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Environmental Conditions in Athletics Flashcards

1
Q

What are the two mechanisms of thermoregulation in cold conditions?

A
  • Non- Shivering Thermogenesis

- Shivering Thermogenesis

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2
Q

What are Non Shivering Thermogenesis and Shivering Thermogenesis?

A
  • Metabolic heat production from sources other than muscle contraction
  • Shivering Thermogenesis is heat production as a result of involuntary muscle contractions
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3
Q

How much thermoregulation can be achieved by shivering or exercise in the cold

A
  • Shivering - can increase metabolic heat production by 6 times
  • Exercise - by up to ten times
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4
Q

What are the four mechanisms in which heat is dissipated from the skin to the environment?

A
  • Conduction
  • Convection
  • Radiation
  • Evaporation
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5
Q

What is conduction heat loss?

A
  • When the body comes in contact with something cold, resulting in heat transfer from the warm body to the cooler object
  • Exaggerated by 5 times with wet clothing
  • 25x with water immersion
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6
Q

What is convection heat loss?

A
  • When air (or water) passes over the body, lifting heat away, due to the mass transfer at the boundary layer moving past the skin’s surface.
  • Water is 40x more effective than air at convecting heat away from the body
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7
Q

What is Radiation Heat Loss?

A
  • heat released by the body into the environment, and is independent of ambient air temperature,
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8
Q

What is Evaporative heat loss?

A
  • Vaporization of water from the skin’s surface (evaporation of sweat).
  • The most effective means of heat dissipation
    during exercise.
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9
Q

How likely is a person who has sustained a cold injury to have another cold injury?

A
  • 2-4x more likely than if they had not had a cold injury previously
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10
Q

Where in the brain is the thermoregulatory center?

A
  • Hypothalamus
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11
Q

Why does heat loss affect women more than men

A
  • Surface area to mass ratio is greater

- More surface area for convective heat loss

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12
Q

What types of layers should players wear in the cold?

A
  • An internal layer that allows evaporation of sweat
  • A middle layer that provides insulation
  • An external layer that allows evaporation of moisture, and is wind and water resistant.
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13
Q

What is the danger point at which the temperature can cause rapid cold injury of exposed body parts?

A
  • Ten degrees F
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14
Q

What is Hypothermia?

A
  • When the body’s core temperature falls below 95 degrees Fahrenheit
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15
Q

What are early signs and symptoms of Hypothermia?

A
  • Changes in motor function, cognition and level of consciousness
  • Should be suspected when an individual, following prolonged exposure to cold, shivers, appears clumsy and confused, has slurred speech, and stumbles.
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16
Q

What are signs and symptoms of Moderate to Severe Hypothermia?

A
  • Cessation of shivering
  • Very cold skin upon palpation
  • Depressed vital signs
  • Rectal temperature below 95 degrees Fahrenheit
  • Impaired mental function
  • Gross motor skill impairment
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17
Q

How should you treat Hypothermia?

A
  • Remove wet or damp clothing and insulate the athlete with dry clothing or blankets
  • Passive external rewarming for mild hypothermia (won’t work for moderate to severe)
  • This is because of “Core temperature after-drop”: the return of cold blood from peripheral circulation to central circulation that may cause further core hypothermia.
  • In moderate to severe: Rewarming should occur slowly, either at room temperature or by placing the affected tissue against another person’s warm skin, and rewarming of the trunk should begin before that of the extremities to minimize the risk of temperature after-drop.
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18
Q

What are the three phases of frostbite?

A
  • Frrostnip
  • Superficial frostbite
  • Deep frostbite
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19
Q

What is Frostnip?

A
  • Skin cooling below 50 F
  • Loss of sensation and micro-vasoconstriction
  • No actual freezing of tissue or permanent damage
  • Symptoms are burning and numbness
  • Skin may be grayish pale, usually exposed face or extremities
  • After thawing, skin may be red, flaky, and peel
  • Treated immediately by direct heating or protective clothing
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20
Q

What is Superficial Frostbite?

