Quick reference dictionary for athletic training part 1

See Special Tests— Shoulder Appendix 17.. Allen's test: A special test of the shoulder used to assess thoracic outlet syndrome.. anterior apprehension test:A special test of the shoulder

Julie N Bernier, EdD, ATC

Plymouth State UniversityPlymouth, NH

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ISBN-10: 1-55642-666-6

ISBN-13: 978-1-55642-666-7

Copyright © 2005 by SLACK Incorporated

All rights reserved No part of this book may be reproduced, stored in a retrieval system or mitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without written permission from the publisher, except for brief quotations embodied in critical articles and reviews.

trans-The procedures and practices described in this book should be implemented in a manner consistent with the professional standards set for the circumstances that apply in each specific situation Every effort has been made to confirm the accuracy of the information presented and to correctly relate gen- erally accepted practices The author, editor, and publisher cannot accept responsibility for errors or exclusions or for the outcome of the application of the material presented herein There is no expressed

or implied warranty of this book or information imparted by it.

The work SLACK publishes is peer reviewed Prior to publication, recognized leaders in the field, educators, and clinicians provide important feedback on the concepts and content that we publish We welcome feedback on this work.

Printed in the United States of America.

Library of Congress Cataloging-in-Publication Data

Bernier, Julie N.,

1964-Quick reference dictionary for athletic training / Julie N Bernier. 2nd ed.

p ; cm.

Includes bibliographical references.

ISBN-13: 978-1-55642-666-7 (alk paper)

ISBN-10: 1-55642-666-6 (alk paper)

1 Physical education and training Dictionaries.

[DNLM: 1 Physical Education and Training Dictionary English 2 Athletic Dictionary English 3 Musculoskeletal Physiology Dictionary English ] I Title

Injuries RC1206.B475 2005

617.1'027'03 dc22

2004028843 Published by: SLACK Incorporated

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This book is dedicated to my mentor and very good

friend David H Perrin

Dedication v

Acknowledgments ix

About the Editor xi

Introduction xiii

Dictionary of Terms 1

List of Appendices 163

Appendix 1: Medical Roots Terminology 165

Appendix 2: Acronyms and Abbreviations 191

Appendix 3: Symbols 203

Appendix 4: Anatomical Terms of Orientation and

Direction 205

Appendix 5: Muscles—Origin, Insertion, Action 207

Appendix 6: Manual Muscle Testing 237

Hip, Thigh, Knee 237

Lower Leg, Ankle, Foot 247

Shoulder, Shoulder Girdle 254

Elbow, Forearm, Wrist 263

Hand 270

Appendix 7: Normal Joint Ranges of Motion 279

Appendix 8: Cranial Nerves and Assessment 283

Appendix 9: Concussion Grading 287

Appendix 10: Nerve Root Assessment— Upper Extremity 291

Appendix 11: Nerve Root Assessment— Lower Extremity 293

Appendix 12: Peripheral Nerve Innervations— Upper Extremity 295

Appendix 13: Peripheral Nerve Innervations— Lower Extremity 299

Appendix 14: Grades of Pain 305

Appendix 15: End Feel 307

Appendix 16: Joint Mobility Positioning 309

Appendix 17: Special Tests 313

Shoulder—Ligamentous Tests 313

Shoulder—Special Tests 318

Elbow—Special Tests 324

Hand/Wrist—Special Tests 328

Neck—Ligamentous Tests 332

Spine—Special Tests 335

Sacroiliac Joint 339

Hip—Special Tests 342

Knee—Ligamentous Tests 345

Knee—Meniscal Tests 350

Knee and Leg— Other Special Tests 352

Foot/Ankle—Ligamentous Tests 354 Foot/Ankle—Special Tests 357

Appendix 18: Pharmacology 361

Appendix 19: NATA Membership Standards and Code of Ethics 367

Appendix 20: Weights and Measurements 387

Bibliography 393

viii C ONTENTS

I wish to extend my sincere gratitude to the people atSLACK Incorporated, especially Amy McShane, DebraToulson, Carrie Kotlar, Michelle Gatt, and MeganCharlton I want to thank Marge Albohm, who suggested

I take on this project My sincere thanks to Karen and LaelaJacobs and Jennifer Bottomley for providing the inspira-

tion with the Quick Reference Dictionary for Occupational

Therapy and Quick Reference Dictionary for Physical Therapy.

I must thank my colleagues for putting up with me when

I take on these projects and my students for inspiring meevery day and reminding me why I came into this profes-sion Lastly, I would like to thank the four most influentialmentors in my life: David H Perrin, PhD, ATC, SherryBovinet, PhD, ATC, Charlie Beach, PhD, and DorothyDiehl, PhD

ABOUT THE EDITOR

Julie N Bernier, EdD, ATC is the Associate VicePresident for Academic Affairs at Plymouth StateUniversity She previously served as Department Chair ofHealth and Human Performance and Director of graduateand undergraduate Athletic Training at Plymouth StateUniversity in Plymouth, NH, where she has been since

1988 Julie received her bachelor of science and master ofeducation degrees from Keene State College in NewHampshire and her doctorate from the University ofVirginia She serves on the editorial board of the Journal ofAthletic Training and has served on numerous NATA andNATA-REF committees In her other life she is a potter andalso enjoys building furniture

