&nbs= p; With model sitting down-
1. &nbs= p; Place cuff on left arm and Velcro on
2. &nbs= p; Place stethoscope bell over crease of elbow = and hold firmly
3. &nbs= p; Pump cuff up to at least 200mmHg
4. &nbs= p; Slowly let out and listen for first sound-remember number
a. Then listen for last sound and remember numb= er
5. &nbs= p; Record/report number
NOTES:
&nbs= p; Performing adult cpr
&nbs= p; &= nbsp; Responsiveness-tap and talk
&nbs= p; &= nbsp; Send someone to call 911
&nbs= p; &= nbsp; Open airway
&nbs= p; &= nbsp; Look, listen and feel for breaths, about 5 sec
&nbs= p; &= nbsp; If no breaths—give 2 breaths
&nbs= p; &= nbsp; ***Be sure that the breaths go in, if not re-tilt and try again****
&nbs= p; &= nbsp; Check for circulation at carotid pulse or check for signs of life
&nbs= p; &= nbsp; Start 15 chest compressions-landmark is nipple line
&nbs= p; &= nbsp; 2 breaths-15 compressions-2 breaths-15 compressions-2 breaths-15 compressions= -then check pulse again.
&n= bsp; = ; If victim vomits, log roll towards you, do a finger sweep to the mouth
NOTES:
Helmet
&nbs= p; &= nbsp; State, “athlete would wet hair to simulate sweat”
&nbs= p; &= nbsp; Once helmet is on:
1. &nbs= p; Check back to make sure helmet covers base of skull
2. &nbs= p; Check front pad for approximately 1.5 inches above brow
3. &nbs= p; Check space between face mask and nose—= ;at least 2 inches or 3 fingers
4. &nbs= p; Check to make sure ear holes line up
5. &nbs= p; Have athlete hold head still and grab facema= sk and move helmet around---helmet should not move,= head should move with helmet.
Shoulder pads
Use tape measure to measure width of shoulder
The inside shoulder pad should cover the top of the shoulder in direct line with the lateral aspect of shoulder
The cups should cover the deltoid muscle and allow movements of the shoulder th= at the athlete may need to perform.
Neck opening must allow the athlete to raise the arm overhead but not allow the = pad to slide back and forth
Check straps under arms to make sure they are not too tight.
NOTES:
&nbs= p; Concussion evaluation
&nbs= p; &= nbsp; Check the reaction of the pupils—compare each eye
&nbs= p; &= nbsp; &nbs= p; Normal reaction: the pupils should constrict at an equal rate
&nbs=
p; &=
nbsp; &nbs=
p;
&nbs= p; &= nbsp; Use penlight to check for Nystagmus (shaking of the eyes as they move)
&nbs= p; &= nbsp; &nbs= p; Move penlight in the shape of an “H”, slowly to check for miss track= ing
NOTES:
&nbs= p; Tool used to measure joint range of motions
&nbs= p; &= nbsp; Ankle: plantarflexion=3D50 degree= s &= nbsp; dorsiflexion=3D20 degrees
&nbs= p; &= nbsp; &nbs= p; Inversion-5 degrees = &nb= sp; ever= sion=3D5 degrees
&nbs= p; &= nbsp; Knee: flexion=3D135 degrees &= nbsp; &nbs= p; extension=3D0 degrees
&nbs= p; &= nbsp; &nbs= p; Internal rotation=3D10 = &nb= sp; ext. rotation=3D10
&nbs= p; &= nbsp; Hip: flexion=3D120 degrees &= nbsp; &nbs= p; = extension=3D 30 degrees
&nbs= p; &= nbsp; &nbs= p; Abduction=3D45-50 &= nbsp; &nbs= p; adduction=3D 20-30 degrees
&nbs= p; &= nbsp; &nbs= p; Internal rotation=3D35 = &nb= sp; ext. rotation=3D45 degrees &nbs= p;
&nbs=
p; Shoulder: flexion=3D90 degrees
&nbs= p; &= nbsp; Int. rotation=3D55 = &nb= sp; = ext. rotation=3D40-45
&nbs= p; &= nbsp; Abduction=3D180 degrees &= nbsp; &nbs= p; adduc= tion=3D45 degrees
&nbs= p; &= nbsp; Elbow: flexion=3D135 degrees &= nbsp; &= nbsp; extension=3D0/5 degrees
&nbs= p; &= nbsp; &nbs= p; Supination=3D90 degrees = Pronation=3D90 degrees
