Week 7 Pre-Participation Screening

Question 1

What is the purpose of pre participation screening (primary objectives)

Answer 1

detection of conditions that may limit participation or predispose you to injury, or conditions that may be life threatening or disabling

Question 2

What are the secondary objectives of pre participation screening

Answer 2

meet legal requirements
determine general health
entry point into the healthcare system
opportunity to initiate dialogue

Question 3

what is the difference between a pre participation screen and evaluation

Answer 3

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

Question 4

what is the timing and frequency of a PPS

Answer 4

more than 6 weeks before pre season
secondary education, at entry and then every 2 years
collegiate: initial, and a brief annual

Question 5

what are some of the team members with a PPS

Answer 5

MD/DO, PT, ATC, RN, potentially optometrist, dentist, medical assistant and a dietician

Question 6

what are the components

Answer 6

check in station
vitals 
medial history
MSK screen
general medical eval 
athletic fitness testing 
special populations 
check out

Question 7

what happens at the check in station

Answer 7

consent, medical history form, insurance information and emergency contact form

Question 8

what is part of the medical history

Answer 8

previous hospitalization, surgery, injury status (past and current), OTC and Rx meds, CVS, neuro or enviro factors.

Question 9

what must we do during a medical history with athletes

Answer 9

really ask about past injuries. they may not tell you all about the ankle sprains and concussions they have gotten over the years.

Question 10

what is the 90 second MSK screen

Answer 10

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.

Question 11

what are the components of the medical evaluation

Answer 11

visual, hearing, dental, heart, lungs, chest, hernia, testicular

Question 12

pre participation screening puts you into 1 of 4 categories, what are they. which is most common

Answer 12

1. contingent participation (need a specialist eval, or cleared by someone) MOST COMMON
2. no participation
3. modified participation (no contact sports, or minimal CV risk things)
4. unrestricted participation

Question 13

what are some of the special populations that we will do screening with

Answer 13

disabled, females, sickle cell, solitary organs, diabetic, Olympic.

Question 14

for injury prevention, we look at many functional movements. What are some of those tests

Answer 14

FMS
Y balance
CKC DF test
Tuck jump 
landing error scoring system 
Move2Perform

Question 15

what is the purpose of doing functional movement tests

Answer 15

to get the broad picture

Question 16

what are some agility tests

Answer 16

T test
pro agility
LEFT

Question 17

what are some max aerobic tests

Answer 17

bruce treadmill
balk treadmill
PACER
1.5 mile run

Question 18

what are some power tests

Answer 18

1RM
Broad jump
vertical jump
medicine ball throw

Question 19

what are some submax aerobic tests

Answer 19

Harvard step test
12 minute run
modified brice treadmill

Question 20

what is sudden cardiac death

Answer 20

electrical disturbances in the heart, causing arrest or arrhythmia’s

Question 21

do you need trauma for sudden cardiac death, and it is with or without warning

Answer 21

no, and without warning

Question 22

what are some ways to detect it

Answer 22

prodromal signs, like chest pain, dyspnea, exercise intolerance and history of symptoms.

Question 23

how quickly can death occur

Answer 23

within 1 hour

Question 24

what gender and what race are more likely to die of sudden cardiac death

Answer 24

males, over females

blacks over whites

Question 25

what are the most common sports to die of sudden cardiac death

Answer 25

mens basketball, soccer then football

Question 26

there are 4 types of cardiac death, what are they

Answer 26

congenital structurally abnormal heart acquired structurally abnormal heart congenital structurally normal heart acquired structurally normal heart.

Question 27

under the age of 40, what are the reasons for people to die of sudden cardiac death

Answer 27

hypertrophic cardiomyopathy (HCM) 33-41% coronary artery anomalies 16% commotio cordis 9% myocarditis 5%

Question 28

what is hypertrophic cardiomyopathy

Answer 28

affects 1 in 500, it is the overgrowth of the heart, and it does not pump efficiently

Question 29

HCM and genetics

Answer 29

inherited autosomal dominant gene, with over 100 different genetic defects that can lead to this. 60% of people have affected first degree relative

Question 30

what is marfans syndrome

Answer 30

fibrillin gene defect, that alters connective tissues in the body and can lead to a ruptured aortic aneurysm

Question 31

what are the skeletal components of marfans

Answer 31

tall and thin, arm span is greater than height, pectus excavated and joint hyper mobility, and scoliosis

Question 32

what are the ocular components of marfans

Answer 32

``` myopia (near sided and possibly color blind) chromic myopia ectopic lentis (upward) retinal detachment hypoplasia of dilator muscle flat cornea ```

Question 33

coronary artery anomalies

Answer 33

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

Question 34

what is the primary cause of death with coronary artery anomalies

Answer 34

hypo perfusion

Question 35

what are some early prodromal signs of coronary artery anomalies

Answer 35

fatigue, exercise induced syncope and chest pain, kinda looks like an MI

Question 36

what is commotio cordis

Answer 36

anatomically normal heart, but there is a blow to the chest, that causes a disturbance in the timing of the heart

Question 37

what gender and what age is more affected by commotion cordis

Answer 37

males, and 13.6 years old (developing heart)

Question 38

what percentages of commotio cordis comes from blow from a projectile vs hit from another player

Answer 38

80% projectile, | 20% player

Question 39

what is myocarditis

Answer 39

inflammatory process of the myocardium, from a virus (echovirus, adenovirus or influenza)

Question 40

what are some prodromal signs of myocarditis

Answer 40

dyspnea, orthopnea, exercise intolerance, tachycardia, diarrhea, malaise, myalgia

Question 41

what are 9 vital questions to ask a patient

Answer 41

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

Question 42

Stigmata

Answer 42

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