1. List at least 3 muscles of the foot and at least 6 muscles of lower leg.

Name most important ligament

of ankle and at least 2 other major ligaments. Describe in the following order an inversion type ankle
injury: a.) positions of the foot at the time of the injury, b.) structures usually sprained or ruptured in
sequence, c.) type of fracture that probably will occur if the force continues, d.) give the treatment plan
and, e.) give a brief rehab plan.

3 Muscles of foot:
1. abductor hallucis
2. extensor digitorum brevis
3. plantar interossei
ALSO:
-dorsal interossei
-flexor digiti minimi brevis
-adductor hallucis
-flexor hallucis brevis
-lumbricales
-quadratus plantae
-abductor digiti minimi

6 Muscles of Lower Leg:

1. tibialis anterior
2. peroneus tertius
3. peroneus longus
4. gastrocnemius
5. soleus
6. plantaris
ALSO:
-extensor hallucis longus
-extensor digitorum longus
-peroneus brevis
-politeus
-flexor hallucis longus
-flexor digitorum longus
-tibialis posterior

Most important ligament of ankle : anterior talofibular

2 others: calcaneofibular and posterior and Deltoid Ligament (made up of Posterior and anterior
tibiotalar lig, tibiocalcaneal and tibionavicular lig.)

Describe an inversion type ankle injury:

Grade 1 inversion sprain:
a. positions of foot at time of injury - foot is inverted, plantar flexed and adducted
b. structures sprained or ruptured: may rupture calcaneofibular ligament
c. type of fracture that can occur: avulsion fractures-medial malleolus
d. RICE used 20 mins every few hours for 1-2days. Limit weight bearing activities, and when
weightbearing activities start, wear elastic wrap. Then do rehab.
e. do ROM, isometric, isotonic and strength training exercises. Gradually get back into sport type
exercises. Should be able to return in 7-10 days.
2. In contact sports it is very likely for player to receive a blow on the lateral aspect of the knee joint
while the foot is in a fixed position. Describe what structures probably will rupture in order! Explain
the diagnostic used in detail explaining why the test is used and how is it performed. Give at least 3
tests. Also, explain treatment and rehab.

In contact sports it is likely for a player to receive a valgus blow on the lateral aspect of the knee. In
order the structures that may be injured are the collateral ligaments, then the cruciate ligaments then the
medial collateral ligament followed by the medial meniscus and ACL. (unhappy triad)
3 tests:
1. Posterior drawer test : the test is performed with the knee flexed at 90 degrees and the foot in neutral.
Force is exerted in a posterior direction at the proximal tibial plateau. A positive posterior drawer test
indicated damage to the posterior cruciate ligament.
2. Posterior Sag test (Godfrey's test) : Athlete supine, both knees are flexed to 90 degrees. Observing
laterally on the injured side, the tibia will appear to sag posteriorly when compared with the opposite
extremity if the posterior cruciate ligament is damaged.
3. Apley compression test : Performed with the athlete lying face down the the affected leg flexed to 90
degrees. While stabilizing thigh, trainer applies a hard downward pressure to the leg and rotates the leg
back and forth. If pain results, a meniscal injury has occurred. A medial meniscal tear is noted by
external rotation, and a lateral meniscal tear is noted by internal rotation of the lower leg.

3. Describe adult, child, and infant CPR. Include obstructed airway conscious and unconscious.
Include hand position, compression depth and rate, breathing rate, and cycle. Explain the procedures
for using an AED. If AED advises no shock is needed what should you do? Explain the devices used in
administering oxygen. What are some common pressures used. Give first aid for burns. frostbite, and
heat exhaustion and anaphylactic shock.

