Midterm Review - In Class Activity Flashcards
The first phase of the healing process is:
inflammatory
a patient comes to clinic with ankle swelling s/p injury, an appropriate assessment tool for the edema would be:
volumetrics or circumferential measurements
conduction is
transfer of heat by direct interaction
an example of indirect coupling for ultrasound is
water immersion
factors influencing a patient’s response to cold therapy is
type and size of cooling agent, and pre-temperature of the area being cooled
ACE wraps should be applied in a figure 8 pattern because:
reduces risk for creating a tourniquet
modalities are used to improve or relieve alterations in body function such as
loss of ROM, pain and tissue damage
PRICE stands for
protection, rest, ice, compression, elevation
the outermost layer of the skin is
epidermis
when applying ice massage the patient should be education to expect the following sensations:
“cold beer always nice”
intense cold
burning sensation
aching
numbness
one of the contraindications to cryotherapy is placing it
directly over a regenerating peripheral nerve
does fluidotherapy provide superficial or deep thermotherapy
superficial
in neonates or elderly, they are at increased risk of skin tears because
epidermal dermal junction is flatter
a disadvantage of using a moist heat pack over paraffin is
a moist heat pack does not retain heat for duration of treatment (20ish mins)
decision to use cryo or thermotherapy is based on
stage of injury/disease
medical status
patient preference
main function of the dermis is
tensile strength
support
moisture retention
blood and oxygen to the skin
3MHz ultrasound is used to treat what level of tissue
superficial tissue (1-2cm)
the strength or intensity of the ultrasound treatment is recorded as
W/cm^2
ERA stands for
effective radiating area
cold whirlpools are not the best option in the acute phase of healing because
it puts the limb in a dependent position, encouraging edema in the distal extremity
an apprpriate BNR is
less than 6:1
the cardinal signs of inflammation are
edema (swelling)
redness (erythema)
pain
warmth
loss of function
physiological effects of pulsed ultrasound are proposed to be achieved through
stable cavitation and acoustic streaming
cold induces vasodilation can start to occur after how long of an application of cryotherapy
> 15 mins
when treating a patient in the maturation /remodeling phase of healing, what mode of ultrasound is appropriate
continuous (100% duty cycle)
the ratio of time for hot:cold in contrast bath is
4:1 (end in cold if goal is edema reduction)
if tap water is used as ultrasound medium, the intensity of the ultrasound should be increased by
0.5W/cm^2
pain that is activity related, and can last 4-6 weeks after injury is related to what type of inflammation
sub-acute
electromagnetic waves differ from sound waves (u/s) in transmission in that
they do not require a medium
scar tissue is made out of what substance
collagen
the type of diathermy mostly utilized in the US is
short wave diathermy
other than tissue injury, what are causes of edema
CHF, venous insufficiency, impaired nutrition, fluid overload
a complication that can occur from application of intermittent pneumatic compression is
swelling in other areas
superficial thermotherapy can be used as prep for
e-stim
massage
PROM or AROM
ultrasound
the proposed mechanism of action for infrared therapy is
nitric oxide release
what are the recommended locations for circumferential measurements to the LE
metatarsal heads
5cm prox to lateral malleolus
10cm distal to tibial plateau
these 2 items should be used as guides for progression of controlled mobility after an injury
pain and increased swelling
when applying a hot pack to a patient - this many layers of toweling should initially be applied between a hot pack and a patient
6-8
how long after cryptherapy application should patients be instructed to avoid stressing the area to avoid potentially reinjuring or aggravating the injury
1-2 hours
treatment area of ultrasound should be
2-3x that of the ultrasound head or ERA
why do you want to elevate the extremity when using the dip and wrap method for paraffin
vasodilation d/t heat - may result in edema
if you were performing continuous ultrasound with water as a medium, what temp of water would you want to use
warm water
a patient comes to you with the c/o LE edema. would you place that patient in a compression garment the first day
no - edema should be reduced first
these two heating modalities also allow active movement/exercise/ROM during treatment time
hydrotherapy and fluidotherapy
an effect of cryotherapy of a peripheral nerve is
slowed NCV
why is it important to determine if your patient has a disease such as PVD before applying a thermal modality (hot or cold)
to ensure that there is adequate perfusion to avoid thermal tissue injury (dissipation of heat and cold)
does every patient who clinically presents with edema require cryotherapy
no - need to determine cause of edema. medically related edema will not be imrpved with cryotherapy
what is the advantage of using warm/hot water whirlpool over paraffin for increasing the tissue temperature in the hand
AROM can be performed while heat is being applied with WP
a patient is 1 month s/p TKA. patient has limited knee extension. palpation finds tightness in distal hamstring and post capsule of the knee. what is the most appropriate modality for addressing the impairment
hot pack
patient with lateral ankle sprain that accurred 1 hour ago presents to clinic. what is the most appropriate treatment at this point
ice pack, secured with ACE wrap and elevation during application
what is the advantage of ACE wraps as compared to imtermittent pneumatic compression for reducing edema
ACE wraps allow patient to be mobile and perform exercises
T/F: when a commercial ice pack is applied to tissue, the area will achieve numbness
F: protective layers should be applied between the tissue and the ice pack and the ice pack heats up over the duration of the application period
when applying a hot pack - which type of protective layer will allow the patient to feel the temp increase sooner? wet or dry towels?
wet towels - water transfers heat more efficiently than air. the same is true for cold
what are the possible modalities used for an acute injury
cryotherapy
compression
LLLT
ultrasound (20%)
E-stim
prior to application of any modality, but especially ones that are re-usable, it is important to assess what?
the skin - need to evaluation for any skin alterations, especially something that is easily transmissible
the erythema to the skin when applying a cold modality is caused by what
histamine release
high working load and low resting load defines what kind of compression wrap
short stretch bandages
two opposing pressures that regulate capillary and interstitial fluids are
hydrostatic and osmotic pressure gradients
