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Flashcards in Sports Physical Evaluation Deck (23)
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1

What is an important first step in assisting athletes in maintaining health & ensuring safe participation in training & competition?

Pre-participation physical evaluation

2

Primary/Essential Objectives of Pre-Participation Physical Evaluation

Detect conditions that may limit participation or predispose to injury
Meet legal & insurance requirements
Follow-up previous injuries, conditions, surgeries

3

Secondary/Ideal Objectives of Pre-Participation Physical Evaluation

Assess general health & identify health-risk behaviors
Assess physical maturity
Determine fitness & performance level

4

Timing & Frequency of Pre-Participation Physical Evaluations

6+ weeks prior to beginning sports
Annually in Montana

5

Advantages of Office-Based Sports Physicals

Physician-patient familiarity
Privacy
Continuity of care

6

Disadvantages of Office-Based Sports Physicals

Cost
Limited appointment time
Lack of communication back to school staff

7

Advantages of Group Screening Sports Physicals

Specialized personnel
Time & cost efficiency

8

Disadvantages of Group Screening Sports Physicals

Rushed
Lack of privacy
Potential for poor follow-up of identified problems

9

Stations of Group Screening Sports Physicals

Sign in
Height/weight
Vitals
Vision
History review
Physical exam

10

Medical History of Sports Physicals

Cornerstone
CV questions are key
Health-risk behaviors, female athletic triad

11

Cardiovascular Causes of Sudden Death

Hypertrophic cardiomyopathy
Anomalies of the coronary arteries
Atherosclerotic heart disease
Marfan's syndrome: aortic rupture
Aortic stenosis
Mitral valve prolapse
Myocarditis

12

Describe Hypertrophic Cardiomyopathy

Disease of the myocardium with hypertrophy without any obvious cause

13

Specific CV Questions

Have you ever passed out during or after exercise?
Has anyone in your family died of heart problems or sudden death before age 50?

14

Key Physical Exam Points for HEENT

Pupils (anisocoria)
Visual acuity
Swimmers, scuba divers, wrestlers may need special evals
Oropharynx: smokeless tobacco

15

Define Anisocoria

Condition where the pupil in one eye differs in size from the pupil of the other

16

Key Physical Exam Points for Cardiovascular

Blood pressure
Palpation of upper & lower extremity pulses
Heart auscultation: 2 positions + provocative maneuvers
Arrythmias

17

Benign Arrhythmias

Unifocal in origin
Disappear with exercise
No history of syncope with exercise

18

Musculoskeletal Exam Findings

Identify musculotendinous, bone, or joint problems that may limit participation or predispose to injury
Screen for flexibility
Screen for general neurologic exam, scoliosis

19

Medicolegal Considerations with Sports Physicals

Athlete has legal right to participate AMA
Use a waiver
Medical liability doesn't cover sports physicals

20

Specific Medical Conditions that Require Special Clearance

Atlantoaxial instability
Bleeding disorders
Heart murmurs
DM: controlled

21

Sickle Cell Trait

Heat illness
Sudden cardiac death
Extreme conditions of heat, humidity, & elevation

22

Absence of Kidney

Counseling
Protection for contact

23

Red Flags During Sports Physicals

Hx of exercise intolerance
Syncope or near syncope
Chest pain with exercise
Family Hx of unexplained death prior to 50
Family Hx of hyperlipidemia