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Semester 3 PM Exam 5 > Electrotherapy 1 > Flashcards

Electrotherapy 1 Flashcards

1
Q

Indications

A 
Pain modulation
Mm strengthening/reeducation
Edema control
Dec mm spasm
Tissue healing (wound care)
Inflammation control
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2
Q

Contraindications

A 
Pacemaker
Infection
Malignancy 
Pregnancy 
Musculoskeletal injury specific
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3
Q

Current =

A

The flow of electrons

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4
Q

Voltage =

A

THe force resulting from an accumulation of electrons

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5
Q

Frequency =

A

the number of cycles or pulses per second (Hz = pulse per second)

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6
Q

Conductance

A

The ease at which current flows through a medium

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7
Q

Resistance

A

Opposition to current flow

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8
Q

Impedance

A

Resistance in biologic tissue

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9
Q

Monophasic or DC

A

Direct current
Most likely to cause injury
Current flows either above or below the 0 line

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10
Q

Times that we will use DC

A 
Iontophoresis 
Noxious stim (used sometimes for management of chronic pain)
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11
Q

Biphasic or AC

A

Alternating current
Portion of the wave above the 0 and portion below
Balances the ions - safer to use because it doesnt allow for accumulation of charge that can damage tissue

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12
Q

Biphasic, symmetrical, balanced

A

Above and below the line
Sym - shape of the wave is the same above and below the line
Balanced - area under each wave is equal so no net charge

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13
Q

Biphasic, asymmetrical, unbalanced

A

Above and below the line
Asym - shapes are different
Unbalanced - different SA so there is a net charge that is building up

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14
Q

Biphasic, asymmetrical, balanced

A

Above and below
diff shape
balanced SA above and below so no net charge

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15
Q

Pulsed

A

A way to package monophasic or biphasic current (Inferential Current, Russian) - used for mm strengthening - need special machine

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16
Q

Current flow follows

A

the path of least resistance

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17
Q

Current flow - skin

A

Poor conductor
Has a lot of impedance
Skin prep we do is to dec the impedance

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18
Q

Current flow - blood

A

Excellent conductor

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19
Q

Current flow - mm or tendon

A

Poor conductor

Muscle belly is a little better because of water

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20
Q

Current flow - fat

A

Poor conductor

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21
Q

Current flow - nerve

A

Good conductor

A lot of our protocols use the nerve to stimulate whatever we are targeting

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22
Q

Clinical implication - skin preparation

A

Need to cleanse and prepare the skin to dec impedence

Need to inspect skin after taking electrodes off too

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23
Q

Clinical implication - target tissue (fibers)

A

A delta = fast pain
A beta = non-noxious fast sensory nerve endings
C fibers = chronic or slow pain

24
Q

Treatment parameters

A
  1. Waveform type and shape
  2. Symmetrical vs. Asymmetrical
    Many will be biphasic and balanced, shape doesnt impact as much
  3. Frequency
  4. Pulse duration
  5. Phase duration
    Pulse and phase duration can be used interchangeably
25
Q

Relationship with pulse/phase duration and frequency

More comfortable?

A

Inverse

Higher frequency and lower duration is more comfortable

26
Q

Why is a longer duration more uncomfortable

A

Building up the current and can cause injury to tissue

27
Q

Current modulation or packaging (options)

A

Continuous
Burst
Beat
Ramping

28
Q

Current modulation or packaging - Continuous

A

Light tingle the entire time

29
Q

Current modulation or packaging - Burst

A

Contraction on and then rest time and then back on and rest

30
Q

Current modulation or packaging - Beat

A

Very low frequency - has longer lasting relief when it is off - one wave though and then it is done

31
Q

Current modulation or packaging - Ramping

A

Usually for mm protocol
Slowly ramp up and hits full contraction and then ramp back down
More comfortable for patients

32
Q

Current modulation or packaging - Ramping time period

A

Isometric voluntary contractions - need 6 sec hold

With e-stim do 2 sec ramp up, 6 sec contraction, 2 sec ramp down so 10 total seconds and then rest time

33
Q

Current direction

A

Usually one direction?

FILL IN

34
Q

Current density

A

Density of the current or charge at a certain point
Inversely related to the size of your electrode
Larger electrode - lower density is preferable by patient

35
Q

Electrode placement can be

A

Bipolar
Monopolar
Quadripolar

36
Q

Bipolar electrode placement

A

Density is equal

Both are active

37
Q

Monopolar electrode placement

A

Huge displacement
Iontophoresis will use this
Pad is positive and electrode is neg

38
Q

Quadripolar

A

In picture - beign used for pain/edema

39
Q

Strength/Duration Curve =

A

STUDY IT!

40
Q

Strength/Duration Curve - Charts the

A

Minimal amplitude of stimulus that will depolarize tissue defined as rheobase

41
Q

Strength/Duration Curve - Chronaxie

A

The length of time a current at twice the rheobase intensity must be applied to produce a response

42
Q

Concepts of S-D curve - an extremely short duration stimuli will

A

NOT stimulate tissue unless the intensity is intolerable

43
Q

Concept of S-D curve - different size nerves demonstrate

A

different S-D curves

44
Q

Tetanic contraction

A

The higher the frequency, the more likely you will produce tetanic contraction

45
Q

Single twitch is from

A

Single stimulus

46
Q

Increase the frequency of stimulus and you will get

A

Successive muscle twitches and eventual reach tetany

47
Q

Each mm has individual “best frequency” - usually

A

40-60 pps

48
Q

Clinical effects of e-stim

A

Mm contraction
Sensory nerve stimulation to relieve pain
Creation of electrical field to promote healing
Creation of an electrical field on skin to drive ions through skin

49
Q

How does estim achieve clinical effects - Cellular effects

A

Excitation of nerve cells
Changes in cell membrane permeability
Stimulation of fibroblast or osteoblast
Changes in microcirculation

50
Q

How does estim achieve clinical effects - tissue effects

A

Mm contraction
Tissue regeneration
Bone healing

51
Q

How does estim achieve clinical effects - segmental

A

Requires cellular and tissue changes
Changes in joint mobility
Mm pumping to change blood and lymph flow
Changes to automatic systems

52
Q

How does estim achieve clinical effects - systemic

A

Endogenous pain suppressors release and control pain

Release of NT to dec pain

53
Q

Fiber recruitment - Given

A

More motor units recruit for a muscle contraction the stronger the contraction

54
Q

Fiber recruitment - CNS

A

Asynchronous recruitment

55
Q

Fiber Recruitment - Electrical Stim

A

Limited nerve fibers used therefore limited motor units - synchronous recruitment

56
Q

Motor unit excitability - physiologically

A

Gradation of small motor neurons/units excited than large fibers

57
Q

Motor unit excitability - Electrically

A

Most excitable fibers fire first
large fibers near surface
Fibers directly under stimulation
Easily fatigued

Semester 3 PM Exam 5 (10 decks)

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