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Phys Agents > Electrotherapy for Tissue Healing > Flashcards

Electrotherapy for Tissue Healing Flashcards

1
Q

What occurs during the inflammatory stage of wound healing (4)

A
  1. Hemostasis
  2. Phagocytosis
  3. Autolysis
  4. Fibroblast migration
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2
Q

What is hemostasis

A

Blood clotting due to platelets

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3
Q

What is phagocytosis

A

Breakdown and elimination of foreign substances and bacteria

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4
Q

What is autolysis

A

Breakdown of other cellular debris so it can be removed from the area

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5
Q

What is fibroblast migration

A

Bringing fibroblasts into the area

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6
Q

What occurs during the proliferation stage of wound healing (4)

A
  1. Collagen synthesis
  2. Angiogenesis
  3. Epithelialization
  4. Wound contraction
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7
Q

What is angiogenesis

A

Development of new blood vessels

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8
Q

What occurs during the maturation stage of healing (2)

A
  1. Collagen lysis

2. Collagen replacement

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9
Q

What is collagen lysis

A

Laying down and breaking apart of collagen

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10
Q

True or False:

The 3 stages of wound healing can overlap each other

A

True

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11
Q

What are the factors that impede wound healing (8)

A
  1. Some systemic medications
  2. Some topical medications
  3. Malnutrition
  4. Prolonged pressure or stretch
  5. Infection
  6. Immunodeficiency
  7. Smoking
  8. Dryness or necrotic tissue
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12
Q

What should you assess about chronic wounds (4)

A
  1. Size
  2. Description of wound base
  3. Assessment of periwound tissue
  4. Wound drainage
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13
Q

What should you assess about wound size (3)

A
  1. Surface area
  2. Depth
  3. Volume
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14
Q

What are 4 types of chronic wounds

A
  1. Pressure sores
  2. Arterial insufficiency ulcers
  3. Venous insufficiency ulcers
  4. Diabetic ulcers
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15
Q

What is a pressure sore

A

Area of local tissue loss due to prolonged tissue compression between boney prominences and external surfaces

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16
Q

What are the common locations of pressure sores (5)

A
  1. Sacrum
  2. Heels
  3. Ischial tuberosity
  4. Greater trochanter
  5. Malloeli
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17
Q

What causes a pressure sore

A

Compression of tissues reduces blood perfusion in tissues and produces necrosis

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18
Q

How many stages of pressure sores are there

A

4

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19
Q

What is a stage I pressure sore

A

Non-blanchable erythema of intact skin

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20
Q

What is a stage II pressure sore

A

Partial thickness skin loss to epidermis, dermis, or both

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21
Q

What is a stage III pressure sore

A

Full thickness skin loss including damage to subcutaneous tissue

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22
Q

What is a stage IV pressure sore

A

Full thickness skin loss with destruction or damage to muscle, bone, or support structures

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23
Q

What is an arterial insufficiency ulcer

A

Area of local tissue loss due to arterial blood supply deficiency

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24
Q

What are the common locations of arterial insufficiency ulcers (4)

A
  1. On the foot
  2. Over malleoli
  3. Toe joints
  4. Lateral foot border
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25
Q

What causes arterial insufficiency ulcers (3)

A
  1. Arteriosclerosis
  2. Arterial occlusion
  3. Arterial disruption
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26
Q

What is a venous insufficiency ulcer

A

Area of local blood loss due to deficiency in venous drainage

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27
Q

What are the common locations of venous insufficiency ulcers (2)

A
  1. Above the ankle

2. Medial lower leg

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28
Q

What causes venous insufficiency ulcers (2)

A
  1. Sustained venous hypertension

2. Venous valvular dysfunction

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29
Q

What is a diabetic ulcer

A

Area of local tissue loss due to sensory neuropathy and arterial blood supply deficiency

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30
Q

What are the common locations for diabetic ulcers (4)

A
  1. Plantar surface of foot
  2. Over the heel
  3. Lateral border of the foot
  4. Plantar surface of metatarsal heads
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31
Q

What causes diabetic ulcers (2)

