Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Skills 2 > E-stim: foundations > Flashcards

E-stim: foundations Flashcards

1
Q

What is e-stim

A
  • the electrical current as a flow of electrons
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is e-stim used for

A
  • used with other interventions
  • Used to manage acute, chronic, and postoperative pain
  • produce muscle contractions
  • promote tissue healing
  • enhance transdermal drug delivery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why would you use E-stim to produce muscle contractions

A
  • strength and re-education
  • prevent atrophy/reduce edema
  • prevent DVT formation
  • reduce muscle spasms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Effects of electrical currents

Are the result of what

A
  • the clinical effects of e-stim are the result of current stimulating the production of Action potentials in sensory and/or motor nerves
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does the speed of transmission depend on within the NS

A
  • diameter of nerve
  • myelinated/non-myelinated
  • larger diameter - fast transmission
  • myleination = faster
  • physiologically the AP travels in one direction but E=stim can cause AP in both directions from the site of stimulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Primary Afferent neurons that are associated with pain

A
  • A-beta fibers: large myelinated axons (fast, discriminative touch)
  • A-delta fibers: smaller than A-beta fibers, myelinated (ALST - pain)
  • C-fibers: small, unmyelinated nerve fibers (ALST - pain)
    all 3 work together – 1st you feel where then you fell pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Primary Efferent neurons

A
  • large and myleinateted (fast)
  • slow-twitch type 1 fibers usually smaller than fast-twist type 2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Strength -duration curve

A
  • Abeta sensory stimulated 1st
  • motor neurons
  • A delta - sharp pain
  • C dull pain
  • Denervated muscle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Electrical current parameters/wavefroms

A
  • graphic representation of wave
  • generally 3 types
    1. direct current (monophasic)
    2. Alternating current (biphasic)
    3. Pulsed current (can be mono or biphasic)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Direct current

A
  • a continuous unidirectional flow of charge electrons for at least 1 second
  • commonly used for iontophoresis and stimulating contraction in denervated muscle
  • Direct DC and interrupted DC are most commonly used forms
  • used when the charge matters to attract or repel specific cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Alternating current

A
  • a continous bi-directional flow of charged particles used for pain control and muscle contraction
  • BUT it needs to be modulated to be effected
  • modulated so that brain does not get use to it
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Biphasic pulsed current– other variables

Typesof biphasic pulsed current

A
  • symmetrical: same shape, same energy within each phase
  • balanced asymmetrical: different shape but that same amount of energy within each phase
  • unbalanced asymmetrical: different shapes and different amount of energy within each phase; this current will have a residual net charge
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

E-stim parameters

A
  • pulse duration (width)
  • phase duration
  • interpulse interval
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

pulse duration

A
  • the time from the beginning of the first pulse to the end of the pulse
  • measured in microseconds, miliseconds
  • AKA width
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Phase duration

A
  • the period when current is flowing in one direction
  • if the pulsed current is symmetrical then the phase duration is 1/2 the pulse duration
  • important parameter for comfort and crucial to achieve a muscle contraction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Interpulse interval

A
  • the amount of time between pulses
17
Q

Amplitude

A
  • AKA intensity, strength, voltage
  • units can be milliamps, microamps, volts
18
Q

Frequency

A
  • numbers of cycles or pulses per second
  • often referred to as the rate
  • the length of the interpose interval decreases as frequency increases
19
Q

On/off time

A
  • a period of cycling and a period of rest
  • used commonly for muscle contraction so a muscle is not contracting for 10 minutes straight
20
Q

ramp up/ramp down

A
  • the pulse comes on suddenly and goes up instead of all at once
21
Q

Adaptation

A
  • a decrease in the frequency of AP’s and a decrease in the subjective sensation of stimulation in response to e-stim with unchanging parameters
  • “I don’t feel it anymore”
22
Q

accommodation

A
  • an increase in the threshold to nerve excitation
  • need to turn it higher to get intended response
23
Q

current

A
  • the directed flow of free electrons from one place to another
24
Q

modulation

A
  • any parameter or variation in one or more of the stimulation parameters
  • used to limit neural adaptation
25
Q

Burst mode

A
  • a current composed of a series of pulses in groups know as bursts
26
Q

anode

A
  • the positive electrode
27
Q

cathode

A
  • the negative electrode
28
Q

current density

A

the amount of current per unit area

29
Q

impedence

A

the opposition or resistance to the flow of charge

30
Q

Describing the current requires

A
  1. the waveform type
  2. the pulse frequency (rate)
  3. the pulse duration (width)
31
Q

Contraindications fo E-stim

A
  • demand pacemakers/implantable cardiac defibrillators
  • unstable arrhythmias
  • Over carotids
  • venous or arterial thrombosis or thrombophlebitis
  • pelvis, abdomen, trunk and low back during pregnancy
  • over metal implants
32
Q

Precautions for E-stim

A
  • cardiac disease
  • impaired sensation
  • impaired cognition
  • malignant tumors
  • skin irritation
  • open wounds
33
Q

Adverse effects of E-stim

A
  • burns
  • skin irritation/inflammation
  • some find it painful
34
Q

Coupling medium

A
  • required to reduce impedance and enhance conductivity between the electrode and skin
  • conductive gel, cream or liquid
  • sponges or gauze pads soaked in tap water
  • self-adhesive conductive polymer
35
Q

Application technique

A
  • assess sensation to light touch
  • position patient properly
  • protect modesty and comfort
  • clean the skin with soap and water (creams, analgesic gels etc can impede stimulation.)
  • choose the correct electrodes consider type, size and shape
  • electrodes should lie smoothly against the skin without wrinkles
  • do not place the electrodes over bony landmarks
  • space electrodes appropriately
36
Q

What happens when the electrodes are placed close together verse far apart

A
  • closer = superficial
  • further = deep
37
Q

With the same current which would give more current density

A
  • smaller electrodes
38
Q

When do you use an unbalanced stim

A
  • when charge matters
  • iontophoresis
  • wound care

Clinical Skills 2 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions