Physical Examination for Sports Participation Flashcards
What bodily changes may impact the adolescent’s functional and athletic abilities?
- surge in growth hormone and gender specific hormones
- increasing muscle mass
- increasing subcutaneous adipose tissue
- increased joint flexibility
- lack of coordination
- denser, more brittle bones
- increased size and capacity of the heart and lungs
- late-onset frontal lobe development resulting in lack of impulse control
- increased dopamine and serotonin release resulting in mood swings
How soon should a PPE be performed?
at least 6 weeks before planned sport
What should the history focus on?
the type of sport that the athlete has chosen and the risks associated
Should a HPI be included in a PPE?
Only if the athlete is being evaluated for clearance to return after an injury or illness
What should be assessed if the athlete has a chronic disease?
number of exacerbations influence of chosen sport on disease if sports participation occurred previously complications r/t chronic disease previous restrictions
What guidelines should be utilized to perform a PMH during a PPE?
American Heart Association Cardiovascular Screening Checklist
Why is medication history critical in older school-aged or adolescent groups?
Routine OTC medications, prescriptions, and energy supplements or herbals have certain side effects which the athlete needs to be educated on.
What should be included in the medical history of a PPE?
Allergies (prior testing, type of reaction, management)
Past hospitalizations or sugeries
Concussions/TBIs
Changes in mood, emotions, cognitive function, memory, behavior, sleep
Sensory deficits (hearing or vision loss)
What familial risk factors should be priority during a PPE?
risk factors associated with CV, RESP, and MUSC disorders
What specific questions should be included in a family history?
In a relative <50 years of age: premature death due to heart disease? premature disability due to heart disease? hypertrophic or dilated cardiomyopathy? long QT syndrome? Marfan syndrome? cardiac arrhythmias?
What risk factors need to be addressed in a social history?
cigarette use illicit substance use alcohol use medications other than those prescribed seat belt use extracurricular activities stress coping PP sports equipment employment sexual activity peer relationships nutritional habits
What is the purpose of a social history during a PPE?
to identify opportunities for anticipatory guidance and provide additional support resources as needed
What is an important component of social history?
nutritional history to identify eating disorders
What is the purpose of the ROS in a PPE?
to help detect any additional disorders that may be present
What are some preventative care considerations for a PPE?
immunizations diet strength/flexibility coping and stress familial/peer relationships dental care substance abuse avoidance risk-taking behaviors
How should BP check be performed in a PPE?
sitting and standing
both arms
several minutes apart
What is the most common condition affecting athletes?
hypertension
Can the athlete be allowed to participate in the sport if their blood pressure is elevated?
yes. elevated blood pressures need to be evaluated over several days to ensure sustained elevation
At what point should an athlete be restricted from the sport for hypertension?
If the athlete has stage I or stage II HTN with signs of target organ damage.
How will the athlete with HTN be able to return to the sports activity?
If TWO blood pressure readings are UNDER 130/80 and are performed at least TWO weeks apart.
What should be assessed during a general inspection?
overall appearance facial features mood skin respiratory effort posture gait symmetry limb length
What skin abnormalities would prevent an athlete from being cleared?
tinea corporis or herpes simplex in a wrestler
How will visual acuity be tested during a PPE?
With the Snellen and Rosenbaum eye charts
How will hearing be assessed during a PPE?
whisper test
