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64 Cards in this Set
- Front
- Back
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--itis
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inflammation
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--osis
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degeneration
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--opathy
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pathologic condition
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Incidence
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#cases/time period
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Prevalence
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# cases present at one point in time
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Purpose of Pre-Participation Physical Examination
(PPE) |
Detect any medical or musculoskelatal conditions that may predispose the athlete to injury or illness during competition
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When may a physician delegate authority to an athletic trainer for dispensing prescription medications?
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Depends on each State's Pharmacy laws
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Best answer for Q on actively bleeding athlete during competition:?
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Early reporting of uncontrolled bleeding is the responsibility of the athlete
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Incidence of concussions for sports and recreation in US?
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300,000 cases/year
((1.6 - 3.8million/year all causes for US) |
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sports with higher incidence of concussion?
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football, boxing, soccer, hockey, gymnastics
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likelihood for addional concussion once first sustained?
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Athlete is 4-6 times more likely to sustain a repeated concussion after the first.
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Definition Concussion (General)
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Caused by direct blow or force to the head
rapid onset, short-lived neurological symptoms that resolve spontaneously Acute symptoms represent a functional disturbance rather than a structural injury Symptom resolution follows a sequential course but post-concussive syptoms may be prolonged Normal routine CT/MRI scans |
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Definition Concussion
(Neurobiology |
Increased extracellular K+ in 3-5 minutes
Excitatory amino acids (glutamate) open ligand-dependant channels (Na/K pump) Hypergoycolysis within 10 minutes, lasting up to 10 days decreased cerebral blood flow decreased neuron protein metabolism and reduced oxidatived capacity (fragile?) |
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Concussion symptoms?
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Somatic: headache, nausea, vomiting, loss of balance
cognitive: "Dinged, bell-rung, dazed..." Emotional: lability, distracted |
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Concussion physical signs?
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LOC
amnesia speech problems |
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concussion Behavioral signs?
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irritability, lability
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Concussion cognitive signs?
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slowed reaction time
sleep disturbance (drowsiness) |
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SCAT2?
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Sport Concussion Assessment Tool, Version 2
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Neuropsychological testing tools for assessing consussion?
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ImPACT: Immediate Post-consussion Assessment and Coognitive Testing
ANAM: Automated NP Assement Metric CogSport Headminders |
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Amnesia vs LOC as predictive value for concussion?
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on-field amnesia is up to 10x more predictive than LOC for predicting outcomes
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How long should athletebe asymptomatic from concussion before resuming exercise?
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24-48 hours if they have a full and rapid recovery
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Concusion Return to Play same Day:?
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never in <18yo
mature athletes only if normal personality/ balance/ functional drills **consult neuropsychologist in child |
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24yo soccer player kicked in head, unresponsive x 2 minutes. Remains groggy with sluggish pupils after "coming to" . What is proper treatment?
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Transport from field for ER consult and CT of head (bleed!)
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*Which of these extracellular ions has abnormal concentration after a concussion?
Phosphate Potassium Chloride Sodium Magnesium |
Potassium
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Which of the following would be Normal in an athlete with a concussion?
SAC -Standard Assessment of Concussion Head CT Neuropsych testing Short-term memory testing Balance testing |
Head CT
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Exercise-induced proteinuria?
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Benign, common
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Exercise-induced hematuria?
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Benign, common
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Def "legally blind"
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>20/40 uncorrected vision
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Solitary kidney and collision sports?
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Contact or collision sports NOT ALLOWED if kidney:
pelvic or iliac multicystic has hydronephrosis UPJ abnormalities |
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Q: Football PPE shows normal functioning solitary kidney. What is team doc's response?
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Allow participation after explaining the risks of playing contact sports.
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Facial injuries: When no Return to Play?
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suspected fracture
active bleeding CSF leak airway obstruction LOC visual difficulty |
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Treatment Eye chemica burn?
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IMMEDIATE treatment
NS, LR, or tap water irrigation topical anesthetic flip lids and remove particulate matter with Q-tip and irrigation |
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%population with asymmetric pupils?
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5%
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Corneal Abrasion symptoms and findings?
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pain, photophobia, FB sensation, decreased acuity, edema
+fluoroscein stain |
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Rx Corneal Abrasion?
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antibiotics
eye patch for 24 hours contact lens precautions return to play |
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Corneal laceration: signs, symptoms, treatment, RTP?
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sharp projectile or blunt trauma
flat anterior chamber protruding iris -->Shield and surgery ASAP no return to play |
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Subconjunctivial Hemmorrhage: signs, symptoms, treatment, RTP?
