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Self-insurance
institution estimates they'll pay less money for medical expenses than they would spend on insurance premiums so they self-insure
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Primary coverage
- Medical or accident insurance that begins to pay for expenses as soon as the institution pays deductible
- The athlete's personal insurance is not used to pay medical bill related to athletics
- Institution pays for all
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Secondary Coverage
Medical or accident insurance that begins to pay for expenses only after all other sources of insurance coverage have been exhausted
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Preferred Provider Organization
- policyholders can choose any provider they want, but financial incentives exist when selecting providers identified by PPO
- No "gatekeeper" physicians
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Health Maintenance Organization
- Policyholders can only use those healthcare providers previously approved by insurance company
- Al care must be coordinated by primary physician who is "gatekeeper" for referral services
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Tort
A legal wrong, other than breach of contract, for which courts provide remedy
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Commission
action that violates legal duty
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Omission
failure to act when a legal duty exists
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How to prove Negligence
following four points must be all substantiated: Existence of a duty, breach of duty, proximate cause, damage (injury)
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Malfeasance
- intentionally doing something legally or morally wrong which one had no right to do
- Always involves dishonesty, illegality, or knowngly exceeding authority for improper reasons
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Misfeasance
- Performance of a lawful action in a wrongful or injurious manner
- Wrong or error committed by mistake, negligence or inadvertence, but not by intentional wrongdoing
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Nonfeasance
Failure to do something that should be done or especially something that one is under a duty or obligation to do
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Blow-out fracture
- Direct force to globe
- Fx to medial wall
- Sx: mechanical difficulty with eye motion, numbness, sunken/retracted globe
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Hyphema
- Blood in anterior chamber due to direct trauma to eye
- Sx: pain, photophobia, blurring vision, elevated intraocular pressure
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"Saddle-Nose" deformity
Avascular necrosis of septal cartilage via repetitive trauma
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Carpal bones
- Proximal bones: scaphoid, lunate, triquetrum, pisiform
- Distal row: trapezium, trapezoid, capitate and hamate
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wrist extensor muscles are located...?
On the radial side of the elbow
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flexor muscles are generally located...
on the ulnar side of the elbow
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carpal tunnel contains
median nerve, flexor policus longus tendon, FDS tendons, FDP tendons
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anatomical snuffbox
scaphoid
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Colles's fracture
- Fx of distal radius/ulna secondary to FOOSH mech.
- Characterized by dorsal displacement of distal radius/ulna related to proximal shafts
- creates silver fork deformity
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Smith's fracture
- volar displacement of distal radius/ulna related to proximal shaft
- occurs secondary to hyperflexion injury
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Bennett's Fx
axial loading of 1st metacarpal will cause shear fx at base of metacarpal
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most common fx carpal bone
spaphoid- MOI compression against radius during FOOSH or axial loading during wrist EXT and RD
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easiest carpal bone to dislocate
Lunate- caused by FOOSH or wrist hyperextention; lunate displaced in volar direction
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Gamekeeper's thumb
- Ulnar collateral ligament injury involving 1st MCP joint
- Results from forced ABD and hyperextension
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Swan neck deformity
hyperextension deformity at PIP may cause hyper flexion at DIP joint due to tensioning of flexor tendons
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Jersey finger
- avulsion of flexor digitorum profundus tendon
- Occurs when distal phalanx is forcefully extended while finger is flexing
- With complete rupture patient will be unable to flex DIP joint while PIP joint is held in extension
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Mallet finger
- also known as baseball finger
- Rupture of distal extensor tendon
- Extended distal phalanx is suddenly and forcefully flexed
- May or may not include avulsion of bony fragment
- distal phalange is flexed
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Boutonniere Deformity
- Rupture of central slip of extensor digitorum tendon at insertion on middle phalanx; results in forced flexion of PIP joint
- deformity characterized by flexion of PIP and hyperextension of DIP (PIP will protrude through lateral bands of extensor hood)
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De Quervain's syndrome
tenosynovitis of APL and EPB tendons
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Trigger finger
- tenosnovitis of flexor tendon
- Results from repetitive trauma to flexor tendon sheath