This book is intended to serve as a reference tool for nicians and students of athletic training It provides quickreference to over 2100 terms related to the field of athletictraining Additionally, it contains 20 appendices that Ihope you will find useful

cli-Appendices 1 to 3 were written to aid the practitioner

or student in writing progress notes and includes a table ofmedical root terminology, acronyms and abbreviations,and symbols commonly used by practitioners Appendices

4 through 11 serve as an anatomical reference for the dent Appendix 4 includes anatomical terms Appendix 5provides figures of the superficial and deep muscles of thebody followed by a table that includes origin, insertion,action, and nerve innervations Appendix 6 is new to thisedition and covers manual muscle testing, which includespatient positioning, examiner stabilization, and patientaction Appendix 7 provides a table of normal joint ranges

stu-of motion Appendix 8 provides a review stu-of cranial nerves.Appendix 9 includes information on grading systems forassessment of concussion, while Appendices 10 through 13cover nerve root assessment and peripheral nerve inner-vations Appendices 14 and 15 provide assessment scalesfor grades of pain and normal and abnormal end feels.Appendix 16 has bee added in this edition and providesreference to loose and tight packed positions for jointmobilization The most comprehensive section, Appendix

17, provides information for more than 85 orthopedic cial tests Appendix 18 provides an overview of common-

spe-ly used prescription medications Appendix 19 providesquick access to pertinent NATA membership standard andCode of Ethics Finally, Appendix 20 provides reference toconversion of weights and measures

Aββfiber (A beta):An afferent nerve fiber that is

stimulat-ed by touch, pressure, tension, movement, and tion

vibra-A δδ fiber (A delta): An afferent neuron responsible for

car-rying temperature and noxious stimuli; responsible for

"fast pain."

abdomen, acute:Acute onset of abdominal pain due toany number of causes including appendicitis, cholecys-titis, perforated ulcer, and ruptured spleen

abdominal aneurysm:An aneurysm within the abdomen

See aneurysm.

abdominal cavity:The cavity formed between the inal wall and the spine that houses a number of organsincluding the stomach, colon, small intestine, liver,gallbladder, pancreas, spleen, kidneys, bladder, andrectum

abdom-abdominal guarding: Involuntary contraction of theabdominal muscles to protect organs in response toinjury or illness to one or more organs

abdominal quadrants: Four divisions of the abdomendetermined by drawing imaginary vertical and hori-zontal lines through the umbilicus The upper leftquadrant contains the stomach, spleen, and pancreas;upper right contains the liver and gallbladder; lowerright contains the appendix; and lower left contains thecolon

abducens nerve:Cranial nerve VI; innervates the lateralrectus femoris muscle of the eye, responsible for lateral

eye movement See Appendix 8.

abduct: To move away from the midline in the frontalplane

A

abduction (ABD): Movement of a body part (usually thelimbs) away from the midline of the body.

abductor muscle: A muscle whose primary responsibility

is to abduct the limb

abrasion:Minor wound in skin surface, caused by rubbing

or scraping

abscess:Collection of pus

absolute refractory period:The period following ization in which another action potential cannot occur

depolar-absorption:The taking in of liquids, gases, or light

acceleration: The change in velocity per unit of time(meters per second per second-m/s2) For example, 1m/s2means that velocity is increased by 1 m/s every

second See also gravity.

accessory motion: Also called secondary motion Thesmall motions of sliding, spinning, and rolling that arenecessary in order to have physiological (primary)motion

accessory movers:Muscles that assist the prime movers inperforming a function

accessory nerve: Cranial nerve XI responsible for theinnervation of the sternocleidomastoid and the trapez-

ius muscles See Appendix 8

acclimatization:To adapt to a new temperature, climate,environment, or situation; the act of adapting to alti-tude, usually taking 1 to 3 days for each change in alti-tude

accommodating resistance:As in the resistance given by

an isokinetic dynamometer The resistance supplied bythe dynamometer is equal to the resistance put in by thepatient

accommodation: Adaptation; adjustment; the act ofadjusting to a stimulus

ACE inhibitor: A drug that inhibits the formation ofangiotensin II; used to treat high blood pressure

acetabulum:The "cup-shaped" socket of the hip joint thatarticulates with the head of the femur

2 abduction (ABD)/acetabulum

acetaminophen:A pain-relieving drug commonly known

as Tylenol (McNeil Consumer & Specialty cals, Ft Washington, Pa)

Pharmaceuti-acetylsalicylic acid: Aspirin; a nonsteroidal matory used for the relief of pain and fever

anti-inflam-achalasia:A disease of the esophagus in which the ability

to swallow is impaired

Achilles' tendon:The distal insertion of the gastrocnemiusand soleus muscles into the plantar surface of the calca-neus; Syn: calcaneal tendon

ACI:See approved clinical instructor.

acid reflux: See gastroesophageal reflux.

acid-base balance:Refers to the control of pH in which thebody's fluids are neither acidic nor alkaline

acidosis:An abnormal condition in which the pH is toolow (ie, becomes acidic); caused by diabetes, kidneydisease, or lung disease; leads to ketoacidosis in the dia-betic individual

