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508 > Cryotherapy > Flashcards

Cryotherapy Flashcards

1
Q

Where do you see the effects of cold

A

systemic and localized

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2
Q

what kind of effect does cold have

A 
hemodynamic on circulation of blood (cold applied for greater than 15 min and below 1 C leads to vasodilation)
reduces local metabolic activity of underlying tissue 
slows n conduction
reduces muscle spasms and guarding 
analgesia
reduce edema 
changes in mm strength
neuromuscular inhibition/facilitation 
herapeutic effects
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3
Q

Time lengths of inhibition and facilitation

A 
inhibition= prolonged
facilitation= short term
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4
Q

What are the effects of cooling dependent on

A

type of agent
duration
mm to adipose ratio
depth of tissue to be treated

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5
Q

what is the most predictable and effective way to apply cold

A

ice/water bath

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6
Q

Why is icing less effective w/ obese pts

A

adipose is an insulator and doesn’t conduct energy well

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7
Q

How to transmit cold

A

conduction
convection
evaporation

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8
Q

What is superficial cooling used with most often

A

neuromuscular and musculoskeletal conditions

acute injury

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9
Q

When is superficial cooling most effective

A

when used as a prep or adjuct method to therapy

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10
Q

What are the purposes of superficial cooling

A

analgesia
lower edema
decrease muscle spasms

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11
Q

What are the 4 stages of sensation

A
  1. intense cold sensation and hyperemia (skin reddening)
  2. Burning
  3. Deep ache
  4. Analgesia
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12
Q

Wha are stages 1-3 like

A

painful and uncomfortable

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13
Q

What are biophyscial effects dependent on

A

time of exposure
method used
conductivity of the tissue

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14
Q

How long should it take to progress through all 4 stages

A

10 min with ice massage but no set time to advance through stages

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15
Q

What are the first n fibers to be affected by cold

A

small, myelinated pain fibers

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16
Q

Why are the small fibers affected first

A

they are myelinated and fatty so they dont conduct and are the 1st t be affected

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17
Q

How long does it normally take for changes in conduction velocity to occur

A

5 min

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18
Q

how long does it in conduction velocity take to reverse the effects

A

15 min

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19
Q

Increased duration of application leads to

A

increase in time it takes for conduction velocity to return to normal
(use this time for ther. act.)
(pain protective purpose is decreased during this time so use caution)

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20
Q

What is the immediate respone to cooling

A

Vasoconstriction

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21
Q

how long does vasoconstriciton continue in cooling

A

15 min

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22
Q

What happens after 15 min of vasoconstriction

A

vasodilation

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23
Q

What is the process of vasoconstriction to vasodilation called

A

hunting response

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24
Q

How to treat pt with acutre trauma

A

combine cold, elevation, and compression

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25
Q

Price acronym for acute traum

A 
Pressure
Rest
ice
Compression
Elevation
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26
Q

What should you never apply cold to

A

Skin graft

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27
Q

Why should you never apply cold to a skin graft

A

slows metabolic reactions of inflammation and healing proces

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28
Q

what kind of cold do you use for post surgical pts

A

less intense (cold pack, ice bag)

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29
Q

how long to ice for post surgical ts

A

3-4x/day

20-30 min

30
Q

What to combine with cold for post durgical pts

A

compression and elevation

31
Q

What does elevation of the superficial temp of the injured area do

A

lowers risk of infection

prevents more severe trauma

32
Q

What do muscle spasms lead to

A

pain and decreased ROM

33
Q

how does cold decrease muscle spasms

A

through the muscle spindle mechanism

34
Q

What do you combine cold with for muscle spasms

A

static positional stretch o r contract relax technique

35
Q

How long to cool for muscle spasms

A

10-20 min

36
Q

How long to col for muscle spasticity

A

up to 30 min

followed by 10-20 min for tone to decrease

37
Q

How long will cold reduce spasticity for

A

approx 1 hr

38
Q

What does cooling do to muscle activity

A

decreases FM ability

39
Q

what is inaccurate after coolin

A

measuring grip or pinch

40
Q

What should be the 1st PAM choice after acutre injur

A

cold (esp w/ edema)

