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Essential Skills III > Final Study Material Part 2 > Flashcards

Final Study Material Part 2 Flashcards

1
Q

Physiologically, why are contrast baths effective in treating conditions like CRPS?

A
  • Causes active vasoconstriction and vasodilation of affected blood vessels, which in theory results in a “pumping” effect on tissue edema.
  • “Re-educates” chronically vasoconstricted vessels to respond normally to hot (vasodilate) and cold (vasoconstrict
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2
Q

In contrasts baths what are the appropriate temperatures for hot an cold baths?

A

Hot - 100-111 degrees
Cold - 50-64 degrees
- elapsed time varies, but often a 4:1 (hot: cold) ratio is used for 2 minutes
- always start and end with hot

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3
Q

When is a contrast bath indicated?

A
  • Reflex sympathetic dystrophy, a.k.a “Complex Regional Pain Syndrome.
  • Sprains, Strains, Contusions in the sub-acute phase.
    Contraindications: Buerger’s Disease (circulatory disorder with glove-like death of the extremities), Diabetes, Arteriosclerosis
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4
Q

What are the temperature ranges for very cold, cold, cool, and tepid water?

A

Very Cold = 35-55
Cold = 55-65
Cool = 65-80
Tepid = 80-92

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5
Q

What are the temperature ranges for neutral, warm, hot, and very hot water?

A

Neutral = 92-96
Warm = 96-98
Hot = 98-104
Very Hot = 104-115

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6
Q

Resistance force to movement in water

A

hydrodynamic force

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7
Q

the pressure exerted by water at increasing depths; more at the bottom of the pool than at the surface of the pool

A

Hydrostatic pressure

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8
Q

a body immersed in water at rest experiences an upward thrust equal to the water the body displaces

A

buoyancy

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9
Q

What is the predominant method of heat transfer in a whirlpool?

A

Convection - movement of water causes water closest to skin to be the same temperature
- without movement (conduction) water closest to the body is slightly cooled bc the heat is transferred into the skin

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10
Q

Where is the center of buoyancy located? how can this be useful for aquatic exercise?

A

T2-T4 - a flotation device can be used to create a force pushing them in a direction for strengthening

  • anterior flotation device pushes posteriorly, cause pt to activate abdominal muscles and, therefore, strengthening them
  • COM at L5-S1 level in land
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11
Q

Will a rectangular or triangular wave shape have more accommodation?

A

Triangular

  • has a longer rise time
  • spike wave shapes have the least accommodation of all shapes
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12
Q

Does a higher or lower carrier frequency have more accommodation?

A

higher has more accommodation

- duration that current is flowing is shortened with higher frequency, so less charge is delivered

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13
Q

Does a shorter or longer pulse/cycle duration result in more accommodation

A

Shorter duration

- less amount of time for charge to be delivered

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14
Q

How long does the off time need to be for a modulation to count as interrupted?

A

the off time must last for at least 1s

- this can occur with DC, AC, or PC

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15
Q

How does current amplitude, cycle/pulse duration, and charge effect muscle contraction?

A
  • Amplitude - higher amplitude = stronger contraction
  • Longer pulse duration (smaller frequency) = stronger contraction
  • more charge delivered = stronger muscle contraction
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16
Q

What are the exercise variables for buoyancy?

A
  1. Position and directions of movement can be used to produce assisted or resisted motion, or a gravity minimized movement
  2. Water depth can be used to alter resistance or assistance
  3. Lever arm length – a longer lever arm gets a greater benefit from a buoyancy assist during AAROM, e.g., AAROM shoulder flexion with the elbow extended greater assist than with the elbow flexed
  4. Equipment used by the patient can either increase the assistance (buoyancy) or increase the resistance (hydrodynamic effect) to movement through water
17
Q

What are the effects of hydrostatic pressure on a pts body?

A
  1. May help people with peripheral edema
  2. Alters cardiac function because of centralization of blood flow, in neutral water temperatures, heart rate slows. Before exercise has started hydrostatic pressure changes cardiac dynamics by causing
  3. Can limit lung expansion- decreased vital capacity
18
Q

What are the alterations of cardiac functions that are caused by hydrostatic pressure?

