Physical Agents Flashcards
Rank the materials in terms of specific heat from least to greatest.
Bone, muscle, water
Name physiologic effects of cryotherapy (10)
- Initial vasoconstriction
- decreases inflammation
- decreases pain via gate-control- numbing
- increases pain threshold
- Decreases spasm
- Decreases spasticity
- Reduces metabolic rate
- increased acute contractility
- isometric muscle strength reduced (<5min)
- Reduces nerve conduction velocity
Indications for Cryotherapy
- Swelling/ Edema
- Acute Inflammation
- Spasticity
- Pain
- Vasodilated
- Acute injury
- Acute spasm
Contraindication for cryotherapy
- Cold hyper sensitivity
- Reynaud’s disease
- Cold intolerance
- peripheral vascular disease
- superficial to a regenerating peripheral nerve
- (gaping) open wound- wet
- paroxysmal cold hypo uremia
Precautions for cryotherapy
- Hypertension
- Impaired thermoregulation- elderly
- neuropathies (impaired sensation
- poor mentation
- main nerves
- wounds
Cryocuff Pros
Also compresses, others?
Cryocuff cons
expensive ???? any others?
not good for small areas.
Cold pack Pros
Can do large broad areas. Relatively cheap. Can teach the patient how to use what they probably already have. can add an a wrap for compression
Cold pack cons
doesn’t include compression. not good for small areas or contours.
Vapocoolant spray advantages
quick to apply. can apply to small areas as desired. can replace lidocane.
Vapocoolant spray cons
only small areas.
ice massage advantages
can apply directly to small areas,
good for contours. can be cheap.
ice massage cons
can’t do large areas. usually requires someone to apply for the patient.
What is the “normal” patient response to cryotherapy? Include times.
Cold. (w/in 3 min)
Burning then (aching) (4-7 min)
Analgesia (8-15 min)
Numbness( local to total)( 15 to 30 min)
Physiologic effects of thermotherapy?
Vasodilation. Increased metabolic rate. Pain control. (increases pain threshold. increases extensibility of soft tissue. increases circulation increases nerve conduction velocity.
Indications for thermotherapy:
- Pain
- Stiffness/ poor ROM
- (want to) accelerate healing
- psoriasis
- sub acute/ chronic inflammation
Contraindication for thermotherapy:
hemorrhage thrombophlebitis impaired sensation impaired mentation malignant tumors
Why use a hot pack?
Cheap. Easy to apply. can cover large, broad areas.
Precautions of thermotherapy:
Acute injury or inflammation pregnancy edema impaired circulation/ thermoregulation open wound topical agents/ transdermal medications cardiac insufficiency
What’s a drawback for a hotpack?
You can’t see the tx area. No good for small, or contoured areas
IR Radiation: Pro
Targets deeper tissues
Fluidotherapy: Pros
Good for contours.
Why use paraffin?
Great for contours. Steady heat to extremities.
Cons for paraffin?
Usually requires submersion. Messy.
Contrast bath: Pros.
Can generate a pumping effect.
Physiologic Effects of Ultrasound?
Increase extensibility increase blood flow promote healing factors increase heat reduce pain
indications for Ultrasound
Pain Soft tissue shortening chronic tendonitis and TP dermal ulcers acute tendonittis bone fractures and delayed healing carpal tunnel
Contraindications for Ultrasound
Malignant tumors pregnancy pacemaker thrombophlebitis eyes and reproductive organs
Precautions for Ultrasound.
Acute inflammation
breast implants
ephypseal plates.
What is the therapeutic temperature range?
104* C to 113*C
How long does it take for 145F water to scald?
3 seconds.
A frequency of 1MHz will target what tissue depth?
2.3-5 cm
A frequency of 3 MHz will target what depth of tissue?
.8 - 1.6 cm
Rank plasma, nerve, water, fat, muscle, and blood in therms of their absorbance? Low to High
Water, plasma, good, fat, muscle, nerve
What is one reason why you should be extra cautious around nerves?
They absorb (nearly) twice as much energy as much.
Rank fat, muscle, nerve, blood, plasma, and water in terms of penetration? (low to high)
nerve, muscle, fat, blood, plasma, water
Why then therefore would you use water as a medium for US?
ultrasound penetrates it really well. So the energy is carried to the tissue you desire to target.
Otherwise most of the energy would be reflected at the air-soft tissue interface.
What’s the treatment area?
Appx. 2x the size of the ERA.
The smallest possible treatment area is 1.25x the ERA.
What are thermal effects of US?
increased collagen extensibility increase blood flow increase tissue extensibility heat reduce pain
What are the non thermal effects of UltraSound?
- stable cavitation
- accoustic steaming?
- microstreaming
i. e. the optimum environment for wound healing?
Thermal Duty Cycle?
100% continous
Non thermal duty cycle?
20% pulse
