Final Exam Flashcards
1
Q
what temperature needs to be applied to get a temperature rise in the skin
A
100 F and 40 C
2
Q
the more area covered the ______ systemic effect
A
more
3
Q
for each 10 degrees C there is a 2-3x _____ in metabolic reactions
A
increase
4
Q
why does tissue burn occur?
A
metabolic activity required to repair the tissue isn’t capable of matching protein denaturation
5
Q
oxygen uptake ____ with heat and promotes _____
A
increases, tissue healing
6
Q
what causes vasodilation with heat
?
A
histamine, prostaglandin and cutaneous thermoreceptors
7
Q
when heat is applied what happens to the sympathetic adrenergic activation?
A
it decreases and sends the info to SC dorsal root ganglion
8
Q
which reflex decreases the SNA adrenergics to blood vessel smooth mm?
A
the Spinal Cord reflex
9
Q
which reflex causes afferents from the cutaneous receptors to release vasoactive mediators for local vasodilation?
A
axonal reflex
10
Q
role of killikren
A
acts on globulin and kininogen to release bradykinin and NO
11
Q
chemical mediators cause
A
vasodilation and increase capillary pressure and permeability
12
Q
an increase in capillary pressure and permeability leads to
A
outward fluid filtration from the vascular to the extravascular space
13
Q
why don’t we want to overheat w/inflammatory conditions
A
overheating will cause blood shunting to the periphery, so if there is inflammation in the periphery already this is bad
14
Q
NM effects of heat
A
increase the pain threshold
alter nerve conduction velocity
change the muscle spindle firing rates
15
Q
firing of the alpha motor neuron and extrafusal fiber activity ____ with heat
A
decrease
16
Q
heat ____ the firing of the muscle spindle
A
decreases
17
Q
DOMS are worse with ____ contractions
A
eccentric
18
Q
what type of heat is best for DOMS
A
moist heat
> heat wraps > chemical wraps
19
Q
why do we stretch after the heat application?
A
water properties become dominant in the extracellular matrix and the tissue can be stretched more with less load
20
Q
which tissues are more likely the tissues affected by superficial heat?
A
superficial tendons and scar tissue
21
Q
how soon do you need to stretch after removing heat
A
between 5 and 6 minutes
22
Q
conduction
A
heat gain or loss through direct contract b/w materials
23
Q
convection
A
heat transfer by movement of air or liquid around the object to be heated
24
Q
whirlpool is a form of ______ heat therapy
A
convective
25
radiation
conversion of heat energy to electromagnetic radiation
26
conversion example
ultrasound
27
conductive heating agents
heat packs and paraffin wax
28
Heat packs are stored in water that is ______ degrees
158-167 degrees f, 70-75 C
29
the greatest tissue temperature increase is seen after _______ minutes
8-10
30
why doesn't superficial heat get to muscle
subcutaneous fat
31
paraffin wax to oil ratio
5-7: 1
32
why is there oil in the paraffin
it decreases the melting point of the wax
33
which type of paraffin is the most aggressive
dip re-immersion
34
adv of paraffin
home treatment
can apply at high temperature without burning
increase skin moisture
contours the body
35
disadv of paraffin
only can be used on distal extremities
no temperature control
some wax is not reusable
36
convective therapy examples
fluido
hydrotherapy
37
no modalities can be used if ABI is < ____
0.6
38
ADV of superficial heat
decrease pain, decrease stiffness and increase tissue extensibility
39
ADV of cold
prevent further swelling and decrease pain
40
DISADV of cold
increase stiffness and decrease tissue extensibility
good for ligaments
41
DISADV of superficial heat
may cause increase swelling: don't do over hemorrhage
42
which thermal agent is preferred in the acute stages of inflammation?
cold
43
if the goal is to decrease joint stiffness and increase CT extensibility then use _____
heat
44
cold typically used to address
pain and edema
45
hemodynamic effect of cold
vasoconstriction
46
direct effect of cold
increase blood viscosity
cause blood vessel smooth mm contraction
decrease production of vasodilators
47
when does cold induced vasodilation occur
after 30 min of prolonged cold < 10 degrees C
primarily occurs in the distal extremities
it is a normal hunting response in the arterioles (protective)
48
NM effects of cold
decrease nerve conduction velocity
greater effect in myelinated/small fibers (motor and sensory)
brief increase in isometric strength < 5 minutes but 20+ minutes of cold will decrease isometric strength
decrease spasticity (decrease gamma mn activity, decrease afferent muscle spindle and GTO activity)
49
why does cold increase the pain threshold?
