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S2 PTA 103 techniques > E-stim > Flashcards

E-stim Flashcards

1
Q

Basic concepts of electrical current

A
  • all matter is composed of ions that posses electrical energy
  • ions move from an area of higher concentration to an area of lower concentration
  • the more ions an object has, the higher the electrical postential
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2
Q

Electrical potential

A

Electrical force capable of propelling particles from higher to lower energy levels

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3
Q

Electrical current

A

The net movement of electrons

  • always move from higher to lower concentración
  • the rate at which current flows is measured in amperes (therapeutic purposes mA or microA)
  • potential difference between 2 points makes electromotive force that provides movement of electrons (volt)
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4
Q

Voltage

A

The force resulting from an accumulation of electrons at one point in the electrical circuit
- usually corresponds to the deficit at another point

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5
Q

Conductors

A

Materials that permit free movement of electrons

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6
Q

Watt

A

Amount of energy or power produced

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7
Q

Electrotherapeutic currents

A
  1. DC: monophasic or Direct/Galvanic unidirectional flow of charged particles
  2. AC biphasic or Alternating bidirectional flow of charged particles (reversing polarity)
  3. PC polyphasic or Pulsatile an alternating current that is modified to produce 3+ phases in a single pulse; pulses are interrupted and repeated
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8
Q

Pic

A

Pic

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9
Q

Continuous mode

A

Uninterrupted flow of current

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10
Q

Interrupted mode

A

Intermittent cessation of flow for a second or more

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11
Q

Surge mode

A

A gradual increase/decrease in intensity over a period of time

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12
Q

Ramped mode

A

A gradual rise of intensity (set time), then.a maintained intensity (for a set time), followed by either a gradual decrease or abrupt decline in intensity

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13
Q

Physiology

A
  • properties of excitable cells
  • electrical action of mm and nerve
  • motor point
  • types of mm contraction
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14
Q

RMP

A

Resting membrane potential

  • the cell membrane is more permeable to K+ compared to Na+ and negatively charged proteins
  • RMP is -60 to -90 mV for excitable cells
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15
Q

AP

A

Action potential

  • generated when the influx of Na+ causes a deduction in RMP (depolarization)
  • K+ channels fully open and Na+ channels close (repolarization)
  • K+ remain open long enough to repolarization membrane to 10-20mV < RMP (hyperpolarization)
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16
Q

Propagation of AP

A

AP movement along surface of cell

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17
Q

Electrical actions

A

ES characteristic required to initiate excitable cell depolarization

  • amplitude or intensity of the stimulus must be great enough to cause membrane potential to be lowered to threshold levels
  • duration of stimulus must be long enough to produce depolarization
  • the rate that the current rises to peak intensity should be fast enough to prevent accommodation
18
Q

Motor point

A

Arena of greatest excitability on the skin surface

  • where the smallest amount of current generates a mm response
  • located at/near where the motor nerve enters the mm for an innervated mm
  • located over the mm dismally, or toward the insertion, Ford enervated mm
19
Q

Brief mm twitch or contraction

A

Each stimulus is produced by a low-frequency pulse (1-10 Hz)

20
Q

Tetany

A

Increasing the number of stimuli (frequency) will progressively fuse the individual mm twitches to a sustained contraction

21
Q

Vermicular

A

An asynchronous or wormlike mm response is noted in denervated mm
- or when almost on motor point but not quite

22
Q

E-stim indications

A 
Pain modulation 
Mm guarding/spasm decrease 
Mm strengthening/re-edu
ROM increase
Swelling/inflammation decrease
Wound healing
Fracture healing
 Transdermal drug delivery
23
Q

How does e-stim work

A

Uses an electrical current to creat a physiological change by targeting afferent nerve pathways to include sensory, motor, and pain fibers

24
Q

How does e-stim cause a change in the nerve fibers of the PNS?

A

Action potentials
- the flow of charged particles depolarizers nerve membranes producing an action potiential with enough simulation to cause a physiological change

25
Q

E-stim precautions

A 
Skin- irritation, wounds, sensation 
Cancer
Cognition decrease
Cardiac decrease
Hypo/hypertension 
Pregnancy 
Bleeding disorders
Edema
Excessive adipose tissue
26
Q

E-stim contras

A 
Pacemaker
Epilepsy
Active bleeding/infection
Donut preggy belly
Dont place over:
  Carotid
  Thrombosis
  Eyeball
  Phrenic nerve
  Bladder stimulator 
  Pharyngeal/laryngeal mm
  Superficial metal implants 
  Transcerebral/thoracic regions
27
Q

E-stim adverse reactions

A
  • electrical burns
  • skin irritation from adhesive
  • pain
  • sensitivity to e-stim (rash, redness)
28
Q

TENS

A

Transcutaneous electrical nerve stimulation

Indications: pain control and modulation

29
Q

Gate control theory

A

Stimulation of non-noxious fibers will interfere with noxious transmission to the brain to decrease the perception of pain (at the level of the spinal cord)

30
Q

Endogenous opioid system

A

Stimulation of endorphins bind with opiate receptors to amuse an inhibitory response
- occurs with stimulation of motor nerve fibers

31
Q

Amplitude

A

Intensity: the current strength or voltage

32
Q

Pulse duration

A

Pulse width: the time to complete one +/- cycle in microseconds

33
Q

Frequency

A

PPS or Hz. The number of pulses delivered by the ES to the body or number of times the nerve is stimulated in 1 second

34
Q

Therapeutic frequencies of E-stim application

A

1-10 Hz creates a tapping effect
35-50 Hz creates smooth muscle contraction
80-150 creates a sensory effect

35
Q

TENS pic

36
Q

Conventional TENS

A

High rate - Better for ACUTE PAIN conditions. Effects last only as long as stimulation is applied; use various modes to decrease accommodation

37
Q

Accommmodation phenomenon

A

When an unchanged, constant stimulus is applied this leads to a decrease in nerve excitability with decreased perception of a sensation after a period of time with the same sensory input

38
Q

Low rate TENS

A

Acupuncture like - better fro CHRONIC PAIN conditions. With increased use, can lead to DOMS. Less accommodation than with high rate

39
Q

Modes of TENS

A
  1. Continuous: frequency, pulse width, and intensity stay as set without change
  2. Burst: gradual increase in intensity which peaks, then decreases in intensity and cycles on/off
  3. Modulated: any pattern variation of frequency, pulse width, intensity, randomly set by the unit
40
Q

Pad placement for TENS

A
  • 2-4 pads (size of area)
  • place pads on or around area of pain
  • place along a nerve to assist with desensitization
  • place on trigger point
  • place along mm fibers (best with acupuncture TENS)
  • 1 inch apart!

S2 PTA 103 techniques (10 decks)

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