Download Christina Leanos Sherry Ann March 4, 2012 General Medical

Christina Leanos
Sherry Ann
March 4, 2012
General Medical Conditions
WEEK 7
1.) explanation of what the condition is, 2.) signs and symptoms of that condition, 3) treatment options,
4.) medication options, and 5.) how does it affect the athletic population including athletic participation.
Please include documentation of sources of your information.
Conjunctivitis
Inflammation of the conjunctiva due to allergens or infection (bacterial or viral).
Signs and symptoms:
a. Itching
b. Burning
c. Mucous or draining from the eye
d. Swollen, red appearance (Pink Eye)
Treatment:
e. Medication
Medication options:
f. Anti-histamines (allergies)
g. Anti-inflammatories (allergies)
h. Antibiotic eye drops (infection)
i. Oral antibiotics (infection)
Athletic participation:
j. Conjunctivitis is easily spread to others, therefore athletic participation in activities that
may allow contact should be avoided. Athletes should not share towels, or anything else
that may have come in contact with the affected eye. Athletes should be encouraged to
maintain vigorous hand washing to prevent infecting others, especially after touching
the infected eye.
O’Connor DP, Fincher AL. Clinical Pathology for Athletic Trainers. Recognizing Systemic Disease. Ed. 2.
Thorofare, New Jersey. SLACK Incorporated. 2008.
Hyphema
Blood in the anterior chamber of the eye.
Signs and symptoms:
a. Eye pain
b. Decreased vision
c. “Falling curtain”
Treatment:
d. Immediate referral to team ophthalmologist or emergency room.
e. Topical steroid
f. Eye patch
g. Decreased activity
h. Hospitalization
Medication:
i. Topical steroid prescribed by physician.
j. AVOID use of NSAID’s
2. Participation:
a. Depends on the severity of the injury.
b. Usually held out until normal vision returns.
O’Connor DP, Fincher AL. Clinical Pathology for Athletic Trainers. Recognizing Systemic Disease. Ed. 2.
Thorofare, New Jersey. SLACK Incorporated. 2008.
Subconjunctival Hemorrhage
1. Bleeding under the clear conjunctiva of the eye.
2. Signs and symptoms:
a. Bright, red patches on the white of the eye.
3. Treatment options:
a. None.
b. Condition typically resolves itself within 1 to 3 weeks.
4. Medication:
a. None.
5. Participation:
a. This condition does not affect participation in athletic activities.
O’Connor DP, Fincher AL. Clinical Pathology for Athletic Trainers. Recognizing Systemic Disease. Ed. 2.
Thorofare, New Jersey. SLACK Incorporated. 2008.
Corneal Abrasion
1. Result from a direct blow to the eye by an external object (ball, elbow, finger, etc.). Corneal
abrasions can also be caused by a foreign object trapped between the upper eyelid and cornea.
2. Signs and symptoms:
a. Photophobia
b. Eye pain
c. Sensation of a foreign object in the eye
d. Increased tearing
e. Redness
f. Possible swelling
3. Treatment:
a. Referral to physician/ophthalmologist
b. Topical antibiotics
c. Eye patch
d. Analgesics
e. Patients should be reevaluated at 24 hours after injury.
4. Medication:
a. Antibiotics
b. Analgesics
i. As prescribed by physician/ophthalmologist
5. Participation:
a. Athletic trainer should work with physician/ophthalmologist to establish a protocol
regarding corneal abrasions.
O’Connor DP, Fincher AL. Clinical Pathology for Athletic Trainers. Recognizing Systemic Disease. Ed. 2.
Thorofare, New Jersey. SLACK Incorporated. 2008.
Corneal Laceration
1. A cut in the cornea
2. Signs and symptoms:
a. Severe pain
b. Tearing
c. Sensitivity to light
d. Blurred or decreased vision
e. Bleeding (blood in the eye)
f. The feeling that there is something in the eye
3. Treatment:
a. Covering the eye and administering medication.
b. Surgery.
4. Medication:
a. Antibiotics
i. Cefazolin
1. Ancef
2. Kefzol
3. Zolicef
ii. Gentamicin
1. Gentacidin
2. Garamycin
iii. Clindamycin
1. Cleocin
iv. Vancomycin
1. Vancocin
5. Participation:
a. Athlete may be encouraged to avoid activities that may place them at risk for eye
trauma, and to use protective eye wear if they will be participating. Participation should
be determined by the treating physician.
