I admit this is totally stolen from a site that only docs/med students have access to, but I figured it would be worth sharing with the SB. Answers are posted after each question.

When everything was on the line during the recent Fédération Internationale de Football Association (FIFA) World Cup, the soccer players, such as German midfielder Bastian Schweinsteiger, shown above, wouldn't quit. Kicks, cramps, blows, bites, gaping lacerations, and worse weren't enough to sideline them.

On the field, team physicians were challenged to quickly assess and treat a variety of injuries, both classic and unusual for soccer, within (and beyond) the scope of orthopedics.

Put yourself in their shoes. Imagine that you're a team physician at the world's most-watched sporting event. How knowledgeable are you about diagnosing and treating the variety of injuries incurred? Take this quiz to find out.

A Common Fracture — But Not for a Sports Injury
Brazil's Neymar da Silva Santos, 22, was hit in the back by another player's knee, causing a fracture of the third lumbar vertebra. This was not a complicated fracture and is being treated conservatively with a support harness during the next few weeks.

This type of injury isn't rare. Over 400,000 new vertebral fractures are diagnosed in Europe annually.[1] Epidemiologists expect that number to double by 2050.[2]

Most vertebral fractures aren't due to sports injuries but rather to osteoporosis. About how many of them occur in the United States each year?

500,000
630,000
700,000
750,000
820,000

Answer: C. 700,000
Osteoporosis causes about 1.5 million fractures each year in the United States alone.[3] Most — approximately 700,000 — occur in the spine. Other osteoporosis-related injuries include distal forearm fractures (approximately 250,000 a year), hip fractures (approximately 250,000 a year), and other limb fractures (approximately 300,000 a year).

When a Soccer Player Bites Off More Than He Can Chew
In the Uruguay-Italy match, Uruguay's Luis Suarez bit another player — the third time he has bitten an opponent during a soccer match. The victim, Italy's Giorgio Chiellini, apparently had only 2 clear bite impressions. But bite injuries are not always without complications. A human bite can be more dangerous than an animal bite because of higher infection rates. One reason: Patients with human bites often postpone an ER visit longer than patients with other injuries. Bites are often in the extremities: the hands and avascular structures, such as the cartilage of the ear.[4] Human saliva contains over 50 species of bacteria, some of which frequently cause infections in bite injuries.[5] Which of these bacteria is usually not implicated in human bite infections?

Streptococci
Staphylococci
Clostridia
Eikenella
Prevotella

Answer: C. Clostridia
A multicenter study revealed that 44% of bite wounds are contaminated with aerobes and 2% with anaerobes alone. A mix of both was most common (54%).[6] Streptococcus, Staphylococcus, and Eikenella species dominate the aerobic bacteria isolated from wounds. Among the anaerobic microbes, Prevotella and Fusobacterium species are most common. Clostridia are most known for causing tetanus (Clostridium tetani) and diarrhea (Clostridium difficile) in hospitalized patients. Transmission of C tetani through bites has been observed but is rare.[7,8]

Among the Most Common Soccer Injuries: Torn Thigh Muscles
Germany's Shkodran Mustafi suffered a typical soccer player's injury in a match against Algeria: a muscle bundle tear in the left thigh. Approximately every third injury in a soccer game affects the musculature of the thighs. Strains, fiber tears, and bundle tears occur mainly in the ischiocrural musculature region. Muscle fiber tears and other soft tissue injuries are treated with the RICE method, regardless of location. What is this 4-step method?

Rest, intensification, compression, ergotherapy
Rest, ice, compression, elevation
Rest, ice, cortisone, epoetin
Rest, ice, cortisone, ergotherapy
Rest, ice, compression, vitamin E

Answer: B. Rest, ice, compression, elevation
Further strain on injured muscles can worsen the injury. Thus, rest — meaning a decrease in the amount, frequency, and intensity of muscle use — is crucial in the treatment of any soft-tissue injury.[9] Immediately after the injury, the application of ice packs, compression, and elevation help to reduce swelling and bleeding.

When Being Forced to Rest During a Game Can Be Risky
An extended pause in play during a soccer match — such as during a player substitution — can have serious (even career-long) consequences for some players. For example, Portugal's Fábio Coentrão, who suffered an adductor injury in the right thigh after a period of rest in the intensely played Portugal-Germany match, was sidelined for the rest of the World Cup. Adductor strains are typical injuries in soccer. A Scandinavian study of 100 soccer players counted 10-18 adductor injuries per 100 soccer players per year.[10]

Why? Frequent movements in soccer can end in an adductor injury. Which are examples of such movements?

Rapid adduction of the hips against an abduction force
Acute and forced abduction with abnormal stretching of the tendon
Rapid acceleration during sprinting
A and B
A, B, and C

Answer: E. A, B, and C
Adductor injuries aren't limited to soccer. They are common in other sports as well. For example, a rapid adduction of the hip while changing direction in tennis, an acute forced abduction during a rugby tackle, or a sudden acceleration in sprinting can all lead to an adductor injury.[11] A failure to stretch the adductor muscles prior to engaging in athletic competition increases the risk for adductor injury even more.

2 ...

