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DPT Spring 2024 > Modalities Quiz > Flashcards

Modalities Quiz Flashcards

1
Q

_______ agents apply energy in the form of electromagnetic radiation or electrical current

A

electromagnetic

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2
Q

Variation of the _______ and _______ of electromagnetic radiation changes it depth of penetration

A

frequency; intensity

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3
Q

Reasons we use E-Stim

_______ modulation
_________ re-education and strengthening
________ prevention/reduction
Decreasing __________
________/________ healing
Muscle _______ reduction
Drug delivery ( __________ )
Reinverting _________ muscle (EMS)
EMG ____________

A

pain
muscle
edema
tissue; wound
spasm
iontophoresis
denervated
biofeedback

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4
Q

________ is the use of electrical current to induce muscle contraction, changes in sensation, reduce edema, or accelerate tissue healing

A

E-stim

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5
Q

_______ ________ = flow of charged particles

A

current flow

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6
Q

Charged particles may be _______ or _______

A

electrons; ions

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7
Q

Current flow is considered to be from ______ to _______

A

anode; cathode

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8
Q

Cathode is when the ______ electrode attracts positively charged ions; anode is when the _________ charged electrode attracts negatively charged ions

A

negative; positively

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9
Q

TENS stands for what?

A

Transcutaneous Electrical Nerve Stimulation

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10
Q

NMES stands for?

A

Neuromuscular Electrical Stimulation

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11
Q

EMS stands for?

A

Electrical Muscle Stimulation

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12
Q

TES stands for?

A

Therapeutic Electrical Stimulation

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13
Q

FES stands for?

A

Functional Electrical Stimulation

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14
Q

If you want sensory stimulation, use a ______ machine?

A

TENS

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15
Q

If you want motor stimulation, use a ______ machine?

A

NMES

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16
Q

________ __________ are the messaging unit of the nervous system, and the basic unit of nerve communication

A

action potentials

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17
Q

To stimulate an AP in a nerve cell, the electrical current must have sufficient ______ and ______ to cause depolarization

A

amplitude; duration

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18
Q

__________ is the changing of flow of the ions across the cell membrane = AP “All or none” event

A

depolarization

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19
Q

___________ is the return to resting membrane potential which is generally more negatively charged
due to electron imbalance inside vs. outside the cell

A

repolarization

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20
Q

After depolrization and repolarization, then the AP will _________ (travel) from the stimulus along the nerves axon until it reaches its terminating point

A

propagate

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21
Q

__________ is the process by which a nerve gradually becomes less responsive to stimulation of normally sufficient amplitude and duration and no longer depolarizes

A

accommodation

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22
Q

__________ once an AP is generated it triggers an AP in the adjacent area of the nerve membrane

A

Propogation

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23
Q

Terminating point:
_______ nerve- muscle creates a contraction

________ nerve- spinal cord creates a tingling sensation

A

motor
sensory

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24
Q

_________ Fatty sheath that wraps around certain nerve axons
(increasing the diameter) that increase the speed in which nerves
propagate

A

myelin

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25
Q

______ ______ _______ small gaps between the Myelin sheath from
which AP jump from one node to the next a process called _______
_______ which accelerates AP propagation

A

nodes of ranvier
saltatory conduction

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26
Q

_______- dependent characteristics
* Phase
* Phase duration
* Pulse
* Pulse duration
* Interpulse interval
* Frequency

A

time

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27
Q

________- dependent characteristics
*Amplitude
* Peak amplitude
* Peak-to-peak amplitude
* Phase charge
* Pulse charge

A

amplitude

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28
Q

_______ ________ (NMES)
* On/Off Time
* Ramp up/down Time

A

Device Parameters

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29
Q

_______ : Period when electrical current flows in one direction

A

phase

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30
Q

_____ : Period when electrical current flows in any direction

May be made up of one or more phases

A

pulse

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31
Q

_____ _______: How long a phase lasts in microseconds (µs)

A

phase duration

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32
Q

_______ ________: How long a Pulse lasts, beginning of the first phase of the
pulse to end of last phase. in microseconds (µs)

