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NPLEX II TIA > MSK > Flashcards

MSK Flashcards

1
Q

Salter-Harris Fractures involvement

A

all types involve the physis (epiphyseal plate)
for one and 5, only the physis is injured
2-4 - metaphysis and/or epiphysis is fractured
- M, E, ME: 2: Metaphysis, 3:Epiphysis, 4: M & E

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2
Q

Salter-Harris Fractures type I

A

physis is widened, distorted, or displaced by traction or shear force

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3
Q

Salter-Harris Fractures type V

A

physis is crushed or compressed by axial copression

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4
Q

Salter-Harris Fractures type II

A

Metaphysis fractured

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5
Q

Salter-Harris Fractures type III

A

epiphysis fractured

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6
Q

Salter-Harris Fractures type IV

A

Metaphysis and Epiphysis fractured

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7
Q

what is the Salter-Harris system used for?

A

classify fractures in CHILDREN ONLY

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8
Q

What is a Jefferson’s fracture?

A

cervical spine;
caused by heavy object falling directly on the head or hitting head while diving.
at least two fractures of c1

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9
Q

What is a Hangman’s fracture?

A

cervical spine;
occurs often in MVA or hangings
B/L pedicle fracture with anterior displacement of C2

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10
Q

What is a Clay shoveler’s fracture?

A

cervical spine;
result of flexion injury in the lower cervical spine in which the spinous process is broken or fractured

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11
Q

What is a Chance fracture?

A

Thoracolumbar spine;
horizontal fracture of a vertebra, usually result of a MVA where the seat belt immobilizes pelvis but upper body is thrust forward

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12
Q

What is a burst/compression fracture?

A

thoracolumbar spine;
collapse or compression of vertebral body, usually caused by fall from a height

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13
Q

What is spondylolysis?

A

defect in pars interarticularis, appears as a collar on the “Scottie dog”
best seen in oblique view

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14
Q

What is spondylolisthesis?

A

bilateral pars interarticularis defect causing misaligned vertebrae causing forward slip, usually L5-S1

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15
Q

What is a bucket handle fracture?

A

pelvis;
fracture through ischiopubic rami on one side and fracture of SI joint on other side

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16
Q

What is a malgaine fracture?

A

pelvis;
fracture through ischiopubic rami and SI joint on same side

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17
Q

What is an avulsion fracture?

A

pelvis;
a small piece of bone is separated from the origin or insertion site of a tendon

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18
Q

how is imaging usually done if there is a suspected AC joint separation?

A

shoulder XR taken with pt holding weights; 3 grades

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19
Q

clavicular fracture most frequently occurs ____ (proximal, distal, middle)

A

middle third of the bone

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20
Q

What should you look for on imaging for a radial head fracture?

A

difficult to see; look for ant and post fat pad signs

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21
Q

What is a Monteggia fracture-dislocation (night stick)?

A

caused by receiving a blow when protecting oneself; dislocation of radial head and fracture of ulna

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22
Q

What is a Galaezzi fracture-dislocation?

A

caused by falling on outstretched hand and dislocating the distal radio-ulnar joint and fracturing the distal radius

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23
Q

Mnemnonic for elbow fractures

A

policeman Radii Galeazzi tried to hit thief Ulna Monteggia for stealing his bike. Ulna Monteggia blocked the blow to his forearm and tripped policeman Radii Galeazzi who fell on his outstretched hand

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24
Q

What is a Colles’ fracture?

A

wrist;
distal radial fracture posteriorly displaced

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25
Q

What is a Smith’s fracture?

A

wrist;
distal radial fracture anteriorly displaced

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26
Q

What is the most common fractured carpal bone? What are signs of fracturing this bone and what complications may arise?

A

scaphoid fracture
pain in anatomical snuffbox
may give rise to avascular necrosis

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27
Q

What is “gamekeeper’s thumb”/”Skiers thumb”?

A

a hand fracture;
fracture of the base of the proximal phalanx of the thumb

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28
Q

What is a Bennett’s fracture?

A

fracture through the base of the first (thumb) metacarpal

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29
Q

What is a Boxer’s fracture?

A

fracture of the 5th metacarpal

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30
Q

What is a “Bar Room/Brawler’s” fracture?

