final Flashcards
Ultraviolet range on the spectrum
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
UVC
1800 – 2900 A (shortest wavelength)
UVB
2900 - 3200 A
UVA
3200 – 4000 A (longest wavelength)
Large vs. small lamps
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
• Physiological effects of UV
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
Clinical Applications for UV
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
Contraindications/Precautions for UV
• 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)
Laser
• 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
• Laser acronym
o Light
o Amplification by
o Stimulated
o Emission of
o Radiation
Use after injury, scar tissue
o Might enhance immune response
o Promotes increased cellular activity during inflammatory phase
o Vague proof
• Production for therapeutic light: simplified
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
• Characteristics of Laser Radiation (makes it different from visible light)
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.
• Some lasers use shorter wavelengths (visible red)
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
• Longer wavelengths (infrared)
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
Laser light sources
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
Treatment Parameters for Laser
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
Laser Ex problem
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)
Energy density (dosage)
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)
