Lecture 4: Pre-Participation Medical Examination Flashcards
What is PPME?
- performed annually or bi-annually
- ensure health and safety while participating in activity or sport
- gather info abt general health, maturity and fitness lvl at beginning of season
- identify individuals who are at risk for participation in physical activity
What are the 9 goals of PPE?
- Determine general health and immunization status
- Detect medical conditions that have not healed or predisposed individual to injury or illness
- Identify behaviours posing a risk to health
- Establish baseline parameters for determining when athlete can return to activity
- assess physical maturity
- evaluate physical fitness
- classify readiness to participate
- recommend appropriate activities to individuals w/ medical contraindications to exercise
- meet legal and insurance requirements
Explain PPE set-up
- completed by primary care physician
- group format: supervising/team physician, ATs and other medical specialists
- usually multiple stations (quicker)
- ideally 6 weeks before start of PA (allow time to correct problems or refer)
What is Medical History? What are some things it includes?
Written form usually filled-out before showing up to PPME
- immunizations/vaccines
- infectious diseases
- LOC
- headaches
- MSK injuries
- cardiovascular and respiratory questions: SOB, heart palpitations, irregular heart beat…
- seizures
- EDs
- contact lenses, corrective glasses
- special equipment (pads, braces, eye guards, neck rolls…)
- family history
What does the Physical Examination include?
- vital signs
- general medical problems
- CV examination (ECG)
- pulmonary examination
- neurological examination
- eye examination
- dental examination
- gastrointestinal examination
- genitourinary examination
- dermatological examination
- examination for heat disorders
Explain the Pulmonary exam
- usually done w/ CV exam
- looking for coughing spells, abnormal breathing sounds, asymmetric lungs mvmt
- HX of allergies or asthma attacks
- excessive coughing during/after physical activity
- abnormal sounds: wheezing, crackles, rhonchi, rubs, rales and abnormal breathing rates
Neurological examination
- PEARRLA (pupils equal and round, react to light, and accommodate)
- cranial nerves assessment
- myotomes/dermatomes
- deep tendon reflexes
- SCAT or other concussion assessment tool (sports w/ high risk of concussions)
Eye examination: what is emmetropia
20/20 vision
- can read letters on the 20-ft line of the eye chart when standing 20ft from the chart
Eye exam: what is myopia
Nearsightedness
- light rays are focused in front of retina
Eye exam: what is hypermetropia
Farsightedness
- light rays are focused behind the retina
Eye exam: what is nystagmus
Cyclical mvmt of the eyes
Eye exam: what is anisocoria
Uneven pupil sizes
Dental examination
- Completed by dentist
- Risk of losing/chipping teeth in sport
- custom made mouthguard
- health of gums (gingivitis: bacteria, tender/swollen/bleeding gums)
Gastrointestinal examination
- Digestive system, eating habits, nutrition
- Palpate organs: liver (hepatitis), spleen (contact sports)
- weight control sports (rowing, martial arts, gymnastics): flag for eating disorders
Gastrourinary examination
Females: menstrual history (risk of osteopenia, stress fractures, osteoporosis), pregnancy
Males: injuries to testicles, number of testicles, masses
Kidney: 1 kidney, warned w/ risks of contact sports
Dermatologic Examination
- Contagious lesions: herpes simplex (cold sores), impetigo, tinea capitis or corporis
Heat disorders examination
- activities in high temps/humidity
- hx of cramping, syncope, exhaustion, heat stroke and sickle cell trait
- sickle cell: increased risk of dehydration or sickle cell episode
- medications: can affect body’s ability to release heat (i.e. antihistamines)
Physical Fitness Profile
- Anthropometry and body comp
- maturation and growth spurts may affect participation: male 14yrs, female 12yrs (affect balance, flexibility)
- flexibility
- strength, power, and speed
- agility, balance and rx time
- cardiovascular endurance
Clearance for participation
- physician must determine lvl of participation based on findings
- will condition increase risk of injury to athlete or other participants?
- can participation be allowed if medication, rehab, or protective bracing/padding is used?
- if clearance denied for particular activity: are there other activities in which they can participate?
