Pre-Participation Sports Physical Flashcards
1
Q
goal of Preparticipation Physical Exam (PPE)
A
- promote the health and safety of student athletes
- creen for conditions that may be life-threatening or disabling and for conditions that may predispose to injury or illness
2
Q
primary goals of PPE
A
- Identify and rehabilitate old musculoskeletal injuries
- Identify and treat conditions that interfere with performances (exercised-induced bronchospasm)
- Remove unnecessary restrictions on participation which can prevent children from establishing healthy lifestyle habits at a young age
3
Q
secondary goals of PPE
A
- Counsel athletes on health-related issues
- Assess fitness level
- Ideal timing is 6-8 weeks before training starts, which allows time to further evaluate, treat, or rehab any identified problems
4
Q
how often should PPE be performed?
A
annually
5
Q
T/F: PPE can replace annual well child check
A
F - it cannot replace
- Parents sometimes expect the PPE to be a comprehensive evaluation of the athlete’s health
- Including areas unrelated to sports - Teenage sexuality, substance abuse, immunizations, among others
6
Q
Methods of PPE
A
- Locker-room method
- Station method
- Office-based method
7
Q
- Athletes traditionally line up single file, and physician examines each individually
- requires few personnel and can be performed with little preparation - little privacy is afforded
- Can be too noisy, auscultation can be hard
what PPE method
A
locker-room
8
Q
- Divides the exam into several components with physicians, nurses, athletic trainers, and coaches assigned to a single task specific to individual components of the evaluation
- Ideal for large numbers
- Benefits are efficiency, inexpensive, and a good ability to identify abnormalities - little privacy afforded and may not provide for continuity of care
which PPE method
A
station method
9
Q
pros and cons of office-based PPE method
A
- Advantage of an established provider-patient relationship in which medical history is known and continuity of care is fostered
- Disadvantages: lack of consistency among providers, potential unfamiliarity with the sport and its disqualifying conditions by the provider, and its lack of cost effectiveness
10
Q
The PPE is routinely conducted by pediatric providers, yet many lack specific training in _____
A
sports medicine or the performance of these examinations
Clinican should be low threshold for referral
11
Q
what is the most important part of the encounter, identifying 75% of medical issues that can restrict activity
A
- The medical history
- The athlete and the parents should complete the form together to obtain a thorough and accurate history
12
Q
components of general MHx
A
- PMH, including current treatments if any
- Prior surgery
- Loss of function in any organ
- Any heat-related illness
- Current medications
- Immunization history
- Menstrual history
- Any rapid increase/decrease in body weight
13
Q
types of sport with contact
A
- Basketball
- Rodeo
- Boxing
- Rugby
- Diving
- Ski jumping
- Downhill skiing
- Snowboarding
- Field Hockey
- Soccer
- Gymnastics
- Ultimate frisbee
- Tackle football
- Water polo
- Ice hockey
- Wrestling
- Martial Arts
14
Q
componets of injury hx
A
- Past injuries, including msk injuries, concussions, spine injuries
- Loss of time from participation and current sequelae of prior injury (paresthesias from spinal injury)
- Previous exclusion from any sports for any reason
15
Q
components of personal CV MHx
A
Aimed at identifying conditions that predispose athlete to sudden death
- Kawasaki disease?
- Heart infection?
- Chest pain or discomfort with exercise? Any chest pain?
- Syncope or near syncope associated with exercise?
- Excessive SOB or fatigue associated with exertion?
- History of heart murmur?
- History of elevated blood pressure?
- Any history of unexplained fever
- Any history of cardiac testing (EKG and ECHO)
16
Q
components of Familial CV MHx
A
- Premature death before age 50 y/o d/t heart disease?
- Disability from heart disease in a close relative younger than 50 y/o?
- Family history of pacemaker?
- Knowledge of specific cardiac conditions: hypertrophic or dilated cardiomyopathy, long QT syndrome, Marfan syndrome, or arrhythmias
17
Q
ROS - Rsp components (2)
A
- Asthma
- Exercise-induced bronchospasm
18
Q
ROS - MSK sx ( 3)
A
- Back pain?
- Neck pain?
- Joint pain or stiffness?
19
Q
ROS - CNS History (2)
A
- History of frequent or exertional headaches, seizure disorders, concussion or head injuries, burners/stingers?
- require further evaluation, rehabilitation, or informed decision making prior to clearance for sports participation - A history of previous concussions should be addressed
- Two grades: simple & complicated
- Complicated: amnesia, loss of consciousness, seizure, or prolonged symptoms
20
Q
after a concussion, when can the child return to learn?
A
- once a child can concentrate on a task
- tolerate visual and auditory stimulation
- all for 30-45 minutes - a child can then return with academic adjustments if/as needed
- limited course load
- shortened classes
- increased rest time
- aids for learning
- postpone high stakes testing (ACT/SAT)
21
Q
for concussion, when can the child return to play?
A
- complete consensus graduated “Return To Play (RTP)” protocol
- happens after period of cognitive/physical rest before competition
- recovered athletes complete course of non-contact exercise challenges of gradually increasing intensity
- Requirements to begin:
- successful return to school
- symptom free and off any meds to help with symptoms
- normal neuro exam
- baseline balance and cognitive function - if unavailable, use age-adjusted normative data
22
Q
Retirement from contact/collision sports indications
A
- for pt’s with structural brain abnormality on neuroimaging
- nonresolving/prolonged neurocognitive deficits