&nbs= p; &= nbsp; Wrist: flexion=3D80degrees &= nbsp; &nbs= p; extension=3D70 degrees
&nbs= p; &= nbsp; &nbs= p; Ulnar deviation=3D30 degrees &nb= sp; = Radial deviation=3D20
&nbs= p; Finger: flexion (PIP)=3D100 degrees = &nb= sp; extension=3D0degrees
&nbs= p; &= nbsp; Flexion (DIP)=3D90 degrees = a= bduction=3D 20 degrees
&nbs= p; &= nbsp; Adduction=3D0 degrees
&nbs= p; Thumb: flexion (MCP)=3D50 degrees= &= nbsp; &nbs= p; extension=3D0-5 degrees
&nbs= p; &= nbsp; = Flexion (IP)=3D85-90 degrees &n= bsp; = ; abduction=3D60-70 degrees
&nbs= p; &= nbsp; Adduction=3D30 degrees
NOTES:
&nbs= p; Tool used to determine intact peripheral nerve function
&nbs= p; Use rubber point and tap on tendon of the following muscles:
&nbs= p; &= nbsp; Triceps: checks Cervical nerve ro= ot 7—COMPARE TO OTHER SIDE
&nbs= p; &= nbsp; Biceps: checks Cervical nerve roo= t 5--- COMPARE TO OTHER SIDE
&nbs= p; &= nbsp; Brachioradialis: checks Cervical = nerve root 6—COMPARE TO OTHER
&nbs= p; &= nbsp; Patellar: checks Lumbar nerve roo= t 3-4 –COMPARE TO OTHER SIDE
&nbs= p; &= nbsp; Achilles: checks Lumbar nerve roo= t 5 – COMPARE TO OTHER SIDE
&nbs= p;
&nbs= p; BABINSKI’S SIGN: checks for thoracic nerve damage
Use metal pointy end and ru= n along foot-normal toes should curl, abnormal toes will splay.
NOTES:
&nbs= p; Tool used to measure body fat
&nbs= p; Take measurements at mid triceps, pectoralis, by ilium, mid quadriceps, by point= of scapula
&nbs= p; Record each and then add up, use graph if available.
&nbs= p; *Remember to only pinch skin and fat NOT muscle.
NOTES:
&nbs= p; Tool used to measure leg length or girth measurements
&nbs= p; Leg length: use tape measure and measure one leg at a time. St= art with tape measure at the ASIS of the pelvis (ilium) and measure down to the medial malleolus, record and repeat with other leg.
&nbs=
p; Girth/swelling/atrophy:
&nbs= p; &= nbsp; Quad: measure 3 inches and 6 inches above mid patella compare to other
&nbs= p; &= nbsp; Ankle: figure eight measurement for swelling compare to other side
NOTES:
&nbs= p; There will be various sizes of ace wraps
&nbs= p; Quad/Hammy: use a 4 or 6-inch sin= gle wrap
&nbs= p; &= nbsp; &nbs= p; Spray with QDA/Tuff skin
&nbs= p; &= nbsp; &nbs= p; Start distal and spiral up making sure you cover the area of pain
&nbs= p; Hip spica: use a 6-inch double
&nbs= p; &= nbsp; Athlete needs to be in spandex or compression shorts
Start with= foot resting on a 12inch box or step
Start wrap= ping from inside pulling out, wrap around thigh 3-4 times
Continue w= rapping up around waist then back down to thigh and back up around waist and contin= ue pattern.
End wrap a= round thigh then secure with tape.
&=
nbsp; Groin Spica: use a 6-inch double<=
/p>
&nbs= p; &= nbsp; Athlete needs to be in spandex or compression shorts
&nbs= p; &= nbsp; Start with foot/leg/thigh internally rotated
&nbs= p; &= nbsp; Start wrapping from outside in and follow same pattern as in hip spica
&nbs= p; Ribs: use a 6-inch single
&nbs= p; &= nbsp; Athlete needs to take a deep breath to expand ribcage
&nbs= p; &= nbsp; Wrap around and secure with tape
&nbs= p;
&nbs= p; Shoulder spica: use a 6-inch doub= le
&nbs= p; &= nbsp; Athlete needs to be standing or sitting-can have shirt on
&nbs= p; &= nbsp; Start with wrap around upper arm outside in for an anchor
&nbs= p; &= nbsp; Wrap around chest under opposite arm
&nbs= p; &= nbsp; Wrap around back then up over the deltoid and then under armpit
&nbs= p; &= nbsp; Continue same pattern until out of wrap, secure with tape.
