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NPTE > modalities > Flashcards

modalities Flashcards

1
Q

increases with thermal

A

HR, RR, CO, metabolic rate, vasodilation

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2
Q

decreases with thermal

A

BP, blood to internal organs, circulation to resting mm, muscle activity, SV

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3
Q

increases with cryotherapy

A

jt stiffness, m activity (quick ice), pain threshold

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4
Q

decreases with cryotherapy

A

local metabolic, capillary permeability, spasticity (with prolonged ice over 20 mins), collagen extensibility, blood flow, N conduction velocity

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5
Q

hot pack temp settings

A

160-170 F
20-30mins
6-8 towel layers (terry cloth can be 4-6 towel layers)
peak heat in 5 mins! want to skin check at 5 mins

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6
Q

cold pack temp settings

A

25 F
10-20 mins
check at 10 mins - want skin to blanch
can be applied every 1-2 hours

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7
Q

stages of cold

A

CBA(A)N
cold, burning, aching, (analgesia), numbness

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8
Q

superficial thermotherapy contraindications

A

thrombophlebitis (blood clot in veins - causing inflammation and pain of vessels)
impaired sensation or mentation
over area of decreased circulation
over area of malignancy
infrared irridation of eyes
arterial disease
bleeding or hemorrhage

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9
Q

superficial cryotherapy contraindications

A

-Cryoglobulinemia (protiens glob together and block blood flow when cold)
-Reynaud’s
-Paroxismal cold hemoglobinuria (immune system produce antibodies that destroys RBCs when with cold)
-Over-regenerating peripheral Ns (need to keep all blood flow it can get)
- Cold hypersensitivity
- Cold intolerance
- Circulatory compromise

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10
Q

pulse frequency

A

how many pulses delivered per second

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11
Q

pulse duration

A

how long each pulse is held for
smaller mm need shorter time than longer mm

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12
Q

amplitude

A

what we want to be produced

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13
Q

ramp time

A

how long it takes to get to maximal delivery

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14
Q

NMES for m strengthening: pulse frequency

A

35-80 pps

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15
Q

NMES for m strengthening: pulse duration

A

150-200us for smaller mm
200-350 for larger mm

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16
Q

NMES for m strengthening: amplitude

A

> 10% MVIC for acute/injured
50% for non-acute/non-injured

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17
Q

NMES for m strengthening: on : off times and ratio

A

1:5 start with - can decrease off time if pt progresses
6-10s on : 50-120s off

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18
Q

NMES for m strengthening: ramp time

A

at least 2s

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19
Q

NMES for m strengthening: treatment time

A

10-20 mins to produce10-20 reps

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20
Q

NMES for m strengthening: times per day

A

every 2-3 hours when awakw

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21
Q

HVPC: goal with polarity

A

negative for healing of inflamed/infected wounds
positive for healing of wounds without inflammation

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22
Q

where to place electrode for HVPC

A

in wound with saline soaked gauze - will conduct electricity
around wound

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23
Q

HVPC: pulse frequency

A

60-125pps

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24
Q

HVPC: pulse duration

A

40-100us

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25
Q

HVPC: amplitude

A

comfortable tingling

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26
Q

HVPC: treatment time

A

45-60 mins
at least 5 days a week

27
Q

where to put ions on for iontophoresis

A

put negative on anode
put positive on cathode
opposites repel - so want to put like charges together so it meds pushed further into tissue

28
Q

hyperhyidrosis
iontophoresis:
ions from medicine
polarity of ions
commonly used medical sources

A

Water
-/+
tap water

29
Q

Sclerotic scars
Iontophoresis:
Ions from medicine
Polarity of ions
Commonly used medical sources

A

Iodone

30
Q

Analgesic
Iontophoresis:
Ions from medicine
Polarity of ions
Commonly used medical sources

A

Salicylate (-), lidocaine (+), xylocaine (+)

31
Q

Calcium deposits
Iontophoresis:
Ions from medicine
Polarity of ions
Commonly used medical sources

A

Acetic acid

32
Q

MSK inflammation
Iontophoresis:
Ions from medicine
Polarity of ions
Commonly used medical sources

A

Dexamethasone phosphate

33
Q

Dermal Ulcers
Iontophoresis:
Ions from medicine
Polarity of ions
Commonly used medical sources

A

Zinc
+
Zinc oxide

34
Q

Fungal infections
Iontophoresis:
Ions from medicine
Polarity of ions
Commonly used medical sources

A

Copper
+
Copper sulfate

35
Q

Edema reduction
Iontophoresis:
Ions from medicine
Polarity of ions
Commonly used medical sources

