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Written Prep > EPA > Flashcards

EPA Flashcards

1
Q

Benefits of heat ? (5)

A
  1. pain relief
  2. reduces muscle spasm and joint stiffness
  3. promotes relaxation
  4. increases blood flow
  5. facilitates fine movement and increases ROM and exercise tolerance in some patients
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2
Q

Generally elevate tissues to __ - __ degree for therapeutic effect

A

40-45

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3
Q

Benefits of cold?

A
  1. decreases swelling after injury / surgery chronic edema and joint effusions
  2. decreases muscle spasm / spasticity
  3. mild cooling enhances muscular isometric contracture and endurance
  4. decrease pain
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4
Q

Infra-red heats via _____ heat transfer

A

radiation

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5
Q

Whirlpool heats via _____ heat transfer

A

convection

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6
Q

Parafinn wax heats via _____ heat transfer

A

conduction

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7
Q

US / diathermy heats via ______ heat transfer

A

conversion

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8
Q

Greatest effect of heat / cold in tissues is at __- __ mm, after that only about a 1 degree change

A

1-2

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9
Q

What MUST you test prior to Rx w/ heat / ice?

A

sensation! (hot / cold)

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10
Q

Paraffin wax usually kept b/w __ - __ degrees Celsius

A

42-52

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11
Q

Hot pack: use __ - __ cm or __ - __ towels between skin and hot pack

A

1-2;4-6

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12
Q

Hot packs: skin takes ~ __ minutes to reach max test, do an objective and subjective test at __ minutes, leave heat on for 15-20 minutes

A

8; 10

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13
Q

Constrast baths: increases blood flow to skin and provides considerable sensory stim, tubs at __ - __ degrees and __ - __ degrees , repeat 3-4x, __ - __ mins total

A

38-44; 10-18; 20-30

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14
Q

Whirlpool = mechanical stimulation + thermoreceptors, can help with wound ______

A

debridement

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15
Q

CI’s to use of thermal agents (heat)? (8)

A
  1. acute inflammation
  2. skin conditions
  3. altered thermal sensation
  4. hemorrhagic disease
  5. malignancies
  6. gonads
  7. open wounds
  8. unreliable pt
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16
Q

Check for allergic reactions to cold after __ minute and again after __ minutes

A

1;5

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17
Q

CI’s / dangers to the use of cold?

A
  1. ice burn
  2. peripheral nerve damage
  3. frostbite
  4. reduced peripheral blood supply
  5. cold sensitivity (Reynaud’s, cold urticaria)
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18
Q

EMG feedback = use for ___ _____ testing; estimated velocity of depolarization along ____ ____ neuron

A

nerve conduction; alpha motor

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19
Q

Normal skeletal mm EMG feedback = usually ____ at rest

A

silent

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20
Q

EMG feedback: reduced insertional activity seen in ____ or severely _____ muscles when needle is inserted

A

fibrotic; atrophied

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21
Q

Abnormal EMG activity at rest suggests _____ or _____

A

neuropathy; myopathy

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22
Q

Neuropathy of myopathy EMG recordings will be indicated by what 3 things?

A
  1. fibrillation potentials
  2. positive sharp waves
  3. fasciculation potentials
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23
Q

______ EMG provides info about mm activity in order to up train or down train avidity

A

surface

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24
Q

Surface EMG is used as a tool, not a treatment (T/F)

A

TRUE

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25
Q

Use _____ for acute and chronic pain, muscle twitch, muscle strengthening and spasticity management

A

TENS

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26
Q

TENS ______ setting = segmental mechanism gaiting at SC

A

conventional

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27
Q

TENS _______ mechanism = release of opiod and serotonin receptors

A

1extra-segmental

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28
Q

Parameters for conventional TENS?

A
  • 80-150 Hz
  • 60 microseconds
  • intensity to comofortable tingle
  • electrodes over site of pain / bracketing
  • 30 mins, immediate pain management
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29
Q

Parameters for AL TENS?

