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Exam 1 Flashcards

1
Q

Stress/tension repair is important to incorporate in what phase?

A

repair

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2
Q

When should you incorporate movement after injury?

A

inflammatory phase

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3
Q

What are the four stages of healing?

A

hemostasis, inflammatory, proliferation, remodeling/maturation

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4
Q

How long after injury does hemostasis set in?

A

seconds/minutes-initial blood clotting to stop bleeding

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5
Q

How long does the inflammatory stage set in after injury?

A

hours/days/weeks

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6
Q

How long after injury does the proliferation phase set in?

A

weeks/months

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7
Q

How long after an injury does the remodeling/maturation phase begin?

A

months/years

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8
Q

CASE: John is 26 and noticed pain yesterday during a foot game. He has full ROM but is sore on a lateral bend.

Cindy is 16 and felt her ankle pop this morning while working in the yard followed by sudden pain.

What phase are they in? Who is likely to heal quicker?

A

Inflammatory phase

Cindy will heal quicker

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9
Q

What is the other name for the inflammatory phase?

A

acute phase

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10
Q

What phase of healing is essential (meaning too much can be a bad thing)?

A

inflammation (avascular tissue won’t heal)

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11
Q

What is the purpose of inflammation?

A

defends against infection, removes damaged tissues and debris, and immobilizes area

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12
Q

What are the signs of inflammation?

A

heat-valor, redness-rubor, swelling-tumor, pain-dolor (loss of function-functio laesa)

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13
Q

Vasodilation, increased capillary permeability, phagocytosis by neutrophils and macrophages are characteristics of what stage of healing?

A

inflammation (controlled and initiated by over 180 chemicals)

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14
Q

What inflammatory chemicals cause pain?

A

bradykinin, prostaglandins and serotonin

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15
Q

Pain can cause an area of muscle to do what? (and vice versa)

A

spasm

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16
Q

Too much inflammation can cause two types of secondary injury called?

A

enzymatic injury and hypoxic injury

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17
Q

What type of secondary injury is characterized by lysosomal enzymes released, not specific and healthy tissue is damaged?

A

enzymatic injury

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18
Q

What secondary injury is classified as hemorrhage, clotting, edema, spasm, hematoma, these lead to decreased O2 and nutrition, damage to surrounding uninjured tissue?

A

hypoxic

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19
Q

The goal for inflammation is to limit the extent and preserve ROM, how can you accomplish this?

A

PRICE-protect, rest, ice, compress and elevate

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20
Q

Ankle sprain timing for grade 1?

A

1-3 days

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21
Q

Ankle sprain timing for grade 2?

A

2-4 days

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22
Q

Ankle sprain timing for grade 3?

A

3-7 days

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23
Q

What is the other name for the proliferative phase?

A

repair phase

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24
Q

In the proliferative phase, angiogenesis occurs. What does angiogenesis mean?