A
  • Involves only the skin
  • Below 28 degrees F
  • Mostly ears, nose, fingers, toes, extremities
  • Painful, then numb and cold, firm, rigid, pale, or waxy to inspection.
  • After thawing, large blisters filled with yellowish fluid may develop
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21
Q

What is Deep Frostbite?

A
  • Involves freezing of the skin, underlying tissues and adjacent tissues, including muscle, tendon, and bone
  • Signs and symptoms include edema, mottled or gray skin, tissue that feels hard and does not rebound, and numbness or anesthesia
  • Skin will appear puffy and turn dark purple.
  • Blisters are absent and gangrene may appear.
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22
Q

How should Superficial and Deep Frostbite be treated?

A
  • In Hospital
  • If not, should submerge in warm water bath, 98-104 degrees F, 15-30 minutes, or until tissue is pliable and color and sensation has returned
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23
Q

What is Chilblain (Pernio)?

A
  • Exaggerated or uncharacteristic inflammatory response to cold exposure, most commonly in the feet or hands
  • Signs and Symptoms: Small erythematous papules with edema, tenderness, itching and pain, in conjunction with exposure to cold, wet conditions
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24
Q

How do parasympathetic and sympathetic nervous systems play a role in thermoregulation in the heat?

A
  • Parasympathetic: Regulates sweating

- Sympathetic: Controls increases in cutaneous blood flow and vasodilation for heat dissipation

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25
Q

Why is exercising in the heat so demanding on the cardiovascular system?

A
  • Has to deliver both sufficient muscle blood flow to support metabolism and sufficient cutaneous blood flow to support heat loss for the body while maintaining blood pressure
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26
Q

What are some of the bodies responses to heat acclimatization?

A
  • Decreased heart rate
  • Decreased Rectal temperature
  • Decreased Perceived exertion
  • Increased plasma volume
  • Increased Sweat rate
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27
Q

How long does heat acclimatization take?

A
  • Most in seven days
  • Reasonably protective after 7-14 days
  • Maximum protection 2-3 months
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28
Q

How much water loss (% body weight) can start to negatively effect the athlete?

A
  • Two percent
  • Impairs power production
  • Increases risk to exertional heat illness
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29
Q

Is drinking ad libitum during exercise enough for athletes playing in the heat?

A
  • No
  • Should pre hydrate
  • Hydrate during
  • Hydrate after at volume consistent with fluid lost during
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30
Q

When is the use of IV fluids for hydration appropriate?

A
  • Athlete who is unable to ingest oral fluids due to nausea and/or vomiting
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31
Q

Why don’t children respond to exercise in heat as well as adults?

A
  • Greater surface area to body mass ratio (greater heat gain)
  • Generate more metabolic heat per mass unit
  • Lower sweating capacity
32
Q

When exercising in hot ambient temperatures, what steps should children take to decrease risk of heat illness?

A
  • Should be encouraged to ingest fluids every fifteen to 30 minutes during activity
  • Should have extended and more frequent rest breaks
  • Should consider decreased intensity of exercise with activities lasting over 30 minutes.
33
Q

During which phase of the menstrual cycle is the female at greater risk for developing heat illness?

A
  • Luteal Phase

- During this phase, elevated progesterone levels cause increase in core temp

34
Q

What environmental factors influence the risk of exertional heat illness?

A
  • Ambient air temperature
  • Relative humidity
  • Air motion (when temp over 98.6, only way to decrease heat is through evaporation)
  • Amount of radiant heat from the sun
  • When these factors are prevalent, the risk of exertional heat illness is greater the next day
35
Q

What is one of the best indicators of impending exertional heat illness?

A
  • Prevalent environmental factors for heat the day prior

- (Crazy hot day yesterday, worked out in it, today is the day for a heat injury)

36
Q
  • What percentage of supplements may be contaminated with ingredients not listed on the label?
A
  • 15-25 percent
37
Q

What type of supplements increase the risk for heat illness or injury?

