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INTEG UNIT 3 > Lecture 2-Electrotherapy > Flashcards

Lecture 2-Electrotherapy Flashcards

1
Q

electrical current creates a mm. contraction through…

A

-creates mm. contraction through nerve or mm. stimulation

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2
Q

electrical current stimulation uses sensory nerves to…

A

sensory nerves to help with pain

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3
Q

electrical current creates an electrical field in biol. tissues to

A

stimulation or alter healing

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4
Q

Applications of e-stim

A
  1. MM. strengthening
  2. mm. re-education
  3. mm. spasm reduction
  4. edema reduction
  5. pain modulation
  6. wound healing
  7. iontophoresis
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5
Q

Indications for Estim

A
  • pain modulation
  • denervated mm. reducation
  • retarding atrophy
  • mm. strengthening
  • increasing ROM
  • dec. edema
  • decreasing spasm
  • stimulating healing process
  • wound/fx/tissue healing
  • stimulating nn. regeneration/peripheral n. function
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6
Q

E-stim contraindications

A

-pacemakers
-over carotid sinus
-venous of arterial thrombosis or thrombophlebitis is present
-pregnancy
(POPV)

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7
Q

Estim precautions

A
  • cardiac disease
  • impaired mentation
  • infection/open wounds
  • malignancies
  • MSK conditions where mm. contraction would worsen condition
  • adipose tissue (wont work well)
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8
Q

Waveforms of estim

A
  • monophasic current- direct current (DC) (galvanic)
  • alternating current (AC)-biphasic current
  • pulsatile current- interferential, russian, also biphasic
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9
Q

monophasic current- direct current (DC) galvanic

A

unidirectional flow of electrons

polarity and direction of flow can be reversed?

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10
Q

alternating current (AC)

A

biphasic current

  • bidirectional- changes direction OR reversing polarity
  • w/ symmetrical waveform, polarity shifts with each pulse
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11
Q

pulsatile current-

A

interferential, russian (also biphasic)

-groups of pulses, interrupted, repeat at regular intervals

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12
Q

Characteristics of electrical current

A
  • amplitude (intensity, strength, voltage)
  • frequency (Hz, pps, bps)
  • phase duration/ pulse width
  • ramp up/down time
  • rise and decay time
  • duty cycle
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13
Q

amplitude is a measure of..

A

how much we turn it up

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14
Q

pulse duration =

A

combined phase durations

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15
Q

use interferential for…

A

pain modulation

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16
Q

premod for…

A

pain modulation

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17
Q

russian for…

A

mm. training

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18
Q

biphasic for…

A

pain modulation, mm. training, and edema

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19
Q

VMS

A

mm. training, edema

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20
Q

HVPC

A

pain modulation, edema, wound healing

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21
Q

microcurrent

A

wound healing

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22
Q

direct current

A

iontophoresis, denervated mm.

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23
Q

types of physiological reactions that happen from electrical current

A
  • physio.
  • thermal
  • chemical
24
Q

current flow through biological tissue

  • blood
  • mm.
  • skin
A

blood: composed of water and ions (best conductor)
- peripheral nerve; conductivity 6x>mm.
mm: ~75% water, contraction dependent on ion movement
skin: primary resistance
- higher impedance—> higher intensities
- skin preparation is important (no soap or alcohol!)

25
Q

fat-

A

contains 14% water- poor conductor

26
Q

bone-

A
  • extremely dense
  • 5% water
  • poorest biol conductor
27
Q

Accomodation

A

adaptation by the sensory receptors to various stimuli over an extended period of time
-fiber becomes unexcitable after exposure to constant level of depolarization

28
Q

to avoid accomodation we…

A

modulation:

