Modalities: Ultrasound Flashcards

1
Q

To achieve thermal effects, should continuous or pulsed ultrasound be used?

A

Continuous Ultrasound

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2
Q

How is US energy/intensity distributed on the surface over of the transducer?

A

Not uniformly distributed

  • causes a higher energy in the center of the US beam relative to the surrounding areas.
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3
Q

How to reduce the effects of a hot spot?

A

Continuously moving the sound head.

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4
Q

How is Spatial Average Intensity measured?

A

Intensity - Total Power (Watts) divided by the area (cm2)

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5
Q

What is Beam Nonuniformity Ratio (BNR), relation to tissue damage?

A

Ratio of spatial peak intensity to spatial average intensity; don’t think that is important tbh

[important maybe]

  • Lower the BNR the more uniform the energy distribution, less risk for tissue damage
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6
Q

What is the ideal BNR?

A

Between 2:1 and 6:1

(an ideal 1:1 is not technically feasible)

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7
Q

To achieve nonthermal effects, should continuous or pulsed ultrasound be used?

A

Pulsed Ultrasound (acute soft tissue injuries)

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8
Q

What is the Duty Cycle?

A

Percentage of ON Time to the Total Time; (time on + time off)

e.g:

  • 2 msec on / (2 on + 8 0ff msec = 20%)
  • 20% duty cycle = on time 2 msec and off time 8 msec.
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9
Q

What is Attenuation

A

Reduction of acoustical energy as it passes through soft tissue.

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10
Q

What tissue type produces the highest absorption?

A

Tissues with high collagen and protein content

  • muscles
  • tendon
  • ligaments
  • joint capsules
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11
Q

Depth of penetration at 3 MHz?

A

Greater heat production in superficial layers. (TMJ)

  • 1-2 cm
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12
Q

Depth of penetration at 1 MHz?

A

Increased heat production in deep layers/tissues.

  • </= 5 cm
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13
Q

What intensity range will result in desired thermal effects?

A

Continuous US: Range 0.5 - 3 w/cm2

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14
Q

What can cause undesirable effects to thermal US?

A
  • Excessive high temperatures may produce overheating of periosteal tissue.
  • Insufficient coupling agent may produce discomfort “hot-spot”.
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15
Q

What to do in the instance of periosteal pain

A
  • Reduce intensity (w/cm2)
  • Increase surface area of treatment if periosteal pain is expressed.
  • Add more coupling agent
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16
Q

Typical duty cycle for nonthermal intervention?

A

20-50% duty cycles.

17
Q

What may cause diffusional changes in cell membranes?

A

Stable Cavitation

18
Q

Goals and Indications of US?

A
  • Modulate pain
  • increase tissue extensibility
  • Reduce soft-tissue inflammation
  • Accelerate tissue healing
19
Q

Precautions to US?

A
  • Healing Fractures
20
Q

Contraindication to US: Physiological

A
  • Impaired circulation
  • Impaired sensation and cognitive functions
  • Malignant tumors
  • Over area of thrombophlebitis
  • Active Bleeding
21
Q

Contraindications to US: Surgical

A
  • Joint cement
  • Plastic components
  • Cardiac Pacemakers
22
Q

Contraindications to US: body regions/part, areas to avoid during pregnancy?

A
  • Abdomen, low back, uterus during pregnancy
  • Vital areas; brain, ears, eyes, cervical ganglia, carotid sinus, reproductive organs
23
Q

How to select the appropriate sound head size

A

Effective Radiation Area (ERA) 1/2 the size of the treatment area

24
Q

What area size should we not cover/treat with US?

A

2-3 times the size of the ERA

25
Intensity Considerations: Lower Intensity?
- **_Acute Conditions_** - _Thin Tissues (wrist joint)_
26
Intensity Considerations: Higher Intensity?
- _Chronic Conditions_ - **Thicker Tissues** (lower back)
27
What are reasons for periosteal pain?
- _High intensity_ - Momentary _slowing/cessation of movement_ of sound head
28
What type of US therapy is indicated for irregular body parts?
**Water immersion**, keeping sound head _1 cm_ from skin surface
29
What is Phonophoresis?
Use of US to _**drive medication** through the skin into deep tissues._
30
Drug for Local Analgesic effect with Phonophoresis?
- Lidocaine - **_Salicylates_**
31
Drug for Anti-inflammatory effect with Phonophoresis?
- Dexamethasone
32
Contraindication to US: Children
- Open epiphyses in children (<18 lbs)
33
If an infection is present, should US be utilized?
NO! It is Contraindicated
34
Continuous or Pulsed US for Phonophoresis?
Pulsed (20-50%)
35
Treatment Time for Phonophoresis?
5-10 Minutes
36
What is the recommended Duration of Treatment for US?
**_5-10 minutes_/2 x ERA**
37
What is the recommendation for Ultrasound Intensity for Thermal Effects utilizing a 3 MHZ Frequency?
0.5 W/cm2
38
What is the recommendation for Ultrasound Intensity for Thermal Effects utilizing a 1 MHz Frequency?
1.5-2.0 W/cm2
39
What is the recommendation for Ultrasound Intensity for Non-Thermal Effects utilizing a 1 MHz or 3 MHz Frequency?
0.5-1.0 w/cm2