ch2: preparticipation examination

Question 1

goals of PPE

Answer 1

• det gen health and current immunization status
• detect med cond that are not healed or may predispose indv to injury or illness
• identufy behaviours posing risk to health
• establish baseline parameters
• assess physical maturity
• eval fitness lvl
• classify readiness to participation
• rec appropriate lvl of participation for indv w/ medical containdications
• meet legal and insurance requirements related to participation in PA or sport

Question 2

what should be assessed in re-evaluation

Answer 2

• height
• weight
• BP
• pulse
• visual acuity
• cardiac asculation
• examination of th skin
• neurocognitive baseline

Question 3

normal pulse
1- males
2- females
3- children
4- conditioned athlete

Answer 3

1- 60-100
2- 60-100 (may inc by 10 during prego)
3- 120-140
4- can be 50 or lower

Question 4

normal bp
1- adults
2- children

Answer 4

1- 120/80
2- 105/70

Question 5

CV red flags

Answer 5

• chest pain during exertion
• unusual fatigue/short breath at rest or with mild exertion
• dizziness or syncope w/ activity
• breathing difficulty while lying down
• ankle edema
• heart palpitations or tachucardia
• known heart murmur
• abnorm HR
• uncontrolled hypertension
• marfan syndrome
• mitral valve prolapse
• conduction abnormalities
• anemia
• enlarged spleen
• fam hx of heart prob or sudden death

Question 6

most common cause of sudden death in young athletes

Answer 6

hypertrophic cardiomyopathy
followed by congenital coronary artery anomalies

Question 7

most common cause of death in the older physically active popu

Answer 7

arteriosclerosis

Question 8

pulmonary red flags

Answer 8

• abnorm coughing
• abnorm shortness of breath at rest w/ minimal exertion
• abnorm breath sounds
• abnormal or prolonged expiratory phase
• asthma (uncontrolled or exertional)
• exercise induced broncospasm
• pneumothorax
• pulmonary insufficiency
• severe allergies

Question 9

msk red flags

Answer 9

• chronic jnt or spinal instab
• unhealed fx, lig or muscular injury
• m. weakness
• inflammation or infectin of a jnt
• unusual hypomob or hypermob
• growth or maturation disorder
• symptomatic spondy
• spear tacklrs spine
• herniated disk w/ spinal cord compresion
• repetitive stress disorder

Question 10

cranial nerve I

Answer 10

olfactory
smell

Question 11

cranial nerve II

Answer 11

optic
acuity

Question 12

CN III

Answer 12

oculomotor
PEARRlA

Question 13

CN IV

Answer 13

trochlear
downward and lat gaze

Question 14

CN V

Answer 14

trigeminal
di sensation on face

Question 15

CN VI

Answer 15

abducens
lat and medial gaze

Question 16

CN VII

Answer 16

facial
smile

Question 17

CN VIII

Answer 17

vestibulocochlear
sound
balance

Question 18

CN IX

Answer 18

glossopharyngeal
gag reflex

Question 19

CN X

Answer 19

vagus
swallow

Question 20

CN XI

Answer 20

accessory
resisted sh shrug

Question 21

CN XII

Answer 21

hypoglossal
stick tongue out

Question 22

deep tendon reflex testing: jaw

Answer 22

site: mandible
respnse: close mouth
nerve: CN V

Question 23

deep tendon reflex testing: Biceps

Answer 23

@: bicep tendon
response: bicep contract
n. c5-c6

Question 24

deep tendon reflex testing: brachioradialis

Answer 24

@: brachioradialis tendon
response: elbow flex/pronation
n. c5-c6

Question 25

deep tendon reflex testing: triceps

Answer 25

@: tricep tendon response: elbow ext n. c7-c8

Question 26

deep tendon reflex testing: patellar

Answer 26

@: quad tendon response: kn ext n. l3-l4

Question 27

deep tendon reflex testing: medial h/s

Answer 27

@: semi mem tendon response: kn flexion n. L5-s1

Question 28

deep tendon reflex testing: lat h/s

Answer 28

@: biceps femoris tendon response; kn flex n. S1-s2

Question 29

deep tendon reflex testing: tib post

Answer 29

@: behind med mal response; PF + INV n. L4-L5

Question 30

deep tendon reflex testing: achilles

Answer 30

@ achilles tendon response: PF n. S1-s2

Question 31

neuro red flags

Answer 31

- more than 1 concussion - C/s instab - func c/s stenosis - hx of frequent or repeated h/a - hx of seizures - hx of amnesia or tinnitus - hx of head innjuries - hx of burner stinger - hx spinal cord shock - hx of nerve palsy

Question 32

myopia vs hypermetropia

Answer 32

m: see close not far H: see far not close

Question 33

ocular red flags

Answer 33

- corrected vison greater then 20/50 - vision in one eye only - severly lim peripheral vision - sevre myopia - retinal detachement or tear

Question 34

dental red flags

Answer 34

- bleeding gums - lesion in the mouth - loose or displaced teeth - loose caps or crown - dental appliances in poor cond

Question 35

GI red flags

Answer 35

- organomegaly (enlarged organs) - hx hepatitis or infectious mono - hx repeated episodes or diarrhea or constipation - hx or gastritis or burning sensation in the stomach - extreme tenderness over appendix, liver or spleen - suspicious of anorexia or bullimia

Question 36

genitourinary red flags

Answer 36

- one kidney or kidney disease - absent or undescended testicle - hernia - pain w/ urination - possible exercise induced amenorrhea - endometriosis - STDs - hematuria - albuminuria - hemoglobinuria - nephroptosis

Question 37

dermato red flags

Answer 37

- herpes - impetigo - molluscum contagiosum - tines wapitis or corposis - furuncles - secondary syphilis - severe acne - dermatitis - warts - fungal infections - psoriasis

Question 38

heat-related red flags

Answer 38

- cardiac disease - uncontrolled diabetes - hypertension - drug use - medication use - excessive m. cramps during participation in heat - heat exhaustion - heat stroke

Question 39

hypermobile traits

Answer 39

- passive opposition of the thumb that can reach the flexor aspect of the forearm - passive hyperextension of the fingers so that they lie paralel with extensor aspect of the forarm - hyperextend elbow at least 10deg - hyperextend knee atleast 10 deg - excessive passive DF of the ank an EV of the foot

Question 40

question physician must ask themselves after PPE completed

Answer 40

- will abnomality inc risk of injury to indv or other participants - can participant be allowed if meds, rehab, or protective bracing are used - if clearance denied can pt participate in other activities