A
  • Stimulants

- Increase core temperature

38
Q

What are heat cramps, s/s, predisposing factors?

A
  • Cramps due to sweat and water loss
  • Cramping
  • Lack of acclimatization, an ongoing negative sodium balance and use of diuretic medications
39
Q

How do you treat heat cramps?

A
  • Immediate oral sodium replacement

- Extreme cases: IV fluid replacement therapy (only if athlete cannot ingest enough fluid)

40
Q

What are heat cramps an early indicator of?

A
  • Heat exhaustion
41
Q

What is Heat Syncope?

A
  • Orthostatic syncopal episode after exercise when circulatory system is maximally vasodilated
  • When athlete stops, blood pools to extremities and away from brain…….syncope ensues
  • Place athlete supine and replace fluids
42
Q

What is Heat Exhaustion?

A
  • Most common heat illness
  • Athlete (usually unacclimatized) cannot continue exertion in the heat
  • Signs and symptoms: Profuse sweating, fatigue, malaise, anorexia, nausea, vomiting, urge to defecate, headache, hyperventilation, tachycardia and hypotension, vertigo, anxiety and confusion
43
Q

What are core temperatures associated with Heat Exhaustion?

A
  • Above 100.4 F
  • Under 104.9
  • 105 and above is Heat Stroke
44
Q

What are the two classifications of Heat Exhaustion?

A
  • Water Depleted

- Sodium Depleted

45
Q

What is Water Depletion Heat Exhaustion?

A
  • More rapid onset that sodium depletion

- More likely to progress to heat stroke if untreated

46
Q

What is Sodium Depletion Heat Exhaustion?

A
  • Slower onset than water depletion
  • Usually in un-acclimatized athletes who replace the water but not the electrolytes over several days of exercise
  • May become “hyperhydrated”
47
Q

What is treatment for Heat Exhaustion?

A
  • Rest, Cooling, Rehydration
  • If altered mental status, vomiting, cardiac arrhythmia, or fails to respond to above treatment:
  • IV Rehydration and Intense Cooling
  • If left untreated, may lead to Heat Stroke
48
Q

What is Heat Stroke?

A
  • Core temp greater than 104.9 F (40.5 C)

- Organ System Failure

49
Q

At what temp do mortality rates remain high for Heat Stroke?

A
  • Above 105.8

- Mortality rates may be as high as Ten Percent

50
Q

What are signs and symptoms of Heat Stroke?

A
  • Tachycardia
  • Hypotension
  • Sweating (although skin may be dry at time of collapse)
  • Hyperventilation
  • Altered mental status
  • Irritability
  • Ataxia
  • Vomiting
  • Diarrhea
  • Seizures
  • Coma
  • Decorticate posturing
51
Q

What is treatment for Heat Stroke?

A
  • Rapid external cooling techniques (cold ice water immersion)
  • Bringing temp below 101.8 greatly improves prognosis
  • If no ice water immersion available:
  • Remove restrictive or unnecessary clothing, spraying the athlete with water, wrapping the athlete in wet towels, applying ice packs to the neck, axilla, and groin and increasing airflow over the athlete
52
Q

What are some negative effects of Environmental Hypoxia? (High Altitude training)

A
  • Decreased cardiac output and blood flow to muscle
    tissue
  • Depression of immune function
  • Increased tissue damage mediated by oxidative stress
53
Q

What are benefits and adaptations to chronic exposure to high altitudes?

A
  • Increases oxygen-carrying capacity of blood by

increasing hemoglobin and hematocrit

54
Q

What are the range of symptoms of High Altitude Illness?

A
  • Range from a simple high-altitude headache, to nausea and vomiting, to life-threatening pulmonary or cerebral edema
55
Q

What are the symptoms of Acute High Altitude Illness?

A
  • Headache is predominant symptom

- Frequently accompanied by nausea, vomiting, anorexia, fatigue and insomnia

56
Q

At what altitude do people tend to get High Altitude Illness?

A
  • Between 2500 Meters and 5000 Meters
57
Q

What is treatment for High Altitude Illness?

