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Clinical Procedures 2 > Exam 1 Info > Flashcards

Exam 1 Info Flashcards

1
Q

Types of electrical therapeutic modalities

A
  1. E-stim
  2. Iontophoresis
  3. biofeedback
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2
Q

Types of sound energy therapeutic modalities

A
  1. ultrasound

2. phonophoresis

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3
Q

Types of thermal energy therapeutic modalities

A
  1. thermotherapy (heat)

2. cryotherapy (cold)

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4
Q

Types of electromagnetic therapeutic modalities

A
  1. diathermy

2. laser

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5
Q

wavelength

A

distance between the peak of one wave and the peak of the next wave

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6
Q

frequency

A
  • number of wave oscillations per second measured in Hz

- number of cycles per second

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7
Q

speed formula

A

wavelength x frequency

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8
Q

How are energy and frequency related?

A

directly proportional; greater frequency = greater energy

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9
Q

What happens to wavelength, frequency, and the energy level if speed is constant?

A

longer wavelengths, lower frequency, and lower energy

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10
Q

Arndt-Shultz Principle

A
  • no reaction/change can occur if E is insufficient to stimulate tissues
  • need high enough dose to do anything
  • deliver enough but recognize flip side that too much could cause damage
  • understanding the amt of enough but not too much
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11
Q

Law of Grotthus-Draper

A
  • inverse relationship b/n penetration of tissues & absorption
  • ultrasound is an example
  • US at a shorter freq, longer wavelength less is absorbed superficially & more gets deeper
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12
Q

Cosine Law

A
  • important for diathermy

- more easily transmitted to deep tissues if placed at the right angle

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13
Q

Inverse Square Law

A
  • intensity of radiation striking surface is inversely related to square of distance
  • decrease distance (closer you are) the exponentially greater it will be
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14
Q

Types of mechanical energy therapeutic modalities

A
  1. traction

2. massage

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15
Q

energy

A

-capacity of a system for doing work

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16
Q

diathermies

A
  • larger regions of radiation with longer wavelengths
  • short & microwave radiations
  • penetrate tissues more deeply than infrared or visible light
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17
Q

depth of penetration for shortwave diathermy

A

3 cm

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18
Q

physiological effects of diathermy

A

-deep tissue temperature, increased vasodilation, increased blood flow

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19
Q

depth of penetration for microwave diathermy

A

5 cm

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20
Q

physiological effects of infrared light

A

-superficial temperature, increased vasodilation, increased blood flow

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21
Q

physiological effects of visible light

A

-pain modulation & wound healing

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22
Q

depth of penetration for visible light

A
  • 5 cm (GaAs)

- 10-15 mm (HeNe)

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23
Q

physiological effects of ultraviolet light

A

-superficial chemical changes, tanning effects, bactericidal

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24
Q

electromyographic biofeedback

A

-therapeutic procedure that uses electronic or electromechanical instruments to accurately measure, process, & feedback reinforcing information via auditory or visual signals

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25
Q

acidic reaction

A

-the accumulation of negative ions under the positive pole that produces hydrochloric acid

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26
Q

active electrode

A

electrode that is used to drive ions into the tissues

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27
Q

alkaline reaction

A

-accumulation of positive ions under the negative electrode that produces sodium hydroxide

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28
Q

electrolytes

A

-solutions in which ionic movement occurs

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29
Q

electrophoresis

A

-movement of ions in solution

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30
Q

ionization

A

-process by which soluble compounds such as acids, alkaloids, or salts dissociate or dissolve into ions that are suspended in some type of solution

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31
Q

Ohm’s Law

A

current flow = (voltage) / (resistance)

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32
Q

modulation

A

-refers to any alteration in the amplitude, duration, or frequency of the current during a series of pulses or cycles

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33
Q

medical galvanism

A

creates either an acidic or an alkaline environment that may be of therapeutic value

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34
Q

iontophoresis

A
  • continuous direct current to drive ions into tissues

- used with medication to help with inflammatory conditions

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35
Q

bursts

A

-combined set of three or more pulses; also referred to as packets or envelopes

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36
Q

Clinically speaking, what is ramping modulation usually used for?