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bright red blood between conjunctiva and sclera
rule out occult injury reassurance, ice, lubricant OK to RTP |
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traumatic Iritis: Sx, Dx, Rx, RTP
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pain, tearing, HA, blurred vision, Photophobia after ocular trauma
*miotic, sluggish pupil *Rx: rest, cycloplegic, steriods *NO RTP- Need to see Eye Docs |
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Traumatic Mydriasis: Sx, Dx, Rx, RTP
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damage to pupillary sphincter
*large, dilated, minimally reactive pupil *May be temp or permanent **Need Eye Docs |
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Conjunctival laceration: Sx, Dx, Rx, RTP
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pain, red eye, FB sensatino
*r/o other ocular damage *Rx like corneal abrasion *large lacs Rx with 6-0 or 7-0 Nylon *tetanus status |
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eyelid lac: Sx, Dx, Rx, RTP
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check lid opening and closing
*r/o other ocular damage *repair with 6-0 nylon *tetanus |
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When to refer for eyelid lacs?
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*medial aspect of lid
*upper eyelid tissue loss *full lid thickness injury |
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Hyphema: Sx, Dx, Rx, RTP
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most common injury
*blood in ant chamber, need slit lamp if early *Pain, decreased acuity, drowsy *r/o other injuries **SHIELD AND REFER*** |
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Ocular Foreign Body
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Pain, redness, photophobia, edema, tearing, decreased acuity
*dirt, cinder, etc *irrigate, Q-tip, needle, spud *f/u 24 hours *RTP ok if doing well |
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Intraocular FB
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*deform ant chamber or iris, disrupt pupil reflex
*none to severe pain * none to complete blindness *ck for entry wound *SHIELD and REFER *CT may help |
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Orbiatal Wall Fracture: Signs and Symptoms?
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blunt trauma to globe, pain + tender, lid edemal and ecchymoses, orbit hemmorrhage and edema, relative ptosis
*SQ and subconjunctival emphysema *eyelid swelling after nose blowing *restricted eye movement |
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Orbital Wall Fracture Triad:
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1) diplopia
2) enophthalmos 3) infraorbital paresthesia |
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Orbital Wall Fracture Rx?
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ice, patch, avoid blowing nose, nasal decongestants, analgesics, antibiotics
*refer, surgery for cosmesis or diplopia **NO RTP |
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Ruptured Globe; cause, S/S?
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blunt trauma or projectile
*pain, decreased acuity, subconjunctival edema and hemorrhage *irregular peaked pupil, prolapse of iris |
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Ruptured Globe: Rx?
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emergency
eyeshhield NPO transport supine or upright no RTP |
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Retinal tear/detachment facts:
age group? Sex? ave age? |
most common cause in children is trauma
85% males average age 15yo |
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Retinal Tear or Detachment signs and symptoms
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dark spots, light flashes, floaters
"curtain of dardkness" begins as small peripheral tear laser/surgical repair ASAP |
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Eye injuries dos and don'ts
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*Do examine eye, unless suspect globe rupture
*Do check acuity ASAP *Do patch unless suspect globe rupture, then DO use eye shield *Don't use steroid drops *don't give athlete topical anesthetic |
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Eye Injury IMMEDIATE REFERRALS
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*embedded corneal FB, hyphema
*decreased or double vision *irregular, sluggish pupil *lid margin laceration/impaired function *suspected globe laceration *broken contacts or shattered eyeglasses |
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Auricular Hematoma Treatment?
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Ice and pressure dressing
Aspirate hematoma with 18ga needle, reaspirate |
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Otitis Externa Causes?
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staph, strep, pseudomonas
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Otitis Externa Rx?
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clean debris from canal
*cortisporin otic suspension *oral cipro if severe *cotton wick 24-48 hours *prevent w ear plugs, drying, vinegar and rubbing alcohol |
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Nasal Fracture Treatment
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quick manipulation if deviated
repeat exam in 3-5 days reduction within 1-2 weeks minimize contact for 1 week custom facemask |
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epistaxis in athletes?
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95% anterior
Fx may tear ant ethmoid artery |
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Epistaxis Treatments?
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sit forward, pinch inf to nasal bone 5-15 minutes
pack with nasal tampon anesthetic with epi cautery anterior packing |
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tooth Fx Small v Large
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Small corner- enamel only, may RTP, bonding
Large corner- air sensitive if dentin exposed, if red pulp exposed see dentist immediate - root canal |
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Tooth Avulsion Rx?
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hold by crown, not root
clean w saline of H2O replace in socket, clench transport in cheek, saline, milk relocate subluxated tooth refer for splinting |
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squash player hit in eye with ball, N acuity, small amount of blood in anterior chamber...How handle?
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immediate transport to ER
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Definition Hyphema?
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anterior chamber bleed
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