Exam 2 Flashcards
1
Q
conduction
A
transfer via direct contact
ex: ice or heat pack on the skin
2
Q
convection
A
transfer via movement of air or liquid
ex: whirlpool or fluidotherapy
3
Q
radiation
A
transfer from energy emitted from surfaces
ex: infrared lamps
4
Q
conversion:
A
energy changed from one from to another
ex: ultrasound absorbed into the tissues
5
Q
definition of cryokinetics
A
cold and motion
6
Q
temperature of cryotherapy is affected by
A
amount of adipose tissue present
7
Q
sensations felt with cooling
A
CBAN
cold, burning, aching, numbness
8
Q
physiological response to cryotherapy
A
1) superficial vasoconstriction
2) slow nerve fiber conduction
3) decrease muscle spindle sensitivity
9
Q
maximum decrease in blood flow of cryotherapy is at what temp
A
57 degrees F
10
Q
what is used to break the pain-spasm cycle prior to exercise
A
cryotherapy
11
Q
PRICE
A
protection, rest, ice, compression, elevation
12
Q
POLICE
A
protection, optimal loading, ice, compression, elevation
13
Q
how does cryotherapy modulate pain
A
-stimulate descending pathways
-prolonged cooling slows nerve conduction
-break the pain-spasm cycle
14
Q
what is used to decrease pain and muscle spasm
A
superficial heat
15
Q
physiological response to superficial heat
A
-increased local blood flow (vasodilation)
-relaxation of smooth muscles
-heat sensation activated A-delta and C-fibers
16
Q
treatment recommendation of heat for low back pain
A
long-duration, low level
17
Q
treatment recommendation of heat for myofascial pain
A
shorter duration, moist heat
18
Q
contrast therapy
A
cycles of vasodilation and vasoconstriction (pumping action) to reduce swelling
-decrease pain and spasm
19
Q
does topical counterirritants change the tissue temperature
A
NO
20
Q
what causes a sensation of cooling or burning
A
topical counterirritants
21
Q
T/F cryptherapy may be used to decreased cell oxygen demand, which may reduce hypoxic cell death
A
true
22
Q
T/F cryokinetics can be used to interrupt the pain-spasm cycle
A
true
23
Q
primary purpose of cryotherapy
A
pain relief
24
Q
arthrogenic muscle inhibition
A
-swelling
-muscle spasms contribute to dysfunction
-linked to early onset joint OA
25
AMI and injuries
-restoring ROM engages lymphatic system and capillary exchange
26
T/F cryotherapy may diminish effects of AMI
true
27
T/F cryotherapy is often used to facilitate recovery
true
28
cautions for cryotherapy
-unknown if cold during inflammatory phase affects healing
-effects of cold remain 15-45 min
29
contraindications for cryotherapy
-Raynauds phenomenon
-complex regional pain syndrome
-cold uticaria
-cold-induced hemoglobinuria
-injuries to larger superficial nerves
30
indications for cryotherapy
-relieve pain
-control swelling
-protect injured tissues
-decrease muscle spasm
31
precautions of cryotherapy
-application over large nerves
-diminished sensation
-poor local circulation
32
modes of delivery for cryotherapy
-ice pack
-cold water immersion
-walk-in pools
-game readys
-ice massage
-cold sprays
33
target tissue temperature of cold
13-15 degrees C (55-60 degrees F)
34
treatment time for cold
15-20 minutes
35
why use cryokinetics
-reduce spasms
-improve AROM
36
why use heat
-soothing and alleviates pain
-reduce muscle tightness
-restore functional ROM
37
indications to use heat
-decrease pain
-decrease muscle spasm
-heat superficial joint capsules
38
contraindications for heat
-diminished sensation
-poor local circulation
-open wounds
39
precautions for heat
-medically unstable
-coronary heart disease
40
modes of delivery of heat
-moist heat pack
-warm water immersion
-paraffin bath
-heat lamps
-fluidotherapy
41
how long should paraffin be applied for
20-30 minutes
42
target tissue temperature for heat
40-45 degrees C (104-113 degrees F)
43
how long should heat be applied
20 plus minutes
44
cold to warm ratio for contrast therapy
1:3 or 1:4
45
how does cryotherapy aide in pain modulation
cold slows down the transmission of pain signals
46
general treatment time for cryotherapy
15-20 minutes
47
which phase of healing should superficial heat not be used in
inflammatory
-or it can be used in any phase
