Final Exam: Modalities Flashcards
Whirlpool is a type of _____ modality
hydrotherapy
What are the 7 effects of whirlpool on wounds
Cleanses wound mechanical debridement softens hard eschar non-selective hydrates wound thermal effect neuronal effects
What are the 4 indications for using whirlpool for a wound
dirty wound
loosely adherent necrotic tissue
exudate
extensive psoriasis or burns
7 Contraindications of using whirlpool on a wound
health granulation tissue Cardiovascular or pulmonary compromise Plebitis, renal failure Temperatured Lethargic Venous ulcer/position Arterial insufficiency
What are the 4 effects of pulsatile lavage with suction
cleansings
debridement
suction with negative pressure
positive impact pressure
What are the 3 indications of using pulsatile lavage with suction on a wound
if there’s an infection
to remove debris
need something portable
What are the 2 contraindications of pulsatile lavage with suction
is not a sterile process
not going to work with yellow adherent eschar
When should a clinician should stop using pulsatile lavage with suction
If there is no increase in granulation tissue after 1 week or if there’s no decrease in necrotic tissue after 1 week
What is the pressure of pulsatile lavage
14-15psi
Ultrasound has mechanical vibration transmitted greater than _____ kHz
20
Low frequency ultrasound should be used as an adjunct to _____ soft tissue
necrotic
High frequency ultrasound should be used as an adjunct to higher pressure ____ injuries
infected
Which phase of healing should ultrasound be done in
The acute inflammatory phase
What are the three effects of ultrasound
thermal
cavitation bubbles
acoustic streaming
Why do cavitation bubbles appear with ultrasound
They occur when there is a sudden drop in pressure
What are the 4 acoustic streaming effects of ultrasound
increases circulation
alters cell membrane
promotes angiogenesis
may accelerate inflammatory phase
What are the indications for ultrasound
chronic diabetic foot ulcers
pressure ulcers
absence of inflammatory phase
What are the contraindications of using ultrasound on a wound
pregnancy malignancy vascular abnormalities DVT Emboli acute wound infections fractures
What is negative pressure wound therapy
an open cell foam dressing in wound cavity and applying controlled sub atmospheric pressure 125mm Hg below ambient pressure
What are the 6 effects of negative pressure wound therapy
increases vascular perfusion removes excess fluid decreases bacterial colonization increases rate of granulation enhances epithelial migration increases flap survival
What are the indications of negative pressure wound therapy
stage 3 or 4 pressure injuries
venous, arterial, neuropathic
burns, dehisced incisions
What are the contraindications of negative pressure wound therapy
necrotic tissue
untreated osteomyelitis
fistulas to organs or body cavities
What are the two foams used for negative pressure therapy and when do you use them
Black polyurethane for deep, burns, flaps-hydrophobic
White is soft and used for superficial and tunneling-hydrophilic
What is the protocol of using negative pressure therapy
Irrigate and debride wound with each dressing change
cut foam to fit wound
When using electrical stimulation, the current is transferred through a (dry/wet) pad in contact
wet
an anode is the (positive/negative) pole
positive
a cathode is the (positive/negative) pole
negative
what is another name for direct current
galvanic
How does ES facilitate wound healing
restores current causes galvanotaxis increases BF reduces edema facilitates debridement
What is the normal skin battery potention
outside of skin is negative and inside is positive
What is the skin battery potential when there is injur
outside of skin is positive and insides of skin is negative
in regards to the galvanotaxic effects of ES to wounds, which cells are attracted to the cathode
neutrophils, fibroblasts, epithelial cells
in regards to the galvanotaxic effects of ES to wounds, which cell is attracted to the anode
macrophages
in regards to the galvanotaxic effects of ES to wounds, which cell is repelled by the anode
mast cells
What are the anibacterial effects of ES on a wound
inhibition of pseudomonas, staph aureus, E. Coli, and staph epidermis
What are the four indications of using ES for wounds
pressure ulcers
vascular ulcers
surgical wounds
neuropathic wounds
What are the contraindications of using ES for wounds
basil or squamous carcinoma and untreated osteomyelitis
are bipolar techniques with ES better for superficial/partial wounds or deep/full thickness wounds
superficial
What is the treatment during which a patient inside a chamber breathes 1–% intermittently, at a pressure higher than sea level pressure
hyperbaric oxygen therapy
For normal healing to occur, what must the tissue partial pressure of oxygen must be
greater than 40 mmHg
What is the purpose of hyperbaric oxygen therapy
increases o2 gradient reduced bacterial growth reduce edema limits risk of reperfusion injury enhances a bunch of other shit
What are the indications of hyperbaric oxygen therapy
chronic or slow healing wounds like a diabetic foot ulcer
decompression sickness
carbon monoxide poisoning
what are some pulmonary adverse effects of oxygen under pressure
coughing and bronchial irritation
what are some ocular adverse effects oxygen under pressure
retinal damage
myopia
nuclear cataracts
What are some CNS adverse effects of oxygen under pressure
visual changes tinnitus nausea twitching irritability dizziness seizure
what are some advantages of hyperbaric oxygen
non invasive test available to predict efficacy
what are some disadvantages of hyperbaric oxygen
expensive and takes a lot of time
what is the treatment protocol for hyperbaric oxygen
daily for 90 to 120 minutes
20-35 treatments with combination therapy
is topical oxygen considered hyperbaric oxygen therapy
no
is topical oxygen a systemic treatment
no
with topical oxygen, affected limb is placed in an ____ box that is filled with oxygen
acrylic
