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TRI 4 - BA > Final Exam Info > Flashcards

Final Exam Info Flashcards

1
Q

What is conduction, convection, evaporation and radiation

A

Cond - Contact
Conv - Air or water
Evap - vapor
Rad - heat into electromagnetic energy

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2
Q

What are some influencing factors of heat transfer

A

Temperature gradient
Time of exposure
Thermal conductivity
Type of cooling agent

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3
Q

What are the biophysical affects of cooling

A 
Increased vasoconstriction
Increased blood viscosity
Decreased tissue metabolism
Decreased nerve conduction velocity
Decreased gamma-motoneuron activity
Decreased muscle-spindle discharge
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4
Q

What are the indications for cryotherapy

A

Pain management
Muscle spasms
Myofascial pain syndrome
DOMS

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5
Q

What are the treatment goals with cryotherapy

A

Reduce tissue metabolism
Reduce inflammation
Reduce edema formation
Reduce pain

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6
Q

What are the effects of cold on muscle performance

A

Decreased strength, proprioception and spasticity

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7
Q

How long should ice massage be performed

A

5-10 mins

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8
Q

What is the appropriate temperature for cold immersion baths an treatment duration

A

limb - 50-65F
Whole body - 65-80F
10-20 mins

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9
Q

What is the procession of sensations that will be felt with cryotherapy

A

Cold, burn, ache, numb

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10
Q

What are some contraindications for cold therapy

A

Cold sensitivity
Compromised circulation
Peripheral vascular disease
Over areas of nerve regeneration

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11
Q

What is edema

A

Abnormal amounts of fluid in the extracellular tissue spaces

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12
Q

What causes edema

A

Injury
Vascular disease
Lymphedema
Cardiac, pulmonary, renal

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13
Q

What are the effects of compression

A

Increase effects of cold application
Increase tissue hydrostatic pressure
Edges bleeding

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14
Q

What are some guidelines when using compression

A

Do not wear while sleeping

Observe for pain, numbness, tingling, discoloration

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15
Q

What are some indications for compression

A 
Edema
Prevention of DVTs
Peripheral artery disease
Venous insufficiency
Lymphedema
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16
Q

What are some compression precautions

A

Recent skin graft
Acute local dermatological infections
Impaired sensation or mentation

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17
Q

What are some contraindications for compression

A 
Acute pulmonary edema
Acute fracture
Acute DVT
Congestive heart failure
Uncontrolled hypertension
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18
Q

What are the metabolic effects of heat

A

Increased metabolic rates

Increased oxygen uptake

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19
Q

What are the vascular effects of heat

A

Cutaneous vasodilation

Increased capillary permeability

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20
Q

What are the neuromuscular affects of heat treatment

A

Elevation of pain threshold
Alteration of pain threshold
Modification of muscle spindle firing rates

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21
Q

What are the effects of heat on connective tissue

A

Decreased joint stiffness
Increased muscle flexibility
Increased elasticity
Decreased viscosity

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22
Q

How many protective layers should be applied for heat depending on position

A

8-10 if supine

6-8 if prone

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23
Q

What are some contraindications to heat treatment

A 
Decreased sensation, cognition
Burns, infections
Acute injury
Excessive HTN
LT steroid use
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24
Q

Describe iontophoresis physiology

A

Electric current is used to drive medication to a treatment area

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25
What are some indications for iontophoresis
``` Inflammatory disorders Pain Neuralgia Edema Scar tissue Acne ```
26
What is electroporation
after electrical stimulation ions are able to penetrate tissue with greater ease
27
What polarity should be used when using iontophoresis
Use same polarity of medication
28
What is Electroosmosis
Movement of the solute in tissues after estim provides a means for movement of ions
29
What are some iontophoresis contraindications
``` Trunk / heart with pacemakers Pelvis, abdominal, lumbar, hips of pregnant females Carotid bodies Neurostimulators PVD DVT Osteomyelitis Hemorrhage ```
30
Describe iontophoresis dosing
Dosage = current x duration Typically 20-80 mA minutes .1-4 mA current
31
Describe biofeedback as a concept
Skeletal muscle assessment or monitoring that is used to affect future activation Increases muscle function and decreases pain
32
Describe biofeedback sensitivity
Sensitivity is the ability of the machine to sense muscle activation If there is a strong contraction then less sensitivity is needed The wider the electrode placement, the more muscle volume is detected
33
Describe biofeedback training
Partial innervation necessary Target threshold set Patient increases or decreases muscle activation to reach target threshold Modification of sensitivity based in muscle activity
34
What is saltatory conduction
movement of an AP down the nodes of ranvier
35
What are some indications for electrophysiological testing
Neuro-signs in a peripheral nerve distribution Segmental demyelination - NCS Axon degeneration - EMG
36
What is neuropraxia
Local conduction block May result from pressure Easily reversible
37
What is axonotmesis
some level of degeneration with axonal involvement May result from prolonged pressure Recovery possible
38
What is Neurotmesis
Axonal degeneration Damage to connective sheath No recovery without surgery
39
What is a nerve conduction study
Evaluation of motor and sensory nerve function
40
What are some influential factors of nerve conduction
``` Age UE vs LE Limb length Temperature Anomalies with innervation patterns ```
41
What is the H-reflex useful for
Identifying radiculopathies
42
What is EMG used for
used to asses innervation capacity of a muscle
43
What are the 4 phases of EMG testing
Needle insertion Rest Minimal activation Maximal activation
44
Describe the needle insertion phase of EMG
Describes as normal, increased sustained, decreased or absent Normal = brief electrical activity that resolves
45
Describe the rest EMG phase
Should be electrical silence MEP - near NMJ End plates spikes - short duration Abnormalities - Positive sharp waves - Downward spikes - Fibrillations - Downward spikes with short duration - Fasciculations - Popping sound
46
Describe the minimal activation EMG phase
Normal = biphasic or triphasic waveform Abnormal = more than 4 phases - Early reinnervation - low amplitude long duration - Chronic neuropathies - large amplitudes - Myopathic disease - low amplitude, short duratiuon
47
Describe the maximal activation EMG phase
Normal = interference pattern Abnormal - Neuropathic - decreased recruitment - Myopathic - small amplitude with little to no effort
48
What are the physical effects of electromagnetic wave
increase temperature and circulation
49
What are some indications for laser therapy
Inflammation Tissue repair Pain modulation
50
What are the differences between LLLT and HILT
LLLT - less than 500mW - No thermal effect HILT - greater than 500mW - thermal effects
51
What are some indications for LLLT
``` Wound healing Epicondylitis Carpal tunnel syndrome Fibromyalgia Neck pain ```
52
What are some indications for HILT
TMD Low back pain Shoulder pain / dysfunction
53
What are some laser, LED and SLED contraindications
``` Direct eye exposure Pregnancy Active malignancy Active hemorrhage Open growth plates in children Over endocrine glands such as thyroid ```
54
What are the effects of LED and SLED
Increase, vasodilation, tissue perfusion, increase nutrient delivery, may stimulate nerve growth
55
What are some indications for LED and SLED
Wounds Shoulder pain and dysfunction DJD Peripheral neuropathy
56
What are the types of Diathermy
Pulsed short wave Continuous short wave Microwave
57
What diathermy method makes the patients tissues store the energy
Capacitive method
58
What diathermy method uses drum sleeves
Inductive method
59
What are the physiological effects of diathermy
Can heat deeper tissues better than superficial ones | Cannot depolarize motor nerves
60
What can diathermy improve
Tissue extensibility Muscle strength after 30 mins Pain Soft tissue and bone healing
61
Describe diathermy dosage 1
Dose 1 - nonthermal - Acute injuries, edema, cell repair
62
Describe diathermy dose 2
Dose 2 - mild heat - 1.8F - 12W - subacute injuries, inflammation
63
Describe diathermy dose 3
Dose 3 - moderate heat - 3.6F - 24W - pain, muscle spasm, chronic inflammation
64
Describe diathermy dose 4
Vigorous heating - 7.2F - 48W - increases tissue extensibility
65
What is a direct current
continuous flow for one or more seconds
66
What is alternating current
Continuous flow in a bidirectional flow for less than 1 second
67
What is pulsatile current
uni or bidirectional current for several hundred microseconds
68
What are some contraindications for E-STIM
``` Anterior thoracic region or carotid sinus Transracially Pacemakers severe vascular compromise Pregnant females ```
69
What is the order of excitation
A-beta Motor A-delta C fibers
70
What kind of pain do A-Delta fibers transmit
Sharp, stabbing, pricking
71
What kind of pain do C fibers transmit
Dull, aching, burning
72
Describe conventional TENS
Pain modulation 80-100 Hz 50-100 μS A-Beta
73
Describe Acupuncture tens
Pain, muscle activation 4 Hz 100 μS A-alpha
74
What is burst train TENS
Combination of conventional and acupuncture
75
Describe Brief intense TENS
High frequency and duration 100-150 Hz 150-250 μS
76
Describe Gate control theory
Activation of A-beta afferents to block A-delta and C-fiber input
77
Describe Central inhibition
Activation of descending inhibitory pathways Low frequency - micro High frequency - delta
78
Describe IFC
Interferential current Commonly used for pain Criss cross electrode configuration
79
What is NMES
Neuromuscular electrical stimulation
80
What are the NMES muscle strengthening parameters
``` 30 Hz > 250 μS 1:3 on off ratio 1-2 sec ramp 10 contractions ```
81
What are the burst for muscle strengthening parameters
50 Hz 10 milliseconds (russian), 4 milliseconds (Aussie) Duration - 10 contractions Ramp - 1-2 seconds
82
What are the NMES treatment parameters for ROM
30-50 Hz > 200 microseconds Time 30-60 mins Treatment frequency: at least every other day
83
What are the Acute edema parameters
``` HVPC Negative polarity 100-125 Hz 2-100 microseconds Continuous ```
84
What are the chronic edema parameters
20-80 Hz | 100-600 microseconds
85
What angles are required to target the C spine levels in traction
C1-C2 - 0-5 C3-C4 - 10-20 C5-C7 - 25-30
86
What intensity should be used at the C spine levels in traction
C1-C2 - 10 lbs C3-C4 - 10-15 C5-C7 - 15-40
87
What traction treatment duration is appropriate for what diagnoses
HNP, hypertonicity - static 5-8 mins | Stenosis, DDD, hypomobility - intermittent 10-20 min

TRI 4 - BA (4 decks)

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