A

fracture of the 3rd metacarpal

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31
Q

What is a subcapital fracture?

A

fracture under the head of the femur; can lead to avascular necrosis

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32
Q

Common mechanism of injury for hip dislocation

A

common MVA injury to have impact on knee when hip is flexed (sitting) which causes femoral head to be displaced posteriorly (90% hip dislocations are posterior)

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33
Q

What is a spiral fracture?

A

common femoral, tibia, or fibular shaft fracture

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34
Q

What is a tibial plateau fracture?

A

impact most common on lateral side

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35
Q

What is a march fracture?

A

stress on the second or third metatarsal

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36
Q

What is a jones fracture?

A

common fracture seen in athletes at the base of the fifth metatarsal

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37
Q

Indications for a bone scan with normal L spine XR?

A

osteomyelitis
bony neoplasm or metastases
occult vertebral fracture

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38
Q

how do bone scans work?

A

radiographic tracer uptakes in areas with high bone turnover

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39
Q

advantages and disadvantages of bone scans

A

sensitive for bony neoplasm and infection

disadvantage: non specific
false pos for osteoarthritis in older pts
false neg for diffuse bony mets, multiple myeloma

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40
Q

what types of joint pain pathologies have a unilateral pattern?

A

infectious
crystalline
trauma
HIP: AVN + SCFE

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41
Q

what types of joint pain pathologies have a paired pattern?

A

RA
enteropathogenic
psoriatic

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42
Q

what types of joint pain pathologies have a paired and wandering pattern?

A

post strep (inc ASO)

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43
Q

what types of joint pain pathologies have a mixed/asymmetric pattern?

A

OA
reactive arthritis

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44
Q

concern for AVN of femur/hip

A

onset of pain in one hip that does not improve
esp ppl on chronic steroid therapy (more likely to throw small microemboli)

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45
Q

what is the most common muscualr dystrophy of children?

A

duchenne’s MD

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46
Q

what is the most common dystrophy in adults?

A

myotonic dystrophy

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47
Q

etiology/presentation/prognosis of Duchenne’s muscular dystrophy

A

sex linked, males
muscle replaced by fat/pseudohypertrophy of calves (gowers sign+)
usu death by 20

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48
Q

presentation myotonic dystrophy

A

presents in adolescence with facial atrophy

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49
Q

what is osteomyelitis

A

pyogenic infiltration of staph; spreads through the blood (concern with open fractures)

brodies abscess: walled off area of bacteria

sinus tracts develop, squamous carcinoma common at sinus tracts

recurs

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50
Q

what is tubercular osteomyelitis

A

blood bourne TB
destructic
thoracic and lumbar spine

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51
Q

common causes of osteoporosis

A

primary: menopausal, reduction of bone mass/matrix and demineralization

secondary: dz; advanced hyperthyroid, PTH dz

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52
Q

what is osteomalacia

A

demineralization of bone

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53
Q

what is osteochondroma

A

most common benign bone tumor

exostoses with cartilagenous covering; chondrosarcoma is a risk with multiple lesions

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54
Q

what is paget’s/osteitis deformans?

A

paramyxovirus; lytic mixed with sclerotic areas
esp skull, bowing of femur/tibia, OA
pathologic fracture common

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55
Q

what is an osteoma?

A

benign; normal bone exostosis on skill; if multiple then gardeners yndrome (intestinal polyps and sarcomas)

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56
Q

what is an osteroid osteoma?

A

benign tumor of osteoblasts in vertebrae and long bones; young adults

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57
Q

what is osteosarcoma

A

primary bone cancer, adolescent males, familiarl
secondary to pagets in elderly

destructive, mixed lytic and blastic, lifts periosteum (painful); heme spread to lungs, bone, brain

second most common primary malignant bone CA

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58
Q

what is the most common primary malignant bone tumor?

A

chondrosarcoma

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59
Q

what is a chondrosarcoma?

A

malignant tumor of cartilage
pelvis of middle aged men; shoulders, ribs, painful enlarging mass
can mets

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60
Q

what is ewings sarcoma?

