Lecture MT 1 Flashcards
Indications for use of cryotherapy
Acute pain, inflammation
muscle spasm
Febrile state
Insect bites
Burns, boils
Contraindications for cryotherapy
Raynauds
Coma
Peripheral vascular disease
Over the heart
Open wounds
Rheumatoid
Pregnancy
Cold hypersensitivity
procedure of cryotherapy
5 minute duration
one towel layer
tell patient they can take it off at any point if it becomes painful
stop when patient reports numbness
indications for use of heat
muscle spasm
chronic pain
vascular stasis
general anxiety
contraindications for use of heat therapy
peripheral vascular disease
over pregnant uterus
over the eyes
over infection
patients with fever
procedure of heat exposure
10-20 minutes
6-8 towel layers
check every 5 minutes
how many towel layers are the heat packs
~4 towel layers
indications for dynatron microcurrent probe
open wound healing
soft tissue repair
pain
contraindications for dynatron microcurrent probes
over pregnant uterus
over tumor
cardiac arrhythmia
implanted electrical devices
procedure for dynatron microcurrent probe
350-550 microamps
.5-10hz
circle the dragon
4-6 points for 10 seconds at each site
press start on the probe
indications and contraindications for dynatron microcurrent pads
IND
open wound healing
soft tissue repair
CONT
over pregnant uterus
over tumor
cardiac arrhythmia
implanted electrical devices
procedure for dynatron microcurrent pads
50microamps
.3 hz
alternating polarity
pads proximal and distal to area of concern
20-30 minutes
procedure for alphastim transcranial
350-550microamps
.5hz
ear clips with water
slide bottom to 60 min or continuous
30min-2 hrs
indications and contraindications for alphastim transcranial
IND
headaches
CONT
implanted electrical devices
pregnant uterus
tumors
procedure for alphastim probe
.5hz
350-550 microamps
4-6 spots
10 seconds at each spot
circle the dragon protocol
slide bottom switch to probes
Indications for cold therapy
Acute/subacute stage of healing
Fevers
Bleeding
Inflammation
Pain
Contraindications for cold therapy
Cold hypersensitivity
Raynauds
Poor circulation
Neuro deficit
Peripheral vascular disease
Open wounds
Infection
Physiologic effects of cryotherapy
Local vasoconstriction
Tissue stiffness
Decrease nerve conduction
Decrease inflammatory effects
Decrease metabolism
Stages of cryotherapy
Cold ____ min
Burning ____ min
Aching _____
Numbness _____ min
Cold 1-3 min
Burning 2-7 min
Aching
Numbness 5-15 min
Cryotherapy treatment
5 minute application
1 towel layer
Never longer than 15 min
1/2 inch penetration
Temperatures of cryotherapy
___° ice pack
____° gel pack
____° chemical pack
38° ice pack
35.4° gel pack
35° chemical pack
Methods of cryotherapy application
Cold pack
Commercial cold pack
Direct ice massage
Chemical cold pack
Chemical topicals
Indications for superficial heat treatment
Subacute/chronic pain
Increase extensibility of collage
Relieve muscle spasm
Reduce chronic inflamm
Reduce exudates
Decrease pain
Contraindications for superficial heat
Directly after injury
Gravid uterus
DM
Diminished sensation
Active infection
Poor circulation
Over the eyes, genitalia
Heat is often used incorrectly by patients at
home, how is that so (3 ways)
Left on too long
Patient lays on hot pack
Too frequently (>1x/hr)
Physiological effects of superficial heat
Promotes abnormal ossification
Prevent adhesion formation
Reabsorption of hematoma
Analgesia
Superficial heat method
6-8 towel layers
Chronic conditions
10-20 minute treatment
1/4 to 1/2 inch penetration
Check every 5 min for blistering
Conduction heat transfer
Whirlpool bath transfers heat via what process:
Convection
What is the process of a Paraffin bath?
126° wax and oil bath
Dip 7-10x
Place hand in plastic bag
20-30 minutes leave was on
Remove and perform ROM exercises
What is Fluidotherapy? What is another AKA known for it?
A dry heating agent that transfers heat by convection. It consists of a cabinet containing finely ground particles of cellulose through which heated air is circulated.
AKA “Corn cobs”
What are Infrared lamps? Process?
1mm depth penetration
20 inch from patient with moist towel over area
15-20 min treatment
What are the three Stages of healing?