NOTES:
&nbs= p; **KEEP ATHLETE COMFORTABLE, STAY AWAY FROM PRIVATE AREAS
&nbs= p; Petrissage-kneading of muscle, us= ed for big muscles like back, quads, hams, calf
&nbs= p; Effleurage- light stroking used a= round joints to get out swelling, also used to at beginning of massage to get ath= lete comfortable to touch.
&nbs= p; Tapotement-hacking, cupping, vibration-used to wake up the muscles not for relaxation.
&nbs= p; Acupressure- find pressure points= and press on for approx 1 minute, shoulders etc
&nbs= p; Friction- used mainly for tendini= tis or to increase specific blood flow. Use thumb and rub back and forth across tendon apply a moderate amou= nt of pressure.
NOTES:
&nbs= p; Examiner will ask you to take a piece of tape and locate bones, processes of bones, ligaments, origins or insertions of muscles.
NOTES:
&nbs= p; Supplies: gloves, gauze, pre-wrap, tape
&nbs= p; Apply direct pressure with a piece of gauze
&nbs= p; Apply a pressure bandage with gauze, pre-wrap, tape
&nbs= p; Elevate if not fractured
&nbs= p; Pressure points: arm-brachial, thigh-femoral
-athlete should be relaxed = for all tests
&nbs= p; Ankle: anterior drawer-checking laxity in ATFL-BILATERALLY COMPARE
&nbs= p; &= nbsp; Talar tilt-checking laxity in CFL- BILATERALLY COMPARE
&nbs= p; &= nbsp; Fracture tests: bump and compress= ion
&nbs= p; Knee: anterior drawer-che= cking laxity in ACL- BILATERALLY COMPARE
&nbs= p; &= nbsp; &nbs= p; Knee is bent at 90 degrees, grab tibia and pull forward
&nbs= p; &= nbsp; Lachman’s- checking laxity = in ACL- BILATERALLY COMPARE
&nbs= p; &= nbsp; &nbs= p; Knee is bent at 30 degrees, one hand pushes down on femur and the other hand pul= ls up on tibia.
&nbs= p; &= nbsp; Posterior drawer-checking laxity = in PCL- BILATERALLY COMPARE
&nbs= p; &= nbsp; &nbs= p; Knee is bent at 90 degrees, grab tibia and push backward
&nbs= p; &= nbsp; Posterior sag- checking for tear = in PCL-BILATERALLY COMPARE.
&nbs= p; &= nbsp; &nbs= p; Have athlete lying supine with hip flexed and knee flexed to 90 degrees, if PCL = is torn tibia will sag down.
&nbs= p; &= nbsp; McMurray’s: checking for te= ar in meniscus- BILATERALLY COMPARE
&nbs= p; &= nbsp; &nbs= p; 1 hand on joint line, other hand around foot, as the knee is flexed externall= y rotate leg/foot, then move knee into extension and internally rotate leg/foot
&nbs= p; &= nbsp; Apley’s Compression/Distraction= : checking for tear in meniscus
&nbs= p; &= nbsp; &nbs= p; Athlete is lying prone, knee is bent to 90 degrees. Apply downward pressure to heel and internally and externally rotate. Then pull up on leg while stabilizing the femur and internally and externally rotate leg.
&nbs= p; &= nbsp; Valgus stress: checking for laxit= y in the MCL- BILATERALLY COMPARE &n= bsp; knee is bent to 30 degrees of flexion, one hand supporting knee, other hand has = a hold of the leg by the ankle, externally rotate leg and push medially on knee at joint line. Repeat with knee = in full extension
Varus stress: checking for laxity= in the LCL- BILATERALLY COMPARE. Knee is bent to 30 degrees of flexion, one hand supporting the knee from the ins= ide, other hand has a hold of the leg close to the ankle, internally rotate leg = and push laterally on knee at joint line. Repeat with knee in full extension
&nbs= p; &= nbsp; Patellar apprehension: checking f= or a subluxing patella.
&nbs= p; &= nbsp; &nbs= p; With knee relaxed in an extended position, apply a mild force to patella lateral= ly and watch athlete’s face for apprehension or pain display.
&nbs= p; &= nbsp; Patellar grind (Clarke’s sign)<= /b>: checking for chondromalacia (softening of cartilage/bone) With knee relaxed in an extended position, apply an inferior force then have ath= lete contract quadriceps-positive if painful.
&nbs= p; &= nbsp; Pivot shift: checking for acl lax= ity. Do a modified McMurray’s.
