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BOC > Chapter 15 - Using Therapeutic Modalities > Flashcards

Chapter 15 - Using Therapeutic Modalities Flashcards

1
Q

electromagnetic energy

A

electrical stimulation, shortwave & microwave diathermy, ultraviolet therapy, laser therapy

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2
Q

electromagnetic energy travels

A

without a medium

3,000,000 m’s in a vacuum

in a straight line

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3
Q

conduction

A

heat is transferred from a warmer object to a cooler one

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4
Q

skin temperature influenced by

A

type of heat or cold medium

conductivity of tissue

quantity of blood flow in the area

speed at which heat is being dissipated

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5
Q

high temperature limit

A

116.6 degrees farenheit

at 113 degress - should not go longer than 30 min

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6
Q

types of modalities using conduction

A

MHP, paraffin, electric heating pads, ice/cold packs

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7
Q

Convection

A

transference of heat through the movement of fluids or gases

ex. whirlpool bath

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8
Q

radiation

A

heat energy is transferred from one object through space to another object

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9
Q

types of radiation modalities

A

shortwave/microwave diathermy, infrared heating, ultraviolet therapy

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10
Q

Conversion

A

generation of heat from another energy form such as sound, electricity, and chemical agents

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11
Q

types of conversion modalities

A

ultrasound, diathermy, liniments/balms

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12
Q

ultrasound

A

mechanical energy into heat energy at tissue interfaces

inaudible, acoustic vibrations of high frequency that may produce thermal or non-thermal physiological effects

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13
Q

diathermy

A

heat produced by applying electrical current of specific wavelengths to skin

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14
Q

liniments/balms

A

create heating sensation through counterirritation of sensory nerve endings

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15
Q

Extent of tissue cooling

A

depends on type of cold medium, length of exposure, and conductivity of tissue

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16
Q

38.8 degrees farenheit

A

muscle temperatures can be reduced as deep as 4 cm

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17
Q

which tissue are good conductors

A

muscle is good, fat is poor conductor

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18
Q

vasoconstriction occurs when

A

cold for 15-30 min at 50 degrees

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19
Q

hunting response

A

slight increase in temperature during cooling (not vasodilation)

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20
Q

physiological effects of cold

A

increased blood viscosity, decrease in release of chemical mediators, decreased capillary permeability

decreased secondary hypoxic death

decreased muscle spasm

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21
Q

frostbite occurs at what temp

A

26.6-24.8 degrees farenheit

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22
Q

raynaud’s phenomenon

A

cold exposure causes vasospasm of digital arteries lasting for 2 minutes to hours

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23
Q

possible contraindications of cold

A

hypersensitivity

cold allergies

over superficial nerves

uncovered, open wounds

circulatory insufficiency

already decreased sensation

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24
Q

ice massage

A

32 degrees

10-15 cm area, 5-10 min

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25
Q

cold/ice water immersion

A

50-60 degrees

10-15 min

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26
Q

ice bag

A

34-36 degrees

wet ice packs are best
15-20 min

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27
Q

vapocoolant sprays

A

fluori-methane

reduce spasm, increase ROM, treat trigger points

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28
Q

Cryokinetics

A

cryotherapy and exercise

ice until dumb (12-20 min)

exercise 3-5 min

ice until numb 3-5 min

repeat 3-5x

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29
Q

effective tissue temperature for thermotherapy

A

100-113 degrees farenheit
or
40-45 degrees celcius

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30
Q

thermotherapy effects

A 
increased extensibility
increased viscosity
decreased joint stiffness
reduced pain
reduced muscle spasm
increased nerve conduction velocity
reduce inflammation, edema, exudate
increased blood flow, venous return, and lympathic drainage
assist inflammation
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31
Q

superficial heat

A

infrared modality
indirectly heats deeper tissues by circulation and conduction

moist heat is greater than dry heat

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32
Q

contra-indications of heat

A

acute inflammation, impaired circulation, poor thermal regulation, anesthetic areas, infections, malignancy, neoplasm, low back/abdomen during pregnancy

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33
Q

moist heat packs

A

160-170 degrees
silicate gel in cotton pad
6 layers of toweling
break pain-spasm cycle (sedative)

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34
Q

whirlpool baths

A

100-110 degrees

convection and conduction

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35
Q

paraffin

A

126-130 degrees
glove methond: 6-12 dips, paraffin cools in between, wrap in plastic bag, rest for 30 min

immersion: submerge for 20-30 min,

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36
Q

contrast bath

A

100-110; 50-60 degrees farenheit

3:1 or 4:1 warm:cold for 19-20 minutes

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37
Q

attenuation

A

sound scatters and is absorbed as it penetrates tissue - energy transferred is decreased

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38
Q

1 MHz or 3 MHz

A

one/three million cycles per second

absorption increases with increase in frequency

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39
Q

US equipment

A

high-freq generator provides current through a co-axial cable to a transducer inside the applicator US head

