final

Question 1

Ultraviolet range on the spectrum

Answer 1

between 1,800 A – 4,000 A

greatest natural UV light is the sun.

this is a photochemical modality

treatment time is 15 seconds - 2-3 minutes

Question 2

UVC

Answer 2

1800 – 2900 A (shortest wavelength)

Question 3

UVB

Answer 3

2900 - 3200 A

Question 4

UVA

Answer 4

3200 – 4000 A (longest wavelength)

Question 5

Large vs. small lamps

Answer 5

o Handheld placed much closer to body
o Large lamps placed far away
o Both have capability of UVA, UVB,
o Mercury, argon gas, other elements – excite atom in lamp of these different elements = creates ultraviolet light artificially

Question 6

• Physiological effects of UV

Answer 6

o Inflammatory response in skin
 Ultraviolet gets absorbed into skin – creates a histamine response (skin peels because create fluid in skin – pushes skin off)
 Want it in wound care where you want to increase blood flow to skin
 Psoriasis: symptoms worsen during the winter – go for treatment with ultraviolet lamps (typically don’t cure the problem but remedy the symptoms – gets rid of dead, itchy skin)
 Dermatologists use it to treat acne (open pores, remove dead skin)
 Best for inflammatory response: UVB, UVC
o Basilar cell layer – UV enhances production of new cells in this layer
 Excessive exposure can cause too much cell production = cancerous cells
 Good for wound care – use a small portable handheld device for this (get inflammatory response and get stimulation of cell production)
 UVA, UVB are best for this
o Increases production of Vitamin D
 Proficiency in vitamin D = Rickets
 Use UV lamps to treat
 Substance in sebum of your skin – pro vitamin D
 When you expose it to UV radiation it converts it to vitamin D
 Osteoporosis – need vitamin D (UV in addition to dietary intake)
 Bands best suited – UVB, UVC
o Enhance the immune response
 Cells in skin that are involved in immunity – Langerhans cells
 Involved in WBC production
 When exposed to UV, enhance production and binding of WBC to bacteria and microorganisms
 Esophylactic Effect
 Enhanced production of WBC ^
 Bands best suited – UVA, UVB
o Direct bactericidal effect
 Only UVC – kills bacteria and other microorganisms in that environment
 use in operating rooms

Question 7

Clinical Applications for UV

Answer 7

o Wounds
o Psoriasis, other skin diseases
o Osteoporosis
o MED test
 Minimal Erythemial Dosage
 Cover body completely, one small area exposed with a cardboard card that has six hold (only thing getting exposed to UV rays), expose one hole, then the next, then the next (expose different holes to different amount of time of UV light – where you see the minimal amount of redness is where you start with treatment time – with progressive treatment they slowly raise your time – wait 6-8 hours to tell patient the results
 People have different reactions to UV light, some could be more photosensitive
 Test = Look at someone’s response to exposure to UV light (optimal exposure dosage time)
 Therapist and patients wear goggles

Question 8

Contraindications/Precautions for UV

Answer 8

• More for general exposure (if you’re treating a small area probably won’t have to worry about these)
• Foods:
o Citrus/lime
o Alcohol
o Strawberries
o Shellfish
o Eggs
• Photosensitive medications
o Antibiotics
o Tranquilizers
o Will tell you if it increases photosensitivity
• Exacerbation of some medical conditions
o Systemic lupus erythramatosis
o Insulin dependent diabetics
o Hyperthyroidism
• Acute skin conditions
o Dermatitis (inflammation, irritation in dermis)
o Cellulitis (inflammation in skin tissue)
• Medical instability/ decreased tolerance
o Pulmonary failure
• Fever
• Other forms of radiation
• Protection of eyes/ protected areas
o Areas that are typically not exposed to UV light (don’t have as much tolerance)

Question 9

Laser

Answer 9

• Photochemical modality (non-thermal)
o More subtle than UV
o Band of radiation is much closer to visible light
 6,000 – 10,000 A (red -> infrared light)

• Specifically cold/low level laser
• Been approved by FDA about 10 years ago
o Looked at efficacy

Question 10

• Laser acronym

Answer 10

o Light
o Amplification by
o Stimulated
o Emission of
o Radiation

Question 11

Use after injury, scar tissue

Answer 11

o Might enhance immune response
o Promotes increased cellular activity during inflammatory phase
o Vague proof

Question 12

• Production for therapeutic light: simplified

Answer 12

o Helium, neon, gallium, aluminum – pass electrical current into chamber and excites atoms – mirrors around chambers so energy bounces back and forth – one mirror is semi permeable to allow radiation to come out – excitation = light let out

Question 13

• Characteristics of Laser Radiation (makes it different from visible light)

Answer 13

o Monochromatic – all of the radiation that comes out = one wavelength (not true with infrared, UVA, UVB, UBC)
o Waves are very coherent – don’t diverge, thin beam that stays coherent (light radiates outward)
o Waves are very collimated – all of the waves are in the same phase – parallel to each other, concentrated to each other
 Contributes to coherency
o Concentrated form of light – wont get as strong of physiological effects like you get with UV

you dont feel any heat.

Question 14

• Some lasers use shorter wavelengths (visible red)

Answer 14

o Shorter the wavelength, less depth of penetration (up to 1 cm)
o Superficial target tissue
o Skin tissue
o Superficial trigger points
o Approx 620 – 695 n,
o HeNe 633
o Ruby 695 nm

Question 15

• Longer wavelengths (infrared)

Answer 15

o Approx. 760 – 1000 nm
o Gallium aluminum arsenide (GaAlAs)
o Ration of gallium and aluminum is varied to create devises of different wavelength
o Deeper penetration
o Up to 5 cm

Question 16

Laser light sources

Answer 16

o Laser diode
o Super Luminous Diode (SLD)
 Power not as strong, not as focused and depth of penetration as laser
o Light Emitting Diode (LED)
 Less likely to have any physiological effects
o Cluster probes (combinations)
 Combination of laser lights, SLD, LED
 Have larger heads

Question 17

Treatment Parameters for Laser

Answer 17

o Be aware of wavelength (nm) (locked into machine)
o Power (mW) (also locked into machine)
o Continuous of pulsed
 90% duty cycle when pulsed
o Energy density (J/cm2) – dosage of laser
 energy x time = J
 wattage x time
 cm 2 is related to size of radiating area of source
 ex: cluster probe – 10cm2
 optimal dosage depending on wound
 program into machine with dosage you want, machine will automatically set treatment time because power and wavelength are already locked in
o Power
 Higher power levels in new generation devices decreases necessary treatment time
 Higher power enhances penetration
 Power can be decreased by pulsing

Question 18

Laser Ex problem

Answer 18

 Cluster probe
 P = 1040 mW (convert into Watts – 1.04 W)
 A = 7.5 cm2
 Protocol says dosage = 10 J/cm2
 How many seconds do you have to treat for to get dosage of 10 J/cm2?
 W x t/ A
 1.04 x t/75
 1.04 t = 75
 = 72 seconds of treatment time (exposure time to get 10 J/cm2)

Question 19

Energy density (dosage)

Answer 19

condition determines dosage

 Describes the energy delivered per unit area amount of energy falling on a surface
 Optimal dose response relationships for different tissues and conditions continues to be studied
 *Acceleration of tissue healing has been shown with doses in the range of 1.0 to 6.0 J/cm2 (more painful conditions – higher dosage; acute – lower dosage; chronic – higher dosage)
 a lot of studies have been in vitro (controlled environment)