Week 7 Pre-Participation Screening Flashcards
What is the purpose of pre participation screening (primary objectives)
detection of conditions that may limit participation or predispose you to injury, or conditions that may be life threatening or disabling
What are the secondary objectives of pre participation screening
meet legal requirements
determine general health
entry point into the healthcare system
opportunity to initiate dialogue
what is the difference between a pre participation screen and evaluation
an evaluation is done in the office, there is a cost, and you get a 1:1 experience, so you can build rapport
a screen is mass participation, free or a reduced cost, low anxiety and may be like performance testing
what is the timing and frequency of a PPS
more than 6 weeks before pre season
secondary education, at entry and then every 2 years
collegiate: initial, and a brief annual
what are some of the team members with a PPS
MD/DO, PT, ATC, RN, potentially optometrist, dentist, medical assistant and a dietician
what are the components
check in station vitals medial history MSK screen general medical eval athletic fitness testing special populations check out
what happens at the check in station
consent, medical history form, insurance information and emergency contact form
what is part of the medical history
previous hospitalization, surgery, injury status (past and current), OTC and Rx meds, CVS, neuro or enviro factors.
what must we do during a medical history with athletes
really ask about past injuries. they may not tell you all about the ankle sprains and concussions they have gotten over the years.
what is the 90 second MSK screen
a brief exam that looks at functional movements, and looks for compensatory movements, differences side to side. includes things like toe touching, squat, lifting arms over head.
what are the components of the medical evaluation
visual, hearing, dental, heart, lungs, chest, hernia, testicular
pre participation screening puts you into 1 of 4 categories, what are they. which is most common
- contingent participation (need a specialist eval, or cleared by someone) MOST COMMON
- no participation
- modified participation (no contact sports, or minimal CV risk things)
- unrestricted participation
what are some of the special populations that we will do screening with
disabled, females, sickle cell, solitary organs, diabetic, Olympic.
for injury prevention, we look at many functional movements. What are some of those tests
FMS Y balance CKC DF test Tuck jump landing error scoring system Move2Perform
what is the purpose of doing functional movement tests
to get the broad picture
what are some agility tests
T test
pro agility
LEFT
what are some max aerobic tests
bruce treadmill
balk treadmill
PACER
1.5 mile run
what are some power tests
1RM
Broad jump
vertical jump
medicine ball throw
what are some submax aerobic tests
Harvard step test
12 minute run
modified brice treadmill
what is sudden cardiac death
electrical disturbances in the heart, causing arrest or arrhythmia’s
do you need trauma for sudden cardiac death, and it is with or without warning
no, and without warning
what are some ways to detect it
prodromal signs, like chest pain, dyspnea, exercise intolerance and history of symptoms.
how quickly can death occur
within 1 hour
what gender and what race are more likely to die of sudden cardiac death
males, over females
blacks over whites
what are the most common sports to die of sudden cardiac death
mens basketball, soccer then football
there are 4 types of cardiac death, what are they
congenital structurally abnormal heart
acquired structurally abnormal heart
congenital structurally normal heart
acquired structurally normal heart.
under the age of 40, what are the reasons for people to die of sudden cardiac death
hypertrophic cardiomyopathy (HCM) 33-41%
coronary artery anomalies 16%
commotio cordis 9%
myocarditis 5%
what is hypertrophic cardiomyopathy
affects 1 in 500, it is the overgrowth of the heart, and it does not pump efficiently
HCM and genetics
inherited autosomal dominant gene, with over 100 different genetic defects that can lead to this.
60% of people have affected first degree relative
what is marfans syndrome
fibrillin gene defect, that alters connective tissues in the body and can lead to a ruptured aortic aneurysm
what are the skeletal components of marfans
tall and thin, arm span is greater than height, pectus excavated and joint hyper mobility, and scoliosis
what are the ocular components of marfans
myopia (near sided and possibly color blind) chromic myopia ectopic lentis (upward) retinal detachment hypoplasia of dilator muscle flat cornea
coronary artery anomalies
an abnormal artery will be compressed as the ascending aorta dilates with exercise, which limits the blood flow to the heart, and hypo-perfusion of the myocardium
what is the primary cause of death with coronary artery anomalies
hypo perfusion
what are some early prodromal signs of coronary artery anomalies
fatigue, exercise induced syncope and chest pain, kinda looks like an MI
what is commotio cordis
anatomically normal heart, but there is a blow to the chest, that causes a disturbance in the timing of the heart
what gender and what age is more affected by commotion cordis
males, and 13.6 years old (developing heart)
what percentages of commotio cordis comes from blow from a projectile vs hit from another player
80% projectile,
20% player
what is myocarditis
inflammatory process of the myocardium, from a virus (echovirus, adenovirus or influenza)
what are some prodromal signs of myocarditis
dyspnea, orthopnea, exercise intolerance, tachycardia, diarrhea, malaise, myalgia
what are 9 vital questions to ask a patient
1 and 2: have you passed out during or after exercise,
3: discomfort, pain or pressure during exercise
4: does your heart race or skip during exercise
5: heart murmur?
6: testing for heart?
7: family death
8: anyone in family with heart problem
9: family died sudden death before age 50
Stigmata
tall and thin build, long arms legs and fingers, flexible joints, scoliosis, pectus excavated, carinatum, halvah palate, small jaw, crowded teeth, flat feet, stretch marks, ocular lens dislocation, nearside, blurred vision, corneal flatness
