Foundational Knowledge Review Guide
Anatomical Terminology
Anterior- toward the front of the body
Posterior- toward the back side of the body
Superior- toward the head
Inferior- toward the feet
Medial-toward the midline of the body
Lateral- away from the midline of the body
Proximal-referring to closer to the trunk
Distal- referring to farther away from the trunk
Superficial- near the surface of the skin
Deep- farther from the surface of the skin
Central- nearer or close to the center of a structure of system
Peripheral- farther away from the center of a structure of system
Contralateral- refers to opposite side
Ipsilateral- refers to same side
Bilateral-refers to both sides
Supine- lying face upward
Prone- lying face down
Movement Terminology
Flexion- bending
Extension-straightening
Abduction- away from midline
Adduction- toward midline
Internal Rotation- rotary movement toward midline
External Rotation- rotary movement away midline
Horizontal abduction- lateral movement away from midline
Horizontal adduction- lateral movement toward midline
Medical Terminology
Root Words
Cardi/o: Related to the heart.
Derm/a/o, dermat/o: Pertaining to the skin.
Encephal/o: Related to the brain.
Gastr/o: Related to the stomach.
Hemat/o: Pertaining to blood.
My/o: Related to muscle.
Oste/o: Related to bone.
Pulmon/o: Refers to the lungs.
Rhin/o: Related to the nose.
Sclerosis: Hard or hardening.
Stasis: Slowing or stopping the flow of a bodily fluid.
Therm/o: Indicates heat.
Prefixes and Suffixes
A-, an-: Lack of or without.
-ation: Indicates a process.
Dys-: Abnormal, difficult, or painful.
-ectomy: Surgical removal of something.
-ismus: Indicates a spasm or contraction.
-itis: Signifies inflammation.
-lysis: Decomposition, destruction, or breaking down.
Macro-: Large in size.
Melan/o-: Black or dark in color.
Micro-: Small in size.
-ology: The study of a particular concentration.
-osis: Indicates something that is abnormal.
-otomy: To cut into.
-pathy: Disease or disease process.
-plasty: Surgical repair.
Poly-: Many.
Pseudo-: False or deceptive, usually in regard to appearance.
Retro-: Behind or backward.
Medical Terminology Website: https://openmd.com/guide/medical-terminology
***Also review BOC Style Guide for additional medical terminology and abbreviations:
https://bocatc.org/system/document_versions/versions/288/original/boc-exam-style-guide20220407.pdf?1649350414 ***
Musculoskeletal Tissues
Ligaments: Dense connective tissue arranged in parallel bundles of collagen
3 Primary functions:
1) Provide joint stability
2) Provide control of position of one bone to another during motion
3) Provide proprioceptive input, or sense of joint positioning
Cartilage: rigid connective tissue that provides support
3 Types of Cartilage
1) Hyaline cartilage: found on articulating surface of bone
2) Fibrocartilage: forms intervertebral discs and menisci
3) Elastic Cartilage: found in auricle of ear and larynx
Cartilage has relatively limited healing capacity
Bone: connective tissue made up of living cells and mineral deposits
3 Major Components:
1) Epiphysis- end of bone
2) Diaphysis- the shaft of the bone
3) Epiphyseal plate: site of bone growth/elongation
Muscle: connective tissue
3 Major Types
1) Smooth (involuntary)
2) Cardiac
3) Skeletal (voluntary)
a. Muscle Tendon- attaches muscle to bone
Nerves: provides sensitivity and communication from CNS to PNS
Tissue Properties
o
o
o
o
o
o
o
Load - outside forces or forces acting on tissue
Stress - internal reaction/response to the external load
Strain - deformation of tissue under loading
Viscoelastic - viscous and elastic properties which allow for deformation; all human
tissue has these properties
Anisotropic - tissue also has this property, dependent on the direction of load, the
tissue will respond with greater or lesser strength
Yield point - elastic limit of tissue
Mechanical failure - what causes tissue to break but the limit being exceeded that
the tissue can handle