Inflammatory response
Fibroblastic repair (subacute)
Maturation-remodeling (chronic)
Explain the Inflammatory response stage
2-4 days after injury
Leukotaxin increases leukocytes along cell walls
Necrosin cleans area with phagocytosis
Explain the Fibroblastic Repair Phase
Begins 4 days after injury
Lasts up to 10 days
Granulation tissue infiltrates
6-7 days after injury fibroblasts lay down collagen haphazardly
Explain the Maturation-Remodeling Phase
Begins around day 7 and lasts for years
Haphazard collagen is realigned along movement patterns
Parallel to tensile forces
Stages of healing are not
Separate and distinct
They overlap from one to the other
What is this definition:
“unpleasant sensory and emotional experience associated with actual or potential tissue damage”
pain
ones perception of pain is dependent on what two factors?
past experiences
current expectation and state of mind
pain is an indicator of the following two:
the presence of a problem
not the degree of the problem
pain can outlive its purpose, when it does so, it is a _____ ______ in itself
Diseased state
What are 4 types of pain?
referred
phantom
radiating
chronic
Explain pain duration
<6weeks acute- easy to locate
chronic >6weeks defies intervention
difficult to locate
persistent- on going treatable problem
What are three pain assessment tools?
VAS
pain drawing
McGill pain questionnaire
sensory receptors
meissners-
pacinian-
merkels-
ruffini-
krauses-
free nerve-
meissners- light touch
pacinian- deep (fast)
merkels-deep pressure (slow)
ruffini- touch/tension, joint position
krauses- thermo
free nerve- chemical, thermal noxious stimulus
specific theory of pain is an indicator of what?
specific nerve fibers and endings carry noxious stimuli to the brain with ascending pathways
pathway determines nature of stimulus
Explain the summation pain theory
excessive stimulation of nerve fibers results in transmission of noxious stimulus
no anatomical basis for this theory
What is the pattern theory?
stimulus must match a certain pattern to be transmitted as pain or other sensations
stimulus must come in abnormal matter
What is the sensory interaction theory?
specialized system exists to control sensory input from large and small afferent fibers
summation is prevented from occuring
LIST all pain theories:
specific theory
summation theory
pattern theory
sensory theory
likely a combination of all to form pain pathways
What are 4 main causes of pain?
external causes (skin)
internal causes (no skin)
lesions of CNS (skin is involved)
non-physiological
Pain at rest is cause and by the following 4 things:
caused by inflammation
crushing injuries
overstretching
viral/bacterial
stimulation of small diameter afferents result in:
release of endogenous opioids
electric stim should not be used in children due to:
open growthplates
geriatric populations should not be treated with cryo/heat due to:
lack of subcutaneous tissue
the height of a electrical wave above or below baseline:
amplitude/intensity
strength of current is measured in:
milliamps/microamps
velocity in electric current is always:
3x10^8
DC (galvanic):
one polarity
positive or negative
russian/biphasic uses ___ type of current:
AC (bipolar)
frequency and wavelength:
inversely proportional
electrical pad placement cannot:
cross the spine
the further apart the electrode pads are placed:
the deeper the penetrating power of the current
muscle spasm, the electrodes are placed on
muscle belly or:
proximal distal Musculocutaneous junctions
current density and depth:
current density decreases with depth of penetration
Give a brief description of russian vs biphasic:
russian penetrates deeper due to its pulse duration being miliseconds vs in microseconds
What is intensity?
amount of energy of wave
increasing intensity increases penetrating power
What will 80pps/hz cause?
enkephalins to be released for short period of time
natural painkiller
What will 10pps/hz cause?
endorphins to be released
natural painkiller that lasts much longer than enkephalins
What is a rheobase?
minimal intensity needed to cause contraction
What is chronaxie?
minimum time it takes to cause contraction at 2x rheobase
What is the definition:
“decrease in sensitivity to and area that is exposed to prolonged stimulation or the same frequency”
wedensky inhibition
Describe ohms law:
amps (current) is directly proportional to the voltage and inversely proportional to the resistance
amps=volts/resistance
increase intensity and resistance will be lessened
What is the Law of Grotthus-Draper?
energy is either absorbed superficially or transmitted to deeper layers
What is the Arndt schultz law?
Physiologic effects of energy absorption are concentration dependent; no change can occur if not enough energy is absorbed
What is the cosine law?
as the source of the energy moves away from the perpendicular its intensity lessens and absorption lessons cosine of 90degree
What is the inverse square law?
intensity of radiation is inversely proportional to the square of the distance from its source
What is microcurrent?
excites physiologic activity
V (volts) =
I (amperes) X R (ohms)
What are some contraindications for use of microcurrent?
gravid uterus
implanted electrical devices
cardiac arrhythmias
over known tumors
What are some carrier frequencies?
2,000-10,000hz that is a medium frequency that is able to penetrate deeper in the body
a ____ frequency is formed due to the interactions of 2 frequencies:
beat frequency
the beat frequency is ____ in interferential:
80-150pps releasing enkalphalins
or 0-10 releasing endorphins
What is pre-mod interferential?
one lead with two pads is the only option that can be used
used for smaller areas or radicular/linear complaints