AC joint (acromioclavicular joint): The articulationbetween the acromion process (the distal end of thespine of the scapula) and the lateral end of the clavicle.The acromioclavicular ligament forms the capsularligament while the trapezoid and conoid ligaments(coracoclavicular ligaments) strengthen this articula-tion

acne vulgaris: A skin condition that most commonlyaffects adolescents; characterized by pus-filled pimples

on the skin caused by overactivity of the oil glands

acoustical spectrum: A means of displaying the range offrequencies and wavelengths of sound waves.Ultrasound is a form of radiation classified in theacoustical spectrum

acquired: A condition not contracted at birth but one thatlater develops

acquired immunodeficiency syndrome (AIDS):Disease

of the immune system caused by the human deficiency virus (HIV)

immuno-acetaminophen/AIDS 3

acromegaly: A disease in which there is continued duction of growth hormone by the pituitary gland afterthe end of adolescence

pro-acromion:The distal end of the spine of the scapula thatforms the top of the shoulder

acromion process: The superior lateral process of the spine

of the scapula that articulates with the clavicle andforms the "top" of the shoulder

acromioplasty:The surgical removal of the inferior distalend of the acromion process of the scapula; a procedureused to relieve soft tissue impingement in the subacro-mial space

AC shear test:AC joint compression test Test to examine

the integrity of the AC joint See Special Tests—

Shoulder (Appendix 17)

action potential: The change in voltage across the brane of nerve or muscle

mem-active assistive range of motion (AAROM):Movement at

a joint achieved by muscular contraction of the agonistmuscles with assistance

active electrode: In electrical stimulation, in which amonopolar pad placement is used (two pads of unequalsize), it is the smaller of the two pads placed over theinjured site, trigger point, motor point, or nerve

active range of motion (AROM): Movement at a jointachieved by muscular contraction of the agonist mus-cles

activities of daily living (ADLs):The skills required forindependence in everyday living including activitiessuch as mobility and self-care

acuity test, visual:A test to measure the clarity of vision;

See also Snellen's chart

acupressure: Pressure applied to trigger points oracupuncture points with the intent of pain control

acupuncture:An ancient Asian healing therapy employingthe use of long, very fine needles; used in modern times

as a method of pain control

4 acromegaly/acupuncture

acute:Referring to brief exposure, sudden, of short tion, not chronic; sometimes used to mean severe

dura-acute mountain sickness (AMS):See altitude sickness

acute otitis media:Inflammation of the middle ear

acute respiratory disease:A life-threatening emergency inwhich O2levels drop and breathing becomes labored

adaptation:Accommodation, to adjust to a stimulus

addiction: A condition in which individuals cannot controltheir desire for alcohol, tobacco, food, exercise, or otheractivities

Addison's disease: Chronic insufficiency of the adrenalcortex characterized by skin discoloration, anemia,weakness, and low blood pressure Tuberculosis is thecause of approximately 20% of cases

adduct: To move toward the midline in the frontal plane

adduction (ADD):Movement toward the midline

adenitis:Inflammation of the lymph nodes

adenoidectomy: The surgical removal of the adenoids

adenoids:Lymph tissue found in the superior aspect of thethroat

adenosine triphosphate (ATP): Adenine, ribose, andtriphosphate; three phosphates that store energy that isreleased when ATP is split into ADP (diphosphate) orAMP (monophosphate)

adhesion:The union of tissue surfaces, also referring tothe formation of scar tissue that often occurs followingsurgery

adhesive capsulitis:Also known as "frozen shoulder"; acondition in which scarring occurs in the shoulder jointcapsule; a complication of rotator cuff injury or bursitis

adipose tissue:A term for "fatty tissue"; tissue composedmainly of fat cells

adjuvant:From the Latin term adjuvans meaning "to help"

or "to reach a goal"; adjuvant therapy is a form of ment that increases the effect of a drug or increases thelikelihood of a positive outcome

treat-acute/adjuvant 5

adrenal gland:An endocrine organ that lies anteromedial

to the kidneys and is responsible for production of cocorticoid, mineralocorticoid, androgenic hormones,epinephrine, and norepinephrine

glu-adrenaline:Also known as epinephrine; a naturally ring substance produced in the medulla of the adrenalgland; its release is part of the "fight-or-flight" response

occur-in which there is a dilation of blood vessels and anincrease in heart rate and strength of contractions

Adson's maneuver:A special test of the shoulder

specifi-cally for thoracic outlet syndrome See Special Tests—

Shoulder (Appendix 17)

adult-onset diabetes:See type II diabetes

advance medical directives:Living will, durable power ofattorney for health care, and health care proxy areexamples of advance medical directives; instructionsrelated to the treatment desires of an individual whocannot speak on his or her own behalf

adverse effect:See adverse reaction.

adverse reaction:A negative or unwanted effect of a ment

treat-aerobic training: Exercise that provides cardiovascularoverload so as to develop functional capacity of the cir-culatory system and enhance aerobic capacity of specif-

ic muscles

aesthesiometer:A device used to measure cutaneous sitivity or the level of anesthesia A two-point discrimi-nator is an example of an aesthesiometer

sen-aetiology:See etiology

affective disorder: A psychological condition in which theindividual suffers extremes in moods and emotions;seasonal affective disorder (SAD) is an illness in whichthe individual is affected by the shorter days and lack

of natural light during the fall and winter

afferent: Conducting toward the center In the case ofnerves, conducting toward the brain, responsible forbringing sensory information to higher centers

6 adrenal gland/afferent

agenesis:The underdevelopment or nondevelopment of

an organ or projection

agonist: Muscle or muscle group responsible for a givenjoint motion Its opposite is the antagonist

AIDS:See acquired immunodeficiency syndrome.