A
  • 10 Hz
  • 200 microseconds
  • intensity to muscle twitch
  • electrodes on motor point
  • duration 40-60 mins
  • prolonged pain management
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30
Q

CI’s to TENS? (8)

A
  1. electronic devices
  2. low back or abdomen of pregnant women
  3. malignancy
  4. DVT or thromboembolism
  5. infected tissues
  6. impaired sensory awareness
  7. cognitive or communication impairments
  8. cardiac disease or arrhythmias
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31
Q

Use _____ for pain, produce muscle twitch, increasing muscle strength and spasticity management

A

NMES

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32
Q

Parameters for pain for NMES?

A

same as TENS

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33
Q

Parameters for edema management NMES?

A
  • over extra-articular edema
  • 5-10 Hz
  • 200 microseconds
  • motor intensity to twitch
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34
Q

Parameters for muscle strengthening NMES?

A
  1. > 35 < 65 Hz
  2. intensity to tetany
  3. rise and fall (2 s ramp up, 1 sec off, 6 s contraction = 9s in total)
  4. on/ off depending on strength of muscle
  5. 12 - 15 contractions
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35
Q

On/off periods for NMES based on muscle grades?

A
  1. Gr I = 1:5
  2. Gr III = 1:3
  3. Gr IV = 1:1
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36
Q

CI’s to NMES?

A
  1. electrical devices / implant
  2. pregnancy ANYWHERE
  3. active DV T of thromboembolism
  4. infected tissue
  5. chest w/ cardiac disease / arrhythmias / heart failure
  6. neck or over eyes
  7. impaired circulation
  8. unstable (recent Sx, OP, #_
  9. intercostal mms or lower abdomen
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37
Q

_____ used for pain management via gaiting and/or endogenous opiate release, edema management via muscle twitch, increasing local blood flow, muscle stimulation for strengthening of pelvic floor

A

IFC

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38
Q

IFC = ___ voltage, ____ intensity, 2 _____ waves at alternating current of 4000 Hz

A

low; medium; sinusoidal

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39
Q

IFC: each wave = slightly different ______ and interfere with one another in tissues creating new wave that varies in shapes frequency and amplitude; what is this interference called?

A

frequencies; linear super-position

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40
Q

Series of wave packets in IFC called ?

A

beats !

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41
Q

Is IFC balanced or unbalanced ?

A

BALANCED!

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42
Q

IFC = symmetrical or unsymmetrical? biphasic or triphasic?

A

symmetrical biphasic !

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43
Q

IFC = amplitude ______ , pulse duration of ____ microseconds, phase duration of ___ microseconds

A

modulated; 250; 125

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44
Q

Motor parameters for IFC?

A
  • 1-10 Hx w/ strong but comfortable twitch

- 40 - 60 minutes

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45
Q

Sensory parameters for IFC?

A
  • 80 - 150 Hz w/ strong but comfortable sensation

- 20-40 mins

46
Q

Motor and sensory parameters for IFC?

A
  • 1-150 Hz for both (less effective for motor though!)
47
Q

Add _____ to IFC to avoid accommodation

A

sweep

48
Q

IFC can treat large, deep areas (T/F)

A

TRUE

49
Q

IFC caution: can output __ - __ mA - NO THORACIC APPLICATION over __ mA

A

50-90

50
Q

Why do you not put IFC over thorax over 50mA?

A

Bc it might cause ventricular fibrillation!

51
Q

IFC: ____ electrodes increase current density and risk of burns

A

smaller

52
Q

IFC: ______ current flow and increased risk of _____ if electrodes placed too close together

A

superficial; burns

53
Q

CI’s to IFC?

A
  1. to chest / thorax
  2. electronic devices
  3. regions of known or suspected malignancy
  4. low back or abdomen of pregnant women
  5. active DVT or thrombophlebitis
  6. actively bleeding tissues or untreated hemorrhagic disorders
  7. infected tissues, TB or wounds w/ underlying osteomyelitis
  8. recently radiated tissue
  9. impaired sensory awareness
  10. to the neck or head
  11. to areas near reproductive organs or genitalia
  12. to areas near or over eyes
  13. damaged or at risk skin areas that would result in uneven conduction of current
  14. cognition of communication impairments
54
Q

Precautions to using IFC?

