Conestoga College Institute of Technology and Advanced Learning

School of Health & Life Sciences and Community Services

Fitness & Health Promotion Program

Injury Prevention and Management for Fitness & Health Promotion

HEAL1230
Midterm Exam
March 11, 2015

Instructions:
1.
2.
3.
4.

Read and follow all specific instructions.

Time allowed: 110 minutes
Total number of pages: 12 (including cover page)
Total marks: 80 marks, worth 20% of final grade

Name: ________________________________________________
Student Number: ________________________________________

This examination booklet is property of Conestoga College Institute of Technology

and Advanced Learning, School of Health & Life Sciences and Community Services

HEAL1230 Injury Prevention and Management

Midterm Exam

March 11, 2015

SECTION A: MULTIPLE CHOICE

Circle the letter that best answers the question. Each question is worth 1 mark.
1. In
a)
b)
c)
d)
e)

the acronym ATC IS IT, the T stands for:

Timing
Treatment
Total patient
a and b
a and c

2. A basic objective of a rehabilitation program is to:

a) Return to competition
b) Prevent deconditioning
c) Strengthen the weakened area
d) Gain full range of motion
3. A short-term goal is measureable, but a long-term goal is not.
a) True
b) False
4. The importance of an outcomes-based rehabilitation program is to
assess the patient at the start and end of a treatment program, in order
to see how far the patient has come.
a) True
b) False
5. You are an athletic trainer and your patient is an Olympic skier that has
just regained full muscular strength in his/her torn quadricep. The next
parameter you will address in your therapeutic program is:
a) Functional activities so the client can return to normal, daily living
b) RICE
c) Proprioception and coordination exercises to re-establish neuromuscular
function to prevent re-injury
d) The client is fully recovered and may return to competition immediately
6. Which statement is most correct regarding the healing process?
a) The only difference between primary and secondary healing is the size of the
wound
b) Primary healing occurs first, followed by secondary healing of a wound
c) Healing by primary intention requires stitches
d) Healing by secondary intention is the process of filling a wound from the
bottom and sides

HEAL1230 Injury Prevention and Management

Midterm Exam

March 11, 2015

7. The role of myofibroblasts is to:

a) Pull the sides of wound together to minimize scarring
b) Lay down new collagen
c) Clean the wound of damaged cells
d) Increase the rate of epithelial production to close the wound
8. A 20-year old male patient, who plays recreational basketball, comes to
you with a grade 3 ACL sprain. Which of the following is NOT a likely
characteristic of this injury:
a) Patient will undergo reconstructive surgery
b) Complete tear of tendon
c) Possible avulsion fracture
d) Instant disability
9. The danger with chronic injuries is that there is a chance the patient
may not recover full function of the limb.
a) True
b) False
10.
A patient comes to you with a wrist flexor strain. During your
assessment, they tell you they strained it two weeks ago playing
hockey. They also say the swelling has mostly gone down, but it is still
tender to the touch. What is NOT one of the therapeutic exercises you
will take them through at this stage?
a) Work on regaining full active ROM
b) Passively challenge wrist with extension/flexion stretching exercises but
careful not to aggravate it
c) Insist that no exercises should be completed at this time because his/her
injury is in the acute stage
d) Prevent deconditioning of cardiovascular system and uninjured areas
11. What are the primary ways rehabilitative programs can reduce the
risk of injury?
a) Slow progression through rehabilitative program
b) Reassessing injured area
c) Reassessing rehabilitative program
d) All of the above
e) Two of the above are correct
12.
a)
b)
c)
d)
e)

Which of the following is NOT a characteristic of an acute injury?

Heat
Redness
Altered function
Swelling
All of the above are characteristics of an acute injury

HEAL1230 Injury Prevention and Management

Midterm Exam

March 11, 2015

13. When an individual strains their Achilles tendon, they are often
immediately unable to perform plantar flexion of the ankle. This
reduced mobility occurs due to swelling pressures of fluid and damaged
cells in interstitial spaces and on free nerve endings.
a) True
b) False
14. When applying ice to an acute injury, the proper technique to follow
is:
a) 20 minutes ice, followed by 20 minutes heat to relax muscles
b) Provide cloth barrier between ice and skin
c) Cycled application of ice is important to promote vasoconstriction and reduce
swelling
d) All of the above
e) b and c
15.
a)
b)
c)
d)
e)

Elevation of an injured limb allows for:

Management of swelling
Draining of fluids away from distal limb
Reduced blood flow to injured limb because of gravity
all of the above
a and c

16. The rule of thumb for icing an acute injury is, ice must be applied in
the first ____________ hour(s).
a) 24-48 hours
b) 48-72 hours
c) 72-96 hours
d) None of the above
17.
a)
b)
c)
d)
e)

Signs that indicate a patient is in the sub-acute stage of an injury is:

