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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
Q

what are high intensity hot lasers

A

used for surgery

can destroy tissue

narrow beam generates heat with selective tissues

cauterizes as it cuts

not used for rehab

26
Q

what do we mean not all lasers are LASERS

A

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
Q

what are photodiodes

A

small, sturdy, inexpensive conductors of energy

semiconductors with positive and negative charges that output energy

types include laser diodes, LEDs, SLDs

28
Q

what is LED

A

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
Q

what is SLD

A

supra luminous diode

monochromatic, noncoherent, nondirectional, deeper penetration

nondirectional (between LED and LASER)

high intensity = shorter application times

30
Q

what is wavelength

A

affects depth of tissue penetraction

longer = deeper

IR is deeper than visible light

some LEDs are deeper than LASERs

31
Q

what is power

A

unit of light intensity

determines clinical effects

hot = high intensity = high power

cold = low = low

32
Q

what is power density

A

irradiance

light intensity per unit of area

33
Q

what is energy

A

determines dose

power over period of time

Energy = power x time

34
Q

what is energy density

A

fluence of treatment

energy/unit of area

preferred measure of dose

light treatment dose based on clinical indication

duration depends on dose

35
Q

how do lasers/light affect the body

A

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
Q

6 specific physiological effects of laser/light therapy

A

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
Q

how can lasers be used with wound healing/fx healing

A

soft tissue and bone healing

38
Q

how can lasers be used with neuro condition

A

carpal tunnel

diabetic peripheral neuropathy

alters n conduction velocity

39
Q

how can lasers be used with MSK disorders

A

soft tissue/arthritic conditions

reduce inflammatory mediators

40
Q

how can laser be used with lymphedema

A

treating post masectomy women to reduce limb volume associated with lymphedema post breast cancer

41
Q

how can laser be used with pain management

A

arthritis, tendinopathy, TMJ, DOMS, LBP, neck pain, trigger points, chronic pain

alalgesic effects most effective when directly over involved dermatome

42
Q

clinical indications for laser treatment dose

A

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
Q

protection for performing laser treatment

A

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
Q

does laser risk burns

A

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
Q

contraindications for lasers

A

direct to eyes
within 4-6 months of radiotherapy
hemorrhagic lesions
locally to endocrine glands
malignancy

46
Q

precautions for laser

A

pregnancy - low back/abdomen
epiphyseal plates
impaired sensation/mentation
photophobia
high sensitivity to light
pretreatment with photosensitizers (meds can increase photosensitivity)

47
Q

what to document when useing a laser, LED, SLD, or light therapy

A

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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