Mechanical Forces
o
o
o
o
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Tension - a force that pulls or stretches the tissue (stretching or lengthening)
Compression - when enough energy causes the tissue to not withstand the force
(squeezing or condensing)
Shearing - force moving across parallel tissue (sliding)
Bending - force on horizontal bone where the stress causes bending or strain
Torsion- a twisting mechanism caused by rotation at opposite ends (twisting)
Trauma and injury
o
Soft tissue trauma can be:
o Inert (noncontractile) - skin, joint capsules, ligaments, fascia, cartilage,
dura mater, and nerve roots
o Contractile - muscle, tendon, or bony insertion
Skin: See Picture for Anatomy
Injuries
Abrasion: caused by friction or sliding, “strawberry”
Blister: caused by frictions or rubbing
Incision: smooth cut usually caused by knife
Laceration: jagged wound, caused by blunt trauma
Puncture wound: pointed object piercing the skin
Avulsion: tearing away a portion of the skin
Bone:
Bone Structure
o Diaphysis - main shaft of long bone
o Epiphysis - at the ends of long bones
o Articular cartilage - covers ends of long bones
o Periosteum - fibrous membrane that covers long bones
o Medullary (marrow) cavity - hollow tube in long bone
diaphysis containing marrow
o Calcium salt - make bone hard
o Osteocyte – bone cell
o Haversian system - haversian canal with alternating
layers of intercellular matrix
o Compact bone - interspersed lamellae fill spaces
between haversian system
o Cancellous bone - numerous open spaces located
between trabeculae
o Volkmann’s canal - blood circulation connects
periosteum and haversian canal
Bone Functions
o Body support
o Organ protection
o Movement
o Calcium storage
o Hematopoiesis
Types of bone
o Flat bones - skull, ribs, scapulae
o Irregular bones - vertebral column and skull
o Short bones - wrist and ankle
o Long bones - humerus, ulnar, femur, tibia, fibula, phalanges
Bone growth
o Osteoblasts synthesize matrix --> calcification of matrix
o Ossification begins in the diaphysis and in both epiphyses
o Growth plate - layers of cartilage cells in different stages of maturity
o Osteoblasts build new bone on outside of bone; at same time
o Osteoclasts increase medullary cavity
o Bone’s functional adaptation - Wolff’s law
Bone Injuries
Fractures: classified as open or closed
Avulsion: separation of bone, piece pulled away
Comminuted: shattered into many fragments
Compression: crushing or impaction
Greenstick: incomplete fracture often in young bones
Oblique: diagonal
Spiral: “S” shaped fracture
Transverse: across the long axis of the bone
Stress: result of repetitive stress
Epiphyseal Fractures Are Classified According to the Salter-Harris System
Muscle
Types of muscle fibers: striated, cardiac, and smooth
Muscle fibers properties:
• Irritability/excitability: sensitive or responsive to chemical, electrical, or mechanical
stimuli
• Contractility: ability of muscle to contract and develop tension or internal force against
resistance
• Extensibility: ability of muscle to be passively stretched beyond its normal resting length
• Elasticity: ability of muscle to return to its original resting length after stretching
Muscle Structure/Anatomy (See Picture)
Types of injuries
Contusions- bruise
Strains-stretching or tearing of muscle
Grade 1: stretching with some fiber damage
Grade 2: partial incomplete rupture
Grade 3. Complete rupture
Muscle spasms- reflex reaction caused by trauma
Muscle cramp- involuntary contraction
Overexertion muscle problems- Delayed onset muscle soreness (DOMS)
Muscle guarding- involuntary contraction as a result of pain
Myofascial trigger points-hyperirritable nodule in skeletal muscle
Contracture- abnormal shortening of muscle
Tendonitis-inflammation in muscle tendon
Tenosynovitis- inflammation of synovial sheath
Atrophy- wasting due to inactivity, mobilization, or loss of nerve function
Joints
3 Major Classifications of Joints and Subcategories