2-3 days after event of injury
Reduced swelling
Still very painful
ROM unchanged
All of the above, except c

18.
a)
b)
c)
d)

During the sub-acute stage of an injury, the regeneration of healing:

Replaces injured tissue with same tissue type
Replaces injured tissue with different tissue type
Undergoes normal restoration, due to little damage to tissue
There is no regeneration type of healing, it is called restoration

19. The most effective way of preventing an acute injury from

progressing to chronic is:
a) Strengthening injured limb past pre-injury state
b) Resting the area and using a brace when needed
c) Adhering to rehabilitation program
d) None of the above

HEAL1230 Injury Prevention and Management

Midterm Exam
20.
a)
b)
c)
d)
e)

March 11, 2015

Ergonomics is:
A method of preventing chronic injury
Product design to improve anatomical positioning during movement
Only necessary when the client has had a previous injury
All of the above
Two of the above

21. A patients description of their pain, on a scale from 0-10, is an

example of_______, whereas, range of motion is an example of______.
a) Objective; subjective
b) Subjective; objective
c) Examination; assessment
d) Assessment; examination
22. Subjective questions should be open-ended and simple.
a) True
b) False
23. An active or passive movement that reproduces the patients pain
symptom is referred to as a(n):
a) Evaluation test
b) Comparable sign
c) Subjective sign
d) Objective sign
24.
a)
b)
c)

Which statement is NOT true regarding objective examinations?

The goal is to determine the extent of the injury
Objective examinations include pain tolerance, and mechanism of injury
Objective examinations begin as soon as you come in contact with the
patient
d) Objective examinations help to determine program progression

25. Active range of motion (AROM) involves assessing which

physiological structures?
a) Contractile tissue
b) Non-contractile tissue
c) Ligaments and tendons
d) All of the above
e) A and C
26. Special tests of a subjective examination involve tests for
neurological damage and functional capability; such as standing on one
foot.
a) True
b) False

HEAL1230 Injury Prevention and Management

Midterm Exam
27.
a)
b)
c)
d)

March 11, 2015

Which of the following is NOT a purpose of an assessment?

To have a strict plan that addresses each goal
To form a guideline for setting goals
To identify whether the program plan is successful
To evaluate the current status of an injury

28. A patient comes to you with an inversion ankle sprain after being
cleared by a physiotherapist to begin treatment. After the second week
of treatment, you notice that the swelling in the ankle has increased;
you should:
a) Continue the treatment as planned
b) Reassess your problems, goals and plan
c) Reassess your goals and plan
d) Tell your client its their fault for not being more careful
29.
a)
b)
c)
d)
e)

When is it appropriate to perform an assessment?

Before treatment
After each treatment session
At the time of discharge
All of the above
All except B

30.
a)
b)
c)
d)

Which of the following is NOT true regarding taping and bracing?

Improper taping techniques may lead to further injury
Works in combination with all elements of a rehabilitative program
Should be worn every time athlete participates in activity/sport after injury
Assists in athletes return to competition

31. The only difference between elastic and non-elastic tape is the
elasticity.
a) True; they both serve the same purpose of stability
b) False; elastic tape provides no stability, whereas, non-elastic tape does
c) False; non-elastic tape provides the best support, whereas, elastic tape
enables normal muscle contraction
32. Andrew was playing hockey with his friends when he fell backwards
and stuck his arm out to break his fall, however, ended up spraining his
wrist. What is the best taping/ bracing option for Andrew?
a) Athletic tape
b) Leukotape
c) Kinesio tape
d) Tensor wrap
33. Kinesio tape should be used when full ROM in the limb is required;
yet, the muscles are too weak to deliver stable contractions.
a) True
b) False

HEAL1230 Injury Prevention and Management

Midterm Exam

March 11, 2015

34. Your patient has been recently diagnosed with a quadriceps

contusion. The best apparatus for this injury is:
a) Protective padding
b) Prophylactic bracing
c) Leukotape
d) Unloader/ Offloader brace
e) Functional brace
35. When assessing an athletes return to competition, the criteria is:
a) The injured limb must be equal in strength and ROM to that of the unaffected
limb
b) The athlete must show confidence in the injured limbs abilities
c) There is an absence of pain during agility and coordination activities
d) All of the above are correct
e) Two of the above are correct
36. It is okay to allow the client to lie down and relax the joint when
taping the ankle or foot.
a) True
b) False
37. The only purpose of underwrap is to prevent the hair from sticking to
the tape and causing pain when removing.
a) True
b) False
38. Flexibility is the response of ________, whereas, range of motion is
the response of ________ to a stretch stimulus.
a) Muscles acting at the joint; all tissues in a joint
b) All Tissues in a joint; muscles acting at the joint
c) None of the above are correct
d) Both involve the response of all tissues within a joint
39.
a)
b)
c)

Flexibility is ________, whereas, range of motion is_________.