A

bone cancer
more common in young, extremely malignant
viscous liquid like pus in marrow, sheets of round cells
metastatic

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61
Q

etiology and presentation infectious arthritis

A

GC, staph, strep, TB, lyme
common post trauma

acute painful swollen single joint, fever

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62
Q

etiology and presentation of gouty arthritis

A

hyperuricemia, uric acid in and around joints
1st MTP, tophi in olecranon, prepatellar, calcaneal tendon, pinna

genetic, heavy alcohol use (ddx pseudogrout, same signs/sx no uric acid inc)

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63
Q

etiology/presentation ankylosing spondylitis

A

marie stumpell dz, adolescent males
bony ankylosis of SI ad vertebral processes with severe spinal immobility

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64
Q

RA presentation/etiology

A

collagen vascular dz, females 25-50, RF pos
nodules at PIP joints, boutonniere deformity
arthritis in 3+ joints, symmetric

pannus (inflamed synovial tissue), rice bodies (fibrin), infiltrates, vasculitis, feltys syndrome
splenomegaly, neutropenia, deformity
bakers cyst, prolonged am stiffness

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65
Q

OA etiology/presentation

A

progressive erosion of articular cartilage (injured/overused joints)

bouchards node at PIP
herberdens nodes (osteophytes at DIP)
sundrondral cysts, osteophytes, hips, knees, lumbar, cervical

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66
Q

what conditions can lead to an inflammatory arthritis and effusion?

A

infection
gout
RA

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67
Q

what are the seronegative arthridities?

A

psoriatic arthritis
enteropathogenic arthritis
reactive arthritis

68
Q

what marker results are present with the seronegtive arthritidies?

A

RF-
HLA B27+

69
Q

presentation psoriatic arthritis

A

HLA B27+
DIP degernation
10% pts with psoriasis

70
Q

enteropathogenic arthritis presentation/etiology

A

HLA B27+
pts with UC / chrohns
also after salmonella/shigella/yersinia infxn

symmetric arthritis of knees, ankles, wrists, SI joints

71
Q

presentation/etiology reactive arthritis/reiters syndrome

A

HLA B27+
male dominant, post chlamydia infxn

urethritis, conjunctivitis, asymmetric lower extremity arthritis (knees, ankles, fingers, toes) - cant pee cant see cant dance w me

72
Q

what is chondromalacia

A

benign softness of the articular (hyaline) cartilage, usually involving the patella

can potentially be caused by unbalancing elements of the quads with patellar misalignment during movement

73
Q

what is a ganglion?

A

cystic tumor (benign) developing on a tendon or aponeurosis

arises from cystic or myxoid degeneration of connective tissue

74
Q

spinal stenosis presentation

A

pain starts in low back and radiates down buttocks BL, continues along back of both legs

sx usually worse with walkign and improve when pt bends foward (like over a shopping cart)

as opposed to true claudication, pain resolves very quickly when person stops walking and assumes upright position and peripheral pulses are normal

75
Q

crepitus is suggestive of what type of pathology?

A

DJD

76
Q

what is ballotment?

A

slightly flexing knee, place one hand on suprapatellar pouch and gently push toward patella to move fluid and push down on patella with thumb; with effusion will “bounce” back up

77
Q

mechanism of injury for the ACL

A

foot is planted while extreme rotational force is applied (a cleated foot caught in turf while athlete attempts to rotate toward that side)

direct force on lateral knee while foot is planted

sudden deceleration, hyperextension, and internal rotation of tibia on femur

78
Q

mechanism of injury for the PCL

A

posterior force on tibia when tibia is flexed or hyperextended (such as tibia striking against dashboard in MVA)

79
Q

mechanism of injury for the LCL

A

direct force on medial knee while foot is planted

80
Q

mechanism of injury for the MCL

A

direct force on lateral knee while foot is planted

81
Q

what is the disease process causing the pain in patellofemoral syndrome?

A

chondromalacia: issue with patella articulation and tracking with femur wears down the underside patellar cartilage

82
Q

what tests would elicit pain in patellofemoral syndrome?