A
  1. active epiphysis in children
  2. skin disease
  3. impaired circulation
  4. metal implants
  5. fragile skin
55
Q

_____ = used for decreased pain, decreased edema, increased wound healing, mm stim

A

HVPC

56
Q

HVPC = ___ peak intensity (current), ____ average intensity

A

high; low

57
Q

HVPC = __phasic

A

mono

58
Q

Monophasic waves can build up a ______ net charge

A

bigger

59
Q

HVPC frequency = __-___ Hz, pulse width sized at _- -__ microseconds

A

1-200; 5-65

60
Q

HVPC: peak current is high (=higher risk of burning) but there is a long _____ _____ so charge has a chance to dissipate, allowing safer application

A

interpulse interval

61
Q

HVPC: parameters for pain management?

A

same parameters as TENS

62
Q

HVPC: parameters for wound healing?

A
  • 50 - 100 Hz (submoto!)
  • 30-60 minutes
  • 3-7 days a weak
63
Q

HVPC for wound healing: polarity is based on ___ of ____

A

stage of healing

64
Q

HVPC: macrophages / epidermal cells / epithelial cells are all _____, fibroblasts are ______

A

negative; positive

65
Q

HVPC : one electrode in _____, one __ - __ cm away

A

wound; 10-20

66
Q

HVPC: parameters for subacute edema reduction?

A
  • 5-20 Hz
67
Q

HVPC edema reduction: want muscle twitch, usually start w/ _____ polarity

A

negative

68
Q

HVPC edema reduction: 2 possible electrode placements?

A
  1. active red on edema (if set as negative, will push away positive portions)
  2. muscle twitch on motor point and nerve trunk for CHRONIC
69
Q

HVPC parameters for muscle stim?

A
  • 35-65 Hz
70
Q

______ = can repel molecules or attract desired cells based on polarity

A

Galvanotaxis

71
Q

CI’s to HVPC? (4)

A
  1. seizure / epilepsy
  2. electronic implant
  3. neck area
  4. inflammation (don’t want to add energy to injury)
    ?
72
Q

Precaution to HVCP?

A

impaired cognition

73
Q

______ = treatment method using current flow b/w two electrodes to push ions through the skin barrier

A

iontophoresis

74
Q

Iontophoresis: current is _____

A

direct

75
Q

Anode = ____ electrode

A

positive

76
Q

Iontophoresis: possible ______ reaction under anode, = skin hardening over time (_____)

A

acidic ; sclerosis

77
Q

Iontophoresis: possible _____ reaction under cathode, = softening and ____ of skin

A

alkaline; burning

78
Q

Iontophoresis: keep the ____ larger ! Current ______ is therefore lower and skin is less likely to burn

A

cathode; density

79
Q

Iontophoresis: current density is limited to __ mA/cm^2 under the anode and __ mA/cm^2 under the cathode

A

1; 0.5

80
Q

______ is used for hyperhidrosis, MSK inflammatory disorders, plantar fasciitis, TMJ disorders, ischemic skin ulcer, fungal infections, bursitis and tendonitis

A

iontophoresis

81
Q

CI’s to iontophoresis?

A
  1. over damaged skin or open lesions
  2. allergy to therapeutic ions
  3. impaired sensation
  4. over electric implants
82
Q

3 features of laser?

A
  1. monochromaticity
  2. coherence
  3. collimation
83
Q

_______ = all photons have a single wavelength

A

monochromaticity

84
Q

_____ = all photons travel in same phase and direction

A

coherence

85
Q

_____ = minimal divergence over distance

A

collimation

86
Q

_____ = used to increase tissue healing, decrease pain, decrease inflammation (wound management)

A

laser

87
Q

Laser head = based on ___ of lesion

A

depth

88
Q

Red - near infrared laser = _- __ mm, near - mid infrared = __ - __mm

A

1-5;5-10

89
Q

Dose of lase: acute __J/point, chronic __ J/point

A

2;4

90
Q

Frequency of laser: acute = < ____ kHz, wavelenght of __ - ___ nm, chronic = > ____ kHz, wavelengths of _____ - _____ nm

A

1000; 600-1000; 1000; 1000-1350

91
Q

Laser can be continuous or pulsed, and non-contact is preferred over contact (T/F)

A

FALSE - contact preferred over non-contact !

