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Integumentary Mid Term > Laser, SWD, HBO, EMG > Flashcards

Laser, SWD, HBO, EMG Flashcards

1
Q

What is an HBO?

A

hyperbaric oxygen chamber

used to increase oxygen in blood plasma which makes it more readily available for wound healing

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2
Q

What is purpose of HBO?

A

increases oxygen gradient, may reduce bacterial growth as more O2 radicals are present

enchances all phases of proliferation, may reduce edema by bringing interstitial fluid out

more O2 delivery to tissue, improve antibiotic uptake

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3
Q

What are indications for HBO?

A

gas gangrene, peripheral ischemia, crush injury or skin graft, DM wagner 3,4,5, OM, thermal burns

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4
Q

Contraindications?

A

pneumothorax, COPD, claustrophobia, pregancy, severe arterial insufficnecy,current chemo

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5
Q

What is method for HBO?

A

patient in chamber at 1.5-2.5 ATM

tx time: 90-120 mins

frequency: 2x/day- 3/xweek

tx length- 10-60 sessions

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6
Q

When will health team know if working?

A

if 50% decrease of would isnt noted after 10 sessions likely not going to respond to rx

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7
Q

What does laser stand for?

A

light amplification by stimulated emissions of radiation

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8
Q

What is laser thrapy?

A

no heating of tissue is cold laser like LLLT, basically non thermal effects of US x 10

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9
Q

How does laser work?

A

photobiomodulation: use of light to modify biological processes

cell absorbs photon produce by laser and turns it into ATP which increases protein synthesis in mitochondria

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10
Q

What are three characteristics a laser must have?

A
  1. coherent
  2. monochromatic
  3. collimated
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11
Q

What does it mean for a laser to be coherent?

A

light waves are closely packed uniform lines

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12
Q

What does it mean for laser to be collimated?

A

all waves are parallel

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13
Q

How can tissues affect tissue repaid and wound healing?

A

cell repair through increased ATP, increased RNA that is pro-collagen

increased O2 and cell proliferation

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14
Q

How can laser help with vasodialation?

A

increased vasodialtion which will decrease ischemia and promote perfusion, decreased prostaglandin , decreased neutrophil migration

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15
Q

How can laser help with pain?

A

increased endorphins, decrease bradykinin, supresses c fiber afferents, decrease sensory and motor nerve conduction

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16
Q

What tyoe of laser do PT normally use?

A

class 3B, medium power level, less than 500 mW power

ex: LLLT

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17
Q

Roughly how deep will a laser light go?

A

5 cm deep

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18
Q

What are contraindications?

A

direct eye exposure, pregnancy, cancer, active bleeding (menstration or blood thinners), open growth plates

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19
Q

What are other precautions?

A

decreased sensation, recent steriod injection (will spread injection and we want it localized), photosensitivity meds

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20
Q

What are 4 key parameters to determine dosage and penetration?

A

wavelength- bigger the deeper
energy- j/cm2
power (mW)
continuous or pulsed

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21
Q

What power settings are needed for different tissue depth?

A

100 mw for superficial less than 1 cm
200 for medium 1-2 cm
300 mW for deeper greater than 2 cm

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22
Q

What are indications for LLLT?

A

wound healing, epicondylitis, fibromyalgia, carpal tunnel, neck pain, TMJ, LBP, shoulder pain

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23
Q

What is short wave diathermy?

A

produces deep heating 3-5 cm via conversion of electromagnetic energy into thermal energy

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24
Q

How does it work physiologically?

A

passes through tissue to cause molecular vibration which results in deep heating and superficial heating

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25
Q

What are two advantages of short wave diathermy?

A

capable of heating large areas (roughly size of cereal bowl)

causes both thermal and non thermal affects

26
Q

What are thermal uses for SWD?

A

deep heat, increase blood flow, cell metab, tissue extensibility, muscular relaxation

27
Q

What are non thermal uses of SWD?

A

edema reduction, lymphedema reduction, superficial wound healing, treeatment of venous ulcers

28
Q

What are contraindications?

A

ischemic areas, metal, perspiration, tendency to bleed, pace maker, PT and pts who are pregnant should avoid

29
Q

What are precuations?

