3 - Sports Medicine

Question 1

What are the two major categories of athletic injury types?

Answer 1

Acute - macrotrauma seen in contact sports

Overuse - microtrauma seen in non-contact sports

Question 2

What is the definition of athletic exposure in sports med?

Answer 2

One athlete participation in once practice or game in which there is a possibility of injury

Question 3

What is the definition of a reportable injury?

Answer 3

Any injury that occurs during a scheduled practice or game that requires medical attention and restricts the athlete from finishing the practice or game or prevents them from future participation

Question 4

Where are the most common/severe sports injuries seen?

Answer 4

Spring Football
Wrestling
Female Gymnastics
Female Soccer

Question 5

What sport has the highest percent of severe injuries?

Answer 5

Female gymnastics - highest percent of reportable injuries too

Question 6

What sports have the highest amount of catastrophic injuries and fatalities

Answer 6

Ice hockey
Gymnastics
Football

Question 7

List some banned substances in sports

Answer 7

DHEA - fountain of youth, anti-aging/obesity via increased serum androgen levels

Androstendione - increases testosterone

Creatine - increases phosphocreatine

Beta-Hydroxy or Beta-methylbutyrate - supplement that is a metabolite of leucine and increases muscle mass and rate of recovery after strenuous exercise.

Question 8

List some restricted drugs in sports.

Answer 8

HGH - increases type II fast twitch fibers and decreases body fat

Diuretics

Beta Blockers (reduced anxiety and reduce tremors), pt with required beta blockers must get physicians proof

Question 9

What is the most dramatic difference in body part injured/prevalence between men and women?

Answer 9

Knee - women have a 5x higher chance

Plus, most female contact sports are non-contact, which makes the difference even more impressive

Question 10

Describe the female athlete triad

Answer 10

Amennorhea, Eating Disorder, Osteoporosis

Question 11

Describe the course of treatment for athletic menstrual irregularities.

Answer 11

If3 yrs since last menarche, then start low dose oral contraceptives

Question 12

Osteoporosis increases in female athletes is likely due to ?

Answer 12

Anemia leading to loss of bone mass

Question 13

List the guidelines for pregnant exercise.

Answer 13

Maternal HR should not exceed 140bpm
Maternal Temp should not exceed 38c
Strenuous activities should not exceed 15 mins
Avoid valsalva maneuver
Remember to increase caloric intake

Question 14

Describe little league shoulder

Answer 14

stress reaction to proximal humeral epiphysis (microfracture and widening)

leads to labral tears

Question 15

Describe pediatric elbow as it is seen in sports.

Answer 15

Little league elbow
excessive acceleration/deceleration
may progress to avulsion

Question 16

Describe madelung deformity.

Answer 16

Shortened or Deformed distal radius
Gymnasts or weightlifter children can have problems with weight bearing at wrist and have dorsal impactoin of RCJ (due to excessive dorsiflexion under load)

Question 17

What is the major cause of juvenile LBP in sports

Answer 17

Spondylolysis - nondisplaced pedicle fractures?
Seen with repetitive hyperextension - usually at L5 level– seen in diving, volleyball, soccer, dance, skating, gymnastics

Question 18

Describe pediatric hip in sports

Answer 18

Snapping hip - causd by tight iliopsoas, bursitis, and/or inflammation

Painful snapping with external rotation

Question 19

Describe osgood schlatters disease

Answer 19

Partial avulsion of tibial tuberosity seen in adolescents involved with frequent running/jumping sports/activities

Question 20

What would your differential be if a pediatric patient (athlete) prestents with posterior heel pain?

Answer 20

Sever’s Apophysitis
Achilles Tendonitis
Plantar Fasciitis
or Osteochondritis of the talus.

Question 21

What is Sever’s disease?

Answer 21

Apophysitis at the achilles insertion on the calcaneus seen in juvenile athletes

Question 22

Where do most muscle strains occur?

Answer 22

At the musculotendinous jct.

Question 23

Define concussion

Answer 23

An alteration of cerebral function caused by a direct or indirect (rotational) force transmitted to the head resulting in one or more of the following acute signs.

Question 24

Describe post concussion syndrome

Answer 24

Continued neurotransmitter dysfunction causing headache, slowed reflexes, impaired memory, and concentration, depression, and excessive sleep

Question 25

What is second impact syndrome?

Answer 25

An athlete who has sustained an initial head injury and returns to play while still symptomatic and sustains a second head injury.

Loss of cerebral autoregulation
Cerebral vascular congestion
Increased intracranial pressure
Brain Herniation

Question 26

List the levels of concussion grading

Answer 26

1 - No loss of consciousness, less than 30 mins amnesia

2 - Loss of consciousness for fewer than 5 minutes, more than 30 mins of amnesia

3 - Loss of consciousness for more than 5 mins, Amnesia more than 24 hours

Question 27

List the recovery criteria based on the cantu grading system.

Answer 27

1 - Athlete may return to play if asymtomatic for one week (same day can be considered if completely asymptomatic)

2 - Athlete may return to play if asymptomatic for one week

3 - Athlete may not return to play for at least one month. If asymptomatic for one full week, may return to play

Question 28

What is heat exhaustion?

Answer 28

Due to loss of electrolytes and fluid from body, muscle cramps, nausea, and vomiting

Fever over 102, body unable to cool itself.

May need IV fluids if initial conservative treatment doest’t work.

Question 29

What is heat stroke?

Answer 29

Most severe form of heat illness, occurs when body’s heat regulation system is overwhelmed

Life threatening

Fever over 104, Warm DRY skin

Confusion, lethargy, stupor, seizures, coma, death