A

pulse duration

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33
Q

________ ________ : the amount of time between pulses.

A

interpulse interval

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34
Q

Pulse duration (“Pulse width”, “Cycle”, “Period duration”)

NMES= should be between _____-_____ _µs small muscles
_______-_______ µs for large muscles

A

125; 200
200; 350

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35
Q

Most NMES units intended solely for stimulating muscle contractions
have a fixed pulse duration of approximately _____ to ______ µs

A

250; 300

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36
Q

With NMES, As the pulse duration is ________, the _________ amplitude current will be
required to achieve the same strength of muscle contraction

A

shortened; higher

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37
Q

With NMES, When ______ protocol is used, the cycle duration cannot be adjusted.

A

Russian

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38
Q

Pulse duration (“Pulse width”, “Cycle”, “wavelength”, “Period duration”)

Pulsed biphasic TENS
High rate: ____-_____ µs to depolarize only A-beta sensory nerves ( _____ _____ effects)

Low rate: ______-______ µs to also depolarize the motor nerves and possibly A-delta nerves ( _______ _______ effects)

A

50; 80; pain gaiting
200; 300; endongenous opioid

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39
Q

Which setting with the TENS machine is often adjusted for patient comfort?

A

pulse duration

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40
Q

With the TENS unit, if _______ ______ is used for pain control, one cannot change the pulse duration

A

inferential current

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41
Q

The NMES/TENS unit we use in lab will refer to this as ______ _____ and is preset to ______ µs

A

pulse width; 300

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42
Q

Frequency is also kown as _______
- number of _____ (pulses) per second
- inverse of cycle ________

Units are:
_______ for pulsed currents
_______ for alternating currents

A

cycles
duration
PPS
Hz

43
Q

NMES Frequency determines the type of response

Low frequency- ____-_____ pps will produce a twitch contraction
Frequency _____-_______ pps the twitches occur closer together, eventually summating into a smooth contraction.
(recommended)
Frequency- _____-______ pps may produce stronger contractions, but it also causes more rapid fatigue.

A

20; 30
35; 50
50; 80

44
Q

TENS “rate” frequency- depends on your goal for treatment and pain relief mechanism

High-rate TENS: Pulse frequency = _____-______ pps ( sensory with _____ ______ effects)

Low-rate TENS: Pilse frequency = < ____ pps (motor with ______ _______ effects)

_______: Preset frequency combining both High Rates and Low Rates in intermittent bursts

A

100; 150; pain gating
10; endogenous opioid
burst

45
Q

________ is a known property of sensory receptors caused by decreased
excitability of the nerve membrane with repeated stimulation

A

adaptation

45
Q

Frequency Modulations (Bursts)
TENS
- rate can be _________ (varied over time) to limit adaptation/accommodation/habituation to stimulus and thus a tolerance as in high-rate
TENS

A

modulated

46
Q

_________
magnitude of the current flow
measured in amps/volts
strength/________
denoted by a range ___-_____
weak to ______ intensity
adjusted according to _______ response

A

amplitude
intensity
1; 10
strong
patient’s

47
Q

______ amplitude
Max Intensity (Highest
Magnitude)
* Measured in amps/volts
* “Strength” “Intensity”

A

peak

48
Q

____-_____-_____ amplitude
Peak Amp= Peak-to-peak
for monophasic waveforms
* Biphasic property

A

peak; to; peak

49
Q

Amplitude or intensity
Often relative to patient ________

A

tolerance

50
Q

Amplitude
NMES
- current amplitude is adjusted to __________________ depending on goal of the intervention

  • hypertrophy of a muscle requires _______, whereas functional external cueing may desire less amplitude
A

produce a contractionof desired strength
overload

51
Q

Amplitude
TENS
- To control _____ with electrical stimulation, the treatment should be comfortable