&nbs= p; &= nbsp;
&nbs= p; Shoulder: apprehension test: checking for glenohumeral instability- B
&nbs= p; &= nbsp; &nbs= p; Bend elbow to 90 degrees, abduct shoulder to 90 degrees, and then externally rot= ate shoulder then push on posterior aspect of shoulder forward.
&nbs= p; &= nbsp; Sulcus: checking for superior/inf= erior glenohumeral instability-B
&nbs= p; &= nbsp; &nbs= p; While stabilizing scapula/acromion pull down on humerus noting if there is a spac= e in shoulder joint.
&nbs= p; &= nbsp; Shift and load: checking for anterior/posterior laxity in glenohumeral joint
&nbs= p; &= nbsp; &nbs= p; While stabilizing scapula/acromion, grab a hold of proximal humerus and try to sh= ift forward and back.
&nbs= p; &= nbsp; Neer’s test (Impingement sign):= checking for impingement of the Supraspinatus m. Passively move the shoulder/arm into full flexion/abduction and check for pain at end of motion
&nbs= p; &= nbsp; Hawkins-Kennedy test: checking for impingement of the Supraspinatus m &nb= sp; = &nb= sp; with hands holding the forearm and humerus, slowly move shoulder into horizontal adduction and internally rotate shoulder-checking for pain
&nbs= p; &= nbsp; Compression/piano test: checks fo= r a fractured clavicle
&nbs= p; &= nbsp; &nbs= p; Grab a hold of clavicle and try to move it up and down checking for clicking and pain.
&nbs= p; &= nbsp; Empty can test: checking for a st= rain or tear in Supraspinatus
&nbs= p; &= nbsp; &nbs= p; With athlete’s arms at 45 degrees of abduction, supinate and pronate forea= rms as though athlete was emptying a pop can onto the ground
&nbs= p; &= nbsp; Drop arm test: checking for tear = in rotator cuff
&nbs= p; &= nbsp; &nbs= p; Have athlete abduct arm then slowly lower, if athlete’s arm drops, test is positive
&nbs= p; &= nbsp; Speed’s test: checking for = biceps tendinitis.
&nbs= p; &= nbsp; &nbs= p; Have athlete put shoulder at 90 degrees of flexion with palm up and hold there w= hile you pull down.
Yergason’s test: checking f= or a subluxing biceps tendon.
&nbs= p; &= nbsp; &nbs= p; Have athlete flex elbow to 90 degrees and forearm pronated, then pull arm into Supination and external rotation.
&nbs= p;
Elbow: valgus stress test: checking for medial instabili= ty. COMPARE BILAT.
&nbs= p; &= nbsp; Varus stress test: checking for l= ateral instability. COMPARE BILAT.
&nbs= p; &= nbsp; Tinel’s test: checking for compression of the ulnar nerve. Tap on the ulnar groove checking for pain/tingling in 4/5 digits.
&nbs= p; &= nbsp; Lateral epicondylitis: checking f= or pain in the wrist extensor muscles. COMPARE BILATERALLY. A= pply resistance while athlete moves wrist into extension.
&nbs= p; &= nbsp; Medial epicondylitis: checking for pain in the wrist flex= or muscles. COMPARE BILATERALLY. Apply resistance while athlete moves wrist into flexion.
&nbs= p; Spine: straight leg raising- checking for nerve pain in low back. Have athlete lie supine and passively raise one leg at a time as hig= h as it will go or until the athlete complains of tightness or pain, then lower = leg to the point where there is no more pain, then have the athlete flex neck a= nd then at the same time dorsiflex foot if there is pain with this it tells you that the covering of the spinal cord is being stretched.
&nbs= p; Hip: Thomas test- checking= for tight hip flexors. Have athle= te lie supine; passively flex one hip to chest checking to see if other leg bows upward. Repeat with other leg.
&nbs=
p; &=
nbsp; Ober’s test- checking for t=
ight
or irritated IT band. Athlete
should lie on side, knee should be in flexion and hip should be abducted.
&= nbsp; Wrist/Hand/Finger: finklestein test- checking for de Quervain’s disease in the thumb. &= nbsp; &nbs= p; Have athlete place thumb inside palm of hand, close hand to make a fist and then move wrist medially.
&nbs= p; &= nbsp; Tinel’s test- checking for carpal tunnel nerve compression.
&nbs= p; &= nbsp; Tap on anterior side of wrist and check for numbness and tingling in the first 3 digits.
&nbs=
p; &=
nbsp; Phalen’s test- checking for
carpal tunnel syndrome. Have
patient flex wrists maximally for 1 minute by pushing both wrists
together. Numbness into 1
&nbs= p; &= nbsp; Allen test- checking for radial a= nd ulnar artery blockage. Have a= thlete open and close hand several times as quickly as possible then squeeze hand tightly. Place your fingers o= ver the radial and ulnar arteries, have patient open hand (should be white), release one artery to see if the hand flushes with blood. Repeat with other artery.
