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becky: THER EX > LECTURE 4: MODALITIES > Flashcards

LECTURE 4: MODALITIES Flashcards

1
Q

ultrasound indications

A

Acute and post-acute conditions (non-thermal effects)
● Calcium deposits
● Chronic inflammation
● Delayed soft tissue healing
● Dermal ulcers
● Joint contractures
● Muscle spasm
● Myofascial trigger points
● Pain
● Plantar warts
● Scar tissue
● Tissue regeneration

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2
Q

ultrasound contra indications

A

● Areas of active bleeding
● Areas of decreased temperature
sensation
● Areas of decreased circulation
● Deep vein thrombosis
● Infection
● Malignancy
● Over breast implants
● Over carotid sinus or cervical ganglia
● Over epiphyseal areas in young
children
● Over eyes, heart, and genitalia
Over methylmethacrylate cement area (TKR) or plastic
● Over pelvic, lumbar or abdominal areas in pregnant women
● Over pacemaker
● Thrombophlebitis
● Vascular insufficiency

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3
Q

ultrasound is a what?

A

Sound frequency (acoustic energy in waves) that is deep heat modality!!!! up to 5 cm

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4
Q

true or false: ultrasound can be thermal and nonthermal

A

true!

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5
Q

What is attenuation?

A

decrease in energy intensity bc some of ultrasound waves got bent due to reflection or refraction

This is why we use gel and sound head firmly against body part

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6
Q

US passes through _____ content, and is absorbed in ___tissues

A

passes through high water content, absorbed in high protein like tendon
frequency increases, absorbtion increases

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7
Q

small area, what sound head size?

A

smaller the transducer size, more contact with the skin

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8
Q

Treatment area should be what compared to effective radiating area

A

2-3x effective radiating area

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9
Q

Larger transducer and higher frequency = more

A

collimation (focus of the beam)

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10
Q

a higher BNR means

A

losing lot of energy/heat inside the unit

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11
Q

What are 4 parameters of ULTRASOUND

A

duty cycle (pulsed vs continuous)-miliseconds!!!! 5th of a sec
frequency
intensity
treatment time

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12
Q

ERA IS

A

The portion that produces the sound wave
○ Energy output is greatest at the center
○ Is is smaller than the transducer size
○ Treatment area = 2-3x ERA

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13
Q

What does

A

thermal: CONTINUOUS DUTY CYCLE
non-thermal: pulsed! 1 ms on/4 ms off duty cycle is 20%, 1/5th

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14
Q

nonthermal effects are what?

A

good for early inflammatory phase
cavitation and microstreaming!
good for 1st 2 weeks of tissue healing and for stable fractures!

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15
Q

does thermal effects have tissue healing properties?

A

not really, mainly warms up tissues!

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16
Q

ultrasound frequency is WHAT

A

depth!!!! 0.75-3 MHz

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17
Q

1 MHz frequency ultrasound settings:

A

DEEP TISSUES! goes up to 5 cm
-if cushioned
-if quads, hams, thicker areas

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18
Q

3 MHz ultrasound frequency

A

3 MHz: shallower depth (1-3 cm) for superficial tissues

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19
Q

nonthermal duty cycle is for

A

acute injury, edema, tissue healing (no temp increase!)

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20
Q
A
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21
Q
A
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22
Q

what do you do for documentation?

A

Body part to be treated
○ Modality used
○ Patient position
○ Treatment duration
○ Parameters
○ Patient response to treatment
○ Skin effects
○ Outcome measure

*communicate to other providers so they can let them do the same

23
Q

WHAT IS HIGH VOLT PULSED CURRENT

A

does same numbers as russian!
paired monophasic wave
modulation: none
muscle contraction
CAN BE GOOD FOR WOUNDS, EDEMA**

24
Q

iontophoresis is WHAT

A

continuous direct current to deliver medicine! Drives ions into body…. through skin/mucous membranes

25
Q

iontophoresis cathode has a

A

alkaline effect

26
Q

iontophoresis anode has a

A

acidic effect (+)

27
Q

iontophoresis dosage of med

A

40 mA-min dose = 4 mA x 10 min
40 mA-min=2 mA x 20 min

amount of med is same, but what changes is INTENSITY and TIME

28
Q

dexamethasone

A

polarity: negative
4 mg/mL
tendonitis!!! bursitis!!!!

