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Ther Ex 1 > E stim > Flashcards

E stim Flashcards

1
Q

which body structure is the best electrical conductor?

A

blood

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2
Q

which body structure is the poorest conductor?

A

bone

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3
Q

which body structures are good conductors?

A

blood
nerve
muscle

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4
Q

which body structures are poor conductors?

A

skin
fat
tendon
bone

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5
Q

what is intensity?

A

stimulation or amplitude

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6
Q

what is pulse duration?

A

current pulse length
changed to target specific structures

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7
Q

what is capacitance?

A

the ability of tissue to store electricity

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8
Q

in what order are neurons stimulated from least capacitance to highest?

A

AB
AD
C
muscle fiber
muscle tissue

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9
Q

when turning the amplitude up on an e stim unit, what is the order in which nerve are stimulated?

A

AB (tingle feeling - sensory only)
motor
AD (stimulated with chronic pain)
C (dull pain)
denervated muscle

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10
Q

what are the pain relieving e stims?

A

IFC
Tens

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11
Q

what frequency does tetany occur at?

A

50 pps (Hz)

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12
Q

where is the site of depolarization?

A

cathode

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13
Q

what is the waveform for NMES or FES?

A

pulsed at 1-500 hz

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14
Q

what is the waveform and frequency for Russian currents?

A

pulsatile biphasic
2,000 - 10,000 hz

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15
Q

what is the waveform for interferential currents (IFC)?

A

interfered biphasic continuous
1,000 - 10,000 hz

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16
Q

what is the waveform for high-volt pulsed current?

A

twin-peaked pulsed waveform

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17
Q

what is the waveform for transcutaneous electrical nerve stimulation (TENS)?

A

asymmetric biphasic currents

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18
Q

what is low-volt current (DC) used for?

A

iontophoresis

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19
Q

where is the electrode placed for strengthening e stim?

A

at the motor point

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20
Q

motor point is where the threshold is the ___ for a given electrical input

A

lowest

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21
Q

what are the main uses of high-volt currents?

A

reducing edema
wound healing

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22
Q

conventional TENS:
____ rate
____ intensity
best for ___ pain
theory?

A

high rate
low intensity (sensory level)
acute
gate control theory (stimulate AB)

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23
Q

acupuncture-like TENS:
____ rate
____ intensity
best for ___ pain
theory?

A

low rate
high intensity (motor level)
chronic
descending pain control theory (release of enkephalin)

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24
Q

noxious-level TENS:
________ analgesia
theory?

A

hyperstimulation
endogenous opiate pain control theory

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25
Q

brief intense TENS:
____ rate
____ intensity
best for ___ pain
theory?

A

high rate
high intensity
fast pain relief during wound debridement
peripheral and central analgesia

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26
Q

conventional TENS:
frequency:
duration:
time:
theory:

A

frequency: 80-125 pps
duration: 70-150 microseconds
time: 30mins-few hrs
theory: gate control theory

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27
Q

low-frequency (acupuncture) TENS:
frequency:
duration:
intensity:
duty:
time:
theory:

A

frequency: <20 pps
duration: 100-600 microseconds
intensity: elicit sensory and motor
duty: 30s-60s on
time: 15-60 mins
theory: descending pain control theory

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28
Q

noxious level TENS:
frequency:
duration:
duty:
time:
theory:

A

frequency: 1-5 pps
duration: 100-1000 microsec
duty: 30-45 sec off
time: until pain no longer perceived
theory: endogenous opiate pain control

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29
Q

brief intense TENS:
frequency:
duration:
intensity:
time:
theory:

A

frequency: 100 pps
duration: 100-600 microsec
intensity: sustained muscle contraction
time: ~15 mins
theory: peripheral & central analgesia

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30
Q

which e stim is used during wound debridement?

A

brief intense TENS

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31
Q

main uses for IFC

A

pain control
reduce mm spasms

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32
Q

which type of e stim uses 4 pads in a diagonal pattern that produces sine waves at different frequencies?

A

IFC

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33
Q

what are some ways/settings that can be used to vary e stim in order to prevent the body from habituating to IFC?

A

target mode
sweep
scan

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34
Q

contraindications for e stim

A

pacemaker or auto defibrillator
thrombosis or occlusive vascular disease
confused and/or disoriented
internal stimulator
seizure disorder
infection
open wounds
malignancies
pregnancy
MSK Issue where contraction worsens it
high level SC injury

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35
Q

where should electrode NOT be placed?

A

chest or near heart
over carotid sinus (C3/C4)
over open wound, scars, skin lesions, areas receiving radiation therapy, protruding metal implants

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36
Q

electrons are ____ charged

A

negatively

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37
Q

what is an ampere?

A

indicates the rate

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38
Q

what is the current?

A

net movement of electrons from higher potential to lower potential

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39
Q

what is the electromotive force called?

A

volt

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40
Q

what is conductance?

A

the ease at which current flows along a conducting medium

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41
Q

what resists current flow?

A

insulators

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42
Q

what is ohm’s law?

A

the current in a circuit is directly proportional to the voltage and inversely proportional to the resistance
(current flow = voltage/resistance)

43
Q

resistance to current flow (amp) is also known as

A

ohm

44
Q

resistance of electrical flow depends on

A

the characteristics of the conductor

45
Q

as the frequency goes up, skin impedance does _____

A

down

46
Q

what are the 3 types of current?