- Tendon "catches" then "lets go" as moves through sheath, finger can be observed "snapping" as it is flexed
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Ape hand deformity
- In severe cases of muscle atrophy in thenar eminence resulting from prolonged inhibition of Meidan Nerve
- Extensor muscles draw thumb parallel to fingers and ability to oppose and flexion thumb are lost
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Cubital fossa (elbow)
includes from lateral to medial: biceps tendon, brachial artery, median nerve
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Tennis elbow
- Lateral Epicondylitis
- Activities that stress wrist extensors and supinator muscle
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Golfer's Elbow
- Medial epicondylitis
- Activities that stress wrist flexors and pronator muscle
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AC joint ligaments
Acromioclavicular ligament, Coracoclavicular ligament, Coracoacromial ligament
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Glenohumeral ligaments
- Superior (SGHL)
- Middle (MGHL)
- Inferior (IGHL)
- Coracohumeral ligament
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SGHL
- limits inferior translation at 0 degrees
- Limits anterior and EX ROT at 45 degrees
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MGHL
limits EX ROT from 45-90 degrees
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IGHL
- Limits inferior translation above 90 degrees
- Anterior band= taut in EX ROT
- Posterior band= taut in IN ROT
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Coracohumeral ligament
- Limits inferior translation
- Helps limit EX ROT below 60 degrees
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Rotator Cuff muslces
- Supraspinatus
- Infraspinatus
- Teres Minor
- Subscapularis
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Supraspinatus
- Inserts on greater tuberosity
- Little force contributed to ABD
- Fires in early abduction to "set" HH and prevent migration superiorly
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Infraspinatus
- Inserts on greater tuberosity
- Acts to EX ROT humerus (especially in elevation)
- Contracts eccentrically to slow the arm during throwing
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Teres Minor
- Inserts on greater tuberosity
- Acts to EX ROT humerus
- Contracts eccentrically to slow the arm during throwing
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Subscapularis
- Inserts on lesser tuberosity
- Acts to IN ROT humerus
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SLAP Lesion
- Superior Labral tear Anterior to Posterior
- labrum detaching from 10-2 o clock positions
- mild to moderate multi-directional instability results once biceps tendon detaches
- Acute onset: superior compression force during FOOSH mechanism
- Chronic onset: repetitive microtrauma or inferior traction as a result of deceleration while throwing
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Bankart lesion
- Traumatic detachment of anterior-inferior labrum
- Seen in over 85% of traumatic anterior dislocation
- Labrum detachment anywhere from 3-7 o'clock positions
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C1
- Atlas
- C0-C1 articulation primary motivation is flexion extension
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C2
- Atlas
- C1-C2 articulation allows for rotation
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Brachial Plexus
- "Network" formed by consecutive series of spinal nerves
- 5 spinal nerve roots: C5, C6, C7, C8, T1
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Torticollis
- rotation of the chin opposite the side of head tilt
- Congenital or acquired spasm of SCM muscle
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Jefferson's fracture
- A burst fracture of C1 (atlas)
- results from compression (flexion)
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Hangman's fracture
- Bi-pedicular fx of C2 vertebrae
- Sudden deceleration
- Hyper extension --> primary car accidents/sports
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Cerebrum
- Controls motor function: voluntary muscles, relays outgoing messages
- Interprets sensory impulses: temp, touch pain and proprioceptions
- Controls mental functions: memory, reasoning, intelligence, learning and judgement
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Cerebellum
- Designed for quick info processing with cerebrum
- Controls fluid and synergistic motions (balance and coordination)
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Diencephalon
- Processing center for conscious and unconscious brain input
- regulates hormones, temp, hydration level, hunger and emotions
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Brain stem
- relays info to and from CNS
- Regulates and controls involuntary systems (resp rate, HR, blood vessel diameter, coughing, vomiting)
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Aniscoria
- unequal pupils
- Sign of epidural hematoma formation
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Epidural hematoma
- arterial bleeding between skull and dura mater (rapid onset)
- may be briefly unconscious and sx of mild concussion
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Subdural hematoma
- venous bleeding between dura mater and membranes covering brain
- Delayed onset
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Number of ribs and types
- 12 ribs
- True: 1-7
- False: 8-10
- Floating: 11-12
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Imp organs located in RUQ
- liver
- gallbladder
- pancreas
- kidney
- lung
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Imp organs located in LUQ
- Heart
- spleen
- kidney
- stomach
- lung
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Imp organs located in LLQ
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Imp organs located in RLQ
- appendix
- ureter
- bladder
- colon
- gonad
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