Exam 1 Info Flashcards
1
Q
Types of electrical therapeutic modalities
A
- E-stim
- Iontophoresis
- biofeedback
2
Q
Types of sound energy therapeutic modalities
A
- ultrasound
2. phonophoresis
3
Q
Types of thermal energy therapeutic modalities
A
- thermotherapy (heat)
2. cryotherapy (cold)
4
Q
Types of electromagnetic therapeutic modalities
A
- diathermy
2. laser
5
Q
wavelength
A
distance between the peak of one wave and the peak of the next wave
6
Q
frequency
A
- number of wave oscillations per second measured in Hz
- number of cycles per second
7
Q
speed formula
A
wavelength x frequency
8
Q
How are energy and frequency related?
A
directly proportional; greater frequency = greater energy
9
Q
What happens to wavelength, frequency, and the energy level if speed is constant?
A
longer wavelengths, lower frequency, and lower energy
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
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
12
Q
Cosine Law
A
- important for diathermy
- more easily transmitted to deep tissues if placed at the right angle
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
14
Q
Types of mechanical energy therapeutic modalities
A
- traction
2. massage
15
Q
energy
A
-capacity of a system for doing work
16
Q
diathermies
A
- larger regions of radiation with longer wavelengths
- short & microwave radiations
- penetrate tissues more deeply than infrared or visible light
17
Q
depth of penetration for shortwave diathermy
A
3 cm
18
Q
physiological effects of diathermy
A
-deep tissue temperature, increased vasodilation, increased blood flow
19
Q
depth of penetration for microwave diathermy
A
5 cm
20
Q
physiological effects of infrared light
A
-superficial temperature, increased vasodilation, increased blood flow
21
Q
physiological effects of visible light
A
-pain modulation & wound healing
22
Q
depth of penetration for visible light
A
- 5 cm (GaAs)
- 10-15 mm (HeNe)
23
Q
physiological effects of ultraviolet light
A
-superficial chemical changes, tanning effects, bactericidal
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
25
acidic reaction
-the accumulation of negative ions under the positive pole that produces hydrochloric acid
26
active electrode
electrode that is used to drive ions into the tissues
27
alkaline reaction
-accumulation of positive ions under the negative electrode that produces sodium hydroxide
28
electrolytes
-solutions in which ionic movement occurs
29
electrophoresis
-movement of ions in solution
30
ionization
-process by which soluble compounds such as acids, alkaloids, or salts dissociate or dissolve into ions that are suspended in some type of solution
31
Ohm's Law
current flow = (voltage) / (resistance)
32
modulation
-refers to any alteration in the amplitude, duration, or frequency of the current during a series of pulses or cycles
33
medical galvanism
creates either an acidic or an alkaline environment that may be of therapeutic value
34
iontophoresis
- continuous direct current to drive ions into tissues
| - used with medication to help with inflammatory conditions
35
bursts
-combined set of three or more pulses; also referred to as packets or envelopes
36
Clinically speaking, what is ramping modulation usually used for?
-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
37
tetanization
when individual muscle twitch responses can no longer be distinguished & the responses force maximum shortening of the stimulated muscle fiber
38
ramping
-another name for surging modulation, in which the current builds gradually to some maximum amplitude
39
cathode
- greater number of electrons
| - negative electrode
40
anode
- lower number of electrons
| - positive electrode
41
inflammatory-response phase signs & symptoms
-tenderness, swelling, redness, increased tenderness, loss of function
42
inflammatory-response phase cellular response
-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
43
inflammatory-response phase chemical mediators (3)
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
sequence of inflammatory response
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
fibroblastic-repair phase signs & symptoms
-tenderness to touch & pain with movement. gradually subside
46
When does the fibroblastic-repair phase begin?
a. first few minutes
b. first few days
c. first few hours
d. first few weeks
c. first few hours
47
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. up to 4-6 weeks
48
revascularization
-growth of new blood vessels, stimulated by lack of oxygen
49
Process of scar formation?
-granulation tissue -> collagen & elastin fibers
50
maturation-remodeling phase
- realignment of collage fibers
| - may require up to several years for complete healing
51
What are the main goals for treatment using modalities during the acute phase of healing?
-reduce inflammation & pain
52
During which phase of healing should injured structures be subjected to controlled mobilization & progressively increasing loads?