AIDS-related complex:Symptoms related to HIV

air embolism:Caused during surgery or from injury, it isthe presence of air in the arteries that can cause a block-age

airway obstruction:Anything that inhibits the passage ofair to the lungs

akinesia: Impaired body movement; absence of ment

move-akinetic:Literally means "without movement"; refers toimpaired, deficient, or lack of movement

albinism: A disorder in which there is a reduction inmelanin which is responsible for the pigment of hair,skin, and eye color

albumin: A water-soluble protein responsible for themaintenance of plasma volume

alcoholic cardiomyopathy:Heart damage or heart failurecaused by the consumption of alcohol

aldosterone: A hormone responsible for the regulation andbalance of sodium and water in the body

alimentary canal: The digestive tract

alkalosis: A high pH; an abnormal condition in whichthere is a decrease in the normal acidity of the bloodresulting from the accumulation of base or the deple-tion of acid Can be caused by dehydration due to vom-iting, hyperventilation, or high altitudes

Allen's test: A special test of the shoulder used to assess

thoracic outlet syndrome See Special Tests—Shoulder

(Appendix 17)

allergen: A substance that causes an allergic reaction

allergic rhinitis:A reaction to a substance causing ing, runny nose, and sore eyes

sneez-allograft: A transplant of tissue between allogeneic viduals (ie, a member of one's own species)

indi-agenesis/allograft 7

all-or-none response:The principle that describes the lowing: depolarization of a membrane requires a mini-mum intensity to reach threshold Once threshold ismet, depolarization occurs to the fullest extent Anincrease in intensity has no increased effect.

fol-alopecia: Baldness; alopecia areata is characterized bypatchy bald spots; alopecia capitis totalis is total loss ofhair

alpha level: The probability of chance occurrence Thealpha level is chosen a priori (before beginning)

alprenolol:A beta-blocker used to treat high blood sure, angina, and arrhythmias of the heart

pres-ALS:See amyotrophic lateral sclerosis

alternating current (AC):A current that reverses its

polar-ity; a current that crosses the isoelectric line; see also

biphasic current

alternative medicine: Holistic medicine; treatment ods not scientifically proven and generally not prac-ticed in traditional medical facilities

meth-altitude sickness:An illness that affects nearly ters of all people ascending to heights over 8000 feet.Symptoms include headache, dizziness, and nausea.The reduced air pressure can cause fluid to collectaround the lungs and brain If acclimatization does notoccur, altitude illness can lead to a life-threatening con-dition

three-quar-alveolitis: Inflammation of the alveoli can progress tofibrosis or emphysema

Alzheimer's disease: The most common form of dementia;

it is a progressive disorder of the brain that first appearslate in life and is characterized by memory loss, confu-sion, and a continued physical decline; marked by adegeneration of neurons in the cerebral cortex and thepresence of beta-amyloid plaques Named for AloisAlzheimer (1864-1915), a German neurologist who pub-lished a description of arteriosclerotic atrophy of thebrain in 1894

8 all-or-none response/Alzheimer’s disease

ambulation:The act of moving freely; walking.

ambulatory care:Outpatient care

amenorrhea: The absence of the menstrual period for morethan 3 months in women who had previously experi-enced menstruation and are not pregnant

amine:A nitrogen compound derived from ammonia

amino acid:A protein-building block

amnesia: The loss of or impairment of memory:Anterograde is a loss of memory of events occurringafter the injury; Retrograde is a loss of memory ofevents occurring prior to the injury

amniocentesis:A procedure in which a small amount ofamniotic fluid is removed from the mother's womb fortesting of potential fetal disorders

ampere (A): Unit of electrical current, abbreviated asamps; SI unit of electrical current, equal to the flow of

1 volt through or resistance of one ohm

amplitude: Magnitude, intensity; depicted by the height ofthe waveform

amyotrophic lateral sclerosis (ALS):Also known as LouGehrig's disease; a progressive disease of the motorneurons in which function is gradually lost

anabolic steroid:A group of usually synthetic hormonesthat increase constructive metabolism Anabolicsteroids are frequently abused in sports that requirestrength and size

anaerobic exercise:Activity in which the body incurs anoxygen debt; exercise occurring in the absence of oxy-gen

analgesia:A state in which there is a reduction of or aninability to feel pain

analgesic: A pharmacological agent designed to reducepain

analysis of covariance (ANCOVA):A statistical proceduredesigned to account for the influence of one or morevariables that correlate

ambulation/analysis of covariance (ANCOVA) 9

analysis of variance (ANOVA): A statistical procedureused to establish whether a statistically significant dif-ference exists between two or more samples.

anaphylactic shock:See anaphylaxis.

