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Passive Care Exam One > NMES, TENS, Hi-Volt, Microcurrent > Flashcards

NMES, TENS, Hi-Volt, Microcurrent Flashcards

1
Q

What is the overall goal of NMES?

A

Stimulation of alpha motor NEURONS to cause strong muscle contraction

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2
Q

What are the indications for NMES?

A

1 retrain lost muscle function following surgery or injury
2 decrease muscle atrophy
3 decrease muscle spasm

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3
Q

Are slow or fast muscle fibers contracted first with normal physiologic muscle contractions?

A

Slow (fast when needed for greater exertion)

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4
Q

What does minimal fatigue occur with normal physiologic muscle contractions?

A

1 slow twitch fibers contracting first

2 asynchrony of firing motor units

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5
Q

Are slow or fast muscle fibers contracted first with NMES?

A

Fast (due to lower capacitance)

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6
Q

Why does fatigue happen easier with NMES?

A

1 fast twitch fiber recruitment

2 synchronous firing of motor units

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7
Q

Which exhibits faster fatigue: NMES or normal physiologic muscle contraction?

A

NMES

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8
Q

What currents can be used for NMES?

A

Russian, biphasic pulsed, interferential

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9
Q

What type of current is the stimulation of NERVES through the skin?

A

TENS

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10
Q

What is a common error with the names of TENS and NMES?

A

EMS (electrical muscle stimulation) - muscles aren’t being directly stimulated….NERVES ARE

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11
Q

What is the most common wave form seen with TENS?

A

Biphasic, symmetrical, square/rectangular

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12
Q

What fibers are targeted by TENS sensory level stimulation?

A

A-beta (large diameter)

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13
Q

What fibers are targeted by TENS motor level stimulation?

A

A-delta (in general)

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14
Q

What fibers are targeted by TENS noxious level stimulation?

A

C fibers

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15
Q

What TENS mode is used for sensory-level stimulation?

A

Conventional

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16
Q

What type of pain would be an indication to use sensory level stimulation?

A

Acute

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17
Q

Sensory-level TENS stimulation is often combined with what other treatments?

A

Ice or heat

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18
Q

What is the duty cycle for sensory level TENS stimulation?

A

None

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19
Q

What is the treatment time for sensory level TENS stimulation?

A

20-30 minutes (but could theoretically be 24 hours)

20
Q

Motor-level TENS stimulation is for what kinds of pain conditions?

A

Subacute and chronic (NOT ACUTE)

21
Q

Motor-level TENS stimulation is theorized to release what substance to decrease pain?

A

Endogenous opiates

22
Q

What specific fibers are targeted by motor-level TENS stimulation in acupuncture like mode?

A

A-beta and alpha motor neurons

23
Q

What specific fibers are targeted by motor-level TENS stimulation in burst mode?

A

Alpha motor neurons and delta fibers

24
Q

How does noxious-level TENS stimulation elicit pain relief?

A

Endogenous opiates

25
Q

What is the treatment time for noxious-level TENS stimulation?

A

30 seconds per point (8-10 points per session)

26
Q

What is unique about noxious-level TENS stimulation while a patient is using narcotic analgesics?

A

Results will be diminished (natural opiates then have to compete)

27
Q

What is the purpose of high-voltage pulsed current?

A

Enhancing soft tissue repair and healing (especially slow healing cutaneous wounds)

28
Q

What are other names for high volt stimulation?

A

Electro-Galvanic Stimulation, High Volt Galvanic Stimulation, or High Volt Pulsed Stimulation

29
Q

High volt indicates what level of voltage?

A

Greater than 150V (up to 500)

30
Q

What is the purpose for a high voltage with high volt stimulation?

A

Deeper penetration

31
Q

High volt stimulation must have twin peaks of what type of current?

A

Monophasic

32
Q

What are the benefits of high volt stimulation?

A

1 deeper penetration

2 twin peaks doesn’t allow small sensory fibers (A-delta and C) to be stimulated therefore increasing comfort

33
Q

What is unique about the peak amplitude of micro current?

A

Below rheobase of A-beta fibers (no depolarization, sub-sensory and sub-motor)

34
Q

What is the term for polarized cells being attracted to the opposite polarity thus enhancing healing during micro current?

A

Galvanotaxis

35
Q

What type of polarity is associated with the inflammatory phase of healing, and what cells does it attract?

A

Positive: neutrophils and macrophages

36
Q

What type of polarity is associated with the proliferation phase of healing, and what cells does it attract?

A

Negative: fibroblasts and promotes collagen formation

37
Q

What type of polarity is associated with the remodeling/maturation phase of healing, and what cells does it attract?

A

Negative: keratinocytes and epidermal cells

38
Q

What is the germicidal effect associated with micro current?

A

Increase of bacterial growth inhibition (not a lot of research)

39
Q

What type of current is associated with reducing edema?

A

HiVolt

40
Q

How does negative polarity work to reduce edema through HiVolt?

A

Repels negatively charged proteins

41
Q

What type of electrode placement is used with HiVolt to reduce edema?

A

Monophasic with treatment electrode over area of swelling and dispersal one proximal

42
Q

Why is Russian stimulation preferred for muscle spasm reduction even though HiVolt could possibly help?

A

Lack of polarity effect

43
Q

What is recommended for pain relief instead of HiVolt?

A

Interferential (lack of polarity effect)

44
Q

Although both HiVolt and micro current are used for healing stimulation, what are two things that are ONLY accomplished through HiVolt, not micro?

A

Decrease of edema and spasm/guarding

45
Q

Which polarity attracts acids and repels bases?

A

Positive

46
Q

Which polarity attracts bases and repels acids?

A

Negative

Passive Care Exam One (4 decks)

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