Lengthening; ability to move
Ability to move; lengthening
None of the above

40.
a)
b)
c)
d)

Connective tissue obtains its tensile strength primarily from:

Elastin
Reticulin
Ground substance
Collagen

HEAL1230 Injury Prevention and Management

Midterm Exam

March 11, 2015

41. Which component of connective tissue is responsible for delivering

nutrients?
a) Areolar
b) Reticulin
c) Ground substance
d) Collagen
42.
a)
b)
c)
d)

Elastin:
Is needed to promote tissue repair
Provides joint lubrication to reduce friction
Is a determinant of an individuals range of motion
Is the least important component of connective tissue

43.
a)
b)
c)

Examples of dense regular connective tissue are:

Muscles and tendons
Tendons and ligaments
Ligaments and muscles

44.
a)
b)
c)
d)
e)

What is true regarding areolar tissue?

Contains thin collagen and elastin fibers
Found in skin and fascia
The orientation of the fibers are irregular
All of the above are correct
Two of the above are correct

45. Immobilization is considered to be a risky rehabilitation technique

because it can:
a) Reduce the number of elastin fibers, causing increased cross linkages
b) Reduce range of motion over time
c) Prevent proper alignment of fibers
d) A and B
e) B and C
46.
a)
b)
c)
d)
e)

Changes seen after prolonged immobilization are:

Decreased myofibrils and increased fibrous & fatty tissue
Increased myofibrils and increased fibrous & fatty tissue
Loss of proprioceptive feedback
A and B
A and C

47.
a)
b)
c)

Stretching the hamstrings by touching your toes, is an example of:

Passive stretch
Active stretch
PNF stretching

48. An increase in cross linkages also increases the extensibility of the

connective tissue.
a) True
b) False

HEAL1230 Injury Prevention and Management

Midterm Exam
49.
a)
b)
c)
d)
e)

March 11, 2015

The effectiveness of a stretch depends on:

Amount of collagen
Amount of elastin
Force and duration of stretch applied
Temperature of tissue
All of the above

50. When a muscle contracts, the muscle spindles receive no stimulation.

a) True
b) False
51. Which neurological component responds to a muscle being stretched
quickly?
a) Golgi tendon organs primarily
b) Muscle spindles primarily
c) They both respond equally
52.
a)
b)
c)
d)
e)

How is ROM measured?

Electrogoniometer
Goniometer
Measuring tape
All of the above
Two of the above

53. Safety precautions and contraindications should be used, for

increasing ROM, when:
a) Redness is visible on injured site
b) Infection at a joint
c) Weakness in limb
d) All of the above
54. Andrea is a professional hockey player, who has recently sprained
her left ankle; however, her doctor has permitted movement in the limb.
Which stretching technique should she be doing?
a) Passive stretching
b) PNF stretching
c) Active stretching
55. Doug has poor shoulder mobility due to a fall three months ago,
where he anteriorly dislocated his shoulder. Which stretching exercise
techniques should he participate in?
a) Passive stretching
b) Combined short-term passive followed by active stretching
c) Prolonged-stretch machines
d) PNF stretching

HEAL1230 Injury Prevention and Management

Midterm Exam

March 11, 2015

SECTION B: MATCHING
Match the definition to the appropriate word (10 marks).
Coach/ work supervisor

______

Rehabilitation clinician

______

Chronic

______

Level I, II, III

______

Emergency technician

______

Shear

______

Physician

______

Acute

______

Compression

______

Fibroblasts

______

a) Sharp pain
b) Decides when patient can resume regular activities
c) Extreme pressure causing hematoma
d) Tendonitis
e) Part of secondary rehabilitation team
f) Implements restrictions based on client status
g) Different degrees of strains/ sprains
h) Applied perpendicular to collagen fibers
i) Coordinator/ leader communicates with rest of team

HEAL1230 Injury Prevention and Management

Midterm Exam

March 11, 2015

j) Produces collagen
SECTION C: SHORT ANSWER
Answer each question in the space provided.
1. Complete the chart below with one example of a sign or symptom and
treatment method, and attribute each stage to the corresponding stage
of the tissue healing process (9 marks).

Stage

Acute
Stage

Sub-Acute
Stage

Chronic
Stage

Sign and
Symptom

Treatment
method

Corresponding
stage of healing
process

HEAL1230 Injury Prevention and Management

Midterm Exam

March 11, 2015

2. Your client, Amanda, has recently dislocated her shoulder and has come
to you for a rehabilitative program to get her back to playing volleyball
as soon as possible. Using your knowledge of a rehabilitation
examination, address the problem with specific goals, and specific
method of treatment for Amanda. (6 marks)
Problem Reduced range of motion
Short term goal:

Long-term goal:

Treatment plan:

Problem Reduced strength

Short term goal:

Long-term goal:

Treatment plan: