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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
Q

What are some indications for iontophoresis

A 
Inflammatory disorders
Pain
Neuralgia
Edema
Scar tissue
Acne
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26
Q

What is electroporation

A

after electrical stimulation ions are able to penetrate tissue with greater ease

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27
Q

What polarity should be used when using iontophoresis

A

Use same polarity of medication

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28
Q

What is Electroosmosis

A

Movement of the solute in tissues after estim provides a means for movement of ions

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29
Q

What are some iontophoresis contraindications

A 
Trunk / heart with pacemakers
Pelvis, abdominal, lumbar, hips of pregnant females
Carotid bodies
Neurostimulators
PVD
DVT
Osteomyelitis
Hemorrhage
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30
Q

Describe iontophoresis dosing

A

Dosage = current x duration
Typically 20-80 mA minutes
.1-4 mA current

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31
Q

Describe biofeedback as a concept

A

Skeletal muscle assessment or monitoring that is used to affect future activation
Increases muscle function and decreases pain

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32
Q

Describe biofeedback sensitivity

A

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

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33
Q

Describe biofeedback training

A

Partial innervation necessary
Target threshold set
Patient increases or decreases muscle activation to reach target threshold
Modification of sensitivity based in muscle activity

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34
Q

What is saltatory conduction

A

movement of an AP down the nodes of ranvier

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35
Q

What are some indications for electrophysiological testing

A

Neuro-signs in a peripheral nerve distribution
Segmental demyelination - NCS
Axon degeneration - EMG

36
Q

What is neuropraxia

A

Local conduction block
May result from pressure
Easily reversible

37
Q

What is axonotmesis

A

some level of degeneration with axonal involvement
May result from prolonged pressure
Recovery possible

38
Q

What is Neurotmesis

A

Axonal degeneration
Damage to connective sheath
No recovery without surgery

39
Q

What is a nerve conduction study

A

Evaluation of motor and sensory nerve function

40
Q

What are some influential factors of nerve conduction

A 
Age
UE vs LE
Limb length
Temperature
Anomalies with innervation patterns
41
Q

What is the H-reflex useful for

A

Identifying radiculopathies

42
Q

What is EMG used for

A

used to asses innervation capacity of a muscle

43
Q

What are the 4 phases of EMG testing

A

Needle insertion
Rest
Minimal activation
Maximal activation

44
Q

Describe the needle insertion phase of EMG

A

Describes as normal, increased sustained, decreased or absent
Normal = brief electrical activity that resolves

45
Q

Describe the rest EMG phase

A

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
Q

Describe the minimal activation EMG phase

A

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
Q

Describe the maximal activation EMG phase

A

Normal = interference pattern
Abnormal
- Neuropathic - decreased recruitment
- Myopathic - small amplitude with little to no effort

48
Q

What are the physical effects of electromagnetic wave

A

increase temperature and circulation

49
Q

What are some indications for laser therapy

A

Inflammation
Tissue repair
Pain modulation

50
Q

What are the differences between LLLT and HILT

A

LLLT

  • less than 500mW
  • No thermal effect

HILT

  • greater than 500mW
  • thermal effects
51
Q

What are some indications for LLLT

A 
Wound healing
Epicondylitis
Carpal tunnel syndrome
Fibromyalgia
Neck pain
52
Q

What are some indications for HILT

A

TMD
Low back pain
Shoulder pain / dysfunction

53
Q

What are some laser, LED and SLED contraindications

A 
Direct eye exposure
Pregnancy
Active malignancy
Active hemorrhage
Open growth plates in children
Over endocrine glands such as thyroid
54
Q

What are the effects of LED and SLED

A

Increase, vasodilation, tissue perfusion, increase nutrient delivery, may stimulate nerve growth

55
Q

What are some indications for LED and SLED

A

Wounds
Shoulder pain and dysfunction
DJD
Peripheral neuropathy

56
Q

What are the types of Diathermy

A

Pulsed short wave
Continuous short wave
Microwave

57
Q

What diathermy method makes the patients tissues store the energy

A

Capacitive method

58
Q

What diathermy method uses drum sleeves

A

Inductive method

59
Q

What are the physiological effects of diathermy

A

Can heat deeper tissues better than superficial ones

Cannot depolarize motor nerves

60
Q

What can diathermy improve

A

Tissue extensibility
Muscle strength after 30 mins
Pain
Soft tissue and bone healing

61
Q

Describe diathermy dosage 1

A

Dose 1 - nonthermal - Acute injuries, edema, cell repair

62
Q

Describe diathermy dose 2

A

Dose 2 - mild heat - 1.8F - 12W - subacute injuries, inflammation

63
Q

Describe diathermy dose 3

A

Dose 3 - moderate heat - 3.6F - 24W - pain, muscle spasm, chronic inflammation

64
Q

Describe diathermy dose 4

A

Vigorous heating - 7.2F - 48W - increases tissue extensibility

65
Q

What is a direct current

A

continuous flow for one or more seconds

66
Q

What is alternating current

A

Continuous flow in a bidirectional flow for less than 1 second

67
Q

What is pulsatile current

A

uni or bidirectional current for several hundred microseconds

68
Q

What are some contraindications for E-STIM

A 
Anterior thoracic region or carotid sinus
Transracially
Pacemakers
severe vascular compromise
Pregnant females
69
Q

What is the order of excitation

A

A-beta
Motor
A-delta
C fibers

70
Q

What kind of pain do A-Delta fibers transmit

A

Sharp, stabbing, pricking

71
Q

What kind of pain do C fibers transmit

A

Dull, aching, burning

72
Q

Describe conventional TENS

A

Pain modulation
80-100 Hz
50-100 μS
A-Beta

73
Q

Describe Acupuncture tens

A

Pain, muscle activation
4 Hz
100 μS
A-alpha

74
Q

What is burst train TENS

A

Combination of conventional and acupuncture

75
Q

Describe Brief intense TENS

A

High frequency and duration
100-150 Hz
150-250 μS

76
Q

Describe Gate control theory

A

Activation of A-beta afferents to block A-delta and C-fiber input

77
Q

Describe Central inhibition

A

Activation of descending inhibitory pathways
Low frequency - micro
High frequency - delta

78
Q

Describe IFC

A

Interferential current
Commonly used for pain
Criss cross electrode configuration

79
Q

What is NMES

A

Neuromuscular electrical stimulation

80
Q

What are the NMES muscle strengthening parameters

A 
30 Hz
> 250 μS
1:3 on off ratio
1-2 sec ramp
10 contractions
81
Q

What are the burst for muscle strengthening parameters

A

50 Hz
10 milliseconds (russian), 4 milliseconds (Aussie)
Duration - 10 contractions
Ramp - 1-2 seconds

82
Q

What are the NMES treatment parameters for ROM

A

30-50 Hz
> 200 microseconds
Time 30-60 mins
Treatment frequency: at least every other day

83
Q

What are the Acute edema parameters

A 
HVPC
Negative polarity
100-125 Hz
2-100 microseconds
Continuous
84
Q

What are the chronic edema parameters

A

20-80 Hz

100-600 microseconds

85
Q

What angles are required to target the C spine levels in traction

A

C1-C2 - 0-5
C3-C4 - 10-20
C5-C7 - 25-30

86
Q

What intensity should be used at the C spine levels in traction

A

C1-C2 - 10 lbs
C3-C4 - 10-15
C5-C7 - 15-40

87
Q

What traction treatment duration is appropriate for what diagnoses

A

HNP, hypertonicity - static 5-8 mins

Stenosis, DDD, hypomobility - intermittent 10-20 min

TRI 4 - BA (4 decks)

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