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Final Flashcards

1
Q

anode

A
  • positive

- electron deficient

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2
Q

cathode

A
  • negative

- electron rich

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3
Q

monophasic current

A
  • phase = pulse duration
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4
Q

biphasic current

A
  • phase duration is one step (ex. just positive)

- pulse duration is two steos (positive and negative)

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5
Q

forms of modulation

A
  • amplitude
  • frequency
  • pulse duration
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6
Q

orthodromic

A
  • propagation of an impulse along a conduction system in the direction it normally travels
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7
Q

antidromic

A
  • propagation of an impulse along a conduction system in the opposite direction to that which it normally travels
  • can occur during estim based on location of stimulation on the nerve
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8
Q

current density relates to…

A
  • size of the electrode

- bigger electrode, lower current density

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9
Q

conventional tens settings

A
  • frequency = 100-150
  • pulse duration = 50-80
  • amplitude = strong but comfortable
  • 20-30 min (but can be used for up to 24 hours)
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10
Q

conventional tens mechanism of action

A
  • gate control

- stimulation of a-beta fibers

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11
Q

conventional tens analgesia duration

A
  • immediate relief with little residual effect
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12
Q

acupuncture-like tens settings

A
  • frequency = 2-10
  • pulse duration = 200-300
  • amplitude = strong, visible muscle contraction
  • 20-30 min
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13
Q

acupuncture-like tens mechanism of action

A
  • brief sharp pain through repetitive muscle twitches and stimulation of a-delta fibers
  • endogenous opioid release
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14
Q

acupuncture-like tens analgesia duration

A
  • up to 5 hrs
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15
Q

where should electrodes not be placed for tens?

A
  • transcranial

- over genitalia

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16
Q

interferential

A
  • 2 medium frequency AC currents interfering with each other (beat frequency is the difference)
  • settings mimic tens protocol
  • thought to be more comfortable, can cover a larger area
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17
Q

sweep

A
  • used in interferential

- frequency modulation (+/- 150)

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18
Q

scan

A
  • used in interferential

- amplitude modulation (can treat a larger tissue)

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19
Q

tens/estim precautions

A
  • cardiac disease
  • impaired sensation
  • malignant tumors
  • skin irritation or open wounds
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20
Q

tens/estim contraindications

A
  • pacemakers, heart conditions (unstable arrhythmia)
  • over carotid sinus
  • thrombosis
  • during 1st trimester of pregnancy
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21
Q

how does estim strengthen muscle?

A
  • overload priniciple (increase pulse duration, amplitude, electrode size, external resistance)
  • specificity (greater effect on type II fibers)
22
Q

benefits of estim in SCI

A
  • counteracts disuse muscle atrophy
  • improves circulation
  • can assist with locomotion, hand grasp, respiration, conditioning, voiding
23
Q

requirements of estim in SCI

A
  • sufficient force to carry out activity
  • not painful
  • can be controlled and repeated
  • acceptable to the user
24
Q

benefits of estim in stroke

A
  • LE stim improves gait, increases ankle DF torque, reduces co-contraction
  • antagonist contraction reduces agonist spasticity
  • improves joint stability (GH)
25
estim electrode placement
- one electrode over motor point | - one over stimulated muscle parallel to fiber orientation
26
estim pt. positioning
- no closed packed - no pain - voluntarily contract when machine is active
27
estim amplitude
- maximally tolerated force is best - >10% of MVIC in injured tissues, >50% in uninjured tissues (compared to other limb) - functional goal should help determine amplitude/duration
28
what to do if nmes is uncomfortable?
- turning down amplitude decreases treatment effect - increase electrode size (to decrease current density) - move electrodes further apart to increase depth, spread effects - increase frequency to decrease impedance, increase depth - decrease pulse duration to shift graph to the left
29
muscle contractions in denervated muscle
- pulse duration >10 ms to stimulate muscle directly | - sometimes use continuous DC current
30
estim frequency protocol
- 20-30 (small) - 35-50 (large) - 50-85 may increase strength but also increases fatigue
31
estim on:off times
- on 6-10 s - off 50-120 s - ratio should be 1:5 to 1:3
32
estim ramp times
- 1-4 s | - longer with spastic antagonist muscles
33
estim pulse duration
- 150-200 (small) | - 200-350 (large)
34
ionto def.
- transcutaneous delivery of ions into the body using low amplitude current to insure unidirectional flow of ions
35
ionto basics
- ions created by dissolving an intended drug - drug must be stable in solution, not altered by electrical current, and needs to be small - treated tissue should be small - effects may be more related to increased permeability of skin
36
purpose of ionto
- alternative to phono, oral and injection methods of drug delivery
37
ionto current density
-
38
ionto dosage
- intensity x time | - 40-80 (40 first treatment, increase as quickly as tolerated)
39
ionto amplitude
- max of most machine is 4 | - increase until patient feels strong tingling or until safe amplitude limit is reached
40
ionto current density
- max safe current amplitude/surface area of electrode
41
ionto duration
- as duration increases, skin resistance decreases (greater burn risk) - usually
42
factors effecting efficacy of ionto
- skin integrity - polarity of electrode and ion need to match - pH of drug solution - concentration of drug in solution (low is better) - presence of competing ions - other treatments before/after?
43
ionto contraindications
- allergic to drug - active bleeding in treatment ares - metallic implants in area - any condition that would contraindicate estim
44
EMG
- quantifies muscle tone
45
EMG advantages
- can pick up low levels of activity that may not be palpable - timing of contraction/relaxation can be recorded - can provide patients with a way of learning how to contract/relax (biofeedback) - tone differentiation (neural or biomechanical)
46
EMG disadvantages
- measures only local area of tissue under electrodes | - requires specialized training/equipment (need to rely on palpation and clinical reasoning w/o it)
47
NCV test
- can determine nerve damage or destruction - one electrode stimulates a nerve and sends an impulse to the other electrode - velocity can be derived
48
speed of a nerve
- related to diameter and myelination of nerve | - normal NCV is 50-60 m/s
49
conditions warranting NCV tests
- carpal/cubital tunnel - radiculopathy, polyneuropathy, other peripheral nerve injuries - GB - charcot-marie-tooth
50
NCV precautions
- decreased skin sensation | - extra care if on anti-coags
51
NCV contraindications
- dermatological conditions in testing area - decreased cognition - pacemakers - electrodes not over eyes - fear of needles

Physical Agents (1 decks)

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