L5 Ultrasound Flashcards
How does ultrasound work?
electrical current into sound head transducer
causes metal plate to vibrate
sound energy is directed out of transducer
thermal and non-thermal effects
Thermal effects
most common due to absorption of vibrational energy
Non-thermal effects
cavitation increasing permeability of the cell membrane
When should you use ultrasound?
inflammatory phase
proliferative phase
remodeling phase
Inflammatory & ultrasound
optimizes quality of response w/out increasing the duration or amplitude
does not have an anti-inflammatory effect
Proliferative phase & ultrasound
stimulates cellular growth by increasing protein synthesis and proliferation of growth factors
Remodeling phase & ultrasound
enhances the collagen maturation process which increases it tensile strength
Thermal effects
heats things up
increased blood flow and tissue extensibility
Non-thermal benefits
increasing cell membrane permeability
increase intracellular calcium levels
increase mast cell degranulation
nitric oxide synthesis in endothelial cells
Contraindications of ultrasound
active bleeding
pregnancy
malignancy
lack of sensation
thrombus
pacemaker
precautions of ultrasound
acute inflammation
epiphyseal plates
fractures
breast implants
Indications of ultrasound
acute pain
wound healing
osteoarthritis
carpal tunnel syndrome
What impairments should you not use ultrasound for?
rotator cuff tendinopathy
chronic LBP
plantar heel pain
Wound healing
helps with lack of vascularity and physiologic responses
second-order effects of non-thermal ultrasound may help
increases histamine release and mast cell degranulation. Enhances inflammation phase to make it more effective. Creates new blood vessels, attracts fibroblasts.
enhances wound contraction
1 MHz depth
2.5 cm or greater depth
bigger muscles
3 MHz depth
1.5 cm or less
smaller muscles
Duty cycle dictates…
thermal or non-thermal
more acute is a lower duty cycle
more chronic is higher duty cycle
Intensity of ultrasound
.1 - .5 for acute conditions
>1.0 for chronic conditions
Application of ultrasound
water for small bony areas
1-2x the sound head
max of 15 min
small slow circles
3-5 min after treatment, heat dissapates
LIPUS
low intensity pulsed ultrasound
increases cell upregulation during proliferative phase increase expression of stem cells.
Lower intensity and frequency. 20% duty cycle, 2-20 min
LIPUS indications
fractures that are non-operative
better for upper limb
Shockwave
controlled explosion of increasing air pressure
possibly helps to break up scar tissue
greater peak pressure (1000x)
only non thermal
focused = deeper, higher mPa
Application of shockwave
higher frequency = more comfortable
use gel
3 tx a week
not a standalone treatment
indications for shockwave
plantar fasciopathy
tendinopathies
prostatitis
eretile dysfunction
ultrasound waves are created by
electrical current vibrating a metal plate in the transducer
Shockwave is ____x pressure than ultrasound
1000
more painful but maybe more effective
In order to maximize the depth of penetration of ultrasound energy, you should combine what?
Set frequency to 1MHz and move the sound head slowly in small circles
When attempting to help a non-union or delayed fracture in the healing process, LIPUS appears to be MOST helpful when using which of the following duty cycles?
20%
ultrasound documentation
ultrasound applied at (frequency) and (intensity), (duty cycle) for (time) to the (area of body) for thermal effects, (how patient reacted)