A

biphasic = AC
monophasic = DC
pulsatile = PC (ex: EKG)

47
Q

electrons always moves from _____ to ___

A

negative to positive

48
Q

chemical reactions are balanced when currents are

A

balanced

49
Q

what type of e stim is AC?

A

biphasic, TENS, IFC

50
Q

which type of current may be uncomfortable?

A

DC

51
Q

which type of e stim is DC?

A

iontophorsis
note: monophasic

52
Q

which type of current causes an accumulation of chemicals?

A

DC (iontophoresis)

53
Q

which type of e stim has a pulsed current?

A

hi volt
Russian
*most nerve/muscle stimulating currents

54
Q

what is the accommodation phenomenon?

A

a fiber has been subjected to a constant level of depolarization will become unexcitable at that same intensity (amplitude)

55
Q

T/F: current usually flows from electrode to electrode.

A

F
flows thru nerves and muscle = path of least resistance

56
Q

the higher the ____ the longer before a response

A

capacitance

57
Q

capacitance in a tissue can be reduced by increased ______

A

stimulation frequency

58
Q

an increase in the diameter of the nerve ____ the capacitance

A

decreased

59
Q

increased intensity is need to stimulate nerve with _____ capacitance

A

higher

60
Q

pulse applies to _____ current and cycle refers to a ____ current

A

pulse - monophasic (DC)
cycle - biphasic (AC)

61
Q

amplitude is synonymous with

A

voltage and intensity

62
Q

how can total current increase

A

increasing pulse duration or pulse frequency

63
Q

what determines the amount of chemical formed with DC?

A

pulse charge

64
Q

which current always has a pulse charge >0?

A

monophasic (DC)

65
Q

which current has no pulse charge and is the sum of phase charges?

A

biphasic

66
Q

symmetric wave has a pulse charge of?
asymmetric?

A

symmetric - 0
asymmetric >0 (monophasic)

67
Q

which is more comfortable for the patient? a fast or slow pulse rise

A

slow
doesn’t decrease skin impedance
needs more voltage for same flow

68
Q

which duty ratio causes the most muscle fatigue? least?

A

most = 1:1
least/none: 1:7
(1:5 intermediate)

69
Q

what is pulse duration?

A

length of time current is flowing in 1 cycle

70
Q

____ determines which tissues are stimulated

A

phase duration

71
Q

what is frequency?

A

the number of impulses or cycles produced by electrical stimulating device in 1 sec

72
Q

skin impedance ___ as the inter-electrode distance increases

A

increases

73
Q

skin impedance ____ as frequency decreases

A

increases

74
Q

_____ intensity reaches to deeper tissues

A

higher

75
Q

what is the negative electrode called?

A

cathode (distal)

76
Q

what is the positive electrode called?

A

anode (proximal)

77
Q

which electrode must be active to cause muscle contraction?

A

negative (cathode)

78
Q

chemical effects are caused by which e stim type under what electrode?

A

hi-volt
cathode

79
Q

how far apart should electrodes be placed?

A

1.5 times the electrode’s width

80
Q
A
81
Q

which has a greater current density? active or dispersed (esp for DC)

A

active

82
Q

anode has a ____ effect
cathode has a ____ effect
acidic/basic

A

anode - acidic
cathode - alkaline/basic

83
Q

current carries a ___ charge

A

negative

84
Q

____ moves in during depolarization
____ moves out during repolarization

A

NA+
K+

85
Q

what is the rest charge of the cell membrane?

A

-70 to -90

86
Q

what is the strengthe-duration curvre?

A

threshold for depolarization of a particular nerve fiber

87
Q

what is rheobase?

A

the intensity of a current necessary to cause observable tissue RESPONSE

88
Q

what is chronaxie?

A

duration requires for a current of twice the intensity of rhoebase to produce tissue ECITATION

89
Q

which nerves depolarize first?

A

large and more superficial

90
Q

T/F: e stim causes stimulation of fibroblasts and osteoblasts

A

T

91
Q

which nerve fiber are activated for noxious response?

A

AD and C

92
Q

electrically induced contraction recruits type ___ fibers first

A

2

93
Q

T/F: GTOs can inhibit with electrically induced muscle contraction

A

F

94
Q

____ polarity hi volt is used for wound inflammatory phase

A

negative

95
Q

____ polarity hi volt is used for would proliferative phase

A

positive

96
Q

uses for Russian current

A

muscle strengthening
muscle re-ed

97
Q

is russian AC or DC?

A

AC

98
Q

electrode pattern difference between tens and IFC?

A

IFC crossed
TENS up & down patterns

99
Q

electrode pattern difference between premod and IFC?

A

premod - 2 pads
IFC 4 pads

100
Q

for IFC, which mode alters frequency? amplitude?

A

frequency - sweep
amplitude - scan

101
Q

which IFC pattern is good for poorly localized pain?

A

scan

102
Q

what is the pulse rate and duration for NMES or FES?

A

pulse rate: 35-55 pps
duration: 200-600 microsec

103
Q

how should electrodes be oriented?

A

parallel to muscle fibers

104
Q

what is the on and off settings for HVPC, med. freq. for retardation of atrophy?

A

on: 6-15 sec
off: 1 min

Ther Ex 1 (7 decks)

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