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BOC > Chapter 15: Therapeutic Modalities > Flashcards

Chapter 15: Therapeutic Modalities Flashcards

1
Q

What are the 4 forms of thermal energy transmission?

A

Conduction: heating through direct contact, hydroc/paraffin/ice pack/cold pack
Convection: heating indirectly through a medium, hot/cold whirlpools
Radiation: transfer of heat through space from one object to another, shortwave diathermy
Conversion: heating through other forms of energy, balms/shortwave diathermy

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2
Q

What are some of the physiological effects of thermotherapy?

A

Increase extensibility of collagen fibers, decreasing joint pain, reduce pain/inflammatio/edema, relieve mm spasm, increase blood flow

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3
Q

What is ischemia?

A

Lack of blood flow to a body part

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4
Q

What is the temperature of the paraffin bath? Hydrocullator? Warm whirl pool?

A

126-130, 160-170, <104

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5
Q

What are the physiological effects of cryotherapy?

A

Vasoconstriction of the arterioles and venules, numbness, collagen stiffness

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6
Q

What is the hunting response?

A

It causes a slight temperature increase during cooling (vasodilation if 20-30 minutes of cold)

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7
Q

What is Raynaud’s phenomenon?

A

A condition that causes vasospasm of digital arteries lasting minutes to hours and could lead to tissue death. SYS: skin blanching, cyanosis, skin pallor then red, numbness, tingling, burning

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8
Q

What is the spray & stretch technique?

A

Using vapocoolant spray to for treating trigger points & myofascial pain. Stretch the muscle with the trigger point, hold 12cm away, spray the length of the muscle, firmly stretch to tolerance & keep spraying. After the first spray session, warm with a hot pack or vigorous massage.

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9
Q

What are the main uses of vapocoolant spray?

A

Reduce muscle guarding & increase ROM

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10
Q

What is cryokinetics? How many minutes of ice/exercise? Should passive exercises me performed?

A

12-20 minutes of icing, exercise 3-5, ice 3-5, etc…Only active exercises

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11
Q

What is the temperature of the cold tub?

A

50-60 degrees

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12
Q

What are the precautions of cryotherapy?

A

Intensity of the activity should be limited by the nature of the healing process and perceptions of pain.

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13
Q

What is Ohm’s Law?

A

Ohm: resistance of passing an electrical current along a conductor.

V=IR

voltage across a resistor is proportional to the current. OR the current through a conductor between two points is directly proportional to the potential difference across the two points.

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14
Q

What is a direct current?

A

AKA a monophasic or galvanic current. Flows in one direction from the positive pole to the negative pole

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15
Q

What is an alternating current?

A

AKA biphasic…the direction of the current flow reverses once during each cycle…pain & mm contraction. Continuos and bidirectional flow of charged particles – no net charge.

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16
Q

What is a pulsatile wave?

A

AKA Russian…3 or more pulses grouped together, interrupted for short periods then repeat

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17
Q

What is the beta-endorphin model of pain control? How does noxious pain control work?

A

E-stim stimulates sensory nerves to release encephalin from local sites throughout the CNS and the release of B endorphins from the pituitary gland into the cerebrospinal fluid. Pain modulation when applying a current close to the painful site. Point stimulator set as high as tolerable with maximum pulse duration.

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18
Q

What are 4 things electrical muscle contraction can be used for?

A

Muscle pumping contractions, muscle strengthening, muscle reeducation, & retardation of atrophy

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19
Q

What is iontophoresis? Dexamethasone? Lidocaine?

A

Ionto uses electrical current to drive ions into the skin. Dex: antiinflam…Lid: local anesthetic

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20
Q

What are the physiological effects of ultrasound?

A

Stimulates the repair of soft tissue and relieves pain. It is a deep heating modality

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21
Q

What is attenuation?

A

A decrease in intensity as sound enters deeper tissues

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22
Q

What is the piezoelectric effect?

A

Electrical current produced by applying pressure to certain synthetic crystals (quartz)…causes expansion and contraction of the crystals which produces oscillation voltage at the frequency.

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23
Q

What is the effective radiating area?

A

The portion of the surface of the ultrasound transducer that produces the sound wave (energy)

24
Q

What is cavitation?

A

A nonthermal effect, formation of gas-filled bubbles that expand & compress due to ultrasonically induced pressure changes in tissue fluids. Increases blood flow in area around the bubbles

25
Q

What is Beam Nonuniformity Ratio?

A

The amount of variability in intensity of the ultrasound beam, lower BNR= more uniform, optimal uniformity of 1:1

26
Q

What is micro-streaming?

A

Nonthermal effect…unidirectional movement of fluids along cell membrane boundaries from the mechanical pressure wave in ultrasonic field. Can alter cell membrane structure and function

27
Q

What is underwater ultrasound & how far from the body part should the transducer be?

A

Suggested for irregular body parts…transducer should be 1 inch from the body part.

28
Q

What is phonophoresis?

A

A method of transporting molecules through the skin with US. Hydrocortisone and anesthetic into tissues ,…helpful for trigger points, tendinitis, bursitis

29
Q

What does LASER stand for?

A

Light Amplification by Stimulated Emission of Radiation

30
Q

What are some of the physiological effects of laser therapy?

A

Helium neon (red,2-5mm direct, 10-15mm indirect) or gallium arsenide lasers (invisible, 1-2cm direct, 5cm indirect)… acceleration of collagen synthesis, decrease microorganisms, increase vascularization, reduce pain and inflam, trigger points

31
Q

What is the main therapeutic effect of diathermy?

A

Temperature increases in deeper tissues, high water content tissues absorb the heat, absorbed by fat

32
Q

What are the main precautions when using diathermy?