AED = automated external defibrillation

cannula: 1-6LPM conscious patients only
resuscitation mask: 6-15 LPM conscious or unconscious patients
non-rebreather mask: 10-15LPM conscious patients only
BVM (bag valve mask) : 15+ LPM conscious or unconscious patients

Step 1: Check the area for safety

Step 2: Check for consciousness, tap and ask are you okay? if there is a response monitor
Step 3: If there is no response (unconscious) call or have someone call 911
Step 4: Check for signs of life
- open the airway for no more than 10 seconds (look, listen, and feel for movement)
- if the person is breathing monitor/recovery position
Step 5: If no signs of life Give 2 rescue breaths and check for chest rising
Step 6: Give 2 rescue breaths
Step 7: Check for pulse for no more than 10 seconds
Step 8: If there is no pulse/not sure ( rescue breathing 1 rescue breath every 5 sec. for 2min
Step 9: 30 chest compressions & 2 rescue breaths

AED
1Analyze (shockable)
2. Give 1 shock
3. 5 cycles of CPR
4. Analyze
5. Repeat for 2 minutes
1. Analyze (non-shockable)
2. 5 cylces of CPR
3. Analyze
4. Repeat for 2 minutes

6. Name the four rotator cuff muscles, their individual and overall function. Also, give structure
involved, etiology, diagnostic tests used, signs and symptoms, and treatment for torn rotator cuff,
impingement syndrome, bicipital tendonitis, and ant. and post. glenohumeral dislocations. Give the
procedures for a general rehab plan for the shoulder complex. Explain TOS and throwing phases with
prime movers in each phase, and what structures are injured in each phase.

4 Rotator Cuff Muscles:

1. supraspinatus : abduction
2. infraspinatus : lateral rotator of shoulder joint/humerus
3. teres minor : lateral rotation of humerus
4. subscapularis : medial rotation

Torn Rotator Cuff:

etiology - falling on an outstretched arm
signs and symptoms - pain from abducting arm 80-120 degrees, discomfort at night
tests - drop arm test (pull arm down slowly 120-90 degrees, then use small weight)
- empty can test (abduct arm, thumb up and flip thumb down as if to empty a can)

Impingement Syndrome:
etiology - mechanical compression of surpraspinatus tendon
signs and symptoms - pain with overhead motion, external rotators feel weaker

Glenohumeral dislocations:
etiology - abduction and external rotation
signs and symptoms - pain which is relieved by holding arm by side, pain abducting arm
tests - apprehension test (lay down, abduct, externally rotate arm, pain during movement = positive)

Bicipital Tendonitis:
Etiology: jerking, straining
signs and symptoms: pain in anterior shoulder, discomfort
tests - yergasons test (supinate against resistance, 90 at elbow)
-speeds test (arm out, palm up, push down)
TOS (thoracic outlet syndrome)
etiology - none
signs and symptoms - weakness, numbness, pains, pins and needles
tests - Roo's test (clench and unclench fists for few minutes, tingling = positive)

General Rehab : consists of exercises with the primary goal to establish pain free active range of
motion with minimal strength, may also include wearing slings or splints.

Throwing Phases:
1. wind-up phase - external rotation (90-120degrees), abduction, elbow flexion (90-120degrees)
2. acceleration phase - from external to internal rotation
3. follow through phase - triceps, forearm flexors, internal rotator (subscapularis)

11. Wall of the eye contains three distinct layers, or tunics. Name the tunics, their parts in detail and
their functions. Explain the central processing of visual information (visual pathway) from the retina.
Also, explain in detail the sequential evens of phototransduction (photochemistry of the eye).

11. Eye layers

Sclera/cornea
choroid
ciliary body (process, iris)
Retina (optic disc, macular lutea, fovea centralis)

Tunics
Fibrous tunic- Avascular- no blood
Sclera (white)- protects and shapes eyeball & holds muscle
Cornea (clear)- sodium pumps to keep it clear
Vascular tunic (uvea)
secretes aqueous humor to keep in focus
-iris
-ciliary body
-choroid- highly vascular
Sensory Tunic
functions: phagocytosis- kills germs and vitamin a is stored

Visual Pathway
1. Visual Field (temporal/nasal)
2. After passing lens, light from each half projects to opposite side of retina
3. An optic nerve (axons within) retina to optic chiasm
4. optic chiasm- axons(nasal of retina) cross & project to the brain; temporal doesnt
5. Optic tract axons that passed o. chiasm to thalamus
6. Axons synapse in lat. Geniculate nuclei of thalamus.
collateral branches of the axons in optic tract synapse in sup. Colliculi
7. optic radiation axons from thalamic neurons project to visual cortex