A
  1. Tissue trauma in insenate tissue

2. Peripheral vascular disease (PVD)

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32
Q

What is the electrochemical effect at the negative electrode

A

2Na+2H2O to 2NaOH+H2

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33
Q

Is the negative electrode increase acidity or alkalinity

A

Alkalinity

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34
Q

What is the electrochemical effect at the positive electrode

A

2Cl+2H2O to 4HCl+O2

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35
Q

Is the positive electrode increase acidity or alkalinity

36
Q

What is electrokinetic

A

Ionic movement

37
Q

What is an example of electrokinetics

A

Depolarization of an excitable membrane

38
Q

What is the electrothermal effect of electricity

A

Microvibration of charged particles produces heat

39
Q

What is the equation for heat produced electrically

A

H=0.24I^2R*t

40
Q

What does I equal

A

RMSa current

41
Q

What does R equal

A

Impedance of tissue

42
Q

What does t equal

43
Q

What causes an increased thermal effect of electricity

A

High RMSa, high skin impedance, and prolonged treatment time

44
Q

What are the physiologic effects of E-stim that benefit wound healing (7)

A
  1. Galvanotaxis
  2. Collagen synthesis
  3. Proliferation of fibroblasts
  4. Angiogenesis and wound microperfusion
  5. Bacterial
  6. Enhanced rate of epithelialization
  7. Enhanced blood flow to the wound
45
Q

What is galvanotaxis

A

The movement of an organism or any of its part in a particular direction in response to an electrical current

46
Q

During the inflammatory stage of wound healing which organisms move because of the electric current and which electrode do they move toward (2)

A
  1. Macrophages: negative

2. Inactive neutrophils: negative

47
Q

During the proliferation stage of wound healing which organisms move because of the electric current and which electrode do they move toward (1)

A
  1. Fibroblasts: positive
48
Q

During the maturation stage of wound healing which organisms move because of the electric current and which electrode do they move toward (3)

A
  1. Myofibroblasts: positive
  2. Keratinocytes: positive
  3. Epidermal: negative
49
Q

What are macrophages, inactive neutrophils, fibroblasts, myofibroblasts, and keratinocytes used for

A 
Macrophages: phagocytosis
Inactive neutrophils: autolysis
Fibroblasts: collagen formation
Myofibroblasts: wound contraction
Keratinocytes: epithelialization
50
Q

What is the amplitude, treatment duration, treatments per day, and treatment days per week of low intensity DC

A

Amplitude: 200-800 mA
Treatment duration: 1-2 hours
Treatments per day: 1-3
Treatment days per week: 5-7

51
Q

What is low intensity DC

A

Unidirectional flow of current with a low amplitude that continues until you turn of the machine

52
Q

What is the pulse amplitude, pulse duration, pulse frequency, mode, treatment duration, treatments per day, and treatment days per week for high voltage pulsed current (HVPC)

A 
Pulse amplitude: 100-150 V peak
Pulse duration: 100-200 usec
Pulse frequency: 30-130 pps
Mode: Continuous
Treatment duration: 30-60 minutes
Treatments per day: 1-2
Treatment days per week: 5-7
53
Q

What is HVPC

A

Twin peak monophasic pulse

54
Q

True or False:

HVPC is a pair of monophasic spike like waveforms

55
Q

True or False:

In HVPC there is almost an instantaneous rise followed by exponential decline

56
Q

What is the pulse amplitude, pulse duration, pulse frequency, mode, treatment duration, treatments per day, and treatment days per week for rectangular monophasic pulsed current (RMPC)

A 
Pulse amplitude: 30-35 mA peak
Pulse duration: 150 usec
Pulse frequency: 64-128 pps
Mode: Continuous
Treatment duration: 30 minutes
Treatments per day: 2
Treatment days per week: 7
57
Q

What is monophasic rectangular pulsed current

A

Unidirectional flow of a finite pulse followed by a rest period

58
Q

What is the pulse amplitude, pulse duration, pulse frequency, mode, treatment duration, treatments per day, and treatment days per week for biphasic pulsed current (rectangular asymmetric)