Synarthrodial- suture, gomphosis
Amphiarthrodial- syndesmosis, synchondrosis, symphysis
Diarthrodial- arthrodial, ginglymus, trochoid, condyloid, enarthrodial, sellar
o Types of synovial joints (Common Names)
o Ball and socket - glenohumeral, hip joint
o Hinge - elbow
o Pivot - cervical atlas and axis, proximal ends of radius and ulna
o Ellipsoidal - wrist
o Saddle - carpometacarpal joint of the thumb
o Gliding - joints between the carpal and tarsal bones, intervertebral joints
Joint capsule - strong, the cuff of fibrous tissue consisting of collagen and helps to maintain
relative joint position
Ligaments
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o
o
o
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Collagen fibers that connect two bones
o Intrinsic - where the articular capsule is thickened
o Extrinsic - outside of joint
Contain elastic and collagen fibers - wavy, irregular, spiral
o Strongest in middle; weakest at ends
o Avulsion fractures
Injury factors
o Constant compression or tension leads to deterioration
o Intermittent compression or tension increases strength
o Chronic inflammation shrinks collagen fibers leading to acute injuries
Joint protection
o Capsules and ligaments provide protection
o Roux's law of function adaptation - an organ will adapt itself structurally
to an altercation, quantitative or qualitative, of function
Synovial membrane and synovial fluid
o Connective tissue with flattened cells and villi
o Fluid secreted and absorbed acts as a lubricant
Articular cartilage
o No direct blood flow or nerve supply
o Three types:
▪ Hyaline (articular) - nasal septum, larynx, trachea, bronchi,
articular ends of bones ▪ Provides static and dynamic stability; no direct
blood supply
▪ Motion control, stability, and load transmission
▪ Fibrous - vertebral disks, pubic symphysis, menisci
▪ The elastic - external ear, Eustachian tube
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o
o
o
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Additional synovial joint structures
o Fat pads - knee and elbow
o Fibrocartilage - disks connected to the capsule
Nerve supply
o Mechanoreceptors provide information about the relative position of the
joint; myelinated
Synovial joint stabilization
o Hilton's law - the joint capsule, the muscles moving the joint, and the skin
on top have the same nerve supply
o Muscles help stabilize
o Shunt muscles - muscles that attach directly to articular cartilage
Articular capsule and ligaments
o Ligaments are strongest in middle, weakest at the ends
o Quick response than muscles
Synovial joint trauma
o Capsule
▪ Acute - tension, compression --> sprains, dislocation,
subluxation, synovial swelling
▪ Chronic - tension, compression, shearing --> capsulitis,
synovitis, bursitis
o Hyaline cartilage
▪ Chronic - compression, shearing --> osteochondrosis,
traumatic arthritis
Joint/Ligament injuries
o Joint sprains (Grade I, Grade II, Grade III)
o Subluxation- incomplete separation of two bones
o Dislocation- complete separation of two bones
o Osteochondrosis- disorders that affect growing bones
o Osteoarthritis-degenerative joint disease
o Bursitis- inflammation of bursa
o Capsulitis- inflammation of joint capsule
o Synovitis- inflammation of synovial membrane
Nerve
o Neuron-cell body dendrites, axon
o Large axons in peripheral nerves
enclosed in neurilemmal sheaths
o Schwann cells, Satellite
cells)
o CNS - neuroglial cells - astrocytes,
oligodendrocytes, ependymal cells,
microglia - work together to bind
neurons and provide support for
nervous tissue
o Injuries - compression, tension
o Neuritis
o Referred pain
o Microtrauma and overuse --> injury
o Pathomechanics - poor mechanic of movement
o Many sports are unilateral --> imbalance
The Healing Process
Inflammatory Response Phase
o 4 days
o Cellular injury = altered metabolism and release of the substances that initiate this
process
o Signs and symptoms
▪ Redness
▪ Swelling
▪ Tenderness