29
Q

lidocaine

A

polarity: pos
4% lidocain
for: trigeminal neuralgia

30
Q

acetate

A

2-5% acetic acid for CALCIUM DEPOSITS (-)

31
Q

iontophoresis indications

A

Analgesia
● Calcium deposits (bone spurs)
● Dermal ulcers
● Edema reduction
● Fungal infections
● Hyperhidrosis
● Muscle spasms
● Musculoskeletal inflammatory conditions- tendonitis

32
Q

ionto contras

A

Those general rules for EStim
● Impaired skin sensation
● Allergy or sensitivity to medication
● Denuded area of recent scars
● Cuts, bruises, or broken skin
● Metal in or near treatment area

33
Q

how can ionto burns happen?

A

Chemical: usually alkaline reaction at cathode
● Heat: high resistance to flow, poor contact
● Irritation/rash: allergy to medication

34
Q

how can you minimize burns?

A

Decrease current density
● Inspect skin prior to application
● Ensure sufficient filling of medication
● Ensure good contact with skin
● Ask about allergy to medications

35
Q

what is biofeedback?

A

Used to measure motor unit action potentials (MUAP) .
● Signals are detected, amplified, and converted to audiovisual signals
● Electronic or mechanical instrument used to help patient develop greater voluntary control via relaxation or neuromuscular re-education
NO SHOCKING

36
Q

Biofeedback is for

A

muscle re-education! beeps loader with more contraction

37
Q

EMG biofeedback is used in conjunction with patient’s ______to increase or decrease muscle activity towards a functional goal.

A

voluntary contractions/efforts!

38
Q

what does biofeedback measure?

A

skin temp
skin conductance
vasoconstriction or pulse via phototransm
EMG activity
pressure

39
Q

who do you use biofeedback on?

A

● Good vision, hearing, and communication abilities
● Good comprehension of simple commands and concentration
● Good motor planning skills
● No profound sensory or proprioceptive loss

40
Q

how does heat transmission occur?

A

Conduction
● Convection
● Radiation
● Conversion

41
Q

conduction works by

A

CONDUCTION OVEN
DIRECT CONTACT

cooling penetrates deeper than heat! does not go deep, less than 1 cm deep

42
Q

Convection

A

body in contact with moving fluid (air or liquid)

● Hot or cold whirlpool
● Fluidotherapy
● Whole or partial body cryotherapy

43
Q

radiation

A

Transfer of energy (not necessarily heat) to the body without physical contact.

-Laser
● UV light
● Infrared lamps

44
Q

conversion

A

Energy changes from one type (i.e. sound, electromagnetic energy) into another (i.e. heat)

45
Q

ultrasound is what? CONVERSION

A

US: Sound waves create vibration of molecules which produces heat

46
Q

diathermy is what? CONVERSION

A

Dia: EM energy induces electrical fields and heat currents within the tissue.

47
Q

factors affecting thermal transfer

A

Temperature difference between modality and tissue Treatment time
Exposure of body area to modality
Specific heat and mass of body and source
Type of heat transfer
* Conduction > Convection > Conversion > Radiation

48
Q

thermotherapy indications

A

Modulate pain
● Increase connective tissue
extensibility
● Reduce or eliminate soft
tissue inflammation and
swelling
● Accelerate rate of tissue
healing
● Reduce or eliminate soft
tissue or joint restriction
● Reduce muscle spasm

49
Q

thermotherapy contras

A

Acute and early subacute traumatic and inflammatory conditions
● Decreased circulation
● Decreased sensation
● DVT
● Impaired cognitive function
● Malignant tumors
● Tendency toward hemorrhage or edema
● Very young patients
● Elderly

50
Q

thermotherapy precautions

A

Cardiac insufficiency
● Edema
● Impaired circulation
● Impaired thermoregulation
● Metal in treatment area
● Pregnancy
● Topical counterirritants recently
applied
● Demyelinated nerves
● Open wounds

51
Q

what increases with heat?

A

CO
metabolic rate
pulse rate
RR
vasodilation

52
Q

what decreases?

A

BP
mm activity
Blood flow to internal organs and blood flow to resting muscle
stroke volume

53
Q

aquatic therapy is good for what arthritic condition?

A

RA

54
Q
A

becky: THER EX (11 decks)

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