A 
Pulse amplitude: Strong sensory just below motor threshold
Pulse duration: 100 usec
Pulse frequency: 50 pps
Mode: Continuous
Treatment duration: 30 minutes
Treatments per day: 3
Treatment days per week: 5-7
59
Q

What is the charge of the outside of the skin

60
Q

What is the charge of the inside of the skin

61
Q

What happens to the charge of the inside and outside of the skin with injury

A

Polarity shifts so outside is positive and inside is negative

62
Q

How many protocols are there for wound healing

63
Q

What is protocol 1

A

Cathode over wound days 1-5

64
Q

What is protocol 2

A

Cathode/anode over wound if infected

65
Q

What does the wound need to be infected with for the cathode to be placed over the wound (2)

A
  1. E coli

2. P aeruginosa

66
Q

What does the wound need to be infected with for the anode to be placed over the wound (1)

67
Q

What is protocol 3 based on

A

The type of healing the clinician wants to induce

68
Q

What are the 2 types of healing the clinician could want induce caused by

A
  1. Anode

2. Cathode

69
Q

What type of wound healing does the anode induce (1)

A

Attract macrophages and neutrophils to stimulate phagocytosis and autolysis

70
Q

What type of wound healing does the cathode induce (3)

A
  1. Attract fibroblasts to increase granulation tissue
  2. Stimulate myofibroblasts to increase wound contraction
  3. Stimulate keratinocytes to increase rate of re-epithelialization
71
Q

What is protocol 4 based on

A

Electrochemical response in tissues being stimulated

72
Q

What are the 2 types of electrochemical response in tissue being stimulated caused by

A
  1. Cathode

2. Anode

73
Q

What electrochemical response in tissue being stimulated does the cathode induce (3)

A
  1. Solubilize
  2. Liquefy
  3. Soften tissue
74
Q

What electrochemical response in tissue being stimulated does the anode induce (1)

A
  1. Stimulate epithelialization
75
Q

Is the cathode the positive or negative electrode

A

Negative electrode

76
Q

What are the therapeutic effects under the cathode/negative electrode (5)

A
  1. Increased blood flow
  2. Galvanotaxic
  3. Enhances growth of granulation tissue
  4. Induces epidermal cell migration
  5. Antimicrobial
77
Q

What is galvanotaxic

A

Movement of an organism or any of it’s parts in response to to an electric current

78
Q

What is the cathode/negative electrode galvanotaxic for (6)

A
  1. Activated neutrophils
  2. Fibroblasts
  3. Lymphocytes
  4. Plateletes
  5. Mast cells
  6. Keratinocytes
79
Q

Is the anode the positive or negative electrode

A

Positive electrode

80
Q

What are the therapeutic effects of the anode/positive electrode (6)

A
  1. Galvanotaxic
  2. Promoted growth and reorganization of epithelial cells
  3. Decreases mast cells in healin gwounds
  4. Vasoconstriction
  5. Decreased blood flow
  6. Antimicrobial
81
Q

What is the anode/positive electrode galvanotaxic for (3)

A
  1. Macrophages
  2. Epidermal cells
  3. Inactive neutrophils
82
Q

True or False:

Electrotherapy can reduce edema formed with acute injury and inflammation

83
Q

How does electrotherapy reduce edema formed with acute injury and inflammation

A

Negative pole theories

84
Q

What are the negative pole theories (3)

A
  1. Repel negatively charged serum proteins
  2. Reduce microvessel diameter
  3. Reduce pore size
85
Q

How does the negative pole reducing microvessel diameter decrease edema

A

Reduce the leakage of fluid into the interstitial space

86
Q

What is the waveform of electrotherapy that causes edema reduction

87
Q

What is the pulse duration, polarity, frequency, on/off time, current amplitude, and treatment time for HVPC for edema reduction

A 
Pulse duration: 40-100 usec
Polarity: Negative
Frequency: 100-200 pps
On/off time (mode): Continuous
Current amplitude: Comfortable sensory
Treatment time: 20-30 minutes

Phys Agents (19 decks)

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