A

dont let sweat near treatment site, thick fat can increase heating, operator should remain 2-3 feet away from energy source

30
Q

What are two types of SWD generators?

A
  1. induction field 1 electrode

2. capacitive 2 electrodes

31
Q

What type of tissue is mainly heated with inductive SWD?

A

muscle due to electrolytes

32
Q

How does capacitive SWB work?

A

two electrodes on each side on leg for example to create an electrical circuit

33
Q

What type of tissue is heated more with capicitive?

A

sueprficial skin and fat but muscle is heated some by conduction from adipose

34
Q

How does SWD affect inflammation?

A

assists of removal of cell debris and toxins

35
Q

How does SWD help wound healing?

A

by vasodialating you increase blood flow, capillary filtration, cap pressure and oxygen perfusion

non thermal can increase rate of phagocytosis, ATP increase

36
Q

What is an EMG?

A

examines integrity of neuromuscular system including UMN, LMN and muscle fibers or delineated components of motor unit

study of motor unit activity

37
Q

What does an EMG allow providers to see?

A
  1. can identify location of impairment
  2. can NOT identify cause of impairment
  3. can identify severity of impairment
38
Q

What types of things can stimulate a nerve or muscle response in an EMG?

A

electric stim, needle provocation, voluntary activation

39
Q

What type of pt can benefit from an EMG?

A

pts who have numbness, tingling, pain involving PNS, weakness in PNS

done for PNS not CNS

40
Q

What are two diff type of nerve injuries?

A
  1. segmental demyelination- issue can be identified immedietly
  2. axon degeneration- takes 21 days after injury to identify
41
Q

How long does it take for a nerve to heal?

A

1 mm a day

42
Q

What is an abnormal velocity finding with EMG?

A

increase in latency reflects a decrease in conduction velocity

43
Q

What is an abnormal amplitude response?

A

lower the amplitude will mean less motor units working

44
Q

What is an abnormal duration response?

A

long duration can signal certain demyelinating disorders

45
Q

What other factors can affect an EMG?

A

UE faster than LE, age slower in 7 y/o, heigher- longer limbs slower velocity, temp- cooler is slower

46
Q

What is neurapraxia?

A

mild local conduction block, feels like arm fell asleep

axons intact but local demyelination

weeks to recover

47
Q

What is axonotmesis?

A

more severe, disruption of axonal continuity

recovery is possible but could take several months, connective sheath must be intact

48
Q

What is neurotmesis?

A

most severe

axonal degeneration and connective sheath damage

likely no recovery

49
Q

What should happen on an EMG upon insertion?

A

normal- brief spike

PND- increased or prolonged

myopathic process- brief or increased

50
Q

What should happen on EMG with spontaneuous activity?

A

normal- none

PND- present

MP- usually none

51
Q

What should happen on EMG with minimal motor unit activation?

A

normal- normal activity

PND- increase duration, large sharp amplitude

MP- decrease duration small amp

52
Q

How to treat denervated muscle?

A

use estim to decrease amount of atrophy

53
Q

What would be parameters?

A

pulse duration- greater than 50 msec

frequency- 1-5 pps

on off ratio 1/5

do 3x/day for 5-20 reps

place one probe of muscle belly and other proximally

will get a worm like contraction

54
Q

What are laser parameters for inflammation?

A

dosage- 2-5 j/cm2

frequency- 5000 hz

application- over area of inflammation

55
Q

Acute pain?

A

6 j/cm2

continuous

over painful area

56
Q

Chronic pain?

A

12 j/cm2, cont., over pain area

57
Q

acute soft tissue injury?

A

4-8 j/cm2, under 100 hz, over lesion

58
Q

Chronic soft tissue injury?

A

12 j/cm2, cont, over lesion

59
Q

Tendinitis/Bursitis?

A

2-10 j/cm2, 5000 hz, over inflamed tissue

60
Q

Trigger points?

A

5-12 j/cm2, cont. over TP

61
Q

Acute wounds?

A

8 j/cm2, 700 Hz, in or around wound bed/periwound

62
Q

Chronic wound?

A

1-6 j/cm2, cont. in and around wound bed/ periwound

Integumentary Mid Term (11 decks)

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