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Upper Test 2 > Laser Lecture - Lecture 2 (modalities) > Flashcards

Laser Lecture - Lecture 2 (modalities) Flashcards

1
Q

Using electromagnetic waves to heat human tissue from microwaves and radiofrequencies

A

Diathermy

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2
Q

From visible radiation levels

A

Laser

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3
Q

What kind of electromagnetic waves are felt - infrared rays or UV?

A

UV rays

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4
Q

KNOW: Xrays / Gamma rays are the most powerful

Visible light has much less wavelengths

A
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5
Q

Are most electromagnetic waves sensed by the body?

A

Nope

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6
Q

Laser therapy is part of light therapy

A
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7
Q

Light Amplification by Stimulated Emission of Raidtion is what?

A

Laser

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8
Q

What can be used to cauterize wounds in surgery?

A

High power lasers

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9
Q

KNOW: Low level lasers can be used for healing, pain, inflammatory neuromuculoskeletal conditions

A
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10
Q

KNOW: Theres two kinds of lasers - low level lasers and high level lasers (strength differs)

A
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11
Q

KNOW: Low level laser therapy can be used for carpal tunnel

A
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12
Q

KNOW: High level laser gets that tissue and icnreased theraml effects (warms it up more to get those thermal effects)

A
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13
Q

KNOW: How a laser works

A power source produces energy which in turn excites the electrons

When those electrons get excited they emit photons (or light energy)

Within the laser itself there are little mirriors and the photons continue to bounce off of those and eventaully they run into electrons which excites them even more to release more photons (positive feedback loop)

This gives us a very consintrated light energy

Then we have this small opening in the front of the laser that allows this highly condinced light energy to escape

A
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14
Q

The depth of the tissue able to absorb energy from the laser depends on what?

A

The wavelength (deeper tissue needs different wavelengths to absorb)

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15
Q

623nm laser is what color and transmits how deep

A

red/orange 2-3cm

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16
Q

830nm is what kind of laser and transmits how deep

A

infrared
2-4cm

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17
Q

1064nm is what kind of laser and transmits how deep?

A

Infrared from HILT
4-7cm

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18
Q

Photosensitive molecules in membranes of cells and organelles that are sensitive to specific wavelengths of light

A

Chromophores

For example if you should a wavelength into skin which is a wavelength of 7000-1200 nm thats goign to stimulate mitochondrial chromophores which will stimulate the mitochondrial and cause increased ATP synthesis / cellular repair /repdodruction / increased production of mRNA for procollagen

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19
Q

Mitochondrial chromophores are what wavelength. What effects do you get (3)

A

700-1200nm

Increased ATP synthesis
Cellular repair/reproduction
Increased production of mRNA for procollagen

20
Q

Myoglobin and hemoglobin chromophores are stimulated at what wavelength

A

400-700nm

21
Q

We get increased tissue healing from laser due to these chromophores

A
22
Q

Why is inflammation decreased w/ laser

A

Increased histamine and nitric oxide = increased vasodilation = improved BF

23
Q

KNOW: laser decreases pain
* reduction in bradykinin

Increased levels of beta endorphine

Supression of C-fiber afferent pain nerves

Decreased nerve conduction and amplitude

A
24
Q

KNOW: Laser causes increased tissue healing increased osteoblastic proliferation

improved diabetic / neuropathic foot ulcers

increased BF

increased blood vessel permeability

cell metabolism/anti-inflammatory mechanisms

A
25
Q

Indications from laser
* TMD
* Lumbar/cervical dysfunction
* Shoulder pain / dysfunction
* Fibromyalgia, myofascial dirsoders
* Lateral elbow epicondylitits
* Knee degenerative joint disease
* Carapl tunnel syndrome
* Achilles tendonitis
* Wounds

However - lots of studies found that this wasnt true

So you have to weigh the pros and cons of actucally purchasing
* generally evidence is not strong for laser utilization and they’re expensive so lots of clinics dont buy them

A
26
Q

Determines depth of energy absorption and what kind of tissues are most affected (deep vs non deep) in a laser

A

Wavelength

27
Q

Low Level Laser Therapy (LLLT) peak output

A

Less than 500mW

28
Q

High Intensity Laser therapy peak output

A

> 500mW

29
Q

KNOW: Power is measured in mW

A
30
Q

Rate of pulses of laser emission is known as

A

Frequency

31
Q

Why should pulses of be utulized w/ HILT? What are the benefits of it being pulsed?