&nbs= p; ALWAYS BILATERALLY COMPARE
&nbs= p; Ankle: Plantarflexion-gastrocnemius/soleus
&nbs= p; &= nbsp; Dorsiflexion-anterior tibialis
&nbs= p; &= nbsp; Inversion-anterior tibialis, posterior tibialis
&nbs= p; &= nbsp; Eversion-peroneus longus, Brevis
&nbs= p;
Knee: Flexion-semimembranos= is, semitendinosis, biceps femoris, gracilis
&nbs= p; &= nbsp; Extension-rectus femoris, vastus lateralis, vastus medialis, vastus intermedialis
&nbs= p; &= nbsp; Rotation- biceps femoris, semitendinosis, semimembranosis, sartorius
&nbs= p; Hip: Flexion-pso= as, sartorius, rectus femoris
&nbs= p; &= nbsp; Extension-hamstrings, gluteus maximus
&nbs= p; &= nbsp; Adduction- adductor magnus, adductor longus, adductor Brevis, pectineus, gracilis
&nbs= p; &= nbsp; Abduction-sartorius, gluteus medius
&nbs= p; &= nbsp; Internal rotation
&nbs= p; &= nbsp; External rotation
&nbs= p;
Finger: Flexion-flexor digi= torum profundus, flexor digitorum superficialis, lumbricals
&nbs= p; &= nbsp; Extension- extensor digitorum, extensor digiti minimi
&nbs= p; &= nbsp; Abduction-dorsal interossi, abductor digiti minimi
&nbs= p; &= nbsp; Adduction-palmar interossei
&nbs= p; Thumb: Flexion-flexor pollicis Brevis, flexor pollicis longus
&nbs= p; &= nbsp; Extension-extensor pollicis Brevis, extensor pollicis longus
&nbs= p; &= nbsp; Adduction-adductor pollicis
&nbs= p; &= nbsp; Abduction-abductor pollicis Brevis, abductor pollicis longus
&nbs= p; Wrist: Flexion-flexor carpi ulnaris, flexor carpi radialis,
&nbs= p; &= nbsp; Extension-extensor carpi ulnaris, extensor carpi radialis longus and brevis,
&nbs= p; &= nbsp; Pronation-pronator teres, pronator quadratus
&nbs= p; &= nbsp; Supination-biceps brachii,
&nbs= p; Elbow: Flexion- biceps brachii
&nbs= p; &= nbsp; Extension- triceps brachii
&nbs= p; &= nbsp; Pronation- pronator teres, pronator quadratus
&nbs= p; &= nbsp; Supination-biceps, supinator
&nb= sp; Shoulder: Flexion-deltoid, coracobrachialis
&nbs= p; &= nbsp; Extension-deltoid, latissimus dorsi, teres major
&nbs= p; &= nbsp; Adduction-pectoralis major, latissimus dorsi
&nbs= p; &= nbsp; Abduction-supraspinatus, deltoid
&nbs= p; &= nbsp; Int. rotation-subscapularis, pectorialis, latissimus dorsi, teres major
&nbs= p; &= nbsp; Ext rotation-infraspinatus, teres minor
&nbs= p; &= nbsp; Scapular elevation-traps, levator scapulae
&nbs= p; &= nbsp; Scapular retraction-rhomboids
&nbs= p; &= nbsp; Scapular protraction-serratus anterior
&nbs= p; To determine the appropriate crutch size, athlete must be standing if able:
&nbs= p; &= nbsp; Crutch should be placed 6 inches away from foot and 2 inches to the front of the f= oot.
&nbs= p; &= nbsp; The top of the crutch should be approximately 1.5 inches or 3 fingers from armp= it.
&nbs= p; &= nbsp; The hand should rest on the hand brace so the wrist is flexed to approximately = 30 degrees of flexion.
&nbs= p; &= nbsp; Be sure that the athlete bears weight on hands and not shoulders
&nbs= p; Walking with crutches
&nbs= p; &= nbsp; Swing to gait
&nbs= p; &= nbsp; Shuffle gait
&nbs= p; &= nbsp; Swing thru gait.
&nbs= p; Stairs
&nbs= p; &= nbsp; UP--Good leg goes first, followed by bad leg and crutches
&nbs= p; &= nbsp; DOWN—bad leg and crutches go first followed by good leg.