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pmod 2nd shift > ES for pain relief > Flashcards

ES for pain relief Flashcards

1
Q

what type of current does TENS deliver

A

pulsed currents

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2
Q

rationale for TENS

A

pulsed currents that depolarizes peripheral nerves through the skin = electroanalgesia

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3
Q

what are the 2 mechanisms for pain relief

A

gate control theory and descending pathway inhibitory tract

GCT and DPIT

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4
Q

exp how ES affects the GCT

A

vibration from ES is transmitted by A fibers which are faster than C fibers kaya mauuna sha mag activate ng SG which will block transmission of pain in the C fibers

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5
Q

how long does pain relief via GCT last

A

relief only during the treatment

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6
Q

exp how ES affects the DPIT

A

ES produces noxious stim that will activate the release of opiopeptins like endorphins and enkephalins via analgesia system

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7
Q

how long does pain relief via DPIT last

A

longer lasting than GCT since opiopeptins stay in the blood

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8
Q

what are the modes of application for pain relief

A

conventional
acupunture-like
brief-intense
hyper stimulation
burst mode
IFC

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9
Q

conventional TENS is aka

A

high-rate TENS

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10
Q

explain what kind of ES conventional TENS uses

A

short duration high frequency pulses

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11
Q

what is the rationale of conventional TENS

A

produce comfortable sensations without muscle contractions to modulate acute pain

GCT

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12
Q

why is ES modulated

A

to prevent accommodation or adaptation of nerves that will lead to dec in AP and sensation

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13
Q

explain what kind of ES acupuncture-like TENS uses

A

repetitive stim of motor nerves or to stim A delta nerves

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14
Q

what is the rationale of acupuncture-like TENS

A

stim of motor nerves - repetitive muscle contraction or twitches

stim of A delta - brief sharp pain for DPIT

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15
Q

expected feeling of patient for acupuncture-like TENS

A

motor: visible muscle twitch

sensory: brief sharp pain

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16
Q

expected feeling of patient for conventional TENS

A

comfortable tingling sensation

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17
Q

acupuncture-like TENS is aka

A

low-rate TENS

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18
Q

explain what kind of ES brief-intense stim TENS uses

A

combines sensory and motor TENS; high freq and short pulse + low freq and long pulse

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19
Q

what is the rationale of brief-intense stim TENS

A

intensity up to patient’s maximal tolerance for DPIT

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20
Q

expected feeling of patient for brief-intense stim TENS

A

visible strong muscle twitches

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21
Q

explain what kind of ES hyperstimulation TENS uses

A

applied using probe electrode over acupuncture points

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22
Q

what is the rationale of hyperstimulation TENS

A

noxious stim over acupuncture points for relief via DPIT

23
Q

expected feeling of patient for hyperstimulation TENS

A

highest tolerated painful stim

24
Q

hyperstimulation is aka

A

point stim or electroacupuncture

25
Q

explain what kind of ES burst mode TENS uses

A

stim is delivered in bursts

26
Q

what is the rationale of burst mode TENS

A

pain relief via DPIT

27
Q

expected feeling of patient for burst mode TENS

A

visible muscle contraction

28
Q

explain what kind of ES IFC uses

A

alternating MFC that are slightly out of phase

29
Q

uses of IFC

A

pain relief
muscle re-education
improving circulation
enhance healing process

30
Q

compare LFC, MFC and HFC

A

LFC - has the physio effects but low penetration due to high skin resistance

MFC - low skin resistance; easier to penetrate but no physiologic effects

HFC - thermal effects

31
Q

relate interference and IFC

A

since 2 MFC na out of phase mag kaka interference

constructive - waves adds
destructive - cancels each other

32
Q

explain the concept of beat frequency and AMF

A

2 MFC - so may 4000 Hz and 4100 Hz

beat freq - is the diff = 100 Hz

apply concept of interference

phase na may constructive is the beat tas may destructive = series of beat and wala = heterodyned = LFC na sila with good penetration and physio effects

33
Q

what is the carrier or base frequency

A

the lower frequency betw the 2 MFC

34
Q

usual base frequency for sensory and motor

A

sensory - 4 kHz
motor - 2 kHz

35
Q

what is the usual beat frequency

A

diff of about 1-200 Hz

36
Q

usual beat freq for pain relief and motor

A

pain relief: 80-200 Hz

motor: < 50 Hz

37
Q

compare constant beat freq and variable beat freq

A

constant - constant diff betw 2 circuits

variable - freq betw 2 circuits vary within a preselected range to address accomodation; 20 Hz - plus/minus 10 Hz in 100 Hz base

38
Q

types of IFC

A

quadripolar static mode
quadripolar scanning mode
premodulated mode
hexipolar mode

39
Q

exp quadripolar static

A

2 circuit static IFC field

4 pads in X pattern = 2 circuit = 2 IFC

but effects is one area intersection lang - exactly 45° to perpendicular lines between 2 circuits

40
Q

exp quadripolar scanning

A

2 circuit static IFC field

4 pads in X pattern = 2 circuit = 2 IFC

but effect is larger area/scanning - about 45° to perpendicular lines between 2 circuits

41
Q

use for quadripolar static

A

localized pain

42
Q

use for quadripolar scanning

A

diffused pain

43
Q

exp premodulated mode

A

bipolar/exogenous method

MFC is mix in the stim tas appli is via 2 electrodes lang - 1 circuit

44
Q

exp hexipolar mode

A

3 circuit IFC c 3 pairs of electrode within in 2 Y-shaped applicators

3 currents intersect within the tissues

45
Q

sensory effect of IFC

A

cutaneous stim of sensory nerve fibers

analgesic effect via GCT

wedensky inhib of type C nociceptive fibers - non-acute pain

46
Q

motor effect of IFC

A

synch excitation of large diameter and lower threshold or more excitable motor nerves

glidemeister effect

wedensky inhib of motor nerves

47
Q

exp the glidemeister effect

A

normal physio contraction - asynch

IFC will start synch then eventually mimic asynch or normal physio contraction

48
Q

exp the wedensky inhib of motor nerves

A

d/t prolonged appli = loss of excitation since refractory state na

should be prevented kaya may variable beat

49
Q

disadvantage of synch muscle excitation

A

early fatigue of the muscle

50
Q

indications for both TENS and IFC

A

pain control

51
Q

indications for IFC only

A

relief of muscle spasm
promote tissue healing
edema reduction
muscle re-education

52
Q

contraindications for both TENS and IFC

A

over anterior cervical area

demand type cardiac pacemakers or implanted cardioverter-defibrillators

DVT

over pregnant abdomen, pelvic, lumbar in 1st trim

epileptic episodes

over hemorrhagic area

over cancer

w/in 3m from SWD

53
Q

precautions for both TENS and IFc

A

over thoracic cage
over cranial are
over metal implants
confused or unreliable patients
over damaged skin

54
Q

adverse effects of both TENS and IFC

A

burns - electric or thermal
blisters

pmod 2nd shift (12 decks)

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