92
Q

CI’s to laser? (8)

A
  1. over eyes (WEAR GOGGLES!)
  2. known or suspected malignancy
  3. low back or abdomen of pregnant women
  4. hemorrhage or severe vascular disease
  5. tissue infected by TB of virulent bacteria
  6. actively bleeding tissues o untreated hemorrhagic disorders
  7. active DVT of thrombophlebitis
  8. reproductive tissues
93
Q

Precautions to laser?

A
  1. recently radiated tissues
  2. infected regions (compromised immune function)
  3. anterior neck
  4. photosensitive areas
  5. cognitive impairments
  6. epiphyseal plates in children
94
Q

5 BCCDC LASER safety guidelines ?

A
  1. use in a controlled area
  2. laser eye protection is required ***
  3. only authorized personnel must occupy the area
  4. the area must have appropriate warning sign
  5. any windows, doorways openings etc must be either covered or restricted !
95
Q

____ therapy = treat psoriasis, eczema, vitiligo, pruritus (secondary to liver / kidney disease), acne, photodermatoses, wound healing, atopic dermatitis

A

UV

96
Q

UV dosage based on _____

A

MED

97
Q

UV dosage: start at __% MED, then work up by __ -__ % as tolerated

A

70; 5-10

98
Q

UV therapy = combo of both UVA and UVB (T/F)

A

TRUE

99
Q

CI’s to UV therapy ?

A
  1. photosensitivity
  2. skin cancer
  3. CT disorder
  4. on eyes (wear protection!)
100
Q

UV on eyes can cause _____ or ______ (inflammation of the cornea) - cataracts are cursed by chronic exposure to UV

A

conjuntivitis; photokeratitis

101
Q

____ = accelerates inflammatory phase to make it as efficient as possible, alters membrane permeability and released wound healing factors

A

US

102
Q

Thermal effects of ultrasound? (4)

A
  1. decreased pain
  2. decreased joint stiffness
  3. improved blood flow
  4. promote healing
103
Q

Non thermal effects of ultrasound?

A
  1. wound healing
  2. inflammation and soft tissue healing
  3. altered scar tissue formation
  4. stimulation of collagen synthesis
  5. angiogenesis
  6. repair of articular cartilage
104
Q

US parameters: frequency = __ Mz for deep, __ MHz for superficial

A

1; 3

105
Q

US intensity: __ - __ W/cm^2 inflammatory phase; __ - __ W/cm^2 proliferation phase; up to __ W/cm^2 during remodelling phase

A

0.1-0.5; 0.5-0.8; 2.5

106
Q

US: ___ for acute, ____ for chronic

A

pulsed; continuous

107
Q

US: apply to area nor larger than __ - ___ x ERA

A

2-2.5

108
Q

US ERA = areas producing __% or more of max power output

A

5

109
Q

CI’s to US? (15)

A
  1. implantable devices
  2. abdomen and pelvis if pregnant
  3. malignancy
  4. bleeding disorder
  5. acute sepsis or infection
  6. TB of lungs or bone
  7. active DVT or thrombophlebitis
  8. myositis ossificans
  9. fracture
  10. impaired circulation or sensation
  11. pelvis and lumbar spine if menstruating
  12. radiotherapy
  13. gonads
  14. abscess
  15. areas of acute inflammation (if using continuous as it generates heat)
110
Q

Precautions to US? (4)

A
  1. SC or superficial nerves
  2. regenerating nerves
  3. epiphyseal plate unfused
  4. implants (metal ok if used pulsed!)
111
Q

Can leave tape on for __ - __ days, or take off if it increased pain, is red or itchy, etc

A

2-3

Written Prep (9 decks)

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