anaphylaxis:A histamine reaction to an allergen produced

in response to injection Can result in a severe systemicreaction including edema, circulatory failure, anddeath

anastomosis:A communication between vessels or organsthat are normally not connected; a surgical procedure inwhich a connection is made between healthy sections ofthe colon or rectum after a cancerous or diseased por-tion has been removed

anatomical position: A reference position in which thebody is upright, all joints are extended to the neutralposition, and palms are facing forward

anatomical snuffbox:A hollow on the radial aspect of thewrist when the thumb is extended caused by the ten-dons of the extensor pollicis longus and brevis Thename originates from the use of this space to hold pow-dered "snuff" tobacco

anatomy:The study of body structure

androgen:A male sex hormone that produces male sexcharacteristics

anemia:Reduced hemoglobin; symptoms include fatigue,and decreased resistance to infection

anesthesia: Decreased sensation caused by neurologicaldysfunction or pharmacological agent

aneurysm:A bulge in the wall caused by localized tion of an artery, a vein, or the heart

dilata-angina pectoris:Pain experienced in the chest, arms, orjaw because of a lack of oxygen to the heart muscle

angioplasty:The use of surgery to make a damaged bloodvessel function properly again; may involve widening

or reconstructing the blood vessel

Angiotensin-converting enzyme (ACE):A ing peptide

vasoconstrict-10 analysis of variance (ANOVA)/ACE

angle of pull (of a muscle):The angle formed by a tudinal line through the bone from the axis and throughthe line of action (line of pull) of the muscle.

longi-anisocoria:Unequal pupil size

anisotropic: Having different mechanical propertiesdepending upon direction of the load or force of appli-cation

ankle mortise:The ankle joint; talocrural joint; the lation between the tibia and the talus

articu-ankle-foot orthosis (AFO):A prosthetic for the foot orankle; an AFO is commonly used for "drop-foot syn-drome."

ankylosing spondylitis: Rheumatic disease of the ovial joints of the vertebrae In severe cases, the spinebecomes completely fused

syn-ankylosis:A disease process that results in the stiffening orfusion of a joint

annulus fibrosis:The tough outer covering of a vertebraldisk

anode:The positive electrode The electrode toward whichnegatively charged ions are attracted

anomaly:A deviation from the norm

anorexia nervosa: Most common in females, loss ofappetite most commonly caused by an obsession to loseweight Symptoms can be severe and can cause death

anosmia: The loss of the sense of smell, often due toobstruction of the airway or injury to the olfactorynerve

ANOVA:See analysis of variance.

anoxia:Decreased oxygen to the tissues, occurs frequently

at high altitude

antacid: A pharmacologic agent used to counteract theeffects of hydrochloride acid released during digestion.Common agents include sodium bicarbonate, magne-sium hydroxide, aluminum hydroxide, and calciumcarbonate

angle of pull/antacid 11

antagonist:The muscle or muscle group responsible forproducing motions opposite of that being performed.The opposite of agonist

anterior:Front, ventral

anterior apprehension test:A special test of the shoulder

to assess the anterior stability of the glenohumeral joint

See Special Tests—Shoulder (Appendix 17).

anterior cruciate ligament (ACL):A major ligament of theknee that prevents forward displacement of the tibiafrom the femur The term cruciate literally means "tocross" and refers to the "crossing position" of the anteri-

or and posterior cruciate ligaments Females are two toeight times more likely to suffer ACL injury than males

anterior draw (drawer) test:A special test of the knee toassess the continuity of the anterior cruciate ligament or

of the ankle to assess the anterior talofibular, deltoid,

and anterior tibiofibular ligaments See Special Tests—

Knee, and Ankle (Appendix 17)

anteroposterior:From anterior to posterior; from front toback

anteversion:A forward displacement An anteverted hip ischaracterized by increased medial rotation

anthropometry:The science involved in measurement andcomparison of the human body

antibiotic:A pharmacologic agent used to treat infections

by inhibiting the growth of microorganisms

antibody:A protein that is part of the immune responsethat is produced by white blood cells in response to aforeign protein

anticoagulant:A substance that hinders coagulation

antiemetics:A pharmacologic agent used to treat nauseaand vomiting

antihistamine:A pharmacologic agent used to treat gic reactions by inhibiting the effects of histamine

aller-antihypertensives:A pharmacologic agent used to treathigh blood pressure

12 antagonist/antihypertensives

anti-inflammatory:An agent used to reduce

inflamma-tion See Appendix 18 for a list commonly used

antipyretic:A pharmacologic agent used to reduce fever

antiseptic: A bacteria-killing chemical used to preventinfections by its application on the skin

anus:The opening at the distal end of the rectum

aorta:The main artery leaving the heart responsible forsupplying oxygenated blood to the body

apex:The tip, or most superior portion, of a tissue

aphasia:A disease of the left brain in which both speechand understanding of speech are affected

aplasia:The complete or partial failure of any organ or sue to grow

tis-aplastic anemia:A condition in which there is reduction inthe number of red blood cells, white blood cells, andplatelets

Apley's compression:A special test of the knee used to

assess the meniscus See Special Tests—Knee (Appendix

17)

Apley's distraction:A special test of the knee used to ferentiate between injuries to the meniscus and liga-

dif-ment injury See Special tests—Knee (Appendix 17).

Apley's grind test:See Apley's compression.

