525	(1)
Dental Injuries	526	(1)
Objective Tests	527	(13)
Observation and Palpation	527	(1)
Range of Motion	528	(1)
Neurovascular Examination	529	(1)
Special Tests	530	(10)
Injury Examination Strategies	540	(14)
On-Site Examination of Head Injury	541	(3)
Acute Examination of Head Injury	544	(5)
Follow-Up (Clinical) Examination of Head Injury	549	(3)
Examination of Facial Injuries	552	(2)
Learning Aids	554	(5)
Summary	554	(2)
Review Questions	556	(1)
Critical Thinking Questions	557	(1)
Cited References	557	(1)
Additional Resources	558	(1)
Thorax and Abdomen	559	(28)
Functional Anatomy	560	(2)
Thoracic Cavity	560	(1)
Abdominal Cavity	561	(1)
Injuries of the Thorax and Abdomen	562	(8)
Thorax	562	(4)
Abdomen	566	(4)
Objective Tests	570	(6)
Palpation	570	(2)
Range of Motion and Strength	572	(2)
Neurovascular Examination	574	(1)
Special Tests	574	(2)
Injury Examination Strategies	576	(8)
On-Site Examination	576	(4)
Acute and Clinical Examination	580	(4)
Learning Aids	584	(3)
Summary	584	(1)
Review Questions	585	(1)
Critical Thinking Questions	586	(1)
Cited References	586	(1)
Additional Resources	586	(1)
Part III RECOGNITION OF GENERAL MEDICAL CONDITIONS	587	(66)
EENT and Cardiorespiratory Conditions	589	(18)
Eyes, Ears, and Mouth	590	(2)
Eye Conditions	590	(1)
Ear Conditions	591	(1)
Dental and Gum Disease	592	(1)
Respiratory System	592	(6)
Upper Respiratory Conditions	592	(2)
Bronchial and Lung Infections	594	(1)
Other Respiratory Conditions	595	(3)
Cardiovascular System	598	(3)
Viral Syndromes	601	(2)
Learning Aids	603	(4)
Summary	603	(1)
Review Questions	604	(1)
Critical Thinking Questions	604	(1)
Cited References	605	(1)
Additional Resources	605	(2)
Digestive, Endocrine, Reproductive, and Urinary Conditions	607	(26)
Endocrine System	608	(4)
Digestive System	612	(2)
Eating Disorders	614	(2)
Sexually Transmitted Diseases and Diseases Transmitted by Body Fluid	616	(3)
Genitourinary Tract and Organs	619	(3)
Gynecological Conditions	622	(7)
Menstrual Dysfunction	622	(2)
Pregnancy Issues	624	(2)
Pelvic Conditions	626	(1)
Breast Conditions	627	(2)
Learning Aids	629	(4)
Summary	629	(1)
Review Questions	630	(1)
Critical Thinking Questions	631	(1)
Cited References	631	(1)
Additional Resources	632	(1)
Musculoskeletal, Nervous, and Integumentary Conditions	633	(20)
The Skin	634	(9)
Skin Infections	634	(6)
Inflammatory Conditions	640	(1)
Environmental Exposures	641	(1)
Other Lesions	642	(1)
Musculoskeletal Conditions	643	(1)
Bone and Joint	643	(1)
Muscular Disorders	644	(1)
Neurological Disorders	644	(3)
Systemic Diseases	647	(2)
Learning Aids	649	(4)
Summary	649	(1)
Review Questions	650	(1)
Critical Thinking Questions	650	(1)
Cited References	651	(1)
Additional Resources	651	(2)
Glossary	653	(20)
Index	673	(24)
About the Authors	697