41
Q

How to apply cold after acute injury

A

20-30 min per 2 hr period for 1st 6-24 hrs

42
Q

What to use cryotherapy for

A 
acute/subacute inflammation 
acute/chronic pain secondary to muscle spasms 
Acute swelling 
myofascial trigger points 
muscle guarding 
muscle spas
acute mm/lig strain 
acute contusion
bursitis
tenosynovitis
arthritic flare up
spasticity
delayed mm onset soreness
postexercise to maintain longation
43
Q

what is important in cold packs

A

conformity

44
Q

what can cold packs be combine with

A

elevation

45
Q

how much surface area to cover with cold packs

A

from orgin to insertion

46
Q

what is ice massage used for

A

to anesthitize an area

trigger points

47
Q

What will impede effectiveness of ice massage

A

adipose tissue

48
Q

what area is ice massage used for

A

small localizzed area

49
Q

What are cold/ice water immersion baths used with

A

compression wrapping and compression garments

50
Q

What are cold/ice water immersion baths used for

A

digital and hand injuries (use generally up to mid thigh)

51
Q

What is the water temp for immersion bath

A

35-75

52
Q

What do immersion baths help do

A

reduce edema

53
Q

What do ice towels contain

A

ice chips or are dipped in ice water

54
Q

how ofter to change ice towes

A

every 5-6 min

55
Q

What do ice towels work for

A

spasticity

56
Q

how to apply ice towel

A

circumferentially cover extremity

57
Q

What is a cold compression unit

A

refrigerated units that circulate coled air and water through a sleeve

58
Q

When to use cold compression units

A

post surgical

musculoskeletal injuries

59
Q

What is vapocoolant spray used for

A

trigger points

60
Q

How to use vapocoolant spray

A

spray entire length of mm un unidirectionl motion w/ passive stretch

61
Q

Cryotherapy precautions

A

careful/frequent skin monitoring
never place directly on skin
never place longer than 20 min
vapocoolant sprays can freeze on contact
protective sensation is removed during numbness
in distal extremities, too much cold can lead to edema
monitor BP (cold can increase it)
avoid in those w/ poor circulation, hypersensitivity to cold
avoid directly over wounds 2-3 wk post injury
avoid prolonged placement over superficial nerve

62
Q

Cryotherapy contraindications

A 
skin grafts
deep open wounds
raynauds disease 
cold urticaria 
cryoglobulimemia 
history or presence of frostbite
impaired sensation
inability to verbalize sensation
med condition which vasoconstriction will aggravate symptoms
peripheral vascular disease 
hypersensitivity to cold 
skin conditions
63
Q

Any form of cryotherapy should never be what

A

Used for longer than one continuous hour

64
Q

What is cold urticaria

A

cold hypersensitivity or cold allergy

65
Q

Reactions from cold urticaria

A 
Wheals
sneezing
dysphasia
increased HR
Decreased BP
Syncope
66
Q

What is cryoglobulinemia

A

blood becomes gel like
cold reaction= abnormal collection of blood proteins that form a gel in small vessels that leads to tissue ischemia or gangrene

67
Q

Things you see in Raynaud’s disease

A 
Pallor
cyanosis
Rubor
numbness
tingling
buring sensation in digits
68
Q

Where does Raynauds occur

A

in distal extremities

69
Q

what is raynauds phenomenon associated with

A

Carpal Tunnel
thoracic outlet
frost bite
traumatic injuries

70
Q

Where does raynauds only occur in

A

cooled extremity

71
Q

What to document in cryotherapy

A 
tx parameters (purpose for use)
duration
site of application
method used
patient comments
response to tx (4 stages)
any change in occu performance
72
Q

What is the general rule fro cryotherapy

A

apply cold for 10-20 min max

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