Aronson AA. Corneal Laceration. Medscape Reference. 2011.
http://emedicine.medscape.com/article/798005-overview. March 1, 2012.
Orbital Fracture
1. Orbit is composed of 7 facial bones: frontal, zygoma, maxilla, lacrimal, ethmoid, sphenoid and
palatine. Blow-out fractures occur when a blow to the eye increases pressure in the orbit,
causing the weak floor or lamina papyracea to "blow out" into the maxillary sinus or ethmoid
bone.
2. Signs and Symptoms:
a. Depending on the severity of the injury and fracture
i. Pain with attempted eye movement
ii. Double vision (diplopia)
1. Resolves when the patient covers one eye
iii. Numbness
iv. Hypesthesia
v. Distribution of the infraorbital nerve
vi. Restricted ey movemnts in up- or down-gaze
vii. Decreasesed sensation in the cheek or upper lip on the same side as the injury
viii. Misalignment of the orbital rim on palpation
ix. TTP
1. Sometimes a “crunchy feeling”
x. Eyelid ecchymoses
3. Treatment:
a. Surgical Repair
i. Not all need repair
4. Medications:
a. NONE
5. Participation
a. Complete resolution of the signs and symptoms and my return to sport participation in
approximately 2 to 4 weeks, with facial and eyewear protection for approximately 4 to 6
months
Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed., pp. 277-278).
Mosby.
Retinal Detachment
1. Retinal detachment occurs when the inner layer of the retina separates from the wall of the eye.
2. Signs and Symptoms:
a. Brief flashes of light (photopsia)
b. Curtain or shadow moving over the field of vision
c. Loss of central visual acuity
3. Treatment:
a. Surgery
i. Use of lasers or cryoprobes to create adhesions between the detached retina
and the back surface of the eye.
ii. Silicone oil, filtered air, or special gases are sometimes injected into the vitreous
cavity to push the retina against the back of the eye during the healing process
4. Medications:
a. NONE
5. Participation
a. Return to participation depends on the extent of the retinal injury and the success of
the repair. It also depends on the sport involved. Lengthy discussion between the
patient and the doctor are necessary to determine the athlete’s safety and risks of
Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed., pp. 278-279).
Mosby.future visual loss when returning to sports.
Oritis Externa
1. Otitis Externa is an inflammation or infection of the external auditory canal and tympanic
membrane
2. Signs and symptoms:
a. Pain
b. Itching
c. Burning
d. Drainage
e. Edematous and erythematous of the external auditory canal
f. Pulling on the pinna will increase pain
3. Treatment:
a. Ear drops
b. Hot pack to the side of the face for its soothing properties
4. Medications
a. Ear drops
i. Acidifying agent
1. Aluminum acetate
2. Vinegar and a drying agent
a. Isopropyl alcohol
b. Oral antibiotics
i. Usually in swimming athletes
5. Participation
a. Athletes other than those in water sports may participated as symptoms allow, provided
the head stays dry.
b. Aquatic athletes are kept out of the pool until completing at least 24 hours of
antibiotics.
Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed., pp. 300-301).
Mosby.
Otitis Media
1. The presence of fluid in the middle ear accompanied by signs and symptoms of infection
2. Signs and Symptoms:
a. Earache
b. Fever
c. Feeling of fullness in the ear
d. Dizziness
e. Tinnitus
f. Headache
g. Diminished hearing
3. Treatment
a. Antibiotics
4. Medications
a. Antibiotics
i. Amoxicillin
ii. Cephalosporin
iii. Erythromycin
5. Participation:
a. After dealing with the discomfort that accompanies otitis media, the patient who is
afebrile may participate in sports.
Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed., pp. 302-303).
Mosby.
Ruptured Tympanic Membrane
1. A ruptured eardrum is an opening or hole in the thin layer of tissue (eardrum) that separates the
outer and middle ear.
2. Signs and Symptoms:
a. Audible whistling sounds
b. Decreased hearing
c. Purulent fluid or bleeding
3. Treatment:
a. Tends to heal itself
b. Large or complicated ruptures may require surgical procedures
i. Graft of surgical paper, fat, muscle or other material.
4. Medications:
a. OTC analgesics for pain
b. If the TMP was caused by an infection the physician will prescribe drying agent drops as
well as topical and oral antibiotics.
5. Participation
a. For small, uncomplicated perforations of the tympanic membrane should result in
minimal time lost, especially in the non-swimming athlete.
b. Divers may be held out of activity longer than swimmers because of the combination of
water and pressure changes associated with the sport
Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed., pp. 302-303).