(crystal - barium titanate, zirconate titanate)
2-3 mm thick and 1-3 cm diameter

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40
Q

Reverse piezoelectric effect

A

alternating current passing through crystal causes expansion contraction of crystal (produces acoustic energy)

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41
Q

1.0/3.0 MHz - frequency absorption

A
  1. 0: 3-5 cm

3. 0: 1-2 cm

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42
Q

effective radiating area

A

surface of transducer that produces sound energy

1MHz is more divergent than 3 MHz

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43
Q

transverse wave

A

displacement perpendicular to direction of propagation (solids)

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44
Q

longitudinal wave

A

displacement in direction of wave propagation (liquids and solids -soft tissue)

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45
Q

beam non-uniformity ratio

A

amount of variability
ideal 1:1
typically 6:1

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46
Q

US - intensity

A

w/cm^2

power/ERA

47
Q

types of US

A

continuous - intensity remains constant

pulsed - intensity periodically interrupted

ducty cyle - % of time that US is being generated

48
Q

Biphasic Current

A

alternating current
-direction of current reveres itself once during each cycle

uses: pain modulation or muscle contraction

49
Q

Monophasic Current

A

Direct current
flows only from positive to negative pole

pain modulation, muscle contraction, produce ion movement

most commonly used in AT settings

50
Q

Pulsatile Current

A

3+ pulses grouped together
interrupted and repeat at regular intervals

used in interferential pre-modulated and Russian currents

51
Q

type of current parameters

A 
waveform
modulation
intensity
duration
frequency
polarity
electrode setup
52
Q

waveform

A

graphic representation of the shape, direction, amplitude, and direction of a particular electrical currents (sine, square, triangular)

53
Q

modulation

A

ability of the e-stim unit to change the magnitude or duration of a waveform

bursts, continuous, surging (biphasic), monophasic, or pulsatile

54
Q

Intensity

A

voltage output of the e-stim unit.

low voltage - 150 V - monophonic
high voltage - 500 V - biphasic or monophasic

55
Q

Duration

A

length of time that current is flowing
pulse or width duration
normally is preset

56
Q

frequency

A

number of waveforms being emitted by the e-stim unit in 1 second

pules/sec (pps)
cycles per second (cps
Hertz (Hz)

57
Q

polarity

A

direction of current flow

58
Q

electrode set up

A

large pads - dispersive - away from tx area

small pad - active - close as possible to tx area

59
Q

e-stim parameters for gate control

A

intensity adjuted to create tingling

no contraction - with pulse and freq high as possible

60
Q

e-stim parameters for descending pathway control

A

very high intensity, almost painful, 10 microseconds for pulse duration; freq at 80 pps

61
Q

opiate pain control e-stim parameters

A

intensity - as high as can be tolerated
pulse duration - max
freq - 1-5 pps

62
Q

muscle pumping e-stim parameters

A

freq - 20-40 pps
surged mode at 5 seconds each for on/off modes
injured part elevated
active contraction encouraged

63
Q

muscle strengthening e-stim parameters

A 
high-freq bi-phasic current
50-60 pps
surging curent at 15 sec on, 50 sec off
10 reps, 3x a week
combined with titanic muscle contraction with maximal active contraction against resistance
64
Q

retardation of atrophy e-stim parameters

A

high-freq bi-phasic
30-60 pps to elicit a tetanic contraction
voluntary isometric contraction

65
Q

muscle re-education

A

intensity increased to comfortable contraction
30-50 pos using interrupted or surged current
15-20 min, several times per day

66
Q

iontophoresis

A

drives ions into the body via electrical current

67
Q

interferential indications

A

pain control, joint pain w/ swelling, neuritis, retarded callus formation following fx, restricted mobility
20-25 pps for muscle contraction and 50-120 pps for pain management

68
Q

shortwave diathermy

A

emits electromagnetic energy that is capable of producing temperature increases in the deeper tissues

69
Q

Laser

A

light amplification by stimulated emission of radiation

Helium-NEon) or (Gallium-Arsenide

70
Q

physiological effects of thermal US

A

increased blood flow, metabolism, enzymatic activity, collagen extensibility,

decreased viscosity, pain, chronic inflammation, muscle spasm, joint stifffness

71
Q

mild heating US

A

1 degrees celcius - accelerates metabolic rate

72
Q

Moderate heating US

A

2-3 degrees celcius - reduces muscle spasm, pain, chronic inflammation, increase blood flow

73
Q

vigorous heating 3-4 degrees celcius

A

decreases viscoelastic properties of collagen

74
Q

physiologic effects of non-thermal US

A

microstreaming

cavitation

separation of collagen fibers

increased extensibility

increased fibroblastic activity

mechanical break-up of metabolites and waste products
reduction of edema and pain

75
Q

microstreaming

A

flow of fluid/tissue components causes mechanical pressure waves - alters cell membrane permeability to Na+ and Ca2+ ions