  • any alteration in amp, frequency, or duration
  • usually built into a machine
  • decreases accomodation
29
Q

shortest durations access…

A

sensory n., then motor, then pain

30
Q

Law of Dubois Reymond

A
  • the effectiveness of a current to target specific excitable tissues is dependent on three major factors:
    1. adequate INTENSITY to reach threshold
    2. CURRENT ONSET FAST ENOUGH to reduce accommodation
    3. DURATION long enough to exceed the capacitance of the tissue
31
Q

motor points

A
  • most comfortable place to get a contraction is the motor point (easiest place with least intensity)
  • usualy found within mm. belly where motor nerve fibers synapse w/ mm.
32
Q

all mm. contain 2 types of fibers:

A

T1 (slow twitch)
-high endurance, slow to fatigue, low strength, static, postural
T2 (fast twitch)-need more power
-fast contraction, low endurance, fast to fatigue, high strength, dynamic, explosive

33
Q

T2 are normally ___x the size of T1

A

2x the size of T1

34
Q

during mm. contraciton, size principle…

A

small type 1 fibers recruited first

large t2 fibers recruited later when effort increases!

35
Q

metal backed electrodes reuqire…

A

an interface

36
Q

3 types of electrodes:

A

metal backed
carbon film
dure-stick plus (specific to pt.) 10 times ues

37
Q

to minimize electrode resistance:

A
  • use large electrodes
  • maintain even, firm contact
  • use clean electrodes
  • keep sponge interface well moistened?
  • remove excess hair and oils
38
Q

whenever possible use largest electrode possible to reduce…

A

reduces local increases in current density…when small pads are required use the lowest stimulation intensity necessary to achieve the desired clinical results

39
Q

electrodes should be placed with ___ inch or more

A

1 inch or more.. 2 if you can! (lots of trial and error to find best placement)
further apart= deeper current

40
Q

electrodes can be placed..

A
  • on or around the painful area
  • over specific dermatomes, myotomes, or sclerotomes that correspond to painful area
  • close to spinal cord segment that innervates an area that is painful
  • over sites where peripheral nerves that innervate the painful area becomes superficial and can be easily stimulated
  • over superficial vascular structures
  • over trigger point locations
  • over acupuncture points
  • in a crisscrossed pattern around the point to be stimulated so the area to be treated is central to the location of the electrods
  • bipolar application resulting in similar physiologic effects beneath each electrode
41
Q

MOst commonly used gate level TENS set up is…

A

Bracketed! (criss-crossed pattern)

42
Q

dermatome=

A

-surface area supplied by a nerve root

43
Q

peripheral nerves are made up of…

A
  • several spinal nerve roots
  • ex: ulnar n. is made up of C7, 8, T1 nn. roots
  • they are most relevant with peripheral injuries and stresses!!
44
Q

Estim frequencies

A

low, med, high

45
Q

low frequency estim

A
  • 1,000 Hz (cycles per second) and below

- BioMed 2000 XL

46
Q

medium freq. estim

A
  • 1,000 to 100,000 HZ
    • Mettler all medium freq.
    • vectra genysis
47
Q

high freq. estim

A

> 100,000 HZ

- vectra genysis

48
Q

Mettler sonicator Plus 930

A
  • all medium freq
    • interferential- 4000 Hz and 4100 Hz
    • premod- 4,000 Hz
    • medium freq. (russian) - 25000 Hz, burst!
49
Q

continous=

A

no amplitude modulation

50
Q

surge=

A

can set the on/off times (NMES)

51
Q

reciprocation=

A

stimulation changes from one channel to the other

52
Q

Vectra genysis=

A

preprogrammed

53
Q

Intelect NMES (blacK)

A
  • asymmetric biphasic square pulse
    • ONE mode
    • pulse amplitude
    • pulse freq.
    • pulse width
    • adjustable on/off time (duty cycle)
54
Q

Intelect NMES (white)

A
  • asymetric biphasic square wave (3 modes)
    • constant- adjustable rate and PW (no on/off time capability)
    • alternate (ch. 1 and ch. 2)
    • synchronous- channel 1 and 2 run the same
55
Q

BioMed 2000XL (TENS)

A

3 modes

  • continous
  • burst
  • modulated

INTEG UNIT 3 (2 decks)

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