A

pushing on patella with slightly flexed leg
moving patella side to side/palpate undersurface
hold patella in place while pt contracts quads

83
Q

presentation/PEs lateral epicondylitis

A

tennis elbow; repetitive extension (back hand motion in tenni) of wrist can cause inflammation and pain around lateral epicondyle where extensors/supinators of wrist insert

pain on palpation around lat epicondyle
reproducing pain with resisted wrist extension and supination
absence of warmth, erythema, or other signs acute inflammation

84
Q

presentation medial epicondylitis

A

golfers elbow; repetitive flexion of wrist can cause inflammation and pain around medial epicondyle where flexors and pronators of wrist insert

pain on palpation around med epiconyle
reproduced pain with resisted wrist flexion

absence of warmth, erythema, or other signs acute inflammation

85
Q

etiology and presentation of non-inflammatory olecranon bursitis

A

repeated trauma > excess fluid within bursa

swelling at tip of elbow
no pain, redness, warmth
full, painless ROM of elbow

86
Q

etiology and presentation of inflammatory olecranon bursitis

A

infxn (via abrasion to overlying skin) or other inflammatory process (gout, RA)

swelling at tip of elbow
warmth, redness, pain
ROM usually preserved (distinguishes from infl arthritis)

87
Q

etiology and presentation of carpal tunnel syndrom

A

precise cause unknown

numbness/tingling in median n distributino (thumb, index, middle, lateral 1/2 of ring)
sx worse at night (flex wrist during sleep)
pts try to “shake out” hands to reduce pain/restore “blood flow”

88
Q

what is a ganglion cyst?

A

idiopathic, spontaneous protrusion of joint fluid outside articular space

painless, dorsal aspect of wrist
swelling
fluid filled consistency, non tender to palpation
transilluminates

89
Q

etiology/presentation “trigger finger”

A

flexor tendors connect muscles proximal to wrist to the fingers; when muscles shorten, pulls on tendons to flex fingers

nodules/irregularities along tendons interfere with the flexion/extension of affected finger and when it slips through > sudden freeing of tendon (triggering)

90
Q

most common acute sports injury and mechanism of injury

A

ankle sprains; inversion and plantar flexion of the foot when landing off balance or clipping another players foot

91
Q

sequence/incidence of affected ligaments in ankle sprains

A

anterior talofibular ligament
calcaneofibular ligament
posterior talofibular ligament
musculotendious units supporting ankle joint

92
Q

dx ankle sprains

A

xrays, stress tests
inversion stress, ant drawer stress
MRI in uncertain cases

93
Q

grade 1 (mild) sprains
ligament(s) affected
stress test results
tx

A

ant talofibular ligament
minimal change on inversion, normal ant drawer
encourage early active movement (walking with semi rigid brace/splint, stationary cycling)
NSAIDs, physiotherapy, functional progression to running, jumping, etc into 6 weeks

94
Q

grade 2 (moderate) sprains
ligament(s) affected
stress test results
tx

A

complete tear of anterior talofibular ligament with some damage of calcaneofibular ligament

laxity with inversion, ant drawer present
tx: 1 week crutches, joint taped, or in aircast splint, follow grade 1 rehab

95
Q

grade 3 (severe) sprains
ligament(s) affected
stress test results
tx

A

uncommon; associated with fractures

tx: 10 days NWB in aircast brace or POP, then PWB with the brace up to 6 weeks
aggresive rehab follows, surgical reconstruction considered

96
Q

action and mechanism of injury peroneal tendon

A

strong everters and weak plntar flexors of foot

lateral ligament injuries

forced dorsiflexion with slight inversion and reflex contrtaction of tendons (sprinting, uneven ground, ballet)

97
Q

peroneal tendon injury presentation and tx

A

discomfort/swelling behind lat malleolus
subluxation on resisting dorsiflexion with eversion

acute phase: well moulded short case with pad over lat malleolus
chronic: surgical correction, POP 4 weeks
rupture of peroneal tendons: surgical correction

98
Q

peroneal tendonitis etiology and tx

A

dancers, basketball players, volleyball players

rest, temp use heel wedge
physiotherapy ( extreme: local injection into sheath)
avoid rapid direction changes or sprinting for 6 weeks

99
Q

plantar fasciitis causes

A

running on hard surfaces, tennis, netball, jumping

MTP extension produces a “windlass” stress over plantar fascia lifting the longitudinal arch of the foot

periosteal rxn may product a heel spur (XR)

100
Q

plantar fasciitis presentation and tx

A

pain under medial aspect of heel, worse on tip toeing, early in morning, stairs

tx:
200,000 IU retinol daily for 2 mo
NSAIDS, 4-8mm heel raise, physiotherapy, orthotics to modify overpronation

101
Q

sesamoiditis etiology and tx

A

sesamoid bones in the tendon of flexor hallicus brevis

dancers, ice skaters, gymnasts, basketball

crush fractures, avulsion, osteonecrosis

XR and bone scan

tx: shoes w elevated heels avoided, orthotics, adhesive padding and rest, surgical excision

102
Q

common ankle fractures and tx

A

talus fracture: surgical tx to avoid osteonecrosis

calcaneum fractures: most conservative, early ROM

metatarsal fractures: reduce dislocations, most common fracture 5th metatarsal base (Jones)

toe fractures: most tx conservative, strapping w next toe for 3 weeks

103
Q

workup of osteoporosis

A

urinary N telopeptide assesses bone breakdown
DEXA scan

104
Q

what is adhesive capsulitis? what is the tx?

A

frozen shoulder
primary: idiopathic, DM - BL, resolves in 9-18 mo
secondary: prolonged immobilization post shoulder trauma, stroke, MI

tx: NSAIDSm steroids, PT

105
Q

what ortho test would be used for lateral epicondylitis?

A

cozens/mills

106
Q

what ortho test would be used for medial epicondylitis?

A

reverse cozens/mills

107
Q

ulnar nerve entrapment would present with what findings?

A

nerve pain down 4th/5th fingers

108
Q

what ortho test would be used for carpal tunnel syndrome

A

+ Phalens
+ Tinels

109
Q

what is de quervain tenosynovitis?

A

tenosynovitis of first dorsal compartment of wrist (APL and EPB)

110
Q

what ortho test would be used for de quervian tenosynovitis

A

+Finkelsteins

111
Q

what is dupuytren contracture and how do you tx it

A

painless contracture of palmar fascia causing flexion contractures at metacarpophalangeal joint and interphalangeal joint
most common 4th > 5th > 3rd finger

tx: therapeutic US, surgery

112
Q

what is spondylosis?

A

progressive degenerative process of cervical spine > canal stenosis
C5-C6 more common

M>F, 40-50

113
Q

what is torticollios?

A

rare condition where neck muscles contract, causing the head to twist to one side
can be inherited and is seen soon after birth

114
Q

at what level is sciatica?

A

L4-S3

115
Q

orthos positive in sciatica

A

pos
Bechterews
SLR <70 deg and aggrevated by ankle dorsiflexion
Braggards
Kernigs

116
Q

what is IT band syndrome? how can pain be reproduced?

A

laternal knee pain worse with activity

reproducable with knee flexion to 30 degrees w varus stress applied to knee

117
Q

what is a baker cyst? how is it usually detected?

A

popliteal cyst arising between tendons of medial head of gastroc and semimembranosus, posterior to medial femoral condyle

often deteced by MRI

118
Q

what is osgood-schlatter disease?

A

childhood repetitive use injury that causes a painful lump below the kneecap

119
Q

what is medial tibial stress syndrome

A

pain in tibial compartment due to ischemia and minute muscle tears after running on hard surfaces

120
Q

what is gowers sign? in what condition would it be positive?

A

walking up thighs to stand
+ in duchennes MD

121
Q

what is the most frequently dislocated joint?

A

glenohumoral (90% anterior)

122
Q

describe the type of fracture:

oblique

A

angular fracture line

123
Q

describe the type of fracture:

spiral

A

spirals along long axis

124
Q

describe the type of fracture:

transverse

A

fracture line perpendicular to long axis

125
Q

describe the type of fracture:

comminuted

A

2+ fracture fragments

126
Q

hallux valgus vs varus vs malleus

A

valgus (bunion): big toe deviates laterally toward other toes
varus: big toe points away from second toe, creating gap between them
malleus: “hammer toe”, flexion of IP joint

127
Q

what is a morton neuroma? what are sx?

A

thickening of tissue surounding an interdigital nerve, usu due to nerve irritation and compression from tight shoes/heels or repetitive pressure on forefoot - typically between 3rd and 4th toes

sharp burning pain on ball of foot
feeling a pebble/fold in sock
nerve sx of affected toe

128
Q

Patterns of joint pain: U/L pain DDX

A

Infectious, crystalline, trauma, hip AVN / slipped capital femoral epiphysis

129
Q

Patterns of joint pain: B/L pain DDX

A

RA, enteropathogenic, psoriatic

130
Q

Urinary n-telopeptide is used to measure _______

A

Bone breakdown
Typically used when evaluating effectiveness of osteoporosis tx.

131
Q

What effect does cholecalciferol have on the absorption of calcium, magnesium, and phosphorus?

A

Increases all 3

132
Q

Supplements most beneficial for building strong bones

A

D3, K2, calcium

133
Q

Common benign tumor in growing children, grows slowly and painlessly on bone, sometimes in the same area of a previous injury.

A

Osteochondroma

134
Q

Osteochondromas increase the risk of _______

A

Fractures d/t structural weakness of affected bone

135
Q

Which of the following herbs is best for relieving pain in JA?
Lobelia
Thymus
Harpagophytum
Sambucus nigra

A

c. Devils claw (topical)

136
Q

Positive RF in JA suggests the condition will:
Resolve in 6 months
Progress to adult arthritis
Progress to death in 6 months without treatment

A

Progress to adult arthritis

137
Q

Which herb is best for prevention of OA?
Salix alba
Arnica montana
Curcuma long

A

Curcuma long

138
Q

What does the Lachman ortho test assess for?

A

ACL path

139
Q

What does the knee valgus stress test assess for?

A

MCL path

140
Q

What is diathermy and what can it be used for?

A

Short wave: 1.8-30 MHz freq, 3-200 wavelength. Most common = 27.12 MHz

Uses: arthritis, back pain, muscle spasms, sprains, arthritis

141
Q

Safety considerations diathermy

A

Avoid use with:
Metal implants
Over open growth plates
Areas with reduced blood supply
Infections
Bleeding disorders
Pregnancy
Over eyes, ears, brain, spinal cord, heart, reproductive organs
In demyelinating conditions like MS (inc rate of nerve conduction can cause conduction block)

142
Q

What is high voltag galvanism and what can it be used for?

A

Unidirectional, monophonic, interrupted current up to 500 volts

Dec pain, muscle spasms, and edema; muscle exercise and re-education; inc circulation

(+) pole = analgesic, constricts blood vessels, mild germicidal
(-) pole = trigger points, soften adhesions, dilate blood vessels, exercise muscles

143
Q

Safety considerations high voltage galvanism

A

CI:
Over low back/abdomen during pregnancy
Over neoplasms
Pacemakers
Over eyes, brain, heart
Hemorrhage

144
Q

What is low voltage galvanism and what can it be used for?

A

Acid base rxn under active pad (risk for chem burn, do not exceed therapeutic times)

Stimulates de-innervated muscles, restricted joint motions, arthritis, neuralgia, sprains, strains, pain, excessive scarring, pressure ulcers

(+) pole (anode) = oxidative rxn, attracts oxygen, hardens scar tissue, vasoconstriction, analgesics, antimicrobial

(-) pole (cathode) = reductive rxn, attracts hydrogen, softens scar tissue, vasodilation, tissue relaxation

145
Q

Safety considerations low voltage galvanism

A

Do not exceed therapeutic time, risk of chem burn

Do not break circuit suddenly

CI
Over abdomen/pelvis in pregnancy
Over cancer lesions
Pacemaker
Metallic implants
Tx on metal table

146
Q

What is infrared and what can it be used for?

A

Light of 700 nm - 1 mm wavelength

Uses: arthritis, chronic low back pain, fractures, peripheral neuropathy, muscle spasm, strains, skin infxns, psoriasis, relaxing tissues before other PT, Raynaud’s, thrombophlebitis

147
Q

Safety considerations infrared

A

CI
Photosensitivity
Poor blood flow
Hemorrhage
Edema
Gangrene
Sunburn
Fair skin
Over abdomen during pregnancy
Eyes
Infants
Metal

148
Q

What is interferential current? What can it be used for?

A

Form of TENS with 2 alternating medium frequency (4000 Hz) currents. 4 pads (further = deeper) x 10-20 mins

Uses: pain relief, inc blood flow, muscle stimulation post injury

149
Q

Safety considerations for interferential current

A

CI:
recent sutures, open wounds, abscesses
Circulatory conditions
DVT
Metal implants
Over pacemakers
Near low back/abdomen in preg
Local malignancy
Fracture or areas of bone fusion

150
Q

What is iontophoresis and what can it be used for?

A

Low amplitude electrical current to facilitate transdermal drug delivery, esp with dexamethasome

Penetration depth 3-20 mm, drug penetration 40-80 milliamp mins

151
Q

List the types of iontophoresis and their uses

A

Acetate for Ca deposits
Copper for fungal infxn
Dexamethasone for inflammation
Lidocaine for local anesthetic
Magnesium for muscle relaxation
Zinc for dermal ulcers/wounds

152
Q

Safety considerations for iontophoresis

A

CI:
Pacemaker
Implant cardiac defibrillator
Unstable arrhythmias
Pregnancy over abdomen/low back
Malignant tumors
Venous or arterial thrombosis
Thrombophlebitis

NO USE after ice/heat/US

153
Q

What is microcurrent and what can it be used for?

A

Stimulation between 200-800 microamps, floods tissue with ATP to speed healing. Stim > 1000 = plateauing then reduction in ATP. Place electrode with sterile hydrogel over wound, and other one 5 cm away

Uses: inc wound healing, sprains, strains, contusions, chronic pain, acute pain, OA

154
Q

Safety considerations microcurrent

A

CI
Pain syndromes without est etiology
Pregnancy
Pacemakers
Over metal implants
Infected wounds
Malignant or benign tumors
Through eyes, carotid sinus
Over laryngeal musculature
Over thorax intersecting heart

155
Q

What is sine wave and what can it be used for?

A

Low frequency current, low voltage, low amperage

Continuous alternating, slow pulsating, surged sinusoidal, tetanizing sinusoidal

Uses: adhesions, muscle spasms, muscle atrophy, restricted joint motion, passive exercise, pain, edema, de-inneravation, ischemia

156
Q

Explain the four forms of sine wave and their uses

A

Continuous alternating (1-2000 Hz) - dec edema/congestion

Slow pulsating (5-30 Hz) - contracted smooth muscle

Surged sinusoidal - develop strength in muscles, tendons, ligaments

Tetanizing sinusoidal - muscle spasms, pain

157
Q

Safety considerations sine wave

A

CI
Over eye
Brain hematoma
Fracture
Metallic implant
Pregnancy
Pacemaker
Cancerous lesion

158
Q

What can therapeutic US be used for?

A

CTS

159
Q

What is TENS and what can it be used for?

A

Short duration (50-80 us) high frequency (100-150 pps)

Controls pain via dorsal column stimulation (gait control with noxious stimuli)

Endorphin release: 1-15 Hz, for chronic pain (lasts hours)

Enkephalin release: 80-140 Hz, for acute pain (ends when tx ends)

160
Q

TENS safety considerations

A

Do not use with muscle or tendon tear, overuse, acute injury because it may disrupt healing

161
Q

What is UV radiation and what can it be used for?

A

EM radiation frequency range of 7.5 x 10^14 to 10^15 and wavelengths of 290-400 nm

UVA: 320-400, fluorescence
UVB: 290-320: skin erythema, psoriasis
UVC: <290, germicidal, wound healing

162
Q

Safety considerations UV radiation

A

CI
Irradiation of eyes (use goggles)
Skin cancer
TB
Cardiac/liver/kidney dz
SLE
Fever
Photosensitizing meds/sups

163
Q

Use of hot hydrotherapy applications

A

Chronic inflammation, muscle tension

164
Q

CI for hot hydrotherapy applications

A

Ischemia
Bleeding
Impaired sensation, inability to respond to pain/communicate
Acute trauma
Scar tissue
Edema
Atrophic skin
Poor thermal regulation

165
Q

Uses of cold hydrotherapy applications

A

Acute inflammation/traumatic conditions, arthritis, bursitis, trigger points, immediate tx of minor burns

166
Q

CI cold hydrotherapy applications

A

Raynauds
Cardiac disease
Hypoesthesia

NPLEX II TIA (18 decks)

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