Apley's scratch test:A special test of the shoulder used to

determine range of motion See Special Tests—Shoulder

(Appendix 17)

apnea:A period where breathing stops

aponeurosis: A fibrous sheath continuous with musclefibers giving rise to the origin and insertion, in somecases becoming a tendon

anti-inflammatory/aponeurosis 13

apophysis:A bony outgrowth; tubercles and tuberositiesare examples of apophyses.

apophysitis: Inflammation of the apophysis, often at apoint of tendinouos attachment

apparent leg length:A leg length measurement taken fromumbilicus to medial malleolus, useful only when true(real) leg length differences are negative A positive test

is indicative of pelvic obliquity

appendectomy:The surgical removal of the appendix

appendicitis:Acute or chronic inflammation of the dix caused by blockage Signs and symptoms includenauseau, fever, acute abdominal pain, particularly inthe lower right quadrant, rebound tenderness overMcBurney's point Occasionally pain does not localize

appen-to lower right quadrant making diagnosis difficult.Surgery is usually required

appendicular skeleton:The upper and lower extremities

appendix:A small, finger-like projection of the large tine

intes-apprehension test:A special test which by its nature

caus-es the patient to become apprehensive or withdraw,especially when the sensation of dislocation is immi-nent; patella apprehension, anterior, posterior, and infe-rior (shoulder) apprehension

approved clinical instructor (ACI): A certified athletictrainer who has successfully completed an ACI work-shop conducted by the clinical instructor educator fromthe institution in which the ACI will be supervising ath-letic training students In order to assess clinical profi-ciencies of a student enrolled in a Commission onAccreditation of Allied Health Education Programs(CAAHEP) accredited program, one must be an ACI

approximate:To bring near, to place next to; the act ofbringing the edges of a wound together

approximation test:A special test used to assess sacroiliacdysfunction in which the patient is positioned side-lying, and the examiner applies a downward pressure

of the iliac crest

14 apophysis/approximation test

arch:A bony structure that resembles an arch and impartselasticity or flexibility to it; the foot has four main arch-

es See lateral longitudinal arch, medial longitudinal

arch, metatarsal arch, and transverse arch

Arndt-Schultz principle:The amount of energy absorbedmust be sufficient to stimulate the absorbing tissues or

no reaction will occur

arteriosclerosis:A disease in which there is progressivethickening and hardening of the walls of the arteries

artery:A large blood vessel that carries oxygen-rich bloodfrom the heart to the rest of the body

arthokinematics:The study of joint movements

arthralgia:Pain in a joint, not an inflammatory condition

arthritis:Pain and stiffness characterized by inflammation

of a joint

arthrogram: Radiographs of a joint taken after injection of

a contrasting medium (dye)

arthroplasty: The replacement of a joint or joint surfaces torestore the integrity and function of the joint

arthroscopy:A surgical procedure performed through anendoscope

arthrosis:Degenerative disorder of a joint

articulate:Referring to an articulation, a joint

articulation:A joint, a place where two or more bones are

joined in such a way as to allow motion; See also

uniar-ticulate, biaruniar-ticulate, and multiarticulate

artificial respiration:The act of providing ventilation for aperson who has stopped breathing

ascorbic acid:Vitamin C

aseptic:Relating to a state of sterility, the absence of ogenic organisms

path-asphyxia:Suffocation; a situation in which an individual isunable to obtain adequate oxygen

aspiration:The inspiration of fluid or foreign bodies intothe lungs, such as with vomitus

assumption of risk:A written statement signed by an lete or his or her legal guardians stating that they are

ath-arch/assumption of risk 15

aware of the dangers inherent in participation in a ticular sport and voluntarily accept the risk.

par-asthma:Also known as reactive airway disease; a ing of the airway due to swelling, spasm, or inflamma-tion of the submucosa

narrow-astigmatism:A condition of the eye in which the cornea

is not exactly spherical; can often be corrected withlenses

asymmetrical:Not the same, as in comparing one bodyarea to its counterpart; the opposite of symmetrical

asystole:The cessation of heartbeats

ataxia:Jerky, uncoordinated movements of the limbs; aninability to move in a smooth coordinated fashion

Ath:Abbreviation for "athlete."

atheroma:Atherosclerosis; a narrowing of the blood sels caused by fatty deposits on the inner walls

ves-athlete's foot:See tinea pedis.

athletic pubalgia: Pain in the area of the pubic symphysiscaused by muscle strain to one of the muscles thatattach in the area such as the adductor longus, iliop-soas, rectus femoris, or rectus abdominus

atrial fibrillation:An irregular heartbeat in which the atriabeat "out of sync" and are ineffective in circulatingblood

atrium (atria-plural):The upper chambers of the heart

atrophy:A wasting away of tissue; often used to describeloss of muscle tone

attenuation: Loss of radiant energy due to reflection,refraction, or absorption; a decrease in intensity due toabsorption into deeper tissues

auditory nerve: See vestibulocochlear nerve.

auricle:External ear

auricular hematoma:An inflammation of the external earcaused by repeated friction; common in the sport ofwrestling Commonly called cauliflower ear; also calledhematoma auris; pinna hematoma

16 asthma/auricular hematoma

auscultation: Listening to body sounds, usually with astethoscope.

autism: Also known as Kanner's syndrome; tion to the point of loss of reality characterized by repet-itive and limited actions

self-absorp-autogenic inhibition:A reflex activation of the antagonistand relaxation of the agonist caused by a suddenstretch

autograft: A tissue or organ transferred from one part of apatient's body to another

autoimmune disease:A disorder of the body in which theimmune system is unable to distinguish between for-eign material and that of itself and thus attacks its ownotherwise healthy tissues

automatic external defibrillator: An electric devicedesigned to apply a "shock" to the heart with the intent

of returning the fibrillating heart to normal sinusrhythm

autonomic nervous system:The nervous system ble for involuntary functions

responsi-avascular: Lack of blood supply

avascular necrosis: Death of a tissue due to lack of bloodsupply

average current: The amount of current applied over agiven time

avulsion: A tear in which part of the structure is pletely torn away

com-axial skeleton:The skull, thorax, and spine

axilla: Pertaining to the space inferior to the shoulder joint;under the arm; armpit

axillary nerve: A branch of the brachial plexus; it isresponsible for supplying the teres minor and deltoidmuscles

axonotmesis: Axonal compression injury in which theendoneural sheath remains intact and thus regenera-tion could occur

auscultation/axonotmesis 17

Babinski's reflex/sign: A test for upper motor neuronlesion The test is performed by running a blunt object

on the plantar aspect of the foot starting at the neus and moving upward in an arc toward the greattoe In the adult, a positive test is indicated by extension

calca-of the great toe and splaying calca-of the lateral toes Thisresponse is opposite in the infant

bacitracin:An antibacterial ointment

bacteremia: Bacteria found in the blood

bacteriostatic:Halting the growth of bacteria

bacterium:A small unicellular microorganism that plies asexually through cell division

multi-bacteriuria: Bacteria in the urine indicating infection of thebladder or kidneys

Baker's cyst: A synovial fluid swelling in the poplitealspace first reported in 1877 by William Morrant Baker,

MD (1839-1896)

balance:A state of equilibrium; a constant state of motion

in which attempts are made to keep the center of ity well within the base of support; ability to maintainposture either statically or dynamically

grav-ballistic stretching: A stretching technique that usesmomentum to force the tissue beyond its normal range

of motion Not synonomous with dynamic stretching

bandage:A piece of cloth, gauze, or other material used tohold a dressing in place or to immobilize an injuredbody part

Bankart's lesion: An avulsion of the anterior glenoidlabrum caused by anterior dislocation

B

barbituates:A group of drugs from barbituric acid thatdepress activity of the central nervous system; most areused as sleeping pills; a strong dependence may bedeveloped and barbituates can be fatal when takenwith alcohol.

barium enema:An enema used during an x-ray ment of the large intestine and rectum to check for dis-ease

assess-baroreceptors: A nerve ending responsible for sensingchanges in pressure

baroreflex: A reflex triggered by baroreceptors in anattempt to maintain pressure

Barton's fracture: A fracture/dislocation of the distalradius

basal cell carcinoma: Skin cancer found most commonly

on the face, neck, and arms; caused by excessive sure to sunlight

expo-basal metabolic rate: The rate at which energy is sumed at absolute rest

con-baseline:A starting point that serves as a basis for parison

com-base of support: A kinesiology/biomechanics term thatrefers to the surface area of a body that is in contactwith an external surface For example, during singlelimb standing, the base of support is equal to the size ofthe foot

basilar artery:Artery at the base of the brain It later splits

to form the two posterior cerebral arteries

BCG vaccine:The vaccine for tuberculosis

beam nonuniformity ration (BNR): The ratio of peakintensity to average intensity across an ultrasoundhead A measure of the quality of the sound head Thecloser the number is to one, the more even the beam

beat:A waveform created by the combining of two wavesfrom different circuits

barbituates/beat 19

Becker's muscular dystrophy:A form of muscular phy that starts later in life and advances more slowly;similar to Duschenne's; hereditary disease

dystro-Bell's palsy:A unilateral paralysis of the face The cause isunknown, and it usually resolves spontaneously Insome cases taste is affected and hearing becomes over-sensitive

Benazepril (Lotensin):An ACE inhibitor

bends: See decompression sickness.

Benediction hand deformity:Also called Bishop's hand; adeformity caused by weakness of the thenar eminence,interossei, and two medial lumbricales due to ulnarnerve denervation Flexion of fourth and fifth fingers is

a sign

benign tumor:A tumor that is not cancerous

Bennett's fracture: A fracture/dislocation of the firstmetacarpal at the carpometacarpal joint

beta blocker:A pharmacologic agent that reduces heartrate and the strength of the beat; it is used to treat highblood pressure and other heart diseases

beta carotene: A substance found in orange fruits and etables that is converted to vitamin A

veg-beta (b) endorphin:A hormone naturally occurring in thebrain having pain control properties similar to opiates

biarticulate: Referring to the crossing of two joints.Example, the extensor carpi radialis longus crosses andperforms a function at the elbow joint as well as thewrist

bifid:A division into two lobes separated by a cleft

bifocal: Glasses that are designed such that the upper tion of the lens restores distant vision while the lowerportion of the lens restores near vision

por-bilateral: Relating to both sides of the body

bile:A substance produced by the liver responsible for thebreakdown of fat and the removal of waste from theliver