▪ Pain
▪ Warmth (increased temperature)
▪ Loss of function
o Leukocytes, phagocytic cells, exudates --> injured tissue
o Phagocytosis = dispose of injury byproducts, i.e. blood, damaged celled
o Vascular reaction
▪ Immediate vasoconstriction (within minutes)
▪ Vascular dilation
▪ Initial effusion lasting about 24-36 hours
▪ Chemical mediators
▪ Histamine
▪ Leukotaxin - margination --> diapedesis
▪ Necrotic
▪ Leukocytes release - bradykinin and prostaglandin
o Formation of clot
▪ Starts at 12 hours post-injury --> finish within 48 hours
Due to injury to a vessel
Blood coagulation
▪ Thromboplastin release --> prothrombin changed to thrombin
--> thrombin converts fibrinogen
Phagocytosis
▪ PMN's (polymorphonuclear neutrophils) - kills bacteria
▪ Mononuclear phagocytes/macrophages
▪ Debris removed --> blood coagulates --> epithelial cells migrate
Chronic inflammation
▪ Replaces leukocytes with macrophages, lymphocytes and plasma cells
▪
▪
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o
▪
Fibroblastic Repair phase
o Day 4 - 6 weeks
o Fibroplasias - scar formation
o Revascularization
▪ Capillary buds grow into wounds by way of decreased oxygen
▪ Fibroblasts lay granulation tissue (fibroblasts, collagen, capillaries)
o Wound contraction
▪ Extracellular matrix - collagen, elastin, ground substance - start at the
margins of the wound and work their way towards the center of the wound
o Types of repair
▪ Resolution = back to normal
▪ Granulation tissue = initial is type III collagen but changes to type I within two
weeks leading the tensile strength to begin low
▪ Regeneration = new cells of the same type are made and can still perform
the function of previous cells
Maturation/remodeling phase
o 6 weeks – 2 to 3 years
o Realignment and remodeling of collagen fibers depend on the tensile forces that are put
on the scar tissue
▪ Fibers should realign parallel to lines of that tensions
o After about 3 weeks, a scar exists
o Wolff's law = "bone and soft tissue will respond to the physical demands placed on
them, causing them to remodel or realign along lines of tensile force."
▪ When inflammatory symptoms decrease --> controlled mobilization
▪ ROM and strengthening should be done during this phase and depending on
the pain
Pain
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Types of pain
o Acute - lasting less than 6 months
o Chronic- longer than 6 months
o Referred - pain is not necessarily at the site of injury
Nociceptors and neural transmission
o Nociceptors - pain receptors; sensitive to mechanical, thermal, and chemical factors
o First-order afferents
▪ Transmit impulses from nociceptor
▪ A-alpha and A-beta = large-diameter
▪ A-delta (fast-skin) and C (slow-skin and deeper) - small diameter
▪ Pain and temperature
o Second-order afferents
▪ Carry sensory messages from the dorsal horn to the brain
▪ Receive input from A-betas, A-deltas, and Cs
o Third-order afferents
▪ Carry information to the brain for interpretation
Facilitators and inhibitors
o Serotonin-descending pathways
o Norepinephrine - inhibits pain transmission between first and second-order
o Substance P - in first order
o Enkephalins - in descending pathways
o Beta-endorphins – CNS
Mechanisms of pain control
o Level 1 = Gate Control Theory
o Level 2 = Central Biasing
o Level 3 = Release of Beta-Endorphins
Foot
Classification of Injury
Forefoot
• Contusion
• Sprain
• Great Toe Hyperextension
• Fracture / Dislocation
• Structural & Functional Abnormalities
• Sesamoiditis
Hindfoot
• Calcaneal Fracture
• Calcaneal Stress Fracture
• Apophysitis
• Retrocalcaneal Bursitis
• Heel contusion
Midfoot
• Pes Planus
• Pes Cavus
• Morton’s Toe
• Longitudinal Arch Strain
• Plantar Fasciitis
• Metatarsal Fracture
• Jones Fracture
• Metatarsal Stress Fracture
• Metatarsalgia
• Metatarsal Arch Strain
These injuries should be paired with
the special tests, etc in the Orthopedics
unit. I recommend making note of any
key signs or symptoms, MOI, etc.
