Passive Care Flashcards
What are the contraindications to ALL modalities?
Hemorrhage
Infection with suppuration
Malignancy (except TENS)
(HIM)
What are the contraindications to ALL heating?
Diabetes mellitus
Encapsulated swellings
Active TB
Decreased thermal sensations
Edema
Abdomen or low back during pregnancy
Acute conditions
What defines an acute injury?
Up to 72 hours
What defines a subacute injury?
Swelling is limited but debris and discoloration prevents healing
What is beneficial to a subacute injury?
Pumping
What defines a chronic injury?
2 weeks or longer than anticipated
What are the contraindications to ALL electrical? (8)
Brain
Eyes
Heart
Carotid sinus
Pacemaker
Anesthesia
Pregnancy- low back
Open wounds
Treatment for acute conditions…
Protect
Rest
Ice
Compression
Elevate
Support
What modality is considered an ultra low frequency (<1) and used for cellular healing?
MENS (microamps)
What modalities are considered low frequency (1-150) and used for contraction?
EMS
HV
LVG
Sine
Faradic
Interference (IF &RS)
TENS (milliamps)
What modalities are considered medium frequency (1,000-10,000) and used for depth?
IF
RS
What modalities are considered high frequency (1 million Hz) and used for heating?
Superficial Heat: IR and UV
Deep Heat: MWD, SWD, and US
What setting on US is used to get deep into tissues?
1 MHz
What setting on US is used for superficial heating of tissues?
3 MHz
What is the purpose of low frequency modalities?
Fatigues, irritates, and rehabs muscle
When can you use pulsed US?
For acute conditions
Can you use continuous US for acute conditions?
NO
What type of modality is the best contractor that leaves no charge in the patient?
Sine
When would you use high volt?
When the patient has anesthesia or lost sensation
What does electrothermal treatment result in?
Micro-vibration electrically leads to heat= Joules Law
What is considered an electrochemical treatment?
Iontophoresis
What drug can be used with iontophoresis?
Opioids
What frequency of opioids leads to endorphins?
1-10
What frequency of opioids leads to enkephalins?
70-120
What electrical treatment results in a contraction via molecules shifting Na+/K+ pump?
Electrophysical
How many pads are used to isolate 1 muscle belly?
1
How many pads are used when the muscle is especially weak?
2, on either side of muscle belly
What is the pad rule?
1 mA per square inch of pad size
i.e) 3” square pad= 9mA
When is monopolar treatment used?
large area or trigger/acupuncture points
How many pads are used in monopolar treatment?
one large dispersal pad as the ground and several small active pads (active pads have to be less than the ground when added together)
When would you use bipolar treatment and how many pads?
A small muscle group
2 pads- dispersal and active pads are the same size
What is an example of quadripolar treatment?
Russian stem- criss cross pattern of pads
What duty cycle is used for exercise/rehab?
1:3
What duty cycle is used for fatigue/spasm?
1:1
What is continuous used for?
pain
What electrical test is used to test muscle best?
EMG
What electrical test is used to test nerve best?
NCV
What law states that the energy of modality has to be absorbed by the body to stimulate physiological response?
Arndt- Schultz Principle
What law states the inverse relationship between penetration and absorption of energy (US)
Law of Grotthus- Draper
What is the cycles of events with cryotherapy?
Vasoconstriction
Anesthesia
Pumping Reaction
What mnemonic is used to the timeline of cryotherapy?
CBAN (cold, burn, ache, numb)
What is the timeline for cryotherapy?
5 minutes- cold
10 minutes- burn
15 minutes- ache
20 minutes- numb
What happens after 20 minutes of cryotherapy? What happens if you leave the ice pack on too long?
Hunting- lewis Reaction aka pumping
What are the 4 types of heat transmission?
Convection
Radiation
Conversion
Conduction
What temperature is considered “hot”?
99-104
What type of heat transmission uses baths (either hot or cold) or infrared (IR)?
Convection
What type of heat transmission uses lamps?
Radiation
What heat modalities are considered radiation?
MWD
IR
UV
What type of heat transmission converts electrical energy into heat or mechanical energy?
Conversion
What modality is considered conversion?
US
What modality is considered reverse piezoelectric?
US
What type of heat transmission transfers heat through substance , often heating up a solid?
Conduction
What are the conduction modalities?
Ice
Hydrocollator
Paraffin
IR
Effects of cold on circulation? (3)
Vasoconstriction
Decreased blood flow
Decreased edema
Effects of heat on circulation? (3)
Vasodilation
increased blood flow
Increased edema
How does cold effect metabolism?
Decreased
How does heat effect metabolism?
Increased
Effects of cold on connective tissue? (2)
Increased viscosity (thicker)
Decreased ability to stretch
Effects of heat on connective tissue? (3)
Decreased viscosity
Increased ability to stretch
Decreased stiffness
How does cold effect pain?
Decreased, after initial increase, numb
How does heat effect pain?
Decreased, sedate
Effects of cold on neuromuscular system? (3)
Decreased spasticity, trigger points, and MFS
Increased or decreased strength
Decreased motor skill tasks
Effects of heat on neuromuscular system? (3)
Decreased muscle spasm, torticollis, tender points
Decreased muscle strength
Decreased endurance
What heat modalities are considered deep?
MWD
SWD
What modalities are considered superficial?
IR
UV
What are the local primary effects of cryotherapy?
Decrease edema
Anesthesia
Increase pain tolerance
What are the secondary effects of cryotherapy?