-depends on clinician
48
pharmacology definition
science of drugs, including their biochemistry, uses, and biological and therapeutic effects
49
pharmacodynamics
study of the actions of drugs on living organisms
50
what is pharmacodynamics dependent on
isomers, dosing, potency, and interactions
51
what has to happen for a drug to have an effect
must bind to a receptor
52
dosage
the amount
53
standard dose
single size dose appropriate for all adult patients regardless of age or body size
54
pediatric dose
drugs dosed according to age, weight, body surface area, and anticipated action of the drug
55
potency
a drugs strength
-more potent a drug is, the less dose required
56
drug interactions
when one drug alters the effects of another
-divided into altered pharmacokinetics and altered pharmacodynamics
57
altered pharmacokinetics
interaction of two or more drugs alters the way the body handles a particular drug
58
altered pharmacodynamics
interaction of two or more drugs changes the actions of the drugs themselves
-inhibitory: each drug decreases effect of each other
-additive: similar effects of two drugs add together to produce a stronger total effect
59
drugs interactions with alcohol
-have serious life threatening effects
-may cause GI bleeding
-liver damage
60
drug interactions with food
-dairy may limit effect of some drugs
-some foods increase absorption of a drug
61
adverse drug reactions
-aka negative side effects
-any drug effect that is undesirable
-can be local or systematic
62
pharmacokinetics
study of how the body handles a drug
63
what does pharmacokinetics depend on
absorption
distribution
metabolism
elimination
64
absorption
-must be absorbed into bloodstream to exert its effect
-speed influenced on solubility, intended sites surface area, administration
65
enteral admin
routes that involve absorption of a medication by GI system
-ex: oral, buccal, sublingual, rectal
66
parenteral admin
introduced into the body in a manner other than digestive system
-ex: intramuscular, subcutaneous, IV, intra-articular injections
67
intranasal or oral inhalation admin
drugs introduced by nasal or oral inhalation
-ex: nasal spray or inhaler
68
topical applications
drugs administered via the eye, ear, and skin
69
T/F exercise may decrease the absorption of orally ingested drugs by diverting blood flow to the skeletal muscles and away from the GI tract
true
70
bioavailability
amount of a drug that is actually active in the body issues and therefore able to exert a therapeutic effect
71
distribution of a drug
ready for circulatory system to distribute it throughout the body so it can exert its effect
-increase cardiac effect = increase distribution
-exercise may speed up distribution
72
metabolism
sum of all chemical processes that take place in the body
-carried out by the liver
-increase activity can decrease clearance of some drugs
73
elimination
eliminate drugs from body tissues and organs via urinary, feces, lungs, sweat glands
74
half-life
time required for the body to eliminate one-half of a dosage of the substance by regular physical processes
75
which drug admin takes quicker effect
injection and inhalation
76
over the counter medications
-drugs considered safe for self-admin without prescription
-treat minor illnesses, injuries, etc
-must be approved by the FDA
77
dietary supplements
-any medication to promote "natural substance" with claims of improved function (strength, function, endurance), and health, no claim to affect the illness
78
how are controlled substance ranked on (3)
-risk of abuse
-risk of addiction
-is there a recognized medical usage
79
schedule 1 drugs
-high abuse rate
-no medical use
-lack of accepted safety for use
ex: heroin, LSD
80
schedule 2 drugs
-high abuse rate
-has minimal accepted medical use (with severe restrictions)
-abuse may lead to addiction
ex: oxycodone (Percocet)
81
schedule 3 drugs
-less risk for abuse
-currently accepted medical use
-moderate to low dependency
ex: codein, hydrocodone, anabolic steroids
82
schedule 4 drugs
-low potential for abuse
-accepted medical use
-abuse may lead to limited dependency
ex: lorazapam
83
schedule 5 drugs
-very little risk of abuse
-accepted medical use
-abuse may lead to limited dependency
ex: diphenoxylate hydrochloride
84
generic name
official assigned name
ex: acetaminophen
85
brand name
Advil or Tylenol
86
guidelines for storing and dispensing meds
-AT have poor compliance with federal drug laws
-keep updated inventory with expiration dates
-record all meds dispensed
-lock med cabinet
-no dispensing to minors
87
what does medication labels need to have on them
-PT name and address
-prescriber name
-drug name, potency, quantity
-pharmacy name, address, number
-dosage directions
-number of refills
-date the pharmacy filled the prescription
88
OTC drug labels
-active ingredients
-use
-warning
-inactive ingredients
-purpose
-directions
-expiration date
-lot or batch number
-manufacturer info
-net quantity
-what to do if an overdose occurs
89
how can the AT prevent legal action
compassion
communication
competence
charting
90
best definition of pharmacodynamics
study of the actions of drugs on living organisms
91
T/F you are not required to be aware of the medications your patients are taking
false
92
T/F studies have shown AT have high compliance with federal drug laws
false
93
4 A's of aspirin
anti-pyretic
anti-inflammatory
anti-platelet
analgesic
94
what is aspirin used for
pain, fever, inflammation
95
what does aspirin bind to
COX enzyme
96
antipyretic
anti-fever
97
how does aspirin bind to COX
irreversibly
98
what happens when aspirin binds to COX
increased prostaglandins increase pain, promote coagulation, contribute to inflammatory process
99
aspirin routes of admin
orally (tablet)
-liquid, dissolvable powders, suppositories
100
max dose for aspirin
4000 mg in 24 hrs
101
loading dose
larger first dose for quicker effects
102
how long does it take for aspirin to be absorbed into the GI
30 minutes
103
aspirin side effects
-GI bleeding, ulceration
-hepatotoxicity
-increased bleeding risk
-nephrotoxicity
-allergic reaction
-Reye's syndrome in children
104
what should you NOT combine with aspirin
-anticoagulants
-corticosteroids
-other NSAIDs
-alcohol
105
aspirin contraindications
-pregnancy
-people with peptic ulcer disease, GI bleeding, or liver disease
-nasal polyps
-asthma
106
how does NSAIDs bind to COX
reversible
-less anti-platelet action
107
brand names of ibuprofen
Advil
Motrin
108
brand names of naproxen
Aleve
109
NSAID 4 A’s
anti-inflammatory
analgesic
antipyretic
minimal anti-platelet
110
T/F NSAIDs could diminish the inflammatory response and could delay the healing process
true
111
max daily dose of ibuprofen
1200 mg
112
max daily dose of naproxen
660 mg
113
max daily dose of katoprofen
75 mg
114
NSAID side effects
-GI bleeding, ulceration
-hepatotoxicity
-increased bleeding risk
-nephrotoxicity
-allergic reaction
115
NSAID contraindications
pregnancy
peptic ulcer disease, GI bleeding, liver disease
nasal polyps
asthma
116
aspirin and NSAID guidelines for ATs
-acute injuries may not require meds
-must be aware of who is taking them and how much
-contraindicated under 18
117
corticosteroids effects
suppress inflammatory process and can effect almost all of the body's organs
-prescription only
118
hydrocortisone ointment
treat external itching and inflammation associated with fungal infections (does not kill the fungus)
119
what is corticosteroids prescribed for
-skin disorders
-nasal inflammation
-respiratory ailments, asthma
-RA and bursitis
-GI disorders, Crohn's
-treat inflamed joints
120
corticosteroids routes of admin
-topical creams and ointments
-nasal inhalants and sprays
-lung inhalants or sprays
-tables or syrups
-intra-articular, bursal, or tendon sheath injection
121
side effects of corticosteroids
-increase blood sugar in those with diabetes
-local injections may burn, hypopigmentation, local tissue atrophy
-suppress body's immune system
-prolonged use and increase risk of osteoporosis, cataracts
-eye pain, loss or blurred vision
-stomach pain or burning, black, tarry stools, nausea, vomit
-swelling of feet and legs
-skin rash, hives, burning, blisters, acne
-menstrual irregulatries
-prolonged sore throat, fever, cold
122