A

Hyaluronidase
+
Wydase

36
Q

Muscle spasm
Iontophoresis:
Ions from medicine
Polarity of ions
Commonly used medical sources

A

calcium, magnesium
+
calcium chloride
magnesium sulfate

37
Q

acute pain (high rate)
TENS:
Type:
Waveform:
Pulse Freq:
Pulse duration:
Amplitude:
Tx duration:

A

Type: sensory stim
Waveform: monophasic or biphasic pulsed
Pulse Freq: 100 pps
Pulse duration: 50-100us
Amplitude: comfortable tingling
Tx duration: 20-30mins or during activity

38
Q

acupuncture like (low rate)
TENS:
Type:
Waveform:
Pulse Freq:
Pulse duration:
Amplitude:
Tx duration:

A

Type: motor stim
Waveform: mono or biphasic pulsed
Pulse Freq: <10pps
Pulse duration: >150us
Amplitude: visible twitch
Tx duration: 20-45 mins

39
Q

Brief intense
TENS:
Type:
Waveform:
Pulse Freq:
Pulse duration:
Amplitude:
Tx duration:

A

Type: motor stim
Waveform: mono or biphasic pulsed
Pulse Freq: 100pps
Pulse duration: >150us
Amplitude: strong m twitch
Tx duration: <15 min

40
Q

Noxious
TENS:
Type:
Waveform:
Pulse Freq:
Pulse duration:
Amplitude:
Tx duration:

A

Type: Hyperstim
Waveform: Direct Current DC or Monophasic
Pulse Freq: high 100pps
low 1-5pps
Pulse duration: >250us up to 1 sec
Amplitude: highest tolerance/painful stim
Tx duration: 30-60s/area

41
Q

noxious TENS indication

A

trigger points

42
Q

US intensity

A

amount of energy delivered per unit area
W/cm^2
depends on treatment goal
Deeper and larger mm use higher intensity

43
Q

US frequency

A

amount of cycles per second
1 MHz - for deep mm
3 MHz for superficial mm

44
Q

US duty cycle

A

on time/(on + off time)
pulsed or continuous

45
Q

when to use thermal US?
what duty cycle for thermal?

A

soft tissue shortening, pain
100% duty cycle (continuous)

46
Q

when to use non-thermal US?
what duty cycle for non-thermal?

A

delayed tissue healing, inflammation, acute condition
less than 100% - 20% duty cycle

47
Q

when to use 3MHz US frequency

A

1-2cm depth

48
Q

when to use 1MHz US frequency

A

up to 5cm depth

49
Q

would greater trochanteric bursa be deep or superficial for US?

A

deep because under mm and adipose

50
Q

What US intensity to use for thermal and deep mm?

A

1.5-2 W/cm^2

51
Q

What US intensity to use for thermal and shallow mm?

A

.5 W/cm^2

52
Q

What US intensity to use for nonthermal US?

A

.5-1 W/cm^2

53
Q

what is ultrasound hot spot
ways to fix it

A

patient feels deep heat and burning during US
caused by periosteum burn: bone is feeling heat
need to add more coupling gel, decrease intensity, increase freq to 3Hz, move soundhead, decrease duty cycle, change to pulsed

54
Q

EMG biofeedback for muscle relaxation

A
  • to inhibit/relax m
  • use low sensitivity
  • place electrodes close together
55
Q

EMG biofeedback for muscle re-education

A
  • to facilitate/recruit m
  • use high sensitivity
  • place electrodes far apart
56
Q

when to use supine for lumbar traction

A

put pillows under knees for more spinal flexion
intervertebral joints, facet joints, muscle elongation

57
Q

when to use prone for lumbar traction

A

disc herniation

58
Q

lumbar traction to increase intervertebral space L5-S1 position

A

hip flexion 45-60deg

59
Q

lumbar traction to increase intervertebral space L3-L4 position

A

75-90deg hip flexion

60
Q

Bodyweight for lumbar traction

A

disc protrusion, spasm, elongation: 25% BW
joint distraction: 50 lbs or 50% BW

61
Q

weight for initial cervical traction

A

7-9lbs

62
Q

weight for cervical traction for disc protrusion, spasm, elongation

A

11-15lbs

63
Q

weight for cervical traction for joint distraction

A

20-29lbs max
or 7% BW

64
Q

mechanical traction contraindications

A

Immobilization
Acute injury or inflammation
Joint hypermobility or instability
Peripheralization of symptoms with traction (radiating/radicular pain)
Uncontrolled hypertension

NPTE (53 decks)

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