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DPT 690 - PT Interventions II > Lasers, UV Radiation > Flashcards

Lasers, UV Radiation Flashcards

1
Q

The clinical effects of EM Radiation are determined by = ?

FWI

Lasers, UV Radiation

A

The nature of the clinical effects of EM Radiation are determined by:

  • Frequency
  • Wavelength range of the radiation
  • Intensity of the radiation
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2
Q
  • Examples of low frequency EM radiation include = ?
  • Examples of high frequency EM radiation = ?

Lasers, UV Radiation

A

Low Frequency EM Radiation:

- Extremely low-frequency waves (ELF)

- Shortwaves

- Microwaves

- IR radiation

- Visible light

- Ultraviolet A and B (UVA, UVB)

  • Nonionizing; cannot break molecular bonds or produce ions
  • Can be used for therapeutic medical applications

High Frequency EM Radiation:

- X-rays, gamma rays

  • Ionizing, can break molecular bonds to form ions
  • Can inhibit cell division
  • Used for imaging or tissue destruction
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3
Q

Intensity of EM Radiation:

Intensity of EM is greatest when = ?

3 things…

Lasers, UV Radiation

A

Intensity is greatest when =

  1. Energy output is high
  2. Radiation source is close to the patient
  3. Beam is perpendicular to the surface of the skin
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4
Q

Clinical Use of EM Radiation:

IR radiation produces = ?

Lasers, UV Radiation

A

Clinical Use of EM Radiation:

  • IR radiation produces superficial heating.
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5
Q

Clinical Use of EM Radiation:

UV radiation produces = ?

Lasers, UV Radiation

A

UV radiation produces:

  • Erythema
  • Tanning
  • Epidermal hyperplasia
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6
Q

Clinical Use of EM Radiation:

Shortwave and microwave radiation are used to heat = ?

Lasers, UV Radiation

A

Shortwave and microwave radiation = Used to heat deep tissues, decrease pain, decrease edema, facilitate tissue healing

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7
Q

Clinical Use of EM Radiation:

Low-intensity laser are used to promote = ?

Lasers, UV Radiation

A

Low-intensity laser – Used to promote tissue healing, control pain and inflammation

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8
Q

Physiological Effects of EM Radiation

Arndt-Shulz Law = ?

Lasers, UV Radiation

A

Arndt-Shulz Law:

  • Minimal stimulus needed to initiate biological process.
  • Too strong may be inhibitory.
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9
Q

Laser = ?

Think L.A.S.E.R

Lasers, UV Radiation

A

Laser = Light Amplification by Stimulated Emission of Radiation.

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10
Q

Laser light can be = ?

Lasers, UV Radiation

A

Laser light:

  1. Monochromatic
  2. Coherent
  3. Directional
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11
Q

What source of light?

High-intensity light in one area = ?

Lasers, UV Radiation

A

Laser diodes:

  • Each producing light in the visible or IR range of the EM spectrum.
  • Many applicators include a few laser diodes, SLDs and LEDs together in a cluster (10-20 diodes).
  • High-intensity light in one area
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12
Q

Sources of light:

LEDs produce = ?

Lasers, UV Radiation

A

LEDs (Light emitting diodes) produce:

  • Low-intensity, non-coherent, non-monochromatic, non-directional light that may appear to be one color and spreads widely.
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13
Q

Sources of light:

SLDs produce =?

Lasers, UV Radiation

A

SLDs (Supraluminous diodes) produce:

  • High-intensity, almost monochromatic light
  • Not coherent
  • Require shorter application than LEDs
  • Deliver energy to a wider area than laser
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14
Q

Laser

Three sources of light = ?

Lasers, UV Radiation

A

Laser - Sources of light:

  1. LEDs (Light emitting diodes)
  2. SLDs (Supraluminous diodes)
  3. Laser diodes
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15
Q

High power lasers are used for = ?

scope…

Lasers, UV Radiation

A

High power - AKA “hot” lasers:

  • Surgical cutting and coagulation
  • Ophthalmologic
  • Dermatologic
  • Oncologic
  • Vascular
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16
Q

Lower power lasers are used for = ?

Lasers, UV Radiation

A

Low-level laser therapy (LLLT) - AKA low-power laser, “cold” or “soft” laser:

  • Treatment of tendon or ligament injury
  • Arthritis
  • Lymphedema
  • Soft-tissue healing
  • Bone healing
  • Neurological conditions
  • Pain management
17
Q

Wavelength

  • Longer wavelength = ?
  • Shorter wavelength = ?

Lasers, UV Radiation

A

Wavelength:

- Optimal depth of penetration is 600-1300 nm (red or IR).

  • Longer wavelength = Lower frequency = Penetrates deeper.
  • Shorter wavelength = Higher frequency = Penetrates less deeply.

