Hot and Cold Flashcards
Greatest effect is produced at depths of about __-__ mm
1-2
By __cm depth, the increase in tissue temp is a trivial __ degree.
2;1
The deeper, smaller change in tissue temp takes __-__ mins to occur
20-25
What are 6 therapeutic effects of superficial tissue heating?
- tissue healing
- relief of pain
- reduction of muscle spasms
- sedative effect
- increase joint ROM
- infection control
General agreement that application of heat to inflammatory injuries in the early stages is _______ to be beneficial
unlikely
Very mild heating stimulates early ______ - used after the initial risk of further _____ has passed.
repair; bleeding
______ _______ and tissue healing stages of repair and regeneration are all appropriately treated with ____ to ____ heating
chronic inflammation; mild to mod
Increased blood flow = increased number of ______, ______, enzymes, nutrients and oxygen.
leukocytes; antibodies
Increased blood flow = removes by-products of ________ process
inflammatory
Evidence that superficial heat affects the ______ NS.
sympathetic
Most therapeutic heating is of the _____, implying major pain-relieving effects are _____ based.
skin; reflex
Heat may decrease muscle spasm by reducing ________ associated with prolonged contraction.
ischaemia
Altered output of muscle spindle and GTO afferents = reduced level of muscle _______
excitement
During and after heat treatments, pt’s _____ more readily. Why?
sleep; still don’t know
Heat and stretching causes increase joint _____
ROM
What are the two mechanisms whereby heat increases joint ROM?
- analgesic effects of heat allows greater tolerance of stretch
- tissue deformability increases with heating
______ tissue extensibility increases slightly at higher temps
collagen
Joint ROM changes are ______ at therapeutically useful temps
small
Bodie’s _____ mechanisms are enhanced by heat
defense
Heating may ____ bacterial or viral cell division.
enhance
What 4 things does the therapeutic effects of temp depend on?
- extent of temp increases
- rate at which energy is added
- volume of tissue heated
- composition of tissue being heated
To provide a therapeutic effect, tissue should generally be elevated to between ___ - ___ degrees C
40-45
There may be times when you will choose to heat less intensely, somewhere between body temp and 40 deg C (T/F)
TRUE
Skin temps over ___ deg C can cause tissue damage
45
Both injury and pain at temps over 45 deg C are the result of permanent damage of the ______ skin cells
basal
45 deg C can be tolerated for __ hour before damage occurs
1
50 deg C can be tolerated for 1 ___
min
65 deg C tolerated for approx 1 ___
sec
For safe application of heated treatments, it is essential to test ________ _______.
thermal sensation
Thermal sensation testing: two dry test tubes are filled with water, one at __-__ deg C and one at __ - __ deg C
40-45; 15-20
Thermal sensation testing = apply to ________ area first
contralateral
Therapeutic conduction heating includes what 6 methods?
- paraffin wax baths
- hot packs
- contrast baths
- hydrotherapy
- whirlpool baths
- others
Paraffin melts at ___ deg C, can be lowered by addition of liquid paraffin oil
54
Paraffin baths usually kept at __ - ___ deg C
42-52
Wax is _____ but it still should enter an open wound.
sterile
Patients with skin infections or acute inflammation of underlying joints (should/should not) receive wax
should NOT; increase in temp may increase inflammatory response
Wax is highly ______ if it becomes overheated
inflammable
What are the 2 classes of hot packs?
- hydrocollator packs
2. microwaveable packs
Hydrocollator packs = _______ gel encased in canvas
silicate
Hydrocollator packs take __ mins - __ hrs to fully heat
30 - 2
Must use _____ with hot packs so that 75 deg C pack only heats skin to about 42 deg C
towel
Takes __ mins for skin temp to reach max with hot packs
8
When using hot packs, check pt at __ mins for skin temp to reach max
10
It is acceptable for pt’s to lie on hot packs (T/F)
FALSE
______ baths = alternate immersion in hot and then cold
contrast
In contrast bath, temp subcutaneously can fluctuate from ___ to ___ deg C
8-14
By 1cm deep intramuscularly, temp varies only ____ deg C when using contrast baths, which is less than ice baths
.5
Contrast baths provide considerable ________ stimulation.
sensory
There is evidence of reduction in local edema with ice baths (T/F).
FALSE
Should you stay longer in your cool or hot contrast bath?
hot
What is the temp of a whirlpool bath usually?
between 36-41
In whirlpool bath, water agitation stimulates skin mechanically; large diameter _______ and _______ = gating
mechanoreceptors; thermoreceptos
In whirlpool baths, increase in temp = increase in blood flow, may lead to ______
edema
Rx from whirlpool baths usually lasts?
20 minutes
In cold therapy, extent of temp change in tissues depends on what 2 things?
- RATE of heat energy removal
2. AMOUNT of heat energy removal
What is the current recommendation for cold-induced analgesia skin temp?
< 13 deg C
What is the current recommendation for metabolic reduction in tissue temp?
5-15 deg C
Crushed ice for 5-15 mins can induce optimal levels of ________
analgesia
Lowest superficial muscle temperature (1cm, subadipose) after cryotherapy = ___ deg C
21
Reaching currently acceptable threshold for metabolic reduction in muscle tissue ,in terms of cold therapy, seems unlikely (T/F).
TRUE
After applying cold treatment, check after __ minute and again at ___ minutes
1;5
Cryotherapy units are more effective than ice alone (T/F).
TRUE
Cryotherapy units have the potential to be more dangerous than ice alone (T/F).
TRUE
_______ immersion = extremity is immersed in cold water + ice chips
local
Continuous immersion tolerated at __-__ deg C for 15-20 mins
15-20
At around __ deg C, can only tolerate 1 min immersion, then rest, repeat
10
Contract bather has two water baths, at what temps?
- 10-18 deg C
2. 38 - 44 deg C
Duration of contrast bathing = __ - __ mis
20-30
Contrast bathing resulted in significantly greater improvements in muscle _______ recovery compared to no intervention/ rest.
soreness
How often should you replace ice towels?
Every 2-3 minutes
Repeat ice towels for up to ___ minutes
20
When giving an ice massage, _______ ______ improves muscle function
neuromuscular facilitation
Does ice massage or ice packs cause greater intramuscular cooling?
ice packs
Evaporating sprays can cause _______ is used excessively
frostbite
For Raynaud’s phenomenon, and other vascular conditions with an element of vasospasm, don’t use cold therapy (T/F).
TRUE
___________ = an abnormal protein is present in the blood, and it precipitates out in the
cryoglobinaemia
_____ _______ = cold causes degranulation of mast cells, release of histamine, and can be local or systemic
cold urticaria
To ensure there is no cold urticaria, check skin under ice after __ min, and again after __ mins for weals/ histamine response
1;5
Cooling large segments can cause a transient rise in _______ BP.
arterial
With cold therapy, there is danger of possible _______ with prolonged cooling of superficial nerves.
neurapraxia
What is the ice cube test?
massage area to be treated for 3 mins with an ice cube, normal redness appears within 5 minutes of start
What indicates a positive ice cube test?
A wheal (localized skin edema)
Recent trauma (inflammation) = treated with ______
cooling
__-____ injury can be treated with mild heat to increase metabolism and gently increase healing
sub-acute
What are 3 advantages of using heat?
- decreased pain
- increased tissue extensibility
- decreased stiffness
What is a disadvantage of using heat?
may cause increased swelling
What are 2 advantages of using cold?
- may prevent further swelling
2. decreased pain
What are 2 disadvantages of using cold?
- increased stiffness
2. decreased tissue extensibility