A

new capillaries

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25
What type of collagen is weak, disorganized, and beginning cross-linking?
type III (used in the body for the proliferative phase of healing)
26
The goals for proliferative phase of healing include?
decrease swelling if still present, decrease pain, encourage and increase proliferation, increase pain free ROM, begin non-weight bearing proprioceptive training, and provide protective support as needing
27
What electrical modalities can decrease pain and swelling?
IFC, PreMod, Hi-Volt
28
What modalities can a patient get to decrease pain and swelling?
ice, contrast baths, massage and soft orthotics
29
What is the other name for the remodeling phase?
maturation
30
What phase of healing does scar contraction occur?
remodeling phase (can lead to joint adhesion and loss of motion)
31
In the remodeling phase of healing, type III collagen fibers from the proliferation phase are replaced by which type of fibers?
type I collagen (and cross linking continues)
32
Stress can increase 4 areas of the injured/healing region...what are they?
increase-collagen fibril diameter, cross-linking, number of collagen fibrils, and collagen fibril packing density
33
In which stage of healing would collagen fibers be aligned in an organized, parallel fashion?
remodeling (forms the greatest number of cross-links, posses optimal strength)
34
What are the goals for the remodeling phase?
increase pain free ROM, progress proprioceptive training, regain full strength, normal biomechanics, and protect and strengthen any residual joint instability
35
The ability of a material to store a charge is termed?
capactitance
36
Current flow in one direction with one positive and one negative electrode, direct current (DC), aka galvanic is what kind of current?
monophasic
37
Alternating current where the flow of electrons changes direction regularly is?
biphasic current
38
Which nerves have a low capacitance and reach threshold quickly?
large diameter nerves
39
What kind of current is associated with greater depth of penetration?
high peek
40
Measure of the effective current contained in the waveform is called?
Root mean square (RMS)
41
Do you need to know precise phase charge?
no, use the patient's feedback
42
If a px reports tingling but no muscle twitch, you have exceeded A-beta fibers but not?
A-alpha motor neurons
43
What would a patient report if you have exceeded the a-delta fiber capacitance?
burning, needling sensation
44
Minimum amplitude needed to depolarize a nerve fiber when phase duration is infinite is called?
rheobase
45
the time (or phase duration) required to depolarize a nerve fiber when the peak current is twice rheobase is called?
chronaxie
46
The number of pulses or cycles generated per seconds is?
frequency
47
The absolute refractory period is the rate-limiting factor of the number of impulses that can be generated by a?
nerve
48
Stimulation at high frequency near refractory period of the sensory nerve causes inhibition is specifically called?
wedenski's inhibition
49
Russian stimulation uses carrier frequency of how many Hz?
2,500
50
Intrinsic duty cycle of 10 ms on and 10 ms off creates a burst frequency of how many Hz?
50
51
Current density depends on?
the size of the electrodes
52
What sensation will a patient report if you stimulate a-beta fibers?
tingling
53
Low frequency generators use how many Hz?
up to 1,000
54
Medium frequency generators use how many Hz?
1,000-100,000
55
High frequency generators use how many Hz?
greater than 100,000
56
What would allow for deeper penetration of a therapy?
moving pads farther apart
57
If pads are too close together, what would happen to the patient?
this would give the feel of an intenser therapy
58
Which pad would be the dispersal electrode?
the larger one (when sizes vary greatly one may not be able to perceive current under the larger electrode)
59
If pads are place closer together, the current is most concentrated where in the tissues?
superficially
60
What kind of configuration is often used with IFC?
quadripolar configuration
61
What is the goal of NMES?
stimulate alpha motor neurons causing a strong muscle contraction
62
Primary indications for NMES
loss of muscle function, atrophy
63
Secondary indications for NMES
decrease muscle spasm
64
Which fibers are recruited first in physiological contractions?
slow twitch, fast are contracted only when need extra force
65
Which fibers are recruited first in electrical muscle contraction?
large diameter, fast twitch fibers (they have a lower capacitance)
66
Physiological vs electrical contractions : which one would a muscle fatigue?
electrical (because of the fibers being recruited)
67
Which current has a biphasic sine wave current with bursts of 50 bups?
Russian current
68
Which current is symmetrical, balance and square wave with bursts or pulsed at 50Hz?
biphasic pulsed current
69
Which current has two or more biphasic sine wave currents with distinct current beats set at 50 beps?
interferential
70
TENS unit stands for?
transcutaneous electrical nerve stimulation
71
sensory-level stimulation targets stimulation of what kind of fibers?
a-beta fibers
72
Sensory level stimulation would be used for which type patients?
acute pain, post surgically and at a comfortable level (tingling sensation)
73
Pain relief using sensory level stimulation is through pain gating which means?
lasts only as long as the stimulation
74
Why would you combine ice or heat with sensory-level stimulation?
reduce muscle spasm, relaxation, analgesia
75
Motor level stimulation is used for what conditions?
subacute or chronic (NOT acute)
76
Motor level stimulation used is acupuncture like mode targets what?
a-beta and alpha motor neurons
77
motor level stimulation in burst mode targets?
alpha motor neurons and delta fibers
78
Noxious level stimulation stimulates what kind of fibers?
c-fibers
79
Noxious TENS requires how many ms?
10-20
80
What is the arrangement for true interferential?
quadripolar
81
What is the beat frequency for treating acute pain?
80-150 Hz
82
Interferential current uses medium frequency currents in the range of?
3k-5k Hz
83
What is the correct terminology for Russian stim?
neuromuscular electrical stimulation (NMES)
84
What fibers are recruited first for physiologic muscle contraction?
slow twitch
85
Electrically stim muscle contractions recruits which fibers first?
fast twitch
86
What are the indications for russian stim?
muscle strengthening and reeducation, muscle spasm
87
What russian stim is used for strengthening both wrist flexors and extensors in a patient who was recently in a cast?
reciprocal (2 channels) (antagonist/agonist)
88
Which electrode placement is used for high-volt to reduce edema?
monopolar (2 electrodes one being the dispersal)
89
The frequency range for a patient with acute pain with high volt is?
60-120
90
For iontophoresis the phase duration must be long because?
need current to be prolonged in order to push ions into the skin
91
What polarity electrode is needed for ionphoresis using negatively charged chlorine ions?
negative (positive would make the ions stick, need same polarity to repel ions and push them into tissues)
92
What polarity electrode is needed to attract fibroblasts?
negative-used in repair phase of healing (macrophages and neutrophils are attracted to positive-acute phase of healing)
93
Which therapy could be used to aid in the healing of a skin ulceration?
hi-volt or microcurrent
94
What sensation will a patient experience during treatment with micro current?
nothing because the amp is lower than depolarization ability
95
Combination of constructive and destructive interference resulting in a wave with a beat effect is called?
heterodyne

Passive care (2 decks)

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