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OTH 608BL Physical Agent Modalities > Electrical Modalities > Flashcards

Electrical Modalities Flashcards

1
Q

Process of losing energy

A

attenuation

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2
Q

Reversed piezoelectrical effect

A

An AC (electrical charge) compresses a crystal creating a sound wave. This creates a mechanical response in the tissues in front of it.

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3
Q

What is phonopheresis

A

using ultrasound with a topical medication

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4
Q

What is absorbtion

A

how much the sound wave transfers to the tissue and limits penetration.

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5
Q

What is another word for continuous duty cycle?

A

Thermal US - 100%

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6
Q

What is the transmission medium

A

gel or lotion used for coupling

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7
Q

What’s another word for non-thermal?

A

pulsed duty cycle - 20%

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8
Q

What is stable cavitation

A

bubbles created by the pulsed (non-thermal) ultrasound

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9
Q

Define dose / intensity

A

strength of the acoustic energy at the site of the application. Measured in power per unit area of the sound heat = watts/centimeter squared w/cm2
0.1-2.0 w/cm2 is typical use for therapuetic purposes.

Must be greater than 1 to produce thermal effects.

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10
Q

What is the duty cycle for ultrasound?

A

percentage of time sound waves are delivered

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11
Q

What is beam non-uniformity?

A

BNR. This number reflects the intensity of the ultrasound output as it varies from the center of the sound head to the outer edges. Intensity is greatest at the center. (the unit’s ratio will tell the the ratio. typically 2:1

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12
Q

what is the effective radiating area

A

area on the transducer face where the ultrasound energy radiates. this is smaller than the actual size of the face of the transducer. This is why you have to move the transducer to a slightly larger area than you want to treat.

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13
Q

define frequency of electrical stim

A

number of compressions. rarefactions cycles per second. Increased frequency equals decreased depth of penetration. 1MHz or 3MHz.

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14
Q

define penetration of e stim

A

degree of sound wave passage

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15
Q

what is the transducer?

A

sound head

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16
Q

what setting on US will allow for a penetration depth of 1-2 cm deep?

A

3MHz

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17
Q

what setting on US will allow for a penetration depth of 2-5cm deep?

A

1MHz

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18
Q

define reflection

A

redirection of energy away in an equal and opposite direction. generally occurs at skin surface when not enough transmission medium

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19
Q

define refraction

A

energy blocked by tissue or scar

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20
Q

what is therapuetic US

A

medium intensity sound waves

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21
Q

What is an alternating current (more comfortable)

A

AC - characterized by periodic changes in polarity of current flow

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22
Q

What is a direct current

A

DC

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23
Q

What is bipolar of biphasic

A

pulse equal in both direction

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24
Q

What is low frequency TENS

A

Motor or acupuncture technique: good for more diffuse, throbbing, burning pain

1-4 pps, 150-200 micro sec, treatment time 30-45minutes. Looking for a gentle muscle twitch.

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25
Q

how would we describe an uncomfortable sensation under the electrode?

A

biting

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26
Q

What is a tetanic contraction?

A

strong muscle contraction

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27
Q

What is the ramp time?

A

time to turn on and off

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28
Q

What is low frequency TENS setting?

A

1-4 pps, 150-200 micro sec

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29
Q

What is conventions TENS setting?

A

50-100 pps, 0-100 micro sec

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30
Q

Why would we use ultrasound?

A

decrease pain, facilitate healing, increase blood flow

31
Q

When would you use thermal US

A

chronic conditions where it’s ok to use heat

32
Q

when would you use non-thermal or pulsed US

A

acute or subacute or if the person has a contraindication to heat.

33
Q

When would you use NMES

A

for strengthening or reeducating muscles due to weakness or paralysis.

34
Q

When would you use TENS

A

purely for pain management or desensitization.

35
Q

Which type of electrical stim is good for sharp well defined pain

A

Conventional TENS

36
Q

What is the endorphin theory for TENS

A

Motor level theory - must create a twitch. increase endorphins in the central and peripheral nervous system by stimulating the motor nerve

37
Q

Gate theory and TENS

A

Nociceptive nerve fibers (pain fibers) are C fibers that are poorly myelinated and therefore travel slowly.

Sensory nerve fivers are A-beta or Alpha A fibers which are highly myelinated and travel faster and bombard the hypothalamus.

competition of the two fibers results in sensory stimulation blocking the lesser myelinated pain fibers.

38
Q

Acupuncture theory

A

TENS alters the flow of energy

39
Q

Myofascial theory

A

TENS stimulates local vasodilation, which alters the trigger point to decrease pain.

40
Q

effects of iontophoresis

A

reduces inflammation of soft tissue. common for diagnoses of epicondylitis, bursitis, biceps tendonitis or dequiervains tenosynovitis, CTS

Reduces calcium deposits (bone spurs on heel)

reduces scar adhesions.

41
Q

Contraindications for iontophoresis

A

allergy to medication. allergy to sulfites or shellfish. diabetes (alters sugar levels),

42
Q

effects of pulsed duty cycle ultrasound (non-thermal)

A

causes acoustical streaming, micro-streaming, and cavitation, which increases cellular metabolism. results in increased enzyme activity, stimulates the immune system, increases oxygen uptake and increases cellular permeability.

facilitates tissue repair (increase of phagocytic activity, fibroblast and granulation tissue formation)

increases pain threshold (decreases muscle spasm, increases the conduction of peripheral nerves, serotonin release).

