physical examination Flashcards
the ACSM pre participation and pre exercise screening emphasizes
the public health message of physical activity for all
the pre participation health screening identifies
those who are at risk for adverse exercise-related cardio-vascular events and which individuals should be referred for medical clearance
recommended sequence of evaluation
informed consent
medical/health history
exercise pre-participation health screening
CV risk factor analysis
informed consent is important for
ethical and legal consideration
informed consent should be completed prior to
collection of any personal and confidential information
any form of fitness testing
exercise participation
informed consent should ensure that
individuals know and understand the purposes and risks associated with screening, assessment, and the exercise program
7 parts of IC
purpose and explanation
attendant risks and discomfort
responsibilities of participant
benefits to be expected
inquiries
use of medical records
freedom of consent
medical history and CV screening provide
valuable information for designing individualized exercise programs to lower or reduce health risks
CV disease risk factors
hypertension, obesity, dyslipidemia, diabetes
previous physical examination findings
murmurs, clicks, gallop rhythms, other abnormal heart sounds, other cardiac and vascular findings, pulmonary findings, high BP, edema
appropriate components of the medical history may include
medical diagnoses and history of procedures, lab findings, history of symptoms, recent illness, hospitalization, surgeries, orthopedics, medication, drug allergies
FITT
frequency, intensity, time, type
participation health screening before initiating PA or an exercise program is a___-stage process
two
the need for medical clearance before initiating or progressing exercise programming is determined using
ACSM screening algorithm
manner of clearance should be determined by
clinical judgement and discretion of the health care provider
pre participation health screening:
- determine ___ levels
- identify signs and symptoms of ____
- identify individuals with diagnosed ____
-use ___, ___, ____, ____ to guide recommendations for pre-participation medical clearance
PA
underlying CV, metabolic, renal disease
CV, metabolic disease
signs and symptoms, disease history, current exercise, desired exercise
ACSM pre participation screening algorithm is designed to
identify individuals at risk for CV complications during or immediately after aerobic exercise
although resistance training is growing in popularity, current evidence is insufficient regarding
CV complications during resistance training to warrant formal prescreening recommendations
ACSM algorithm 1 components
- classifying individuals who do (yes) or dont (no) currently participate in regular exercise
- identifying individuals with known CV, metabolic, or renal diseases or those with signs or symptoms suggestive of cardiac, peripheral vascular or cerebrovascular disease, diabetes, renal disease
- desired exercise intensity
self-guided method can be easily accomplished by
using PAR-Q+
a patient is at high risk if:
left ventricular ejection fraction ____%
<40
a patient is at high risk if:
survivor of
cardiac arrest or sudden death
a patient is at high risk if:
complex ________ at rest or with exercise
ventricular dysrhythmias
a patient is at high risk if:
MI or cardiac surgery complicated by
cariogenic shock, CHF, and/or signs/symptoms of post procedure ischemia
a patient is at high risk if:
abnormal ____ with exercise, especially flat or decreasing ____ blood pressure or _____ with increasing workload
hemodynamics
systolic BP
chronotropic incompetence
a patient is at high risk if:
significant silence ischemia (ST depression ___ or greater without symptoms) with exercise or in recovery
2mm
a patient is at high risk if:
signs and symptoms of ____,____,____,___ at low levels of exercise or in recovery
angina, dizziness, light-headedness or dyspnea
a patient is at high risk if:
maximal functional capacity of less than
5 METs
an individual does not participate in regular exercise:
No CV, metabolic or renal disease and no signs and symptoms
medical clearance?
exercise intensity recommended?
no medical clearance
light to moderate, gradually progress to vigorous
an individual does not participate in regular exercise:
known CV, metabolic or renal disease and no signs and symptoms:
medical clearance?
exercise intensity recommended?
medical clearance recommended
light to moderate, gradually progress as tolerated
an individual does not participate in regular exercise:
any signs or symptoms of CV, metabolic, renal disease:
medical clearance?
exercise intensity recommended?
medical clearance
light to moderate intensity, gradually progress as tolerated