A

Because of the increased power

Reduces the excessive thermal effects and tissue damage

32
Q

Total energy develered is measured in

A

Joules

33
Q

The amount of joules of energy delevered is based on what (4)

A

Power
Frequency
Treatment size
Treatment time

34
Q

How is total energy calculated?

A

Peak power x pulse frequency x pulse duration x time applied to pt / total treatment area

30mW=0.03W; continuous; 30 sec treatment time
0.03W * 30 sec /1cm2= 0.9J/cm2 for single probe 1 cm2
For cluster with 6 probes 0.9J/cm2 * 6 = 5.4J/cm2

30mW with pulse rate of 1,000Hz and pulse duration of 300μsec
(0.03W * 1,000Hz * 0.0003 sec) = mean power = 9mW
0.009W * 30 sec /1cm2 = 0.27J/cm2

dont really know what this means - but her audio didnt work

35
Q

KNOW: For carpal tunnel we use low laser

for latearl epicondylitis / trigger points we use low and high intensity

A
36
Q

KNOW: part of the problem w/ lasers it that we need them coming in 5 times a week for several weeks which isnt doable for lots of pts

A
37
Q

Joules = treatment time * power

2/.3 = 3.5sec??????????

A
38
Q

Single diode has how much power

A

300mW

39
Q

Cluster has how much power?

A

540mW

40
Q

GRID method is 1cm squares holding laser there for a second or 2 then moving on and going down your grid

in contact w/ pts skin

A

So you’re only holding it in each box for about a second

if I was doing single diode 1J i would hold it for 1 second 3-4 times

41
Q

W/ scan method for laser you’re hovering over pts skin and doing sweeps

hard to gage the amount of E going into the pt

A
42
Q

Point stimulation

for one point were trying to hit really hard
1 J = 3.5 secofons remove and do it over and over again

going to have to relearn all this shit

A
43
Q

Contraindications for laser
* direct eye exposure
* Prgnancy
* Active malignancy
* Active hemorrhage
* Ope/Active growth plate (not yet ossified) (age 22)
* Endocrine system - thyroid gland - can alter hormone release

Precuations
* Impaired sensation (can generate heating effects)
* Indirect eye exposure (risk of retinal damage - wear protective goggles)
* Skin color - darker skin color may lead to greater laser enegery absorption - increased superficial tissue injury release - dosage should be less than 9 joules for darker skin color

A
44
Q

Clinical procedure for laser:
* Select appropriate laser (class 3b or 4) - we use 3b LLLT
* Describe purpose and benefits to pt
* Clear patient of contraindications, skin inspection, sensation check
* Take pre-measures (girth etc…)
* Position patient in appropriate and comfortable position (treatment area exposed / patient weaing protective eyewear)
* Set appropraite parameters on device
* Don protective eyewear

Position laser applicator in contact w/ skin
* prependicular to skin surface
* if sweep mode is used, hover over skin
* HILT will require a specer (make sure theres space between laser applicator and pts skin)

Begin treatment
* Point to treatment area for time
* Move (point and move)

Inform patient of open communication for adverse effects

Following reatment:
* Turn off machine before removing eyewear
* Remove protective eyewear
* Wipe off applicator w/ alc wipe

Assess pt response
* Skin check
* Post- measures

A
45
Q

Documentation
* Type of laser
* Duration
* Total Energy Delivered
* Frequency if pulsed (pulsed duration)
* Power
* Treatment area

Patient response
* Test, treat, re-test
* Adverse effects (this is a yes or no)

Recommended outcome measures
* AROM/PROM
* MMT Grip dynamometry (especialy w/ eipcondylitits)
* Pain
* Pressure algometry
* Sensory testing
* Nerve conduction
* Functional measures

A

Upper Test 2 (5 decks)

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