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Modalities > Lecture 4: Diathermy and Laser EMR > Flashcards

Lecture 4: Diathermy and Laser EMR Flashcards

1
Q

EMR is composed of what

A

electric and magnetic fields that vary overtime and are oriented perpendicular to one another

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2
Q

how are humans exposed to EMR daily

A

natural UV radiation

manufactured in lightbulbs, computers, appliances, etc

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3
Q

what frequency is good for EMR

A

high frequency bad, low frequency good

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4
Q

how can physical agents deliver energy in the form of EMR (I.e what types of PAs)

A

light = electromagnetic energy close to visible range

infared radiation = superficial healing

microwave and shortwave = diathermy

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5
Q

EMR is categorized by what

A

frequency and wavelength (inversely proportional)

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6
Q

what does it mean that lower frequency EMR is nonionizing

A

i.e. short wave, microwaves, IR, visible light, UV

nonionizing = cant break molecular bonds and thus is medically safe

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7
Q

what does it mean that higher frequency EMR is ionizing

A

i.e. xrays and gamma rays

can break molecular bonds to form ions and inhibit cell division so not used clinically except for very small doses for imaging or large doses to kill cancerous cells

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8
Q

when is intensity of EMR greatest

A

high energy output

radiation is a source close to pt

beam is perpendicular to skins surface

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9
Q

physiological effects on subject for EMR depends on

A

frequency
wavelength
intensity of radiation

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10
Q

what is diathermy

A

conversion mode of heat transfer

EM energy causes RT of polar molecules that cause friction and thus produce heat

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11
Q

continuous vs pulsed diathermy parameters

A

continuous = 10-25 watts; can be SWD or MWD

pulsed = low intensity; nonthermal; SWT

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12
Q

types of applicators for diathermy

A

inductive coil = heat in deeper tissues with high electric conductivity

capacitive plates = more heat in skin/superficial tissues

magnetron = not common

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13
Q

thermal effects of diathermy

A

SWD/ continuous

vasodilatuion

increased rate of n conductuion

reduced pain

increased soft tissue extensibility

accelerated enzyme activity

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14
Q

non thermal diathermy effects

A

SWT

pulsed = nonthermal b/c transient heat of tissues will diffuse between pulses

modulates pain/edema/inflammation

increased microvascular perfusion

increaed blood flow/circulation

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15
Q

advantages of diathermy

A

deep heat

large areas

no direct contact

clinically indicated to reduce pain and improve muscle performance with knee OA

common in SNF

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16
Q

disadvantage of diathermy

A

not widely used

EM field cant be contained and can interfere with other equipment

large/expensive

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17
Q

nonthermal SWT clinical uses for diathermy

A

reduces edema/pain

accelerate tissue healing

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18
Q

application of diathermy

A

position drum- no contact
wrap in towl
can cover drum in plastic
remove metal
no use with pt with implanted stimulator

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19
Q

times for diathermy thermal vs nonthermal

A

thermal = ~20 min

nonthermal = 30-60 min 1-2x/day

20
Q

what to be aware of with diathermy

A

burns

varies with tissue type

wrap pt skin in towel

don’t be around with pregnancy or pacemaker

21
Q

levels of diathermy and their wattage

A

1 = 0; lowest
2= 12; low
3= 24; medium
4= 48; heavy

manually = initially start with 10-25

22
Q

what is light

A

EM energy close to visible range of electromagnetic spectrum

most light = polychromatic (various wavelengths of light)

23
Q

what is LASER light

A

light amplification by stimulated emission of radiation

monochromatic (single wavelength) , coherent (waves in phase/stick together), and directional (little divergence i.e. laser pointer)

24
Q

what is low level laser therapy (LLLT)

A

low intensity cold laser
low lightlevel used in visible red/IR range
used to promote tissue healing
control pain/inflammation

25
what are high intensity hot lasers
used for surgery can destroy tissue narrow beam generates heat with selective tissues cauterizes as it cuts not used for rehab
26
what do we mean not all lasers are LASERS
light devices are named based on what type of photodiodes theyre comprised of some laser devices are comprised of multiple photodiodes including laser and LED diodes a cluster probe is an applicator with more than 1 diode or type of diode of various wavelengths/power
27
what are photodiodes
small, sturdy, inexpensive conductors of energy semiconductors with positive and negative charges that output energy types include laser diodes, LEDs, SLDs
28
what is LED
infared laser technically not a laser light appears to be 1 color but it is neither coherent or monochromatic nondiretcional (diffuse spread of light; covers larger areas) low energy concentration (longer application times are tolerable)
29
what is SLD
supra luminous diode monochromatic, noncoherent, nondirectional, deeper penetration nondirectional (between LED and LASER) high intensity = shorter application times
30
what is wavelength
affects depth of tissue penetraction longer = deeper IR is deeper than visible light some LEDs are deeper than LASERs
31
what is power
unit of light intensity determines clinical effects hot = high intensity = high power cold = low = low
32
what is power density
irradiance light intensity per unit of area
33
what is energy
determines dose power over period of time Energy = power x time
34
what is energy density
fluence of treatment energy/unit of area preferred measure of dose light treatment dose based on clinical indication duration depends on dose
35
how do lasers/light affect the body
photons are absorbed by chromophores causing a cascade of cellular changes chromophores = part of molecule that gives tissue color by absorbing/reflecting different wave lengths absorbed photons can stimulate chromophores to undergo chem reactions and promote cascade of biochem events that influence tissue fxn
36
6 specific physiological effects of laser/light therapy
1 = stimulate mitochondria to produce ATP (up to 70%) 2= stimulate production of mRNA ro promote fibroblasts and increase collagen production 3=induce vasodilation/circulation 4=inhibit bacterial/fungi growth 5=modulate inflammaiton by decreasing mediators 6=improve nerve conduction and regeneration after injury
37
how can lasers be used with wound healing/fx healing
soft tissue and bone healing
38
how can lasers be used with neuro condition
carpal tunnel diabetic peripheral neuropathy alters n conduction velocity
39
how can lasers be used with MSK disorders
soft tissue/arthritic conditions reduce inflammatory mediators
40
how can laser be used with lymphedema
treating post masectomy women to reduce limb volume associated with lymphedema post breast cancer
41
how can laser be used with pain management
arthritis, tendinopathy, TMJ, DOMS, LBP, neck pain, trigger points, chronic pain alalgesic effects most effective when directly over involved dermatome
42
clinical indications for laser treatment dose
low dose - more acute/superficial conditions high dose = chronic/deeper conditions higher dose = longer treatment average dose = 4-12 J/cm^2 **dose automatically adjusts treatment time
43
protection for performing laser treatment
wear goggles - PT and pt goggles should not wavelength range they protect from don't point towards eyes, even if you can's visibly see laser
44
does laser risk burns
rare with low level class 3B lasers are harmless to skin generally; no thermal effect diodes can cause burns if left for a long period of time; thus LEDs that require longer treatments should not be used for pts with poor sensation
45
contraindications for lasers
direct to eyes within 4-6 months of radiotherapy hemorrhagic lesions locally to endocrine glands malignancy
46
precautions for laser
pregnancy - low back/abdomen epiphyseal plates impaired sensation/mentation photophobia high sensitivity to light pretreatment with photosensitizers (meds can increase photosensitivity)
47
what to document when useing a laser, LED, SLD, or light therapy
type of diode (laser, LED, SLD) wavelength (nm) power (mW) area of bidy treatment dose/energy density (J/cm^2) duration not included b/c automatic

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