counterirritant effect via the gate-control theory
50
Cold therapies will not improve ____ _______
tissue healing
51
to address edema, cold should be used alongside
compression and elevation
52
after ___ min you can see a decrease in clonus and resistance to passive stretch
10-30 min
53
Cold can be used in MS to
reduce tremors and fatigue
54
compression phase of ultrasound
molecules compress while crystal expands
55
rarefaction phase
molecules expand/spread out while crystal compresses
56
shear wave
molecule movement is at a right angle or perpendicular to the source
57
attenuation
reduction of sound as it travels through a medium
58
scattering
deflection of soundwaves from its path by reflection at interfaces
59
reflection
redirection of beam at an equal and opposite angle
60
refraction
redirection of a wave at interface at a different angle than angle of incidence
61
velocity _____ as material density increases
increases
62
when can you apply ultrasound to bone
under water or to fibular fractures within 2 weeks to facilitate tissue healing
63
dangerous effect where bubbles collapse on themselves causing more tissue heating
unstable cavitation
64
what can accentuate microstreaming
stable cavitation
65
effect of acoustical streaming
increase cell membrane permeability and vascular wall permeability
changes in ion fluxes
movement of fluids
66
microstreaming causes
eddy current
67
what is targeted in phonephoresis
the non-thermal mechanical/micromassage effect
movement of fluid in the interstitial space
68
4 types of coupling agents
aquasonic gel, glycerol, distilled water, air
69
common parameters for phonophoresis
3 MHz, 20% duty cycle, 0.5-0.75 w/cm2, for 5-10 minutes
70
why does phonophoresis work?
increases the permeability of the stratum corneum so the medication can be collected by the capillary network of the dermis
71
local effects of phonophoresis detected in
2 hours
72
systemic effects of phonophoresis detected in ______ hours
12-24 hours
73
electric and magnetic fields are ___ to each other
perpendicular
74
velocity of light (300,000,000)
frequency x wavelength
75
is ionizing or non-ionizing EMR used
non-ionizing: can't break molecular bonds
76
what is diathermy used for
generate heat and other physiological changes w/in tissues
77
shortwave diathermy (f and wavelength)
decreased frequency and increased wavelength
78
microwave diathermy (f and wavelength)
increased frequency and decreased wavelength
79
common frequency of SWD
27.12 MHz
80
most diathermy applications are ____
pulsed
81
common wavelength used in SWD
11 nm
82
inductive SWD
patient placed within the EM field, for muscle and fat, (deeper)
83
capacitive SWD
patient is a part of the electrical current, targets more superficial tissues
84
in SWD what causes increase tissue temperature
oscillations of charged particles
85
what power is non-thermal effect of SWD
38 W
86
diathermy conditions
contractures, contusions, pain control, before stretching, ligament/mm strain, tendonitis/synovitis, bursitis, myofascial trigger points, OA
87
Laser components (Principle)
monochromatic
coherent and collimated
88
two popular lasers
HeNe, GaAs
89
which laser has increased wavelength
GaAs
90
which laser is more superficial
HeNE
91
what is HILT used for
cauterize or make incisions during surgery Power >300 W
92
LLLT can be used to
facilitate healing
doesn't use heat and has energy density of less than 35 J/cm2
93
LLLT is class ____
3B
94
HILT is class_____
4
95
Power Density =
Power/Area of Irradiation
96
how to get energy density
multiply power density x time
97
what does MIRE stimulate
release of NO from hemoglobin for vasodilation and increased microcirculation
98
what can MIRE be used for
neuropathic wounds, decrease pain and increase circulation
99
does UV light produce heat
no
100
UVA
longest wavelength (320-440)
associated with tanning booths and CA
101
UVB
narrow band 311-313
associated with sunburn and premature aging of skin
102
UVC
shortest wavelength
kills bacteria and viruses
provides least amount of pigment change
103
common conditions for UVR
psoriasis, vitiligo, acne and infectious wounds/conditions
104
What is the MED
smallest does producing erythema within 8 hours after exposure that disappears within 24 hours
105
E1 is ____x the MED
2.5
106
E2 is _____ x the MED
5
107
E3 is _____ x the MED
10
108
E3 dose will cause
erythema with severe blistering, peeling and exudate
109
which UV for psoriasis
UVB
110
which UV for infected/chronic wounds
UVC
111
dosage for wound healing UVR:
use the MED or E1
112
increase dose by ______ % per treatment/day to maintain the MED
25-35
113
increase by ____ for E1 dose (every other day)
50%
114
increase dose by ____ for E2 and E3 (every 3 to 4 days)
75%
115
at what temperature do the water properties become dominant in the extracellular matrix?
45 C
116
how many terry layers do we need
6-8
117
all objects above -______C emit and absorb radiant energy
273
118
wax is molten from _____ to _____ C
45-54 (melting point is 54 but the oil brings that down)
119
wax has a low _____
specific heat
120
temperature ranges of fluido
38-48 degrees C
121
what other forms of heat are involved in hydrotherapy other than convection?
radiation and evaporation
122
spasticity can be decreased with _____ therapy
cold
123
when might cold increase edema
when intense cold left on for long periods of time, can damage the lymphatics
124
cold application for up to ___ min will show decrease in DTR
5 minutes
125
contraindications to cold
cold HTN
cold intolerance
cryoglobulinemia
hemoglobinuria with cold (men)
raynaud's
126
which p. nerves commonly are overactive regenerating and cold therapy is a precaution?
ulnar n and long thoracic
127
deep heating agents cause tissue temp change at depth ≥
2 cm
128
longitudinal wave
compressed in the direction the wave travels from the source (ultrasound is typically longitudinal)
129
US beam decreased in _____ the deeper it passes
intensity
130
there is low attenuation of sound in ________
blood and fat
131
BNR =
SPi:SAi
132
in ultasound a ____ BNR is best
low
133
SAi is used for
dosage
134
in continuous ultrasound the TPi=
TAi
135
to alter blood flow: Ultrasound parameters
2 W/cm, 1 MHz, 10-20 min
136
continuous mode will ___ velocity in the motor nerve
increase
137
pulsed mode will ___ velocity in the motor nerve
decrease or no change
138
parameters of ultrasound for fibular fractures
1.5 MHz, 0.5 w/cm, 20 % for 20 min
139
monochromatic
uses one wavelength
140
coherent
all waves are in phase
141
collimated
minimal divergence
142
intensity using ultrasound over an open wound
pulsed, 0.5-1.0 MHz
143
what produces the eddy current in inductive SWD
the magnetic field and coil are perpendicular to eachother
144
eddy currents cause
charged particles to oscillate
145
contraindications to PSWD
malignancy, pacemaker, metal, pregnancy, testers, growing epiphyses
146
precautions of PSWD
cooper IUD, electronic or magnetic equipment in the area, obesity
147
duration and frequency of PSWD chronic
20-30 min, less than 1-2 times daily
148
duration/frequency of subacute PSWD for inflammatory conditions
10-15 minutes, daily or twice daily
149
HeNE =
633 nm and red light
150
GaAs=
904 nm closer to infrared
151
what causes accelerated tissue healing for laser therapy
increased ATP for cellular reactions, increased RNA synthesis for protein degeneration and cell replication, decreased nociceptor activity
152
what is MIRE
process of delivering photo energy directly to the skin via light emitting diodes
153
MIRE augments
collagen formation in healing wounds
154
Avg Power density of MIRE pad
9 mW/cm2
155
dosage for MIRE
43.2 J/cm for 30- 40 minutes, 1-2 x/day for 7 days
156
most UV is absorbed in the first _______ mm of the skin
1-2 mm
157
UVR acute inflammatory response occurs in
8-12 hours following treatment
158
which laser is pulsed
GaAS
159
Which laser is continuous
HeNe
160
E1 produces redness in ___ hours and lasts for ____ days
6, 1-3
161
E2 produces redness in ___ hours and ______ is likely to occur
2 or less, peeling