-remodeling phase of healing
53
indications for using high volt estim
-pain modulation, muscle reeducation, muscle pumping contractions, retard atrophy, muscle strengthening, increase ROM, fracture healing, acute injury
54
indications for using low volt estim
-wound healing, fracture healing, iontophoresis
55
indications for using interferential estim
-pain modulation, muscle reeducation, muscle pumping contractions, fracture healing, increase ROM
56
indications for using russian estim
-muscle strengthening
57
indications for using MENS (microcurrent electrical nerve stimulator)
- fracture healing
| - wound healing
58
indications for using shortwave & microwave diathermy
-increase deep circulation, increase metabolic activity, reduce muscle guarding/spasm, reduce inflammation, facilitate wound healing, analgesia, increase tissue temperatures over a large area
59
indications for cryotherapy (cold packs, ice massage)
-acute injury, vasoconstriction (decreased blood flow), analgesia, reduce inflammation, reduce muscle guarding/spasm
60
indications for thermotherapy (hot whirlpool, paraffin, hydrocollators, infrared lamps)
-vasodilation (increased blood flow), analgesia, reduce muscle guarding/spasm, reduce inflammation, increase metabolic activity, facilitate tissue healing
61
indications for using low-power laser
- pain modulation (trigger points)
| - facilitate wound healing
62
pain
-an unpleasant sensory & emotional experience associated with actual or potential tissue damage, or described in terms of such damage
63
chronic pain
- persists
| - lasts more than 6 months
64
referred pain
-pain in an area that seems to have little relation to existing pathology
65
radiating pain
-nerves & nerve roots
66
deep somatic pain
-seems to be sclerotomic (associated with a segment of bone innervated by a spinal segment)
67
accommodation
- 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
afferent nerve fibers
-transmit impulses from the sensory receptors toward the brain
69
efferent nerve fibers
-transmit impulses from the brain toward the periphery
70
cell injury (chemicals released & the nociception pathway)
-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
Which types of pain & temperature sensations do A-delta fibers transmit & what are theircharacteristics?
- large diameter
- originate in skin
- fast conduction velocity
- transmits "fast", acute, localized pain
72
What types of pain & temperature sensations do C fibers transmit & what are their characteristics?
- originate in skin & deeper tissue
- smaller diameter
- slower conduction velocity
- transmits "slow", chronic, general pain
73
Gate Control Theory of Pain
- 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
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.)?
-gate control theory of pain
75
descending pain control
- 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
B-endorphin & dynorphin definition & their relationship to pain
- 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
Which modalities, during pain management, can be used to stimulate large-diameter afferent fibers?
-TENS, massage, analgesic balms
78
Which modalities for pain management can be used to decrease pain fiber transmission velocity?
-cold, US
79
Which modalities being used for pain management can stimulate small-diameter afferent fibers & descending pain control mechanisms?
-deep massage, TENS
80
Which modalities for pain management can be used to stimulate a release of B-endorphin & dynorphin through prolonged small-diameter fiber stimulation?
-TENS
81
ampere
-rate of electron (electrical current) flow
82
resistance/impedance
-opposition to electron flow (ohm)
83
Which biological tissue is the worst conductor?
-bone
84
Which biological tissue is the best conductor?
-blood
85
current density
-amount of current flow per cubic area
86
closer electrode spacing for current density
-superficial current density
87
further electrode spacing for current density
-deeper current density
88
importance of electrode size with current density
- larger electrode spreads out the current
| - smaller electrode concentrates the current into one area & goes deeper compared to the larger electrode
89
noxious level frequency range
1-10 pps
90
motor frequency range
20-70
91
tetany frequency range
40-70
92
muscle contraction frequency range
20-40
93
sensory frequency range
80-125/150
94
examples of electrophysiologic testing
1. nerve conduction studies (NCS)
2. electromyography (EMG)
3. somatosensory evoked potentials (SEP)
95
proper room temperature for EMG
- room temp should be around 25 deg Celsius
| - limb temp should be 30-32 deg Celsius
96
What ages would have slower nerve conduction?
-below 16 years old and older than 60
97
What kind of wave does the stimulating electrode create during sensory nerve conduction studies?
-single, monophasic square wave
98
general NCV values for UE & LE
- UE = at least 50 m/s
| - LE = at least 40 m/s
99
What do motor nerve conduction studies assess?
-functions of the nerve, neuromuscular junction, & muscle fibers innervated by the available axons
100
What parameters do nerve conduction studies assess?
-amplitude, rise time, duration, shape, NCV, latency compared with NCV
101
latency vs. NCV
- directly related to each other
- latency = time
- NCV = speed
- short latency = fast NCV
- long latency = slow NCV
102
examples of abnormal spontaneous activity with EMGs
- fibrillation potentials
- positive sharp waves
- myotonic discharges
103
What does SAD stand for when looking at graphs for motor unit characteristics?
-shape, amplitude, duration
104
precautions/contraindications for iontophoresis
- 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
indications for biofeedback
-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
contraindication for biofeedback
-any MSK condition that a muscular contraction may exacerbate