A

-to elicit muscle contraction & is generally considered to be a very comfortable type of current since it allows for gradual increase in intensity of a muscle contraction

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37
Q

tetanization

A

when individual muscle twitch responses can no longer be distinguished & the responses force maximum shortening of the stimulated muscle fiber

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38
Q

ramping

A

-another name for surging modulation, in which the current builds gradually to some maximum amplitude

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39
Q

cathode

A
  • greater number of electrons

- negative electrode

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40
Q

anode

A
  • lower number of electrons

- positive electrode

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41
Q

inflammatory-response phase signs & symptoms

A

-tenderness, swelling, redness, increased tenderness, loss of function

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42
Q

inflammatory-response phase cellular response

A

-leukocytes & other phagocytic cells & exudate are delivered to injured tissue. this protective response disposes of injury by-products through phagocytosis & sets the stage for repair

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43
Q

inflammatory-response phase chemical mediators (3)

A
  1. histamines - release from injured mast cells, cause vasodilation & increased cell permeability
  2. leukotrienes - responsible for marginalization, adhere to cell walls, “walling off”
  3. cytokines - regulate leukocytes & attract them to the site of inflammation
44
Q

sequence of inflammatory response

A
  1. injury to cell
  2. chemical mediators liberated (histamines, leukotrienes, cytokines)
  3. vascular reaction (vasoconstriction -> vasodilation -> exudate creates stasis)
  4. platelets & leukocytes adhere to vascular wall
  5. phagocytosis
  6. clot formation
45
Q

fibroblastic-repair phase signs & symptoms

A

-tenderness to touch & pain with movement. gradually subside

46
Q

When does the fibroblastic-repair phase begin?

a. first few minutes
b. first few days
c. first few hours
d. first few weeks

A

c. first few hours

47
Q

How long does the fibroblastic-repair phase last?

a. up to 4-6 weeks
b. up to 4-6 hours
c. up to 4-6 days
d. up to 4-6 minutes

A

a. up to 4-6 weeks

48
Q

revascularization

A

-growth of new blood vessels, stimulated by lack of oxygen

49
Q

Process of scar formation?

A

-granulation tissue -> collagen & elastin fibers

50
Q

maturation-remodeling phase

A
  • realignment of collage fibers

- may require up to several years for complete healing

51
Q

What are the main goals for treatment using modalities during the acute phase of healing?

A

-reduce inflammation & pain

52
Q

During which phase of healing should injured structures be subjected to controlled mobilization & progressively increasing loads?

A

-remodeling phase of healing

53
Q

indications for using high volt estim

A

-pain modulation, muscle reeducation, muscle pumping contractions, retard atrophy, muscle strengthening, increase ROM, fracture healing, acute injury

54
Q

indications for using low volt estim

A

-wound healing, fracture healing, iontophoresis

55
Q

indications for using interferential estim

A

-pain modulation, muscle reeducation, muscle pumping contractions, fracture healing, increase ROM

56
Q

indications for using russian estim

A

-muscle strengthening

57
Q

indications for using MENS (microcurrent electrical nerve stimulator)

A
  • fracture healing

- wound healing

58
Q

indications for using shortwave & microwave diathermy

A

-increase deep circulation, increase metabolic activity, reduce muscle guarding/spasm, reduce inflammation, facilitate wound healing, analgesia, increase tissue temperatures over a large area

59
Q

indications for cryotherapy (cold packs, ice massage)

A

-acute injury, vasoconstriction (decreased blood flow), analgesia, reduce inflammation, reduce muscle guarding/spasm

60
Q

indications for thermotherapy (hot whirlpool, paraffin, hydrocollators, infrared lamps)

A

-vasodilation (increased blood flow), analgesia, reduce muscle guarding/spasm, reduce inflammation, increase metabolic activity, facilitate tissue healing

61
Q

indications for using low-power laser

A
  • pain modulation (trigger points)

- facilitate wound healing

62
Q

pain

A

-an unpleasant sensory & emotional experience associated with actual or potential tissue damage, or described in terms of such damage

63
Q

chronic pain

A
  • persists

- lasts more than 6 months

64
Q

referred pain

A

-pain in an area that seems to have little relation to existing pathology

65
Q

radiating pain

A

-nerves & nerve roots

66
Q

deep somatic pain

A

-seems to be sclerotomic (associated with a segment of bone innervated by a spinal segment)

67
Q

accommodation

A
  • decline in generator potential & the reduction of frequency that occur with prolonged or frequently repeated stimuli
  • if modalities are used too much or too long, the receptors may adapt to the stimulus & reduce their impulses
68
Q

afferent nerve fibers

A

-transmit impulses from the sensory receptors toward the brain

69
Q

efferent nerve fibers

A

-transmit impulses from the brain toward the periphery

70
Q

cell injury (chemicals released & the nociception pathway)

A

-release of 3 chemicals (substance P, prostaglandins, & leukotrienes) that sensitize nociceptors in/around the area by lowering the depolarization threshold. this results in primary hyperalgesia (enhanced pain response) then secondary hyperalgesia (hypersensitivity)

71
Q

Which types of pain & temperature sensations do A-delta fibers transmit & what are theircharacteristics?

A
  • large diameter
  • originate in skin
  • fast conduction velocity
  • transmits “fast”, acute, localized pain
72
Q

What types of pain & temperature sensations do C fibers transmit & what are their characteristics?

A
  • originate in skin & deeper tissue
  • smaller diameter
  • slower conduction velocity
  • transmits “slow”, chronic, general pain
73
Q

Gate Control Theory of Pain

A
  • stimulation from ascending A-beta afferents results in blocking impulses at the spinal cord level of pain messages carried along A-delta & C fibers
  • non-nociceptive pain A-beta pain fibers inhibit the effects of A-delta & C fibers, “closing the gate”
74
Q

Which theory of pain is the basis for many modalities that provide sensory stimulation as a method of pain relief (massage, application of moist heat, etc.)?

A

-gate control theory of pain

75
Q

descending pain control

A
  • stimulation of descending pathways in the dorsolateral tract of the spinal cord by C fiber input results in a blocking of impulses carried along the A-delta & C fibers
  • influence from the thalamus stimulates the periaqueductal gray, the raphe nucleus, & the pons to inhibit the transmission of pain through ascending tracts
76
Q

B-endorphin & dynorphin definition & their relationship to pain

A
  • endogenous opiod peptide neurotransmitters found in the CNS & PNS
  • stimulation of A-delta & C fiber afferent fibers cause the release of endogenous opiods, resulting in prolonged activation of descending analgesic pathways
77
Q

Which modalities, during pain management, can be used to stimulate large-diameter afferent fibers?

A

-TENS, massage, analgesic balms

78
Q

Which modalities for pain management can be used to decrease pain fiber transmission velocity?

A

-cold, US

79
Q

Which modalities being used for pain management can stimulate small-diameter afferent fibers & descending pain control mechanisms?

A

-deep massage, TENS

80
Q

Which modalities for pain management can be used to stimulate a release of B-endorphin & dynorphin through prolonged small-diameter fiber stimulation?

A

-TENS

81
Q

ampere

A

-rate of electron (electrical current) flow

82
Q

resistance/impedance

A

-opposition to electron flow (ohm)

83
Q

Which biological tissue is the worst conductor?

A

-bone

84
Q

Which biological tissue is the best conductor?

A

-blood

85
Q

current density

A

-amount of current flow per cubic area

86
Q

closer electrode spacing for current density

A

-superficial current density

87
Q

further electrode spacing for current density

A

-deeper current density

88
Q

importance of electrode size with current density

A
  • larger electrode spreads out the current

- smaller electrode concentrates the current into one area & goes deeper compared to the larger electrode

89
Q

noxious level frequency range

A

1-10 pps

90
Q

motor frequency range

A

20-70

91
Q

tetany frequency range

A

40-70

92
Q

muscle contraction frequency range

A

20-40

93
Q

sensory frequency range

A

80-125/150

94
Q

examples of electrophysiologic testing

A
  1. nerve conduction studies (NCS)
  2. electromyography (EMG)
  3. somatosensory evoked potentials (SEP)
95
Q

proper room temperature for EMG

A
  • room temp should be around 25 deg Celsius

- limb temp should be 30-32 deg Celsius

96
Q

What ages would have slower nerve conduction?

A

-below 16 years old and older than 60

97
Q

What kind of wave does the stimulating electrode create during sensory nerve conduction studies?

A

-single, monophasic square wave

98
Q

general NCV values for UE & LE

A
  • UE = at least 50 m/s

- LE = at least 40 m/s

99
Q

What do motor nerve conduction studies assess?

A

-functions of the nerve, neuromuscular junction, & muscle fibers innervated by the available axons

100
Q

What parameters do nerve conduction studies assess?

A

-amplitude, rise time, duration, shape, NCV, latency compared with NCV

101
Q

latency vs. NCV

A
  • directly related to each other
  • latency = time
  • NCV = speed
  • short latency = fast NCV
  • long latency = slow NCV
102
Q

examples of abnormal spontaneous activity with EMGs

A
  • fibrillation potentials
  • positive sharp waves
  • myotonic discharges
103
Q

What does SAD stand for when looking at graphs for motor unit characteristics?

A

-shape, amplitude, duration

104
Q

precautions/contraindications for iontophoresis

A
  • burns & skin sensitivity
  • sensitivity to ions = sensitivity to aspirin (salicylates), gastritis/stomach ulcer (hydrocortisone), asthma (mecholyl), sensitivity to metals (zinc, copper, magnesium), sensitivity to seafood (iodine)
105
Q

indications for biofeedback

A

-muscle reeducation, regaining neuromuscular control, increasing isometric contraction & isometric strength of a muscle, relaxation of muscle spasm, decreasing muscle guarding, pain reduction, psychological relaxation

106
Q

contraindication for biofeedback

A

-any MSK condition that a muscular contraction may exacerbate

Clinical Procedures 2 (3 decks)

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