43
Q

effects of continuous duty cycle ultrasound (thermal)

A

all effects of non-thermal AND
- deep penetrating heat 5cm through conversion of the kinetic energy int the tissue
- allows for soft tissue extensibility
- increases blood flow
-increases celular metabolism

44
Q

Types of ultrasound

A

low intensity: diagnostic = sonogram
Medium intensity: therapeutic
High intensity: tissue destruction used for fibroids or tumors, tissue ablation.

45
Q

What is piezoelectric effect

A

mechanical compression of crystals creates a vibration and a +/- charge when the crystals expand and contract

46
Q

how should the sound head or transducer be moved during therapeutic ultrasound.

A

4cm/sec or 1.5 inches per second.

47
Q

sound waves decrease in ___________as they travel through the tissue.

A

Intensity

48
Q

what type of tissue have greater sound wave absorption?

A

denser tissues with more protein and collagen. bone is the highest absorber.

49
Q

What is acoustical streaming

A

the steady flow of cellular fluid induced by the mechanical effects of ultrasound.

50
Q

How is sound energy transmitted?

A

longitudinaly causing cells to compress and decompress

51
Q

Why is transducer always moved constantly in a slow circle?

A

to avoid hot spots and tissues overheating.

52
Q

Which tissues has the greatest potential to absorb sound wave energy?

A

bones, scars, joints, ligaments and tensdons

53
Q

which tissues has the least potential to absorb sound waves?

A

body fluids, blood and water, fat

54
Q

what is the depth of 1MHz (1 millions cycles per second) or frequency ultrasond vs. 3MHz?

A

1MHz = 5cm
3MHz = 1-2cm

55
Q

What ultrasound frequency would you use for elbow down?

A

3MHz

56
Q

What ultrasound frequency would you use for above the elbow or bigger muscles?

A

1MHz

57
Q

When would we use pulsed ultrasound or non-thermal at a duty cycle of 20%?

A

acute stages when heat is not appropriate or when the client does not improve from continuous or in cases where the client experiences periosteal pain (dull ache)

58
Q

When would we use continuous ultrasound or thermal at a duty cycle of 100%?

A

chronic phase where thermal effects would be acceptable in addition to the mechanical effect.

59
Q

General rules for the intensity or dosage of ultrasound

A

Acute conditions: 0.1-0.5 w/cm2
Subacute conditions: 0.5-10 w/cm2
Chronic conditions: 1.0-2.0 w/cm2

60
Q

How do you figure out the time to do ultrasound

A

determined by the size of the area treated. Large areas = 5-15 minutes. Small areas = 2-7 minutes.

61
Q

contraindications and precautions for pulsed ultrasound

A

Contraindications
- Malignancy or infection
- areas of decreased circulation or thrombophlebitis
- Impaired sensation
- not over growth plates.
Precautions
- metal or plastic implants: keep moving
-unhealed fracture sites:
- acute inflammation or edema

62
Q

contraindications and precautions for thermal ultrasound

A

contraindication
- impaired sensation
- cancer
- cardiac disease
- acute injury or inflammation
- pregnancy
- bleeding tendencies
- infection
Precautions
- Cardiac disease
- DVT
- infection (cold)
- RA
- Antiobiotics less than 24hrs.

63
Q

Advantages to using ultrasound

A

significant tissue healing, very localized, short application.

64
Q

Disadvantages to ultrasound

A

patient feels little sensation, the pressure of sound head is not always tolerated and large areas are challenging.

65
Q

If you used pulsed ultrasound (non-thermal) with a hand patient for trigger finger for 5 minutes how would you document

A

PUS 20% 3MHz 1.0 w/cm2 to left middle finger x 5 minutes. The patients pain reduced with exercise from 7/10 to 4/10.

66
Q

Define voltage

A

The pressure or force that moves the electrons. This is built into the device like a 9volt battery.

67
Q

Define resistance

A

Factors that prevent or reduce the ability of the current to pass through the tissue. It effects the comfort level of the unit.

68
Q

ohm’s law

A

I=V/R Intensity (amplitude) = voltage/resistance

69
Q

Pulse Duration

A

The time a stimulus (pulse) is on. ti is measure din milliseconds and is often called Width.

70
Q

What is duty cycle for electrical modality?

A

on/off time. the work cycle vs. rest time. effect’s fatigue of the muscle. recovery time is needed to benefit from the next conrraction. Generally a 1:2 ratio is adequate. 10 seconds on, 20 seconds off. ramp up 2, ramp down 2, on for 6 seconds.

71
Q

contraindication and precautions for electrical modalities

A

Contraindications
- pacemaker
- over carotid artery/anterior neck triangle
- trans-cerebral electrode placement - seizures
- undiagnosed pain
- over pregnant uterus
- infection (except when used in wound healing)
- cancer

Precautions
- polio, MS, peripheral vascular disease
- seizure
- decreased sensation
- over bony area
- over excess adipose tissue/obesity
- over superficial metal implants
- skin irritation or wound
- use of machinery or sleep while unit on
- around microwave or cell phone use
- cognitive, especially when planning home use.

72
Q

Iontophoresis

A

Therapeutic delivery of medication through a non-invasive method of topical delivery of prescribed medication (ionized drugs) into a localized area of tissue by using the force of the direct electrical current to create a therapeutic effect.

73
Q

Methods of ionophoresis

A

uses a DC to move edication acros the epidermis into the subcutaneous tissue.

74
Q

Like charges _________, opposites _________-

A

repel, attract

OTH 608BL Physical Agent Modalities (3 decks)

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