Increase viscosity of blood
Decrease cell metabolism
Increase joint stiffness
What are the indications of cryotherapy? (6)
Headaches (migraine)
Urticaria (red wheals)
Spasticity (trigger points) MFS
Sprain/Strain
Angiomas
Warts and herpes
What are the contraindications of cryotherapy? (7)
Elderly & infant
Hypersensitive to cold
Vascular diseases (Raynauds)
High blood pressure
Chilblains and frostbite
Tension headaches
Spasm FM
What is the penetration of cryotherapy?
Superficial
What is the dosage of cryotherapy?
20 minutes, each two waking hours
What type of cryotherapy is considered convection?
Ice Immersion (ice bath)
What is the time allowed for vapocoolant spray?
5
What method are all forms of cryotherapy, except ice immersion, considered?
Conduction
What does infrared therapy result in?
vasodilation, perspire, decreased BP, increased blood and lymph flow, decreased spasm, phagocytosis
erythema- redness/mottled skin
erythema Ab ignore- mottled skin in area habitually exposed or one prolonged exposure
What are the indications of infrared?
Musculoskeletal- synovitis, tenosynovitis, sprains, strains, bursitis, arthritis, torticollis
Catarrhal- bronchitis, sinusitis, laryngitis, coryza
Infectious- furuncles, burns, ulcers
Other- folliculitis, conjunctivitis, neuritis, bells palsy, raynauds
What are the contraindications to infrared?
pregnancy, diabetes mellitus, thermal sensitivity, active TB, encapsulated swelling, over metal, fair skin, contacts, fever, recent scar, skin rash
What are 3 types of short wave infrared?
Luminous
Wire bound around porcelain
Sunlight- Heliotherapy
What is the distance of short wave infrared?
14-18 inches
What is the penetration of short wave infrared?
10 mm
What is the intensity of short wave infrared?
150-1500 Watts
What is the wavelength of short wave infrared?
7200-15000 nm
Frequency of short wave infrared?
high
Time of short wave infrared?
10-30 min
Distance of long wave infrared.
Direct contact with towel- layers
Types of long wave infrared
Hydrocollator, heating pad, hot water bottle, baths, fluidotherapy
Penetration of long wave infrared
1-3mm
Intensity of long wave infrared
varies
Wavelength of long wave infrared
15,000-150,000 nm
Freq of long wave infrared
High
What is the proper distance for a hydrocollator?
six towel layers
Indications for hydrocollator
Tension headaches, prior to adjustments, fibromyalgia, spasm
Contraindications to hydrocollator
acute conditions, recent scars, fair skin, myofascial syndrome (MFS), trigger points (TrP), decrease circulation
Indications for a contrast bath.
Subacute CT injuries, bruises, early PVD’s, Raynaud’s, Buerger’s, DM
Contraindications for contrast bath
Anesthesia, advanced arterial compromise, late PVD’s
Key things to know about whirlpool
Vasodilator and for debridement (burns and abrasions)
100-105 degrees
20-30 min 2x per day
Contraindications: increased BP or vascular compromised
Key things to know about sitz bath
105-115 degrees
2-10 minutes
Indications: hemorrhoids, cystitis, dysmenorrhea, coccydynia, prostatisis, post partum distress, constipation, urinary retention, sciatica
Contraindications: infertility
Key things to know about paraffin bath
125-130 degrees
20 min
Dip 7-10 times, wrap 20 min. If cracks have to start over
Ratio 7:1 paraffin:mineral oil
Indications: chronic arthritis, hands, injured fingers
Contraindications: actor arthritis, vascular compromise
Key things to know about fluidotherapy “dry whirlpool”
115-120 deg
15-20 min
Indications: chronic arthritis, amputee, strains, to increase ROM, RSDS aka CRPS, dystonia, open wounds
Contraindications: acute arthritis, vascular disease, skin infections, burns, young, old, implants
Indications for cold laser
open lesions, decubitus ulcers, DM ulcers, lacerations, burns, acute and chronic pain, bursitis, tendinitis, decrease ROM, tic douloureux irritation, fibromyalgia, trigger points
Contraindications for cold laser
tattoo, open growth plates, over the eyes, pregnant uterus, photosensitivity, medications, epilepsy, thick eschar, testicles, and regions of infections
Dosage of cold laser
15-30 seconds over a wound
minutes to hours for pain (3-5 minutes)
Define photophoresis.
chemical driven by light into treatment area
Number one precaution for cold laser
Doctor and Patient MUST wear goggles
Benefits of UV
Vasodilation, bactericidal, phototaxis
Increases vitamin D synthesis
Improves skin and muscle tone, elasticity, secretory functions
Stimulates metabolism
Increases reticulocytes
Indications for UV
Skin conditions- fungal, herpes zoster, dermatological conditions, burns, psoriasis, carbuncles, wounds, decubitus ulcers
Bone- rickets, osteomalacia
Contraindications for UV
HIM, vascular diseases, suppurative lesions, hemorrhage, tetracycline, SLE
What is erythema related to in UV therapy?
- Patient sensitivity
- Intensity vs distance (Inverse square law)
- Angle of radiation
Indications for SWD
Deep muscle, thoracic cavity, bronchitis, joints, PID, prostatis, sinusitis, neuritis, amenorrhea, otitis media
Contraindications or SWD
Pregnancy, casts, metal, hearing aid, contacts, wet skin, ulcers, pace makers, advanced osteoporosis
SWD heats _____ first.
fat
Indications for MWD
deep muscle, joints, PID, prostatis, otitis externa, hip conditions, neuritis
Contraindications for MWD
Same as SWD, sinusitis, metal, scars, wet skin, open epiphysis, otitis media
MWD heats______ first
muscle