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Therapeutic Modalities (Lecture) > Chpt. 1: *Pain and inflammation > Flashcards

Chpt. 1: *Pain and inflammation Flashcards

1
Q

What are modalities?

A

A therapeutic method or agent, such as surgery, chemotherapy, or electrotherapy, that involves the physical treatment of a disorder

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2
Q

Can your hands be a modality?

A

yes

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3
Q

What are the 3 stages of Inflammation, and for what stages are modalities mainly used?

A

Stage 1=Acute
Stage2=Subacute Proliferation
Stage 3= Chronic Remodelling

Mainly stage 1+2

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4
Q

Describe each of the 3 stages of inflammation? (ex. duration)

A 
1= 0-72 hrs, PRICE,ROM, Isometrics
2= 72hrs to 3-6 weeks, Isotonic (f.w. + therband)
3= up to 1 year, sport/workspace, isotonics (CKC)
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5
Q

**What are some common modalities in PT?

A
  1. heat/cold
  2. electrotherapy
  3. ultrasound
  4. laser
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6
Q

Why are electrical modalities, or modalities in general, used less commonly now?

A

Over reliance of the use of modalities

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7
Q

Guideline #3?

A

TENS?

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8
Q

What are 4 non-direct activities related to modlities?

A
  1. Cleaning and care
  2. Storage
  3. Reporting of problems
  4. Some maintenance
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9
Q

**What are some basic Cardiovascular Red Flag Signs ?

A
  • pain radiating down upp. extremity
  • Jaw pain
  • Shoulder girdle pain
  • Night Pain (weight loss + night sweats)
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10
Q

What happens to a systemic level when there is pain?

A

ANS (autonomic neurosystem) responds

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11
Q

What happens on a local level when there is pain?

A
  • spasm
  • edema
  • release of pain chemicals
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12
Q

?**Name 4 chemicals that cause pain in the body?

A
  • potassium,
  • serotonin,
  • histamine,
  • substance P
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13
Q

**What are the 3 types of Pain?

A

Acute
Chronic
Referred pain

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14
Q

*What is Acute Pain?

A
  • short lived
  • to do with; muscles strains
    - tendinitis
    - contusions
    - surgery
    - ligament injuries
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15
Q

*What is Chronic Pain?

A
  • persists after 3months after noxious stimuli has been removed
  • cause is unknown/uncorrectable
  • medical treatments ineffective
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16
Q

What is referred pain?

A

Pain that is felt at a site distant from the location of injury or disease

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17
Q

What are some causes for Chronic Pain? (5)

A
  1. Mechanical (nerve entrapment)
    2.Chemical
    3.Regeneration (nerve irritation)
    4, Reflexes (persistent motor reflexes after acute inflammation)
  2. Inhibitory failure (failure of CNS to release “ENDOGENOUS OPIATES”
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18
Q

What is the “cycle of pain”?

–> often psychological

A
  1. pain
  2. spasm
  3. lack of use
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19
Q

**What are some places for Organs that have a referred pain?

A
  • Heart–>arm
  • Gallbladder –>Neck
  • Bladder
  • Kidneys
  • Lungs
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20
Q

What are the 2 Pain Scales?

A
  1. Visual analogue scale (VAS)

2. McGill Pain Questionnaire (MPQ)

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21
Q

What is the VAS?

A
  • It is quite reliable*
  • 10 cm line;
    • R. S. worst pain
    • L. S. no pain
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22
Q

What is the MPQ ?

A

Contains body diagrams and word descriptors

3 catagories: sensory, affective, evaluative

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23
Q

What is the point of Pain scales?

A
  • Quality of Pain
  • Pain intensity
  • Psychological aspects
24
Q

What are some other Pain Scales other than VAS and MPQ? (4)

A
  1. The Oswestry Low Back Disability Questionnaire
  2. Waddell Disability Index
  3. Disability Questionnaire
  4. Arthritis Impact Measurement Scales
25
Q

Is pain usually descending or ascending?

A

Ascending

26
Q

What are Nociceptors?

Found where?

A

Signal actual or potential tissure damage

  • skin
  • viscera
  • soft tissue
  • bone
  • muscle
27
Q

*what is A delta?

A

-biggest; sharp and pricking sensation – well localized and of sharp sensation (acute)

28
Q

*What are C fibers?

A

-smallest; produce a longer lasting burning sensation (chronic)

29
Q

*?What are the 3 types of fibers, and what is their function?

A

(Alpha=motor
Beta=Sensory
Delta=Pain)

30
Q

What cell bodies are found in Dorsal Root Ganglia?

A

A-delta
C-fibers
A-beta

31
Q

What is the function of the Dorsal Horn?

What are it’s cell bodies?

A

-RELAY area; signals sent relayed to THALAMUS

A-delta
C-fibers
A-beta

32
Q

What are relays for?