Mosby.
Allergic Rhinitis
1. Allergic Rhinitis is a hypersensitivity response to nasally inhaled allergens.
2. Signs and Symptoms:
a. Clear nasal discharge
b. Sneezing
c. Nasal Congestion
d. Cough
e. Sensation of plugged ears
f. Itchy, watering eyes
3. Treatment:
a. Medications
4. Medication:
a. Antihistamines
i. Loratadine
ii. Fexofenadine
iii. Nasalcrom
5. Participation:
a. Athletes may participate in athletics as able.
Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed., pp. 257-258).
Mosby.
Sinusitis
1. Sinusitis causes the cavities around your nasal passages (sinuses) to become inflamed and
swollen. This interferes with drainage and causes mucus to build up.
2. Signs and Symptoms:
a. Drainage of a thick, yellow or greenish discharge from the nose or down the back of the
throat
b. Nasal obstruction or congestion, causing difficulty breathing through your nose
c. Pain, tenderness, swelling and pressure around your eyes, cheeks, nose or forehead
d. Aching in your upper jaw and teeth
e. Reduced sense of smell and taste
f. Cough, which may be worse at night
g. Ear pain
h. Headache
i. Sore throat
j. Bad breath (halitosis)
k. Fatigue
l. Fever
3. Treatment:
a. Medication
4. Medication Options:
a. Saline Nasal Spray
b. Nasal Corticosteroids
i. Fluticasone (Flonase)
ii. Mometasone (Nasonex)
iii. Budesonide (Rhinocort Aqua)
iv. Triamcinolone (Nasacort AQ)
v. Beclomethasone (Beconase AQ)
c. Decongestants
i. Sudafed
ii. Actifed
iii. Drixoral
iv. Phenylephrine (Neo-Synephrine, others)
v. Oxymetazoline (Afrin, others)
d. OTC Pain Relievers
i. Aspirin
ii. Acetaminophen (Tylenol, others)
iii. Ibuprofen (Advil, Motrin, others)
e. Antibiotics
f. Antifungal Medications
g. Immunotherapy
5. Participation:
a. The athlete who is afebrile and feels well enough may be allowed to participate in
athletics.
Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed., pp. 259).
Mosby.
Epistaxis
1. Nose Bleed
2. Signs and Symptoms:
a. Blood coming from the nostrils
3. Treatment Options:
a. Direct pressure applied
b. Keep head elevated
c. Ice can be applied
d. Pinching of the nose
e. Cotton plug can be inserted into the nose.
4. Medication:
a. Saline nasal spray
5. Participation:
a. If there is no indication of a nasal fracture, septal deviation, or septal hematoma, the
athlete may return to participation once the nose has stopped bleeding.
Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed., pp. 260-261).
Mosby.
Pharyngitis/Tonsillitis
1. Inflammation of the Pharynx.
2. Signs and Symptoms:
a. Sore Throat
b. Pain with Swallowing
c. Hoarseness
d. Chills or fever
e. Swollen tonsils
3. Treatment:
a. Plenty of rest and fluids
b. Medication
4. Medication Options:
a. Antibiotics
b. Acetaminophen
5. Participation:
a. The athlete should be afebrile and must be able to tolerate fluids before vigorous
athletic activities.
Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed., pp. 261-262).
Mosby.
Laryngitis
1. Inflammation of the Larynx.
2. Signs and Symptoms:
a. Hoarse or weak voice
b. Maybe unable to speak
c. Urge to clear throat
d. Fever
e. Throat pain
3. Treatment:
a. Voice Rest
b. Humidifiers
c. Medication
4. Medication:
a. Acetaminophen
b. Throat lozenges
5. Participation:
a. Athletes with Laryngitis may participate as long as they are afebrile and feel well with
the exception of the laryngitis.
Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed., pp. 262-263).
Mosby.
Rhinitis
1. Rhinitis is a viral, bacterial, or vasomotor-related inflammation or infection of the nasal
passages.
2. Signs and Symptoms:
a. Clear nasal discharge
b. Sneezing
c. Nasal Congestion
d. Cough
e. Sensation of plugged ears
f. Itchy, watering eyes
3. Treatment:
a. Medication
4. Medication:
a. Antihistamines
5. Participation:
a. Performance may be affected if the athlete is using sedating antihistamines. Typically
athletes are able to participate in athletics with few limitations.
Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed., pp. 258-259).
Mosby.