76
Q

Cavitation

A

formation of gas-filled bubbles that expand and compress due to pressure changes in fluid

stable: - increased fluid flow around bubbles
unstable: can cause damage

77
Q

monopolar electrode

A

small (active) and large (dispersive) pad

78
Q

bipolar elctrode

A

2 equally sized pads

79
Q

bifurcate electrode

A

dispersive pad, and 2 active pads

80
Q

quadpolar electordes

A

2 sets of electrodes - IFC

81
Q

biofeedback

A

electronic instruments to accurately measure, process, and feed back reinforcing info via auditory or visual signals

82
Q

EMG biofeedback

A

measures electrical activity in muscle fibers - quality of contraction

83
Q

Mechanical response to massage

A

encourage venous and lymphatic drainage

mildly stretch tissue

avoid stagnant edema

84
Q

physiological responses to massage

A

increased: circulation, metabolism, removal of lactic acid

85
Q

Effleurage

A

stroking
light - sedative
deep - compression of soft tissue
hand over hand or cross body methods

86
Q

petrissage

A

kneading
loose and heavy tissues
wrings out muscle, loosens adhesions, squeeze out material in to circulation

87
Q

friction

A

used around joint where tissue is thin or unyielding
circular movement

stretch underlying tissue, develop heat, increase circulation

88
Q

Tapotement

A

percussion

cuping, hacking, pincing

89
Q

vibration

A

produces trebling effect

relax and sooth

90
Q

indications for traction

A

spinal nerve root

impingement

use to decrease muscle guarding

treat muscle strain

treat sprain of spinal ligaments

relax discomfort resulting form normal spinal compression

91
Q

diathermy

A

emit electromagnetic energy capable of producing temperature increases in deeper tissues,

good for larger surface areas

92
Q

shortwave diathermy

A

heats deeper tissue with high freq electrical current

  • through a condenser (electrostatic field heating, patient is part of circuit)
  • electromagnetic/induction field heating (heated by field, patient is not in circuit)
  • pulsed diathermy - output of continuous shortwave diathermy is consistently interuppted
93
Q

shortwave diathermy equipment

A

power amplifier (converts AC-DC)

Applicators: condenser - electrodes
or
inductive coil or drum

94
Q

shortwave diathermy indications

A

bursitis, capsulitis, osteoarthritis, deep muscle spasm, strains

can reach temps of 107

95
Q

Microwave Diathermy

A

lower freq cause less conversion of energy into subQ tissue

easily absorbed

96
Q

microwave diathermy equipment

A

AC–>DC by magnetron oscillator

coaxial cable transports energy from magnetron oscillator to applicator head

97
Q

indications for microwave diathermy

A

fibrositis, myositis, osteoarthritis, bursitis, calcific tendinitis, sprains, strains, post-traumatic joint stiffness,

can penetrate up to 5 cm

98
Q

conductive thermal energy

A

thermotherapy, cryotherapy

99
Q

electrical energy using modalities

A

E-stim currents, iontophoresis, biofeedback

100
Q

sound energy using modalities

A

ultrasound, extracorporeal shockwave therapy

101
Q

mechanical energy using modalities

A

traction, massage, intermittent compression

102
Q

velocity=

A

wavelength x frequency

103
Q

characteristics of electromagnetic radiation:

A
  1. ) produced when sufficient electrical or chemical forces are applied to any material
  2. ) travel readily through space at an equal velocity (300,000,000 meters/sec)
  3. ) Direction of travel is always in a straight line
104
Q

Electromagnetic radiation can be do what when contacting tissue?

A

reflection, transmitted, refracted, absorbed

105
Q

Arndt-Schultz Principle

A

No changes or reactions can occur in the tissues unless the amount of energy absorbed is sufficient to stimulate the absorbing tissues

106
Q

Law of Grotthus-Draper

A

if the energy is not absorbed utmost be transmitted to the deeper tissues

> absorption =

107
Q

Cosine Law

A

the smaller the angle between the propagating radiation and the right angle, the less radiation reflected and the greater the absorption

108
Q

inverse square law

A

the intensity of the radiation striking a surface varies inversely with the square of the distance from the source

“moving the object away from energy source = less absorption”

109
Q

pulsed SWD can cause

A

depolarization in damaged cells correcting dysfunction

110
Q

when should Diathermy be used?

A

if skin/tissue is tender and cannot handle pressure

if SubQ tissue is thick and deep heating is required

if 1 MHz US is contraindicated, Pulsed SWD will produce the same magnitude and depth of muscle heating

if the tx area is a large area

111
Q

when should UV Therapy be used

A

cause chemical changes in skin, that have a bactericidal effect

effects are superficial in nature

treat skin lesions

topical agents are often better options

112
Q

when should low level lasers be used

A

when you do not desire thermal effects
soft tissue and fracture healing
pain management

113
Q

all electrical stimulating currents are classified as what?

A

Transcutaneous Electrical stimulating currents

114
Q

Types of Transcutaneous electrical stimulating currents

A

EMS - Electrical muscle stimulators
TENS - Transcutaneous Electrical Nerve Stimulators
LIS/MENS - Low Intensity Stimulators

BOC (49 decks)

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