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MM Test 4 > B6.079 Preparticipation Physical Exams > Flashcards

B6.079 Preparticipation Physical Exams Flashcards

1
Q

function of preparticipation sports physical

A

maximize safe participation
identify medical problems with risks to the athlete or another participant during participation
identify conditions requiring treatment before participation
remove unnecessary restrictions on participation

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2
Q

should the PPE serve as a sub for comprehensive health maintenance?

A

no

ugh

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3
Q

when to do a PPE

A

best within 6 weeks of a season

not at a station exam ideally

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4
Q

neurocognitive testing in athletes

A

impact or immediate post-concussive assessment and cognitive testing is the most common
computer based - takes 30 min
get a baseline test for athletes 12 and older before season begins

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5
Q

problems with neurocognitive testing system

A

athletes can “game” the test to get a low score so can return to play
should not replace clinical signs and symptoms

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6
Q

bleeding problems in athletes

A

important in patients who want to play contact sports

mononucleosis - spleen size peaks at one month

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7
Q

recent infections that are important to be aware of in athletes

A 
mono
hep B
HIV
-5-7 mil cases worldwide
-first stage is asymptomatic
-recurrent infections?
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8
Q

important PMH components to be aware of in athletes

A

sickle cell trait history
-extreme heat and exertion may be a risk
congenital or acquired absence of a kidney
-contraindications for contact sports questionable
congenital or acquired absence of a testicle
-mandatory protective cup use
history of a seizure disorder
-water sports athletes need full evaluation

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9
Q

female athlete triad

A

amenorrhea
anorexia (disordered eating)
osteoporosis

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10
Q

primary amenorrhea

A

no menses by 16

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11
Q

secondary amenorrhea

A

no menses for >6 months after onset

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12
Q

heat illness in athletes

A

feeling faint or dizzy in heat, can cause heat exhaustion
athletes tend to have recurring problems
water > sports drinks&raquo_space;> energy drinks

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13
Q

symptoms with exercise requiring further evaluation

A

syncope (cardiac, neuro, endocrine)

coughing, wheezing (pulm causes, asthma, EIB)

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14
Q

important family history in athletes

A

cardiac death before age 50 (hold from participation until cleared)
asthma
diabetes
bleeding problems (contact sports)

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15
Q

2 main parts of PPE

A

MSK exam
-stress fracture history
general physical exam

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16
Q

components of general physical exam on PPE

A 
mental status
neuro
growth parameters
CV status
lung exam
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17
Q

derm conditions in athletes

A

tattooing/piercings
common in athletes
-Hep C most common cause of liver transplant
-3.9 mil americans have hep C

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18
Q

marfans syndrome

A

autosomal dominant
tall, thin, arm span exceeds height
refer to cardiologist for EKG and echo

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19
Q

sexual maturity

A

determine rating
based on stage of sexual maturity, not age or size
if advancement is suspected, think anabolic steroid use (8-9% of high school seniors)

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20
Q

cardio exam in PPE

A

95% of all sports related fatalities are cardiac in nature
more than 50% of those are hypertrophic cardiomyopathy (auto dom)
patient and fam history are important

21
Q

hypertrophic cardiomyopathy

A

disproportionate hypertrophy of the ventricular septum

most cases are previously asymptomatic

22
Q

exercise induced bronchospasm

A 
90-100% of asthmatics have EIB
difficulty breathing during and/or immediately after exercise
loss of FeV1 of at least 15%
worse in summer and fall
pollution can exacerbate
23
Q

important points of an orthopedic exam in the PPE

A

recognizing any preexisting injuries
define injury patterns
identify areas of injury susceptibility
develop rehab strategies to prevent injuries from occurring

24
Q

stance / symmetry instructions

A

stand with arms at sides

25
Q

stance/ symmetry abnormalities

A

enlarged AC joint
enlarged sternoclavicular joint
asymmetrical waist
asymmetrical shoulder height

26
Q

neck exam instructions

A

look at ceiling (c spine extension)
look at floor (c spine flexion)
touch R & L ears to shoulder (lateral flexion)
turn head R & L (rotation

27
Q

neck exam abnormalities

A

limited flexion, extension or rotation

28
Q

components of back exam

A

inspection (scoliosis)
flexion (pain = disc prob)
extension (pain = posterior element problem)
rotation (pain = paraspinous muscle problem)
reflexes

29
Q

spondylosis

A

back pain with extension
worsens with activity
common in extension sports: ballet, gymnastics, skating, line man of football, volleyball

30
Q

scoliosis screen and lower extremity assessment abnormalities (standing)

A

shoulder asymmetry
prominent rib cage
waist curve asymmetry
wasting thigh or calf muscles

31
Q

back extension exam instructions

A

lean back as far as possible

observe back flexibility

32
Q

scoliosis screen and lower extremity assessment abnormalities (bending at waist)

A

rib asymmetry
spinal curvature
wasting calf or thigh muscles
pain

33
Q

shoulder strength exam instructions

A

shrug shoulders while examiner holds them down

expect symmetrical muscle bulk and strength

34
Q

shoulder exam abnormalities

A

indicators of neck and shoulder concerns:
loss of strength
loss of muscle bulk

35
Q

arm / shoulder strength exam instructions

A

hold out arms and lift up while examiner hold them down

expect equal muscle bulk and strength in both arms

36
Q

arm / shoulder strength exam instructions abnormalities

A

loss of strength

wasting of deltoid muscles

37
Q

shoulder external rotation exam instructions

A

hold arms out from sides with elbows bent 90 deg

raise hands back as far as they can go

38
Q

shoulder external rotation exam abnormalities

A

may indicate shoulder problem or old dislocations

-loss of external rotation

39
Q

shoulder internal rotation exam instructions

A

hold arms to side, elbows bent 90 deg

pull hands downward, palms facing backward

40
Q

shoulder internal rotation exam abnormalities

A

limited rotation

41
Q

elbow range of motion exam instructions

A

hold arms out from sides, palms up

straighten elbows completely, bend completely

42
Q

elbow range of motion exam abnormalities

A

may indicate old elbow injury

loss of extension or flexion

43
Q

elbow/forearm/wrist assessment instructions

A

hold arms down at sides with elbows bent 90 deg
supinate palms
pronate palms

44
Q

hand/finger assessment instructions

A

make a fist

open hand and spread fingers

45
Q

hand/finger assessment abnormalities

A

protruding knuckles

swollen or crooked fingers

46
Q

calf strength and Achilles tendon assessment

A

stand on heels, then on toes

47
Q

calf strength and Achilles tendon assessment abnormalities

A

calf asymmetry - muscle wasting

limited ankle flexion

48
Q

knee flexion / extension assessment instructions

A

squat on heels ; duck walk 4 steps, stand up

expect painless movement, equal heel to butt distance, equal knee flexion, rises straight up

49
Q

knee flexion / extension assessment abnormalities

A

inability to flex knees

inability to stand up without twisting or bending to one side

MM Test 4 (20 decks)

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