categoris of non-anti-inflammatory analgesics
acetaminophen
opiate agonists
tramadol
123
when to use acetaminophen
relief of mild to moderate pain or fever
124
when to use opiate agonists
relieve moderate to severe pain
125
when to use tramadol
relieve moderate pain
126
non-anti-inflammatory analgesics routes of admin
tablet or capsule
30-60 min for oral admin
127
max dose of acetaminophen
4000 mg
128
max dose of opiates and tramadol
follow prescription
129
side effect of acetaminophen
liver toxicity
130
side effect of opiate agonists
respiratory depression
constipation
nausea
dependency
131
side effect of tramadol
dependency
increased seizure risk
132
considerations before use of acetaminophen
-not used by those with liver damage or for long periods of time
-avoid alcohol
133
considerations before use of opiate agonist
acts as a depressant to the body's respiratory and CNS functions
134
muscle relaxants
-anti-anxiety medication that decreases bodily awareness
-prescribed for low back pain
-causes general sedative effect resulting in overall relaxation
135
how does injectable anesthetics and topical pain relievers work
reversibly block the conduction of impulses along nerve pathways and other membranes
136
counterirritant
agent that causes irritation or mild inflammation of the skill with the objective to relieve pain
137
most common injectable local anesthetics
lidocaine, blocks pain sensation
138
what is injectable local anesthetics used for
soft tissue injuries
hip pointers
AC joint sprain
turf toe
nondisplaced rib fractures
reduction of phalangeal dislocations
139
injectable local anesthetics side effects
usually safe when used as directed
-stimulation of CNS (tremors/seizures), drowsiness, cardiac arrhythmias, hypotension, hypersensitivty
140
what is a potential side effect to local anesthetics
seizure
141
what changes how the body processes the pain and replaces it with burning or cooling sensation
counterirritants
142
capsaicin
creates a warm, burning sensation
143
menthol
feeling of coolness
144
methyl salicylate
winter-green oil
145
side effects of topical ointments/counterirritants
toxic reactions
seizures and cardiac arrest
rash, hives
146
T/F NSAIDs could delay healing
true
147
an infrared heat lamp is example of what thermal energy transfer
radiation
148
T/F according to the inverse-square law, if light (energy) strikes the skin at 30 degree angle, the heating effect decreases
false
149
what is true regarding temperature decrease during cryotherapy
quantity of adipose tissue affects the rate of cooling due to its insulation properties
150
T/F the application of a cold modality may stimulate the descending neural pathways to modulate pain
true
151
T/F cryotherapy is contradicated for patients with complex regional pain syndrome
true
152
T/F ice massage is an excellent way to reduce pain prior to therapeutic exercise
true
153
therapeutic temperature range for cold modalities
15-18 degrees C
154
what type of disorder is Raynauds phenomenon
vasospastic disorder
155
what modality permits therapeutic exercise during heat application
fluidotherapy
156
how does cooling affect blood flow
-vasoconstriction
-increase blood thickness
-decrease blood flow
157
how does cooling affect muscle
-decrease muscle spasms
-relax muscle spindles
158
how does cooling affect the nervous system
-slower responses
-decrease conduction speed
-freezes all sensations
159
how does heat affect blood flow
-decrease blood viscosity
-vasodilation
-increase blood flow
160
how does heat affect muscles
-relax and soothes muscles
-decreases muscle spindle tension
-increase tissue elasticity
161
how hoes heat affect the nervous system
A-beta fibers modulate pain via ascending pathway
-increase neural conduction rate
162
cooling and AMI
disinhibitory effect via decrease in nerve conduction velocity and stimulation
-decreases nerve sensitivity
-decrease pooling of swelling and muscle weakness
-freezes muscles activities and prevents AMI
163
heat and AMI
-decrease pain and muscle spasms
-increase conduction velocity
-decrease depolarizing the threshold
-increase temp of the area
-increases tissue elasticity
