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Therapeutic Modalities (Lecture) > Chpt. 6 Foundations > Flashcards

Chpt. 6 Foundations Flashcards

1
Q

What are 3 types of electro Therapy (E-Stimulation)?

A

1) Electrotherapy
2) Electrodiagnosis – interpreting the response of nerves and mm to stim
3) EMG – electromyography

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2
Q

What is NMES?

A

Neuromuscular electrical stim

– stimulating innervated mm (muscles) to restore function. Includes strengthening and muscle re-ed

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3
Q

What is TENS?

A

Transcutaneous electrical nerve stim.

– pain management through skin electrodes

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4
Q

What is IFC?

*most liked by patients

A

Interferential Current –

4 electrodes. Used for pain. 2 currents – interfering.

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5
Q

What is EMS?

A

Electrical Muscle Stimulation

– done to maintain muscle viability

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6
Q

Positive charge of the proton in the nucleus is balanced by the ____ electrons outside

A

negative

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7
Q

Movement is caused by losing electrons, and is therefore called:

A

electricity

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8
Q

**What are 3 UNSTABLE ions , that are used in axon (nerve) movement for example?

A

sodium
potassium
calcium

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9
Q

What is the difference between atom and ion?

A

an ion is lacking an electron

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10
Q

What is all matter composed of ?

A

atoms and ions

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11
Q

**What are 8 different atoms in your BODY?

A 
carbon 
nitrogen
hydrogen
calcium 
phosphorus
*sodium
potassium 
magnesium
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12
Q

What ion is Highly reactive ion because it is so unstable (one extra electron) ?

A

sodium

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13
Q

*What is a conductor ?

A

made of material that are composed of reactive atoms

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14
Q

*What is an Insulator?

A

materials with atoms that have stable outer shells

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15
Q

What is a really good conductor ?

- therefore it is used as gel for electrical stimulation (ex. TENS)

A

water

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16
Q

What is a really good insulator?

A

skin (fat)

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17
Q

Where the nerve enters the muscle is the ____ ?

A

motor point

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18
Q

***Electrons flowing continuously in 1 direction is called what?

A

Direct Current (DC)

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19
Q

What is an electric current?

A

he actual flow of electrons in a conductor

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20
Q

What is a current (I) measured in?

***What is a Therapeutic current flow measured in?

A

(A) ampere

mA ( milli amperes)

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21
Q

The more Voltage (V) the more what ?

A

power

ex. the more you open up the water tao, the more comes out

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22
Q

What is Resistance (r) ?

What is it measured in?

A

ease or difficulty of current moving through substances

  • (Ohm)
  • All materials offer some resistance to current flow
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23
Q

What is Impedence?

What is both resistance and impedence measured in?

A

opposition of electrical circuits to flow of AC

-Ohm

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24
Q

What is the formula for Ohm’s Law?

A

V=I x R

Voltage=Current x Resistance

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25
Q

Current and Resistance are ____ related ?

A

inversely

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26
Q

What is directly proportional to Current flow ?

A

Voltage

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27
Q

What are the 2 types of “flows” or electrical current in the body ?

A
  • electron flow

- ionic flow

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28
Q

How is an acidic (HCL=hydrochloric acid) environment created which isn’t very good for you?

A

Negative ions are driven towards the positive pole (anode)

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29
Q

***How does TENS work ?

A

stimulates sensory

sodium and potassium crosses the membranes

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30
Q

What is Saltitory conduction (happens on mylenated nerve) ?

A

happens in TENS

*positive and negative current switch directions the whole time= flipping back and forth

31
Q

Where does the TENS need to be located on your body when in use?

A

peripheral nerve

32
Q

** What is Biphasic pulse and why is it important?

A

One direction of current flow in (+), stops, flips, other direction (-) etc.

*Has a Gap between switching directions

to prevent HCL (hydrochloric acid)

33
Q

Assymetrical Byphasic used in TENS and NMES and is what?

A
  • similar to biphasic but it FEELS good for patients because it it NOT symmetrical (first a square then a a triangle etc.)
34
Q

What is monophasic pulse?

A

has one phase; always unidirectional (+ ve or -ve)

35
Q

*3 important things to know how to use a TENS machine?

A
  1. Amplitude- Adjust current (like turning up volume)
  2. Pulse Width
  3. Frequency
36
Q

What is Peak amplitude?

Higher peak is deeper ___ ?

A

maximum current delivered in one phase

deeper penetration in to tissue

37
Q

What 4 levels stimulation, is E-stim capable of generating?

A
  1. subsensory
  2. sensory
  3. motor
  4. noxious
38
Q

*The longer you have a Pulse Width on, the more you stimulate what neuron?

Longer Pulse width=
Short Pulse width=

A

Stimulate Motor neurons

Longer Pulse width= motor
Short Pulse width= sensory

39
Q

***What is High Rate TENS?

Feelings?