Ankle & Lower Leg
Classification of Injury
ANKLE
Sprain
Inversion
Eversion
Fracture
Dislocation (joint)
Peroneal Tendon Subluxation / Dislocation
Peroneal Tendinitis
Anterior Tibialis Tendinitis
Posterior Tibialis Tendinitis
Osteochondritis Dissecans
LOWER LEG
Achilles Tendon Strain
Achilles Tendinosis
Achilles Tendinitis
Achilles Tendon Rupture
Contusion
• Bone
• Soft Tissue
Leg Cramps & Spasms
Gastrocnemius Strain
Shin Splints
Compartment Syndrome
Fractures
Stress Fractures
Knee
Classification of Injury
Tibiofemoral Joint
Contusion
Sprain
Meniscus Tear
Fracture
Osteochondritis Dissecans
Dislocations
Patellofemoral
Contusion
Bursitis
Patella Tendonitis
Extensor Mechanism Rupture
Patella Subluxation / Dislocation
Patella Fracture
Patella Tracking
Chondromalacia Patellae
Osgood-Schlatter Disease
Thigh
Classification of Injury
Contusions
Myositis Ossificans
Muscle Strain
Quadriceps
Hamstrings
Fracture
Stress Fracture
Hip & Pelvis
Classification of Injury
Hip
Contusion
Bursitis
Groin Strain
Sprain
Fracture/Stress Fracture
Dislocation
Epiphyseal Injury
Pelvis
Contusion
Fracture
Stress Fracture
Osteitis Pubis
Athletic Pubalgia
The Spine
Classification of Injury
Cervical
Contusion
Strain
Sprain
Intervertebral disk injury
Nerve root
Brachial plexus
Fracture
Dislocation
Thoracic
Lumbar
Sprain
Strain
Intervertebral disk
Fracture
Spondylolysis
Spondylolisthesis
Sacroiliac Joint
SI Joint Sprain
Coccyx
The Head
Classification of Injury
Scalp Contusion
Scalp Laceration
Skull Fracture
Intracranial Hematoma
Subdural Hematoma
Epidural Hematoma
Concussion
Post Concussive Syndrome
Second Impact Syndrome
Shoulder Complex
Shoulder Girdle
Scapulothoracic Joint (scapula meets ribs)
Sternoclavicular Joint
Acromioclavicular Joint
Shoulder Joint
Glenohumeral Joint
Classification of Injury
• Contusion
• Sprain
• SC
• AC
• Fracture
• Clavicle
• Scapula
• Strain
• Superficial
• Rotator Cuff
• LH Biceps Tendon rupture
• Impingement Syndrome
• Tendonitis / Tenosynovitis
• Rotator Cuff
• LH Biceps Tendon
• Subluxation
• Dislocation
• Chronic Recurrent Instability
• Traumatic Instability
• Bankart Lesion
• Hill Sachs Lesion
• SLAP Lesion
• Fracture
• Neurovascular
• TOS
• Scapular Dyskinesis
The Elbow & Forearm
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•
•
Humero-ulnar joint
Humero-radial joint
Superior Radioulnar joint
Classification of Injuries
• Contusion/ Upper Arm
• Contusion/Bursitis
• Contusion/Ulnar Nerve
• Strain
• Sprain
• UCL
• RCL
• Epicondylitis
• Fracture
• Dislocation
• Volkmann’s Ischemic Contracture
• Osteochondritis Dissecans
• Cubital Tunnel Syndrome
• Forearm Contusion / Fracture
The Wrist & Hand
Distal radioulnar joint
Radiocarpal joint
Metatcarpalphalageal Joint
Interphalangeal Joint
Carpometacarpal Joint
Distal Interphalangeal Joint
Classification of Injury
• Wrist
• Strain
• Tendinitis
• Sprain
• TFCC Injury
• Scaphoid Fracture
• Hamate Fracture
• Lunate Dislocation
• Colles’ Fracture
• Wrist Ganglion
• Carpal Tunnel Syndrome
• Neurological Injury
• Hand
• Contusion
• Metacarpal Fracture
5th metacarpal
• MCP Dislocation
• Phalanges
• Sprain
• Fracture
• Dislocation
• Mallet Finger
• Boutonniere Deformity
• Jersey Finger
• Thumb
• Sprain
• Gamekeeper’s Thumb
• Fracture
• Dislocation
• Nail Deformities
Please keep in mind that foundational knowledge includes ATR 510 and all prerequisite classes
as required by CAATE and the SUNY Cortland Master of Science in Athletic Training Program
Application.
These courses include:
Biology
Chemistry
Physics
Psychology
Anatomy & Physiology
Statistics
Biomechanics
Exercise Physiology
Sports Psychology
***There is an expectation that you understand the information from these classes without
specific review within the athletic training program. Questions regarding these topics should be
expected on the Comprehensive Examination as well as the Board of Certification
Examination***