Exam 1 Flashcards
Spinal Traction Indications
HNP
Degenerative Joint Disease
Joint Dysfunction (hypo mobility)
Muscle Spasm
Spinal Traction Contradindications
- tumor/infection (structural fault)
- vascular compromise of vertebral artery
- fracture (movement not wanted)
- rheumatoid arthritis
- major neck injury (fracture of the odontoid process has been ruled out)
Spinal Traction Precautions
- acute strains
- pregnancy
- osteoporosis
- hiatal hernia using pelvic traction
- claustrophobic pt.
Spinal Traction Treatment Time
- Disc: 3-5 mins for first treatment
progress to 8-10 mins - all other problems treat for 15-20 mins
Spinal Traction Force (cervical spine)
10% to 20% body weight to 35lb max
- must add weight of head if in a sitting position
Spinal Traction Force (lumbar spine)
25% to 50% of body weight
- must add 25% body weight if table doesn’t slide
Spinal Traction Duty Cycle
disc problems: 60 sec on/20 sec off
all other problems: 20-30 sec on/10 sec off
Spinal Traction Direction of pull (transverse axis)
Disc Problems - as straight of a pull as possible
Muscle/facet problems - pull with 20-30 degrees flexion
Spinal Traction Direction of pull (longitudinal axis)
pt. head/trunk lists to one side
Disc problems - pull on the side needed to maintain the list
Muscle/facet - pull on the side to correct the list
Ultrasound Indications (Thermal)
- pain relief in chronic bursitis, myosis, tendonitis, and arthritis
- pain relief from neuromas (aching nerve pain)
- adhesive scars
- affects nerve conduction velocity
- improve extensibility of CT
Ultrasound Indications (NON-thermal)
lower than 20% duty cycle
- cavitation may break down calcium deposits
- affects nerve conduction velocity (alters pain perception)
- phonophoresis (drive chemicals through skin)
Ultrasound Contraindications
- where heat is not indicated
- hemophiliac pt.
- over DVT
- over neoplasm
- over pregnant uterus
- over the eyes
- over the heart
- near a pace maker
- over growth plates
- sepsis
- malignancy
- severe cardiac disease
Ultrasound Precautions
- over healing fracture
- over the spinal cord
- over metal implants
Ultrasound Frequency
1 MHz penetrates to 5 cm (2 in)
3 MHz penetrates to 1 cm (1/2 in)
Ultrasound BNR
rates the quality of the head
- 1:1 head is perfect and sound
- 6:1 is the minimum acceptable
the higher the BNR the faster you need to move the sound head
Ultrasound Duty Cycle
- Continuous: gives thermal/non-thermal effects
- Pulsed, especially below 10% gives only non-thermal effects
- Acute injury: 10-20%
- Subacute: 30-50%
- Chronic: 60-100%
Ultrasound Intensity 1 MHz
*determined by pt. tolerance
Acute = .1 - .2 w/cm2
Subacute = .3 - .8 w/cm2
Chronic = .9 -1.5 w/cm2
Ultrasound Intensity 3 MHz
schmee
Gown & Glove Order of Donning
- scrub cap
- mask
- shoe covers
- wash
- gown
- glove
Hot Pack Indications
- increase collagen extensibility
- decrease joint stiffness
- relieve muscle spasm
- pain relief
- increase blood flow
- as a warm-up for exercise
- possibly assist in resolving inflammation
Hot Pack Contraindications
- severe cardiac disease
- over malignancy
- sepsis
Hot Pack Precautions
- with insensitive pt.
- with spinal cord injured pt.
Hot Pack Controls
Time: 20-30
Insulation: 4-6 w/foam pad
6-8 layers of towel
Hot Pack Machine: 160-175 F
*reheating of packs 30 minsParaffin Bath Indications
- increase collagen extensibility
- decrease joint stiffness
- relieve muscle spasm
- pain relief
- increase blood flow
- as a warm-up for exercise
- possibly assist in resolving inflammation
Paraffin Bath Contraindications
- severe cardiac disease
- over malignancy
- sepsis
Paraffin Bath Precautions
- with insensitive pt.
- w/spinal cord injured pt.
Paraffin Bath Controls
Temp: 125-130F
Time: usually 20 mins
Application:
A: dip 6 times, wrap in paper bag and towel
B: dip 6 times and re-immerse
Hydrotherapy Indications
- increase collagen extensibility
- decrease joint stiffness
- relieve muscle spasm
- pain relief
- increase blood flow
- as a warm-up for exercise
- possibly assist in resolving inflammation
Hydrotherapy Contraindications
- severe cardiac disease
- over malignancy
- sepsis
Hydrotherapy Precautions
- with insensitive pt.
- with spinal cord pt.
Hydrotherapy Whirlpool Controls
Time: 20 mins
Temp: 55F - 113F
Air Control: High air decreases mass of fluid, increases sensation of fluid
Pressure: high pressure improves convection, but could be painful on wound
Ice Pack Indications
- decrease muscle spasm
- decrease pain
- decrease spasticity
- relieve swelling & edema
- prevent excessive tissue damage following injury
Ice Pack Contraindications
- severe coronary artery disease
- severe hypertension
- some RA
- pt. w/cold hypersensitivity (hives)
- vasospastic disorders (raynaud’s)
Ice Pack Precautions
- paralyzed pts.
- coma pts.
- any skin w/cold > 1hr
- I’ve over superficial nerves
Ice Pack Controls
Time: 3-60 mins
- 3-15 mins to numb
- 20-30 mins for typical treatment
Temp: bath 55-65F
ice packs = 10-15F
Insulations: towels
