Chapter 2 - Participation Examination Flashcards
What does the format of the participation exam depend on?
- level of activity
- community
- availability of personnel
- # of people being screened-preference
T/F: The PPE is always set up in an indivudual format.
False, can also be in a group/station format
What is the ideal time to do the PPE before activity
6 weeks before to allow for time to follow up.
T/F: A full PPE is not required on an annual basis.
True, should be re-evaluated for specific things or if condition changes.
What should a PPE reevaluation focus on? (8)
-height
-weight
-BP
-Skin check
- cardiac auscultation
-visual acuity
-pulse
-medical history
T/F: Both the initial and reevaluation PPE should include a baseline neurocognitive assessment.
True! Important for concussions.
What does the Medical History section of the PPE evaluate?
known diseases, Hx of MSK injuries, autoimmune disorders, allergies, special equipment (glasses, dentures, prothetics, braces, etc.) illness, red flags
What is the main purpose of the medical history?
To establish a foundation.
What does the VItal Signs section of the PPE evaluate?
- heart rate
- BP
- breathing rate
- pulse oximetry
- skin/tenperature
- PERRLA
Average normal heart rate for an adult?
60-100 bpm
Average normal heart rate for a child?
120-140 bpm
Where should the pulse initially be taken?
Carotid artery
Which parameter should be used to take the pulse?
A) 15x4
B) 30x2
C) 60x1
B
What three things should be noted with the pulse?
rate, rhythm, character
How many consecutive BP test are needed to conclude hypertension?
3
Average normal BP for an adult?
120/80 mmHg
Average normal BP for a child?
105/70 mmHg
Are rectal tempuratures higher or lower than oral tempuratures?
Higher by 0.4-0.5 degrees C
What is the average/normal oral tempurature?
37 degrees C
Are axillary tempuratures higher or lower than oral tempuratures?
Lower by about one degree C
Are tympanic membrane tempuratures higher or lower than oral tempuratures?
higher by about 0.8 degrees C
Minimum BP for stage 1 hypertension
140 mmHg systolic
90 mmHg diastolic
Minimum BP for stage 2 hypertension
> 160 mmHg systolic
100 mmHg diastolic
What does the cardiovascular exam look for?
Shortness of breath, palpitations, dizziness, syncope, chest pain, & cardiac anomalies
What does the pulmonary exam look for?
asthma, allergies, lung function
What test should be adminsted to athletes who indicate a history of asthma?
Peak expiratory flow (PEF)
What should you do if an athletes PEF is above 80% of baseline
do not restrict activites
What should you do if an athletes PEF is between 50-79% of baseline
restrict activites and initiate additional testing or treatment
What should you do if an athletes PEF is below 50% of baseline
initiate ERP for respiratory distress
What does the musculoskeletal exam look for?
history of injuries, instablitity / chronic weakness, unhealed injuries, infected/inflammed injuries
T/F: If an athlete has cervical or lumbar instability or limited ROM it may restrict their participation
True, might not be safe to play contact sports
What does the neurological exam look for?
- PERRLA
- concussion baseline and Hx
-c/s instability - burners & stingers
- deep tendon reflexes
- upper & lower sensory + motor
What is the name and function of Cranial nerve I
Olfactory, smell
What is the name and function of Cranial nerve II
Optic, acuity
What is the name and function of Cranial nerve III
Occulomotor, light accomodation & up +down movement
What is the name and function of Cranial nerve IV
Trochlear, lateral eye movement
What is the name and function of Cranial nerve V
Trigeminal, open and close mouth
What is the name and function of Cranial nerve VI
Abducens, shut eyes tight & medial gaze
What is the name and function of Cranial nerve VII
Facial, smile
What is the name and function of Cranial nerve VIII
Vestibulocochlear, snap fingers near ear (listening)
What is the name and function of Cranial nerve IX
Glossopharyngeal, swallow & gag
What is the name and function of Cranial nerve X
Vagus, say Ahhh
What is the name and function of Cranial nerve XI
Accessory, resisted shrug shoulders
What is the name and function of Cranial nerve XII
Hypoglossal, stick out tongue
Which conditions require a full evaluation by a neurosurgeon?
cervical stenosis, flat or reversed lumbar curve, or Spear tackler’s spine (repeated axial impact)
Which activities should people with epilepsy avoid?
(falling and recuurent head trauma) rock climbing, football, skiing, scuba diving, parachuting
What is the laymans term for emmetropia?
20/20 vision
What is the laymans term for myopia?
nearsightedness
What is the laymans term for hypermetropia?
farsightedness
What does anisocoria mean?
pupils different size (congenital)
What does the dental exam look for?
teeth all there, condition of dental appliances
T/F: A dentist should complete the dental exam?
True
What does the gastrointestinal exam look for?
digestive system, eating habits, nutrition,
What does organomegaly mean?
enlarged organs
What does the genitourinary exam look for?
menstruation, testicular health, preganacy, kidney issues
What is oligomenorrhea?
irregular and inconsistent periods
What is amenorrhea?
absence of menstruation
What is dysmenorrhea?
painful menstrual periods
What is menorrhagia?
abnormal heavy bleeding
What does the dermatological exam look for?
contagious lesions, STDs, severe acne, psoriasis, fungal infections, warts
What does the Heat Disorder exam look for?
cramping, heat stroke, syncope, exhaustion, sickle cell trait, medications causing heat intolerance, caffeine use
T/F: Labratory tests are a part of the PPE?
False, reccomended to only be initiated if needed.
T/F: A PPE can replace an annual phyical
False, only intended to determine readiness for sport.
Method for determing body fat percentage?
Skin folds
Upper normal limit of body fat percentage for males
> 14%
Upper normal limit of body fat percentage for females
> 17%
What are the nine skin fold sites
-. abdominal
- triceps
- biceps
- chest
- medial calf
-midaxillary
- subscapular
- supriliac
- thigh
Which side of the body should skin folds occur?
Right side
What does the flexibility exam look for?
Hypo- and hypermobility, total ROM @ joint pain free
What factors impact flexibility?
age, gender, race, genetics
bony block, joint adhesion, tight skin, muscle/ fat
What is strength defined as.
ability to produce 1RM force (isometric, isotonic, isokinetic)
What is power defined as.
ability to produce force in given time (body over distance)
What is speed defined as
ability to move body mass over time
T/F: General testing for strength, power, and speed are appropriate.
False, should be sport specific.
What is agility defined as
ability to change directions rapidly
What is balance defined as
- the body’s coordinated neuromuscular response to hold position/ maintain equilibrium
- ability to respond to stimulus
What changes can be implemented in a balance test?
change in visual, tactile, or kinetic stimuli
What is cardiovascular endurance defined as
- exercise over period of time
- CV / pulmonary efficiency
T/F: The type of aerobic testing should depend on the sport.
True
Describe the Harvard Step test
Steps up-up-down-down on an 18 inch platform at 2 seconds per step (30 times per minute) for 3.5 min followed by 30 seconds as fast as they can. Pulse is then measured sitting down at 30s, 60s, 120s, and 180s.
What is the index formula for the Harvard step test
[duration of exercise (seconds) x100] / (2x sum of any three pulse counts)
Is it better to have a higher or lower index for the Harvard step test
Higher. Indicates better fitness.
What should be the final questions a physician must consider for sport clearance following the PPE?
Will the activity increase a risk? Can they be allowed if on meds? If denied, is there another safe activity instead?
T/F: A physician can completely restrict participation in sport.
False, considered discriminory under Rehabilitation Act and Americans with Disabilites Act.
What legal document can be signed to acknowlegde risk and participation against reccomendation.
An exculpatory waiver