A

Difficult to treat localized body parts, dosage is subjective, towels between applicator and skin, not to be used with metal objects, avoid when hemorrhaging/pregnant/open wounds/contacts, cables and coils can’t touch each other, deep ache may be present

33
Q

What are the 5 types of traction?

A

Manual-change force, direction, duration and position
Mechanical- lumbar/cervical, harness on table
Positional- for comfort or tx goal, ex: laying on back with legs and hips flexed
Wall-mounted- cervical, plates, sand bags or water bags for weight
Inverted- lengthens the spine, gravity pulls trunk weight down

34
Q

What are some physiological effects of traction?

A

Separate vertebral bodies and stretch ligaments and joints, relieve pressure and pain, stretch muscles, increase and change joint proprioception

35
Q

What are some different forms of compression?

A

Intermittent, continuous, with cold/ice

36
Q

What are the general treatment parameters when using intermittent compression?

A

30-50mmHg for upper, 30-60mmHg for lower, thirty minutes reduces edema

37
Q

What are the 5 types of massage?

A

Effleurage-stroking light and deep, either sedation or encourages venous and lymphatic drainage
Pettrissage- loose and heavy kneading, pick up muscles and rolling in opposite direction, loosens
adhesions, squeezes congestive materials into general circulation
Friction- used where tissue is thin, scars/adhesions/muscle spasms/fascia, stretches underlying tissues develop friction in the area and increase circulation around the joint
Tapotement- percussion, hacking, pinching, stimulation to nerves
Vibration- quivering or trembling effect, relax and soothe

38
Q

What are some physiological effects of massage?

A

Increase circulation, increase metabolism to muscles and aid in removing metabolites (lactic acid) helps overcome venostasis and edema, helps with normal venous blood return to the heart

39
Q

Understand the basics of ice massage, ice immersion, and ice packs

A

massage: used of the belly of the muscle, tendon, bursae ,or myofasical trigger points. small body area. 10 minutes, comfort must be taken into consideration
immersion: circumferential cooling is desired. 15 minutes. overcoolig can cause frostbite. allergies?
packs: two types - gel and liquid bag within crystals. should use a towel to prevent reaction with skin.

40
Q

What is fluidotherapy?

A

therapeutic environment with dry heat and forced convection through a suspended airstream. effective in decreasing pain, increasing joint ROM, decreasing muscle guarding, and decreasing swelling. 15-20 minutes

41
Q

Understand basics of moist heat and WWP

A

moist heat: general relaxation. heat for 20-30 minutes. use towels. doesn’t heat deeper muscles, no lying on packs.
WWP: massage and water immersion, provides conduction and convention, more body underwater the cooler it should be. should no exceed 20 minutes.

42
Q

What are the 4 types of sensory receptors?

A

mechanoreceptors: mechanical stress or strain
chemoreceptors: chemical stimuli
nociceptors: damage or threat of damage to body tissues
proprioceptors: sense of position

thermoreceptors, osmoreceptors, magnetoreceptors, electroreceptors, photoreceptors

43
Q

What are excitable tissues?

A

tissue that can undergo rapid change in their membrane potential which is important to transport electrical signals.

44
Q

Difference between cutaneous, deep somatic, visceral, and psychogenic pain

A

cutaneous: pain caused by the body surface
deep somatic: caused by the activation of pain receptors in musculoskeletal tissues
visceral: pain we feel when our internal organs are damaged or injured and is by far the most common form of pain
psychogenic: pain fro the brain

45
Q

When in the healing process should contrast be used?

A

works well on chronic pain and stiffness. contrast is best utilized a few days after the initial injury. go back a forth, but ALWAYS end with COLD

46
Q

What are some precautions in using thermotherapy?

A

pregnancy (avoid abdomen and low back), poo circulation, edema, cardiac insufficiency, areas with metal, open wound, areas where topical counterirritants have recently been applied

47
Q

What is the difference between shortwave and microwave diathermy?

A

micro has higher frequency and shorter wavelength than shortwave. it generates a strong electrical field and relatively little magnetic field. penetration of shortwave is deeper, but micro has an easier application. micro treats 1 aspect of body while shortwave treats 2.

both are used for thermal physiological effects

48
Q

What are the amplitude, peak-to-peak amplitude, phase duration, and pulse duration?

A

amplitude: measure of its change over a single period
peak-to-peak amplitude: difference between the maximum positive and maximum negative amplitudes
phase duration: same as pulse duration
pulse duration: the time from the beginning of the first phase to the end of the last phase of one pulse, the width of the pulse

49
Q

What is frequency?

A

The number of waves or pulses per second … usually measured in Hz.

50
Q

What is impedance?

A

opposition to the current flow, tissue that resist flow, adipose, bone, tendons, and fascia.

51
Q

What is duty cycle?

A

Ratio of on time to total cycle time. the higher the duty cycle the more fatiguing the treatment.

52
Q

What is current measured in? resistance? voltage?

A

current: measured in amperes
resistance: measured in ohms
voltage: measured in volts

53
Q

What is an asymmetrical current?

A

changes in amplitude over time. ramp up or ramp down.

54
Q

What are the first order neurons? What are second order? what are third order?

A

first: they are located in the dorsal root ganglia or the sensory ganglia or cranial nerves. they conduct impulses from cutaneous receptors and proprioreceptors to the brain and spinal cord
second: conducts the impulse from the brainstem-spinal cord to the thalamus
third: conducts nerve impulses from the thalamus to the primary somatosensory area

55
Q

What are the various neurotrasmitters?

A

serotonin: active in descending pathways
norepinephrine: inhibits pain transmission between first and second order neurons
substance P: active in small-diameter primary afferent neurons
enkephalins: found in descending patyways
B-endorphin: found in the CNS

BOC (20 decks)

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