A
  1. centralization of blood flow
  2. increased heart volume
  3. increased stroke volume
  4. decreased heart rate
19
Q

What 2 factors can change the resistance of water?

A
  1. velocity of movement in the water (slow = less resistance)
  2. Surface area of structure moving through the water (large = more resistance)
20
Q

What is the physiological effect of hot and cold water (effect on HR)?

A

Hot = increase in CO, mostly due to increase in HR
Hold = decrease in HR
- no significant change in CO between 75 and 93 degrees F; this range is suggested to minimize stress to the heart

21
Q

What is the effect on HR caused by water depth?

A

Running and jogging in neck deep water = lower HR than running/ jogging in waist deep
- due to hydrostatic pressure assisting in centralization of blood flow increasing SV

22
Q

What different areas of rehabilitation can be done during aquatic therapy?

A
  1. Muscle performance (strength, flexibility, stabilization)
  2. CV endurance (activity must be sufficient duration, performed 3-5x per week, HR intensity needs to be -17, deeper water for WB limitations)
  3. Balance
  4. Functions (transfers, gait training, squatting, etc.)
23
Q

What is the action of cold application? reaction in the patient?

A 
action = local vasoconstriction, decr. local metabolism/ O2 demand, slowed nerve conduction velocity, endorphin release, decr. m spindle activity (decr. spasticity), stiffened connective tissue
reaction = slightly reddened; cold, burning, aching, then numbness
24
Q

What causes a greater depth of current flow?

A

greater distance between electrodes

25
Q

What type of current flow is between electrodes? what type of current flow occurs directly under electrodes?

A 
between = parallel (pathway of least resistance, flows through extracellular fluid)
Under = series (flows through the nerve); causes current to go through more resistance
26
Q

How does an axon’s diameter and distance from the effect recruitment order in estim?

A
  • a larger diameter will be recruited first

- axons closest to the electrode will be recruited first

27
Q

What is the best waveform for producing a m contraction in a denervated muscle?

A
  1. monophasic rectangular interrupted DC
  2. Low frequency sine wave current (<10-20 Hz)
  3. Exponential progressive current with a slow rise time best
    - most comfortable and effective bc the pain receptors have more time to accommodate
28
Q

What is the most appropriate current for treating edema?

A

Burst modulated monophasic PC

29
Q

What are the thermal effects of US?

A
  1. local increase in blood flow
  2. increased metabolism in the tissues in which heat is absorbed
  3. increased extensibility of connective tissue
  4. increased nerve conduction velocity
30
Q

What are the non thermal effects of US?

A
  1. cavitation (creates sites of energy concentration or tear tissue)
  2. separation of collagen fibers with a resultant increase in extensibility of connective tissue
  3. increased membrane permeability (can facilitate ionic exchange, diffusion of metabolites and promoting protein and collagen synthesis)
  4. upregulation of prostaglandin and leukotrienes during acute phases of injury - could exacerbate acute inflammation
31
Q

What tissues attenuate US from least to most?

A
  1. Blood
  2. Fat
  3. Blood vessel
  4. Skin
  5. Tendon
  6. Cartilage
  7. Bone
    - more attenuation = more resistance = more heat
32
Q

How can you tell the difference between innervated and denervated muscle using AC current?

A
  • Denervated muscles lose the ability to respond to short duration pulses (pulse durations less than 10 ms)
  • Denervated muscles do not respond to AC at frequencyis greater than 10-20 Hz ( phase durations = 50-25 ms)
  • denervated muscle takes less amp for tetanus
33
Q

How does a PT screen for lumbar traction with manual traction?

A

Pain should centralize or have no change

- should not increase or peripheralize

34
Q

How does a PT screen for a medial disc protrusion?

A
  1. If manual traction increases symptoms (should pull nerve roots away from protrusion if it is lateral protrusion)
  2. Side bending to the opposite side of sciatica symptoms will increase symptoms with medial protrusion (with lateral protrusion, SB to the opposite side would result in relief)
35
Q

the minimum amplitude required for an excitable response (m. contraction or sensation) while applying a pulse at maximum duration (long pulse), usually > or = 1ms (1000 microseconds)

A

rheobase amplitude

36
Q

pulse duration at 2 x the rheobase amplitude; it indicates tissue excitablility

A

chronaxie duration

Essential Skills III (4 decks)

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