A

to speed up transfers and sinals

33
Q
  • What is the Gate Control Theory of Pain?

* pg. 25=picture

A
  1. A and C fibers transmit pain signals to the Substantia Gelatinosa in the Dorsal Horn (grey matter)
  2. here they’re mixed with other non-nociceptive input
  3. signals (pain or non pain) are then sent via T cells to thalamus
34
Q

What are the 5 components of the Gate Control Theory of Pain ?

A 
A-delta
C-fibers
A-beta
Substantia Gelatinosa
T cells
35
Q

What affects the intensity and type of ascending signal by T-cells?

ex.?

A

Our bodies natural pain killers

ex. endorphins, dopamine, serotonin (“happy hormone” + pain killer) enkephalins,

36
Q

What are the different areas/steps/relays with pain: (11)

A
  1. Stimuli
  2. Impulse Transmission
  3. Sensory Fibers
  4. Cord junctions
  5. Dorsal Horn
  6. Synapse
  7. Calcium release
  8. Synaptic Cleft
  9. Post Synaptic Cell
  10. Nociceptive Pain
  11. Pain perception
37
Q

What brings the patient usually into treatment/assessments ?

A

Pain

38
Q

*What are modalities and/or pain killers directed towards?

A

Breaking the pain-spasm cycle

39
Q

What are 2 types of modalities to break the Pain cycle?

A
  • Thermal modalities

- Electrical modalities

40
Q

What are 3 stages that all soft tissue injuries must progress through to effectively heal?

A
  1. Inflammation
  2. Proliferative
  3. Remodelling
41
Q

What are the three phases of the PROLIVERATIVE Phase (3-20 DAYS)?

A

Phase 1=granulation – fibroblasts and epithelial cells

Phase 2=wound contraction – myofibroblasts – “pull the wound together”

Phase 3=collagen production.

42
Q

*What are (4) reasons for delayed wound healing?

A
  1. compromised immunity (ex. AIDS)
  2. certain meds (ex. NSAID/Steroids/Anti-rejection drugs
  3. radiation/chemotherapy
  4. aging
43
Q

List 3 ways PT can augment (speed up) open wound healing ?

A
  1. (EMS) Electrical stim
  2. CPM machines to assist with scar formation
  3. (PUVA) UV light
44
Q

**What are (5) goals of treatment for Therapeutic Massage?

A
  1. Restore optimal function when possible
  2. Prevent further injury
  3. Maintain or increase tissue/fluid interchange
  4. Maintain or increase joint mobility
  5. Maintain or increase muscle tone (or decrease if needed) and flexibility
45
Q

**What are (11) Contraindications for Massages?

A
  1. Undiagnosed lump
  2. Contagious skin condition
  3. Acute infection
  4. Recent wound
  5. Burn
  6. Open lesion
  7. Contagious disease
  8. Fever
  9. Cancer
  10. Hyperesthesia
  11. Rheumatoid arthritis
46
Q

What are the 3 types of Massages done in class?

Pinswa=

A
  1. Efflurage
  2. Petrissage
  3. Tapotment
47
Q

What are the 2 types of Massages ?

A

Relaxation Massage

Therapeutic Massage

48
Q

After a Therapeutic Physical Intervention such as a massage, ___ or ____ and ____ of the skin occurs.

A

Redness
Blanching
Mottling of the skin

49
Q

What is the test called where nail bed should refill in 3 sec. after pressure?

A

Circulatory Irreg. capillary refill test

50
Q

When HEAT is applied what will be caused?

A

LOCAL VASODILATION (redness)

51
Q

When COLD is applied what will be caused?

A

a cooling effect followed by REFLEX VASODILATION

52
Q

What are 6 Pain Assessments? Why?

A
  1. VAS
  2. Pain Ratings
  3. Questionnaires
  4. Anatomic Pain Drawings
  5. Facial Expression of Pain,

Subjective Data

53
Q

What is Therapeutic Massage defined as ?

A

A series of manipulations of the body done with scientific knowledge of the structure and function of the body in a rational, skillful manner for therapeutic results.

54
Q

What are some non-direct activities, but still part of a TA’s responsibility, related to modalities ?

A

-Cleaning and care
-Storage
-Reporting of problems
Some maintenance

55
Q

What are Basic Principles of Massage:

A

General–> Specific–>General (start and finish large part of body )

  • Superficial–> Deep–>Superficial
  • Proximal–>Distal–>Proximal
  • Periphery to center
56
Q

What are some conditions treated with massage?

A

Musculoskeletal conditions:

  • strains
  • postural concerns
  • inflexibility
  • post exercise (soreness)

Stress conditions: headaches,

  • insomnia
  • chronic pain

Therapeutic Modalities (Lecture) (9 decks)

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