- IR penetrates 2-4 cm into soft tissue

- Red light penetrates only a few mm, just through and below the skin.

18
Q

Power and Power Density

Most laser diodes used for therapy ( class 3B ) have a power between = ?

Lasers, UV Radiation

A

Power and Power Density:

- Power = Rate of energy flow.

- Power Density = Amount of power per unit area.

- Class 3B

  • Most laser diodes used for therapyhave a power between 5-500mW.
19
Q

Energy and Energy Density

  • Energy formula = ?
  • Energy density = ?

Lasers, UV Radiation

A

Energy (J) = Power (W) x Time (s)

  • Since energy includes time, the clinician using a laser light therapy device generally does not need to select (or document) the treatment time.

Energy Density = Amount of power per unit area

  • Measured in J/cm2
  • The treatment dose
  • J/cm2 = Energy (J) / area of irradiation (cm2)
20
Q

Effects of lasers and light include = ?

stimulates, promotes, alters, and initiates…

Lasers, UV Radiation

A

Effects of Lasers and Light:

  • Stimulates ATP , and RNA production.
  • Alters the synthesis of cytokines (inflammation), nerve conduction velocity, and regeneration
  • Inhibit bacterial growth
  • Promote vasodilation
  • Initiates reactions at the cell membrane by affecting calcium channels and intercellular communication.
21
Q

Contraindications for lasers = ?

Lasers, UV Radiation

A

Contraindications for Lasers:

  • Malignancy
  • Direct irradiation of the eyes
  • Within 4-6 months of radiotherapy
  • Hemorrhaging regions
  • Over thyroid or other endocrine glands
22
Q

Precautions for lasers include = ?

Lasers, UV Radiation

A

Precautions for Lasers:

  • Low back or abdomen during pregnancy
  • Epiphyseal plates in children
  • Impaired sensation
  • Impaired mentation
  • Photophobia = Abnormal sensitivity to light, especially of the eyes
  • Abnormally high sensitivity to light
  • Pretreatment with one or more photosensitizers

- Medications that increase a patient’s sensitivity to light (have you ever been on antibiotics that warn you to wear sunscreen when out in the sun?).

23
Q

Adverse effects of lasers and light include = ?

Lasers, UV Radiation

A

Adverse Effects of Lasers and Light:

  • Transient tingling
  • Mild erythema
  • Skin rash
  • Burning sensation
  • Adverse effects from irradiation of the eyes
24
Q

Laser Protocol

  • Clear of _ ? _
  • _ ? _ the skin
  • Clinician & patient wear _ ? _
  • Keep applicator _ ? _ to skin
  • Do not _ ? _ during application
  • Apply with _ ? _

Lasers, UV Radiation

A

Protocol:

