Chpt.2: *Heat and Cold Flashcards
Who recognized the benefits of heat to promote relaxation and ice to control swelling ?
Hippocrates (410 BC)
What are the 5 mechanisms of heat exchange?
- conduction (through something)
- convection, (warmer parts move up and the colder parts move down)
- conversion (process of changing from one form/ state to another)
- radiation
- evaporation
Which fiber is stimulated in the Gate control theory of Pain when heat/ice is applied?
A-Beta fiber
What does Adipose tissue act as ?
acts as insulation to tissues, thus limiting the degree of temperature change in deeper tissues
*What is Conduction? hot pack
heat loss or gain through direct contact between materials with different temps. (ex. hot pack)
*What is Convection: ? whirpool/ blow dryer
Movement of air or water currents around the body to transfer heatEg. Whirlpool (hot or cool)- Ex. Blow dryer
*What is Radiation: ?
transfer of heat from a warmer source to a cooler source. Eg. A heat lamp
*What is Conversion ?
temp change; that happens when energy is transformed from one form to another. Eg. Ultrasound (mechanical energy to thermal energy)
*What is Evaporation:?
transformation from a liquid to a gas. This requires an energy exchange. Eg. Sweating.
What’s an example of therapeutic heat at a superficial level?
How deep do the the deep heating modalities penetrate at SUPERFICIAL level?
- hot packs
- paraffin
1-3 cm
What’s an example of therapeutic heat at a deep level?
How deep do the the deep heating modalities penetrate at DEEP level?
- diathermy
- ultrasound
3-5 cm
*What is the tissue temperatures for body heating?
Mild?
Vigorous?
- Mild (less than 40 degrees C)
- Vigorous (more than 45 degrees C)
*What are some treatment goals for heat?
- helps reduce PAIN which can leads to increase in ROM and function
- Can reduce spasm and guarding
- Improve tissue extensibility
- Decrease pain
Who suggested that HEAT produced a counter-irritant?
Meaning that the body couldn’t fully feel the pain because of heat
Gammon
How does heat and exercise relate to strength?
there’s an initial decrease in strength 30 min after heat was applied but an increase 2.5 hrs later
How long does it take to reach max. temperature in subcutaneous tissue?
6-8 min.
? (dont know if need to know)
To reach depth of 3 cm, how long do you need to put on the heat pad?
15-30 min
What is the temperature of a Hydrocollator?
How long does the hot pack take to re-heat after use?
71-79 degree C
20-30min
What does heat delivered by conduction and the temp. change depend on when putting on a hot pack?
- Size of area being treated
- Temp of the pack
- And duration of application
Maxim. skin temp. is REACHED within how many minutes? and MAINTAINED for how many minutes?
10min
10min
What are 6 Contraindications for Heat Applications?
- Acute injury/inflammation
- Uncovered open wounds
- Compromised circulation (ex. Peripheral disease)
- Anesthetic (numb) skin
- Application directly to eyes or genitals
- Application directly over the abdomen during pregnancy
What are the step to take before applying heat?
- Skin has been checked
- Sensation and discrimination is checked
- History re. Heat is asked
- Area exposed.
- **Are lotions or ointments used?
- Explain to patient what to expect!
- Leave for 2-3 minutes and re-check.
- It should begin to get pink and warm – NOT HOT.
- Normally do not lie on Hot Packs! (especially someone with OA)
What is Fluidotherapy?
How does it function?
What 2 receptors does it stimulate?
Movement of Hot air on skin
-machine that moves particles by CONVECTIVE currents of hot air.
- mechanoreceptors
- thermoreceptors
What is Diathermy?
(Heating someone by microwaving them)
-deep heating agent that increases heat at tissue depths without overheating the skin and fat
Why is Diathermy rarely used in clinical settings?
due to high number of contraindications
What is Cryotherapy used for mainly?
ex. (Cryo-cuff)
edema;
Cryo= COLD
Cold therapy-cold packs, ice massage, and cold whirpool
What can happen to your skin if temperate is sufficiently (below 15 Celcius) cooled?
Reflex Vasodilation (your body feels hot, because all the blood flows back)
If below 10 degrees, tissue what may occur?
tissue damage
What are some treatment goals for Cryotherapy?
*similar to heat
- Pain: A beta and C fiber stim
- Muscle Spasm : decrease muscle spindle activity
- Inflammation : vasoconstriction
- Edema: vasoconstriction
What are some indications/methods of Cold application?
- Ice Massage
- Cold Packs
- Ice bath
What are indications for Ice Massage?
- used for small areas
- Intense cold
- cover an area 10-15cm for 5-10 min.
- Patient will experience: cold, burning, aching and then numb.
What are some Cold Precautions? (4)
- Patients with thermoregulation problems
- Sensory deficits
- Hypersensitivity to cold
- Cold can elevate BP (Hypertensive patients should be monitored during treatment)
What are some Contraindications for Cryotherapy? (2)
-Patients with cold sensitivities
(hives, drop in BP, facial flushing, an increase in HR and syncope)=someone could even pass out
-Raynaud’s disease=hands always feel cold
What should be included in Documentation for therapy? (7)
- Type of modality (Hot pack, Paraffin….)
- Area treated
- Position of patient
- Time of tx
- Subjective response to last tx
- Pain scale
- Objective measure of: (girth, ROM, strength etc.)
Two examples of deep heating?
- Ultrasound
- Short wave diathermy
How does HEAT decrease pain and spasm?
Gaiting; stimulates sensory nerves (can decrease the firing of the stimuli, and increase GTO)
What are some Contraindications for heat and ice? ?
- Lack of sensation (anasthetic skin)
- open wounds on the skin,
- peripheral vascular disease,
- cold sensitivities
What are the explanations for ice?
- Feel cold
- burn,
- ache
- will be numb later on
Why heat vs. cold?
Heat; for CHRONIC conditions (no signs of inflammation) improve tissue extensibility (stretches)