And what conditions is it used for usually?

A

High frequency + Low width pulse;

  • stimulates A-Beta fibers
  • tingling/buzzing*

-ACUTE

40
Q

***What is Low Rate TENS?

Feelings?

And what conditions is it used for usually?

A

Low frequency + High width Pulse
-stimulates A-Beta and A-Alpha

  • twitching= release of endogenous opiates=pain relief)
  • CHRONIC
41
Q

Why do we need adjustments of frequency? (2)

A
  • Switch response

- Depth of penetration

42
Q

What is Rise/ramp time?

A

the time it take for the amplitude to increase from zero to peak amplitude

43
Q

What is Decay time ?

A

– time it takes for peak amp to decrease back down to zero

44
Q

What is the relationship between pulse width and frequency?

A

inverse relationship

45
Q

What is Pulse width?

A

Duration of a pulse wave

46
Q

What is the Most therapeutic frequencies range?

A

1-120 Hz

47
Q

Why is Duty cycle important?

A

for rest time

*ratio of on to off time (1:4)

48
Q

**Why do we change pulse width for TENS?

A

Sensory to motor stimulation

49
Q

What is Modulation in TENS?

A
  • to vary one or more of the electrical parameters

* to prevent accomodation (your body getting used to it)

50
Q

What are the 3 different types of modes in TENS?

A
  • burst
  • modulated
  • continuous
51
Q

**Why do we use TENS?

A

pain relief

52
Q

What are 6 indications for Electrical Stimulation?

A
  • Pain mgmt
  • muscle strengthening
  • stimulation of denervated muscle
  • wound care
  • fracture healing
  • circulation and edema management
53
Q

** What are 5 CONTRAINDICATIONS for E. Stim?

A
  • Pregnancy – over the uterus.
  • Pacemaker – not over pacemaker
  • Cancer- not over cancer site.
  • On or near DVT
  • Over the carotid sinus
54
Q

***What are 4 SAFETY considerations for E. Stim?

A
  • Electrical “shock” is first felt as tingling at 1mA
  • Motor response occurs at 5mA
  • An inability to let go occurs around 20 mA
  • Ventricular fibrillation – 80 mA.
    (Ventricular defibrillation=electric shock given, to start heart again) – 6A. Burns at 12 A
55
Q

**What are 4 Pre-treatment guidelines?

A
  • **Ask history of ES (experience with electrical stimulation)
  • Ask about CI’s (Contraindications)
  • Inspect skin (ex. if medal staples)
  • Sensation check
56
Q

**During Treatment Guidelines?

A
  • give patient instructions on what to expect

(ex. TENS= comfortably strong
NMES=need contraction)

-give patient call BELL

57
Q

What are the 2 types of EXCITABLE CELLS?

A
  • nerve cells

- muscle cells

58
Q

What does EXCITABLE mean?

A

the cells have the ability to have their cell membranes altered to allow ionic changes in potential across the membrane (forcing the movement of sodium/potassium across membrane

59
Q

What is the RMP (Resting Membrane Potential)?

A

-60 - 90 mv

60
Q

**What is Action Potential?

A

-reaching THRESHOLD (which causes a rapid reversals of polarity)

61
Q

**What do Nodes of Ranvier do?

A

-speed up transmission (because myelin sheath jumps from space to space to speed it up)

62
Q

(What are T tubules and the sarcoplamic reticulum?)

A
  • transverse tubule: a deep hole
  • plasma membrane of muscle

(-allow depolarization of membrane to quickly penetrate to the interior of the cell)

63
Q

What is neurotransmitter?

A

a chemical substance that transfers the impulse to another nerve fiber (by crossing a synapse)

64
Q

What is the function of calcium?

A

calcium channnels open and calcium rushes into the neutron terminal during an action potential
- “calcium influx”

65
Q

What is Tetany?

How does strength of contraction increase?

A

a sum of twitches

-more motor units recruit/contract

66
Q

When we VOLUNTARILY stimulate mm (muscle) we recruit which motor units (large or small)?

A

small=Type 1 first

67
Q

When we stimulate with ELECTRICAL stimulation, we recruit which motor units (large or small)?

A

Large=it’s reversed from voluntarily contracting muscle

  • your muscles fatigue!
68
Q

What are the 2 excitable cell properties that effect how much of a stimulus is required for depolarization ?

A
  • Resistance

- Capacitance

69
Q

What does A-Alpha respond to

A
  • Short duration and

- Low Intensity

70
Q

Positive pole is:

Negative pole is:

A
  • anode

- cathode

71
Q

What kind of relationship is there for Current Density and SIZE (of electrode)?

A

inverse relationship

72
Q

Smaller electrodes permit deeper…

A

penetration

73
Q

Where is calcium stored?

A
  • sarcoplasmic reticulum

of the muscle cell

Therapeutic Modalities (Lecture) (9 decks)

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