  • Clear of contraindications and indications
  • Clean the skin
  • Clinician and Patient wear protective eyewear
  • Keep applicator perpendicular to skin
  • Do not move during application
  • Apply with firm pressure if not contraindicated
25
# Parameters - Lasers & Light: * ***Laser*** wavelength = **?** * ***Red*** wavelength = **?** * ***Near***-***IR*** wavelength = **?** ## Footnote *Lasers, UV Radiation*
**Wavelength**: **-** **Laser** = * 500 – 1100 nm **-** **Red** = * 600 – 700 nm * Better for treating ***superficial*** tissues (5-10 mm) **-** **Near-IR** = * 700 - 1100 nm * Longer wavelength * Penetrates ***deeper*** (30-40 mm) **Power**: * Class 1 to class 4 * Clinically used at ***3B*** (5 - 500 mW)
26
Scanning, gridding, and wanding are examples of = **?** ## Footnote *Lasers, UV Radiation*
**Laser Treatment Techniques**: **-** Laser tip should be in light contact with skin. **-** Directed perpendicularly to the target tissue. * **Gridding** – imaginary grid with 1 cm squares. * **Scanning** – no contact between laser tip and the skin. * **Wanding** – uses oscillatory technique over a grid area.
27
What should be documented = **?** ## Footnote *Lasers, UV Radiation*
**Documentation**: * Type of diode (laser, LED, SLD) * Wavelength (nm) * Power (mW) * Area of the body treated * Energy density (J/cm2) * Patient’s reaction to treatment
28
# Physical Properties of UV Radiation * UVA = **?** nm * UVB = **?** nm * UVC = **?** nm ## Footnote *Lasers, UV Radiation*
**-** Divided into three bands: * ***UVA*** = 320-400 nm * ***UVB*** = 290-320 nm * ***UVC*** = < 290 nm
29
# Physical Properties of UV Radiation * UVA = **?** * UVB = **?** * UVC = **?** | *what wavelength (short or long)* ## Footnote *Lasers, UV Radiation*
**Physical Properties of Ultraviolet Radiation**: **-** ***UVA*** * Aka *long-wave UV* * ***Non-ionizing*** * Produces fluorescence **-** ***UVB*** * Middle-wave UV * ***Non-ionizing*** * Produces the most skin erythema **-** ***UVC*** (filtered out by the ozone layer) * Shortwave * **IONIZING** * Germicidal
30
Effects of UV radiation include = **?** ## Footnote *Lasers, UV Radiation*
**Effects of Ultraviolet Radiation**: **-** [Erythema](https://www.sciencedirect.com/topics/medicine-and-dentistry/erythema#:~:text=Erythema%20is%20redness%20of%20the,sun%20(ie%2C%20sunburn).) production **-** Tanning **-** Epidermal hyperplasia **-** Vitamin D synthesis **-** Other effects: * Bactericidal * Suppression of immune response w/ ***low doses*** * Activation of immune response w/ ***high doses*** **-** Wound Healing * Enhances epithelialization * Destroys bacteria * Absorbed equally by all skin colors ## Footnote * ***Erythema*** is redness of the skin caused by injury or another inflammation-causing condition.
31
Precautions for UV include = **?** | *everything photo...* ## Footnote *Lasers, UV Radiation*
**Precautions for UV**: **-** Photosensitizing medications **-** Photosensitizing supplements **-** Photosensitivity * Patients with fair skin and hair color, those w/ red hair have greater risk to UV exposure. **-** Recent X-ray therapy * No dose should be repeated until the effects of the previous dose have disappeared.
32
Contraindications for UV = **?** ## Footnote *Lasers, UV Radiation*
**Contraindications for UV**: * Irradiation of the eyes * Skin Cancer * Pulmonary Tuberculosis * Cardiac, kidney or liver disease * Systemic Lupus Erythematosus * Fever
33
What is UV used to treat = **?** ## Footnote *Lasers, UV Radiation*
**Clinical Indications for use of UV**: **-** **Skin conditions**: * Psoriasis * Scleroderma * Eczema * Atopic dermatitis * Cutaneous T-cell lymphoma * Vitiligo * Palmaplantar pustulosis **-** **Treatments**: ***UVB*** or ***[PUVA](https://dermnetnz.org/topics/puva-photochemotherapy#:~:text=What%20is%20PUVA%3F,(long%20wave%20ultraviolet%20radiation).)*** * Recent study of the use of UVA in conjunction with Psoralen-based topical and systemic drugs. * ***Psoralen*** is a light-sensitive drug that absorbs UVA light and acts like UV radiation. * Psoralens are taken orally or applied topically, with UVA light for treatment.
34
Adverse Effects of UV Radiation = **?**
**Adverse Effects of UV Radiation**: * Burning * Premature aging of the skin * Carcinogenesis * Eye damage
35
Determining the minimal erythemal dose can be affected by = **?**
**Determining the Minimal Erythemal Dose**: **-** Determine the patient’s sensitivity to UV radiation. **-** Varies widely **-** ***Affected by***: * Skin pigmentation * Age * Prior exposure to UV * Type of UV * Use of sensitizing medications **-** Use the same lamp for determining sensitivity and for treatment
36
# Dose-response assessment: * Suberythemal dose = **?** * Minimal erythemal dose = **?** * First-degree erythema = **?** * Second-degree erythema = **?** * Third-degree erythema = **?**
**Dose-Response Assessment**: **-** **Suberythemal dose** (SED): * No change in skin redness occurs in the ***24 hrs after*** UV exposure. **-** **Minimal erythemal dose** (MED): * The smallest dose produces erythema within ***8 hrs after*** exposure that ***disappears within 24 hrs*** after exposure **-** **First-degree erythema** (E1): * Definite redness with some mild desquamation appears within ***6 hrs after*** exposure and ***lasts for 1-3 days***. * This dose is generally 2.5 times the MED **-** **Second-degree erythema** (E2): * Intense erythema with edema, peeling, and pigmentation ***appears within 2 hrs after*** exposure and is like a severe sunburn. * This dose is generally 5 times the MED **-** **Third-degree erythema** (E3): * Erythema with severe blistering, peeling and exudation. This dose is generally 10 times the MED.
37
# UV What should be included in the documentation = **?** ## Footnote Dose-response assessment:
**Documentation - UV**: * If and how [Psoralen](https://www.cancer.gov/publications/dictionaries/cancer-terms/def/psoralen) was given * Area of body treated * Type of UV radiation used * Serial number of the lamp * Distance of the lamp from the patient * Treatment duration * Patient’s response to treatment

DPT 690 - PT Interventions II (13 decks)

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