A
  • Limit Activity - Usually self limiting

- If this fails, supplemental oxygen and/or descent to lower atlitudes

58
Q

What are symptoms of Pulmonary Edema?

A
  • Dyspnea at rest
  • Cyanosis
  • Severe hypoxemia
  • Noncardiogenic pulmonary edema
59
Q

What are symptoms of Cerebral Edema?

A
  • Ataxia
  • Vomiting
  • Decreased level of consciousness
  • Coma
60
Q

What is treatment for Severe High Altitude Illness (With pulmonary or cerebral edema?)

A
  • Immediate Descent
61
Q

How do you prevent High Altitude Illness?

A
  • Limit rate of ascent
  • Hydration
  • Avoid Alcohol
  • Limit training volume and intensity in first few days at altitude
62
Q

What is Overtraining?

A
  • Neuroendecrine disorder characterized by:
  • Imbalance between exercise and recovery, resulting in physical symptoms including severe and prolonged fatigue, as well as emotional and behavioral symptoms.
63
Q

What are some early signs of Overtraining?

A
  • Mood changes in athlete
  • Poor Performance
  • Complaints of “Heavy Legs”
  • Sleep Disturbances
64
Q

What is a common (and uncommon) sequelae of lightning strike?

A
  • Commonly have blunt head trauma from falling

- Rarely have burns because time of the strike is so short

65
Q

How should treatment be given after someone is struck by lightning?

A
  • Ensure the rescuers safety (in the middle of a lightning storm)
  • Normal advanced cardiac life support protocols
  • If person is cold and wet, place layer between them and the ground to prevent hypothermia
66
Q

What is the “flash to bang” method of determining how far away lightning is? 30 Second Rule?

A
  • Count time from flash to bang of thunder
  • Divide by FIVE to determine how many miles away lightning is
  • If flash to bang count is less than 30 seconds (lightning is within 6 miles), remove everyone from event site
67
Q

Once you have postponed an event due to lightning, when can the event resume?

A
  • 30 minutes after both the last sound of thunder and the last flash of lightning
  • Clock starts over if you hear thunder or see lightning
68
Q

What environmental factors increase the risk of crisis during exertion in an athlete with Sickle Cell Trait?

A
  • Ambient Heat Stress

- Altitude

69
Q

What is the primary attributable cause of death in athletes with Sickling During Exertion?

A
  • Acute Rhabdomyolysis
  • Caused by sickle red blood cells clogging vessels and leading to Acute Ischemic Rhabdomyolysis
  • Athletes with sickle cell have 28 fold increase of exertional death than normal individuals
70
Q

What are Symptoms of someone experiencing Sickle Cell Crisis or Collapse?

A
  • Ischemic pain
  • Muscle weakness rather than cramping
  • Will Typically present during the first two to five minutes of exertion
  • Individual may slump over but remain able to talk
71
Q

What is a risk of individuals with sickle cell trait at altitudes over 10,000 feet altitude?

A
  • Splenic Infarction
72
Q

How is Splenic Infarction Treated?

A
  • Hydration, analgesia, rest, and supplemental oxygen.
73
Q

What are Urinary Markers of Dehydration?

A
  • Reduced Urine Volume
  • High Urine Specific Gravity
  • High Urine Osmolality
  • Dark Urine Color
74
Q

What are the Three Markers of Hydration in the Acronym “WUT”?

A
  • Weight
  • Urine
  • Thirst
75
Q

How can Body weight be used as a marker of hydration?

A
  • Weight should stay stable

- For each pound of body weight lost in sweat, athlete should consume 16oz or 500ml of fluid

76
Q

How can Urine be used as a marker of hydration?

A
  • Color and Frequency

- Sample for color is the first void in the morning

77
Q

How should an athlete manage hydration before exercise? During?

A
  • 500ml (16.9oz) 2 hours before a game
  • On hot days drink an additional 250-500ml 30-60 minutes before
  • Additional 250 ml every twenty minutes during exercise in hot environments

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