Report Post

Posted by cwil177

Baton Rouge

Member since Jun 2011

28426 posts

Posted on 9/29/14 at 6:10 pm to cwil177

Team Physicians Often Let Players Play With Serious Concussions
Concussions are classic soccer injuries, but, controversially, players suspected of having even serious concussions are often allowed to continue to play. For example, German midfielder Christoph Kramer's head collided with full force into the shoulder of Argentina's Ezequiel Garay during a rigorously played match. Kramer was allowed to keep on playing. He stumbled across the field for 10 minutes before being replaced. After the game, he reported memory gaps; he was not able to remember the first half of the match at all. What type of amnesia did he have?

Retrograde amnesia
Anterograde amnesia
Transient global amnesia
Lacunar amnesia
Dissociative amnesia

Answer: A. Retrograde amnesia
Retrograde amnesia is marked by a loss of memory access to information that was learned before the injury. Anterograde amnesia describes exactly the opposite loss of memory. Patients suffering from this type of amnesia fail to remember events that happen after their injury. Patients with transient global amnesia show symptoms of both anterograde and retrograde amnesia; in some cases, retrograde amnesia may be minor. Lacunar amnesia describes a loss of memory function for certain events. In dissociative amnesia, the patient is unable to remember vital personal information that has nothing to do with normal forgetfulness; it's commonly seen in individuals who have witnessed a violent crime or a grave accident and doesn't occur with a medical illness.

A Profusely Bleeding Laceration Is No Reason to Call It a Day
Ecuadorian midfielder Christian Noboa suffered a violent head-to-head collision with France's Blaise Matuidi, resulting in a severely bleeding laceration. Noboa's head was bandaged and fitted with a mesh-like cap by his team physician, and he went right back into the game.

Whether the many soccer players who suffered head injuries during the World Cup should have been allowed back onto the field is a matter of heated debate. Many displayed classic symptoms of concussion. Which of these is not a facultative — that is, an optional or discretionary — symptom?

Headache
Brief loss of consciousness
Amnesia
Vomiting
Sensitivity to noise

Answer: B. Brief loss of consciousness
A brief loss of consciousness is an obligatory symptom of a concussion. All of the other answer choices — headache, amnesia, vomiting, and sensitivity to noise — are facultative symptoms.

For One Player, Brutal Injuries From One End to the Other
Argentina's Javier Mascherano collided heads painfully with an opposing player in the World Cup semi-final match, but like so many other injured players in the tournament, he continued playing. Initially he only appeared to be dizzy, but he then stumbled and finally fell to the ground. He was, however, back in the game a few minutes later. This was not Mascherano's only painful experience during the match. Shortly before the referee blew the final whistle, he lunged to attack Dutch midfielder Arjen Robben, whereupon, he says, he tore his anus. Anal fissures aren't classic soccer injuries, but they can be caused by trauma, low fiber intake, and psychological stress. Which of the following should be checked in cases of reoccurring anal fissures?

Sexual preference
Chronic inflammatory bowel disease
Diarrhea
Constipation
All of the above

Answer: E. All of the above
The etiology of anal fissures remains inconclusive, but there are some well-known risk factors. Constipation, diarrhea, and inflammatory bowel disease, as well as a proclivity for anal sex, can increase the risk for anal injury.

An Accidental Face Kick Nearly Costs a Player His Eye
In another instance of bloody head injury, Swiss defender Steve von Bergen and French striker Olivier Giroud collided in the fifth minute of play. Giroud, lunging to kick the ball, struck von Bergen in the middle of the face with his foot instead. The Swiss player fell to the ground with a gaping laceration below the left eye. Subsequent diagnostic imaging revealed an orbital fracture.

Which signs and symptoms would indicate surgery for this injury?

Headaches
Over 50% of the orbital floor is affected
Persistent diplopia
A, B, and C
B and C

Answer: E. B and C
A blow-out fracture doesn't always require surgery. Indications are based on the extent of fracture and ocular motility. Large fractures with displacement or comminution — that is, the act of breaking, or the condition of being broken, into small fragments — of more than 50% of the orbital floor, or persistent diplopia, should be corrected by surgery.[12]

A Soccer Ball Kicked With Bone-Fracturing Force
When Nigerian midfielder Michael Babatunde (shown above being carried off the field in a stretcher, with noninjured arm covering his face) inadvertently blocked his teammate's goal shot, the brutal shot slammed into his right arm, fracturing it.

Several fracture patterns occur in the forearm. Name a fracture of the ulnar shaft with a luxation of the head of radius.

Monteggia fracture
Galeazzi fracture
Chassaignac paralysis
Colles fracture
Smith fracture

Answer: A. Monteggia fracture
Fractures of the lower arms have various kinds of injury patterns with proper names. The Monteggia injury describes a fracture of the ulnar shaft with a luxation of the head of the radius. In a Galeazzi fracture, the radius is broken and the distal radioulnar joint is dislocated. Chassaignac paralysis is most common in children. It describes a subluxation of the head of the radius, which is usually caused by a sudden traction of the child's arm. Colles fracture is known for its bayonet deformity, the result of a radius fracture with a radial displacement of the wrist. Finally, Smith fracture describes a fracture of the distal radius alone.

3 ...

Report Post

Posted by bluebarracuda