Ya Basics
Minimum amount of weeks ideally the evaluation should take place before the first practice
6 weeks
Describe the murmur of hypertrophic cardiomyopathy
Harsh, early systolic, heard best at the right upper sternal boarder. Increases intensity with activities that decrease cardiac preload
This is the third leading cause of atraumatic death in athletes behind sudden cardiac death and exertion heat stroke
True/False: concussion is a clinical diagnosis
true
Any athlete with a previously reported severe or anaphylactic reaction should be required to bring what with them to practice?
Injectible epinephrine
Although not required for the SPPE why is it a good idea to perform a comprehensive evaluation at the same time?
This may be the only time you see the adolescent during the year and can address other concerns
What is the difference between post-exertional syncope and exercise-associated collapse?
Post Exertional Syncope: a common occurrence and benign.
Exercise Associated Collapse: occurs during exertion and ominous sign of hemodynamically significant CV disease or Ventricular tachycardia
What should an athlete demonstrate prior to receiving clearance to return to participate following a MSK injury.
Pain free full range of motion, symmetric strength, joint stability
What is the name of the spell for the full body bind curse? (In Harry Potter, duh)
Petrificus Totalus
True/False: Athletes who have had recent infectious mono can return to play before the recommended 3-4 weeks if evaluation by a physician exam or ultrasound does not detect any splenomegaly
False
What are the components of the female athlete triad
low energy availability with or without disordered eating
Menstrual dysfunction
Low bone mineral density
Name two each of personal or family history or cardiac conditions that should warrant further investigation either by a PCP or Cardiologist
Personal: history of syncope, near-syncope, chest pain, palpitations or SOB/fatigue with exertion
FHx: sudden cardiac death <50 yrs, marfan, cardiomyopathy, arrhythmias (long QT)
The title of this category is a song found in what animated movie?
Madagascar
What sports should patients with seizure disorders be banned from participating in and what sports are allowed with constant supervision?
Banned: skydiving, subs diving, shooting sports
Caution: swimming and diving
Name 3 recommendations to keep athletes with diabetes safe during sports
1. Good glycemic control with monitoring from a DM expert
2. understanding of how exercise changes their insulin/carb needs
3. Coach/Trainers taught to deliver emergency meds
4. Monitor blood glucose before, during and after sports
5. DM ID bracelet
6. Avoid scuba diving, sky diving, rock climbing
What 4 immunizations are important to have in athletes that commonly share close quarters or have frequent contact with other athletes?
Influenza, Hepatitis, Meningitis, HPV
What personal cardiac conditions absolutely need be evaluated by a Cardiologist before sports participation
Known congenital heart disease, cardiac channel-patties, hx of myocarditis, coronary anomalies
Give 4 examples of each sport category: contact/collision, limited contact, non contact
CONTACT OR COLLISION: Basketball Boxing, Diving, Field hockey, Football, Ice hockey, Lacrosse, Martial arts, Rodeo, Rugby, Ski jumping, Soccer
Team handball, Water polo, Wrestling
LIMITED CONTACT: Baseball, Bicycling, Canoeing or kayaking (white water), Cheerleading, Fencing, Field events,
Floor hockey, Football (flag), Gymnastics, Handball, High jump, Horseback riding, Pole vault, Racquetball, Skateboarding, Skating (ice, in-line, roller), Skiing (cross-country, downhill, water), Snowboarding, Softball, Squash, Ultimate frisbee, Volleyball, Windsurfing or surfing
NONCONTACT: Archery, Badminton, Bodybuilding, Bowling, Canoeing or kayaking (flat water), Crew or rowing, Curling, Dancing (ballet, modern, jazz),
Field events (discus, javelin, shot put), Golf, Orienteering, Power lifting, Race walking, Riflery, Rope jumping, Running
Sailing, Scuba diving, Swimming, Table, tennis, Tennis, Track, Weight lifting
Describe the symptoms of transient quadriparesis and prognosis
Sx: looses most/all motor control of all extremities
Prognosis: generally benign as long as they recover full near function
Name 2 out of 4 recommendations from the National Athletic Trainers' Association consensus on sickle cell trait:
1. no contraindications to participation in sport
2. RBCs can sickle during intense exertion blocking blood vessels and posing a grave risk for athletes
3. screening and simple precautions may prevent deaths and help athletes with SCT thrive
4. efforts to document newborn screening results should be made during PPE
What 4 components are listed under Physical Exam in the American Heart Association 14-element CV Screening Checklist for Congenital and Genetic Heart Disease
1. Heart murmur
2. Femoral pulses (to exclude aortic coarctation)
3. Physical stigmata of Marfan syndrome
4. Brachial artery blood pressure (sitting position)
What are the AAP recommendations for athletic participation in those with pre-hypertension, stage 1 HTN, and stage 2 HTN
prehypertension: no limitations - lifestyle modifications and check every 6 months
Stage 1 w/o end organ dysfunction: no limitations – lifestyle and check BP every 1-2 weeks to confirm HTN. Referral if symptomatic or confirmed at 3 total visits
Stage 2 w/o end organ damage: restricted from high-static sports associated with acute elevation in diastolic pressures until BP is in normal range – lifestyle and/or drug tx as well as referral to cardio
Describe and Demonstrate with someone on your team the 14 points of musculoskeletal screening examination
1. Inspection facing forward (trunk/UE)
2. Cervical ROM
3. Resisted shoulder shrug
4. Resisted shoulder abduction
5. Internal and External rotation of shoulder
6. Extension and flexion of elbow
7. Pronation and supination of elbow
8. ROM hands/fingers
9. Inspection facing away (trunk/UE)
10. Back extension
11. Back flexion facing away
12. Lower extremity inspection
13. Duck Walk
14. Standing on toes and heels
What are stingers/burners? When are they benign and when do they warrant additional evaluation/imaging?
Definition: injuries to the brachial plexus and or cervical nerve roots
Benign if symptoms are brief in duration and athlete recovers full strength/sensation
Require further evaluation if symptoms last longer than 48 hr, frequent or recurrant symptoms, bilateral
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