20 Becker’s muscular dystrophy/bile

bile duct:The passageway from the liver to the der

gallblad-binging and purging:A characteristic behavior in uals suffering from bulimia in which the individual eats

individ-to excess with glutindivid-tonous behavior and then eithervomits or uses laxatives to rid him or herself of the foodingested

bioavailability:A measurement of how fast and to whatextent an active drug is metabolized and becomes

"available" to the tissues in the system

biochemistry: The science of the chemistry involved in ing organisms

liv-bioequivalent:A drug that has the same effect on the body

as another drug

biofeedback:A means of giving a patient immediate back about bodily functions which are usually uncon-scious

feed-biomechanics: The study involving the knowledge andmethods of mechanics that are applied to a humanbody

biotransformation: A process in which substances in thebody undergo chemical changes

bipartate:Divided into two distinct parts

biphasic current:A pulse that deviates from the tric line first in one direction, then crosses the line and

iso-elec-deviates in the other direction See also monophasic

cur-rent

monophasic biphasic Examples of square monophasicand square biphasic waveforms

bile duct/biphasic current 21

22 bipolar arrangement/bone spur

bipolar arrangement: An electrical stimulation pad ment that uses two active electrodes (pads) of equalsize

place-bipolar cells: A neuron that has two processes off the cellbody

Bishop's hand: See Benediction hand deformity.

bladder:Internal organ responsible for storage of urine

blood borne pathogen: Infectious disease carried in theblood

blood doping: A technique used by athletes to increase theoxygen-carrying ability of the blood by giving a bloodtransfusion (just before an event) of one's own bloodthat was previously withdrawn

blood poisoning:See septicemia

blood pressure (BP):Pressure created by the blood on thewalls of the arteries The normal average BP for anadult is a systolic pressure of 120 and diastolic pressure

boil:An inflammation of the skin containing pus caused

by staphylococcus bacteria which enters through a hair

follicle or skin wound See also furuncle.

bone marrow: The yellow fatty (or red at birth) tissuewithin the central medullary cavity of bone responsiblefor producing blood cells

bone marrow transplant:A surgical procedure in whichbone marrow is removed from a healthy area within thepatient's body or from a donor and transplanted to adiseased area

bone spur:An abnormal bony outgrowth in response torepeated trauma; a common site of bone spur formation

is the calcaneus at the plantar fascia attachment

Borg scale:A rating of perceived exertion.

botulism:A type of food poisoning which occurs fromingestion of the neurotoxin clostridium botulinum,commonly occurring in improperly canned food

bounce home test:A special test of the knee for meniscal

injury See Special Tests—Knee (Appendix 17).

boutonnière deformity:An injury to the extensor hood ofthe phalanges that causes flexion of the proximal inter-phalangeal and extension of the distal interphalangeal

bowstring test:A special test for sciatic nerve

involve-ment See Special Tests—Spine (Appendix 17).

boxer's fracture: A fracture of the neck of a metacarpal(usually the fifth) with a volar displacement of the head

of the metacarpal

Borg scale/boxer’s fracture 23

Borg Scale of Perceived Exertion

Numeric Rating Verbal Description

brachial plexus:A network of nerves made up of nerveroots (C4) C5-T1 that blend and divide to form a net-work and terminate as the peripheral nerves that sup-ply the arm (axillary, musculocutaneous, median, ulnar,and radial nerves).

brachio:Arm

brachy: Short

bradycardia:An abnormally slow heart rate (less than 60beats per minute)

bradykinin:A polypeptide hormone composed of a chain

of nine amino acid residues formed during the matory process causing vasodilation; responsible inpart for the sensation of pain

inflam-break test: A common method of assessing musclestrength The patient is placed in mid range and theexaminer attempts to "break" the contraction of thepatient

bronchitis: Inflammation of the mucous membranes of thebronchials

bronchoconstrictor: A substance that causes the bronchialtubes to constrict or become smaller in diameter

bronchodilator: A pharmacologic agent that dilates orincreases the diameter of the bronchial tubes toimprove breathing

bronchospasm: A constriction or narrowing of the airway

as a result of muscle contraction or inflammation; may

be exercise induced (EIA—exercise-induced asthma),allergen induced, or caused by infection or other lungdisease

Brudzinski's sign:A variation of the straight leg raise inwhich neck flexion is combined with a straight leg raise

A positive sign of pain in the lumbar region or legs cates nerve involvement

indi-bruise:See contusion.

bruxism: An involuntary action of grinding the teeth

buccal:Referring to the cheek or mouth

24 brachial plexus/buccal

bulimia:A disorder in which the patient binges (ie, eatslarge amounts of food) and then purges the food byvomiting or using laxatives.

bunion: Localized inflammation and calcification of thefirst metatarsophalangeal joint either dorsal or medial;often associated with hallux valgus

Bunnel-Littler test:A special test of the proximal

inter-phalangeal joint to determine cause of tightness See

Special Tests—Hand/Wrist (Appendix 17)

burner:See neurapraxia.

bursa: A closed sac lined with synovial membrane taining fluid; acts as a cushion and lubricant and isfound in areas subjected to friction

con-bursitis: Inflammation of the bursa

bursts:A series of electrical pulses delivered in packets orbeats

bypass:A shunt; a surgical technique in which a new path

is created from which the flow of blood can "bypass" ablockage

bulimia/bypass 25