  • High-rate TENS: Recommended that the amplitude be set to produce a ______ ______ sensation
  • Low-rate and burst TENS: Amplitude should be sufficient to produce a ______ ________ that can be seen or palpated by the clinician
A

pain
strong tingling
muscle contraction

52
Q

Device parameters (NMES)
On Time vs. OFF Time (sec) used to stimulate ________ contraction and ______ phases of physiological exercise

To prevent muscle _________

A

voluntary
relax
fatigue

53
Q

On/Off time usually expressed in a ratio of ___ to _____

___:____ ratio would indicate an on stimulation time of 10 sec and off “rest” time of _____ seconds between current

A

on; off
1; 5
50

54
Q

_____ _____ _____ (sec)
Number of seconds it takes for the current to
increase from zero to maximum amplitude during
“On time”

A

ramp up time

55
Q

______ _____ _____ (sec)
Number of seconds it takes for the current to
decrease from its max to zero during “Off time”

A

ramp down time

56
Q

Ramp up vs down time
This is to minimize the _______ that can occur
when the electrical current turns on and off

A

discomfort

57
Q

_______ is the continuous flow of electrons/ions in one direction

A

direct

58
Q

Which current should not be used for rehab due to being uncomfortable?

A

direct

59
Q

________ current is a continuous, sinusoidal, bidirectional flow of charged particles, where the current is always flowing back and forth

A

alternating

60
Q

Which current comes from a wall outlet?

A

alternating

61
Q

Clinical uses of AC:
______ control
muscle ________

A

pain
contraction

62
Q

________ current is the interrupted current flow of electrons where the current flow in a series of
pulses separated by periods when no
current flows

A

pulsed

63
Q

A pulsed may flow in one directiononly aka _______ or flow back and forth between polarities during each pulse ________

A

monophasic
biphasic

64
Q

Pulsed _______ current is the most commonly used waveform in electrotherapy

These promote muscle _______ and control _______

A

biphasic
contractions
pain

65
Q

Pulsed _______ current is used clinically to promote ______ healing
- manage acute _______
- ________- most common

A

monophasic
tissue
edema
HVPC (high-volt pulsed current)

66
Q

Alternating currents are ALWAYS _______
- alternating _______ between + and -
- Frequency for AC is measured in _____

A

biphasic
polarity
Hertz (Hz)

67
Q

AC waveforms are sometimes referred to as “ ________ frequency” and are used clinically following these treatment protocols:

_________ current
_________ current
________ protocol

A

medium
inferential
premodulated
Russian

68
Q

__________ current uses 2 pairs of 2 independent circuits (Quadripolar
electrode placement) carrying slightly different
frequencies which cause “Interference” at their
intersecting point

A

inferential

69
Q

2 pairs of 2 independent circuits = ________ electrode placement

A

quadripolar

70
Q

With quadripolar electrode placement, the electrodes are placed this way so that the ______ of the current permeates the tissues at a target

A

intersection

71
Q

With IFC and quadripolar placement, it produces envelopes of pulses called “______” within these tissues is where the ACs intersect

A

beats

72
Q

IFC is thought to be more comfortable and penetrate deeper ______ ________ waveforms

A

pulsed biphasic

73
Q

______ _________ (IFC current)
The interference pattern produces a
beat frequency equal to the
difference in frequency between the
2 alternating current frequencies.

A

Beat modulation

74
Q

Beat modulation (IFC current)
creates a beat frequency of _____ beats per second in this case

A

100

75
Q

_______ current
- “Medium frequency” AC
* has __ elctrodes ( __ channel)
* Produces same resulting waveform as IFC
which uses 2 circuits and 4 electrodes but only
uses a single circuit and 2 electrodes

A

premodulated
2; 1

76
Q

With Russian protocol, there is only ___ channel needed

A

1

76
Q

______ protocol is a part of NMES protocol
this is usually intended for LE quad muscle strengthening

A

Russian

77
Q

______ protocol is preset and cannot be modified by a therapist

A

Russian

78
Q

Russian protocol
“Medium frequency” AC
- ______ Hz
- Pulse duration: __ burst per sec
- Burst duration: ____ms long bursts
- Burst modulation: ___ms interburst interval

A

2500
50
10
10

79
Q

TYPES OF TIMING MODULATION: AC CURRENT
ONLY

  • Designed for _____ (Tens) only
  • To prevent ________
A

pain
accommodation

80
Q

What are the two physiologic mechanisms of pain control?

