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NPTE > modalities > Flashcards

modalities Flashcards

1
Q

lumbar traction to increase intervertebral space L5-S1 position

A

hip flexion 45-60deg

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2
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

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3
Q

NMES for m strengthening: treatment time

A

10-20 mins to produce10-20 reps

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4
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

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5
Q

would greater trochanteric bursa be deep or superficial for US?

A

deep because under mm and adipose

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6
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

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7
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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8
Q

ramp time

A

how long it takes to get to maximal delivery

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9
Q

US duty cycle

A

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

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10
Q

What US intensity to use for thermal and deep mm?

A

1.5-2 W/cm^2

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11
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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12
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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13
Q

when to use supine for lumbar traction

A

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

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14
Q

HVPC: goal with polarity

A

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

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15
Q

pulse duration

A

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

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16
Q

EMG biofeedback for muscle relaxation

A
  • to inhibit/relax m
  • use low sensitivity
  • place electrodes close together
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17
Q

What US intensity to use for thermal and shallow mm?

A

.5 W/cm^2

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18
Q

weight for cervical traction for disc protrusion, spasm, elongation

A

11-15lbs

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19
Q

lumbar traction to increase intervertebral space L3-L4 position

A

75-90deg hip flexion

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20
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

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21
Q

EMG biofeedback for muscle re-education

A
  • to facilitate/recruit m
  • use high sensitivity
  • place electrodes far apart
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22
Q

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

A

Acetate (-), acetic acid

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23
Q

NMES for m strengthening: amplitude

A

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

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24
Q

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

A

Iodine (-)

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25
Q

NMES for m strengthening: pulse duration

A

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

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26
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

27
Q

when to use prone for lumbar traction

A

disc herniation

28
Q

increases with thermal

A

HR, RR, CO, metabolic rate, vasodilation

29
Q

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

A

Water
-/+
tap water

30
Q

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

A

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

31
Q

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

A

Copper
+
Copper sulfate

32
Q

noxious TENS indication

A

trigger points

33
Q

US frequency

A

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

34
Q

HVPC: pulse duration

A

40-100us

35
Q

HVPC: treatment time

A

45-60 mins
at least 5 days a week

36
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

37
Q

weight for initial cervical traction

A

7-9lbs

38
Q

increases with cryotherapy

A

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

39
Q

when to use 1MHz US frequency

A

up to 5cm depth

40
Q

NMES for m strengthening: ramp time

A

at least 2s

41
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

42
Q

NMES for m strengthening: times per day

A

every 2-3 hours when awakw

43
Q

amplitude

A

what we want to be produced

44
Q

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

A

Zinc
+
Zinc oxide

45
Q

What US intensity to use for nonthermal US?

A

.5-1 W/cm^2

46
Q

weight for cervical traction for joint distraction

A

20-29lbs max
or 7% BW

47
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

48
Q

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

A

Hyaluronidase
+
Wydase

49
Q

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

A

calcium, magnesium
+
calcium chloride
magnesium sulfate

50
Q

HVPC: pulse frequency

A

60-125pps

51
Q

pulse frequency

A

how many pulses delivered per second

52
Q

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

A

Dexamethasone phosphate

53
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

54
Q

decreases with thermal

A

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

55
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

56
Q

mechanical traction contraindications

A

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

57
Q

Bodyweight for lumbar traction

A

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

58
Q

stages of cold

A

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

59
Q

HVPC: amplitude

A

comfortable tingling

60
Q

NMES for m strengthening: pulse frequency

A

35-80 pps

61
Q

where to place electrode for HVPC

A

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

62
Q

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

A

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

63
Q

when to use 3MHz US frequency

A

1-2cm depth

64
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

NPTE (60 decks)

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