A

Gate control
Endogeneous Opoid release

81
Q

__________ of TENS can affect the physiologic mechanism managing the pain

A

Parameters

82
Q

Gate control theory with TENS

Noxious (painful) ____- fibers are gated by non-noxious ____- Beta fibers from being perceived by the CNS

A

C
A

83
Q

High-Rate (Conventional) TENS: produces comfortable ______ without muscle ______ to stimulate A-beta nerves

High frequency: ____-_____ pps

Short pulse duration ___-___ µs

_____ _______ waveform

A

sensation; contraction

100; 150

50; 80

pulsed biphasic

84
Q

________ _________ release with TENS

The internal stimulation of the production and
release of endorphins (opiopeptins) which bind to
opiate receptors in the CNS to decrease pain
perception

A

Endongenous opiod

85
Q

Low-Rate TENS
- High intensity motor-level electrical stimulation to produce _____,______, ______ contractions (twitches) to stimulate _______ _______ production

A

brief
repetitive
muscle
endongenous opioid

86
Q

Low-Rate TENS

Low frequency- ____-____pps
Pulse duration- _____-_______ µs

Pain controlled 4-5 hours after a ___-____ minute session

DO NOT EXCEED past ______ minutes

A

2; 10
150; 300
20; 30
45

87
Q

______- rate TENS is recommended when sensation, but not muscle contraction
would be tolerated
* Post injury
* Inflammation present
* Tissues may be damaged by repeated muscle contractions

A

High

88
Q

_____ rate TENS is recommended when a longer duration of pain control is
desired and muscle contraction is going to be tired
* More chronic conditions
* Will have effects during and following treatment

A

Low

89
Q

______ _______ TENS is recommended for some individuals to apply more
intensity in shorter bursts for those with higher tolerance
* Equally effective as High-rate or Low-rate, more for comfort and patient
preference
* Decreases likelihood of accommodation.

A

Burst Mode

90
Q

IFC uses AC waveform

do not need to adjust _______ (pulse duration or frequency)

still adjust _______ for desired effects

A

parameters

amplitude

91
Q

IFC may be more comfortable and _______ to a larger, deeper area

A

penetrate

92
Q

Premodulated (Mod) is a variation of _____ current that only uses two electrodes

A

IFC

93
Q

Contraindications for electrotherapy

Implantable ______ electronic devices (pacemaker)

________ electrode placement

________ arrthymias

______ _______ thrombosis

Pregnancy

A

cardiac

transcerberal

unstable

deep vein (DVT)

94
Q

Precautions

______ disease
Epilepsy
________ due to acute trauma or fracture
Impaired ________
Impaired _______
_______ tumors
Areas of skin ______ or open ______

A

cardiac
hemorrhages
sensation
mentations
malignant
irritation
wounds

95
Q

If a muscle is denervated, it requires _____ current or _____current with pulse duration of _____ msec or longer

A

DC; pulsed

96
Q

Denervated muscle requires NMES or EMS?

A

EMS

97
Q

With tretament for denervated nerve, it stimulates the ______ _______ in muscle cells directly through depolarization of the sarcolemma

A

action potential

98
Q

Do Type I OR Type II fibers contract first with NMES and which atrophy quicker?

A

II

99
Q

Prolonged impairment in neural recruitment results in ______ _____ and _____ loss

A

muscle atrophy
fiber

100
Q

Galvanotaxis is _______ _________ of cells

A

directional movement

101
Q

_________ is using current to promote transdermal drug delivery

Uses low amplitude _____ current

Most common drug used in PT is __________

A

iontophoresis
DC
dexamethasone

DPT Spring 2024 (30 decks)

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