Physical Agents

Question 1

Rank the materials in terms of specific heat from least to greatest.

Answer 1

Bone, muscle, water

Question 2

Name physiologic effects of cryotherapy (10)

Answer 2

1. Initial vasoconstriction
2. decreases inflammation
3. decreases pain via gate-control- numbing
4. increases pain threshold
5. Decreases spasm
6. Decreases spasticity
7. Reduces metabolic rate
8. increased acute contractility
9. isometric muscle strength reduced (<5min)
10. Reduces nerve conduction velocity

Question 3

Indications for Cryotherapy

Answer 3

1. Swelling/ Edema
2. Acute Inflammation
3. Spasticity
4. Pain
5. Vasodilated
6. Acute injury
7. Acute spasm

Question 4

Contraindication for cryotherapy

Answer 4

1. Cold hyper sensitivity
2. Reynaud’s disease
3. Cold intolerance
4. peripheral vascular disease
5. superficial to a regenerating peripheral nerve
6. (gaping) open wound- wet
7. paroxysmal cold hypo uremia

Question 5

Precautions for cryotherapy

Answer 5

1. Hypertension
2. Impaired thermoregulation- elderly
3. neuropathies (impaired sensation
4. poor mentation
5. main nerves
6. wounds

Question 6

Cryocuff Pros

Answer 6

Also compresses, others?

Question 7

Cryocuff cons

Answer 7

expensive ???? any others?

not good for small areas.

Question 8

Cold pack Pros

Answer 8

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

Question 9

Cold pack cons

Answer 9

doesn’t include compression. not good for small areas or contours.

Question 10

Vapocoolant spray advantages

Answer 10

quick to apply. can apply to small areas as desired. can replace lidocane.

Question 11

Vapocoolant spray cons

Answer 11

only small areas.

Question 12

ice massage advantages

Answer 12

can apply directly to small areas,

good for contours. can be cheap.

Question 13

ice massage cons

Answer 13

can’t do large areas. usually requires someone to apply for the patient.

Question 14

What is the “normal” patient response to cryotherapy? Include times.

Answer 14

Cold. (w/in 3 min)
Burning then (aching) (4-7 min)
Analgesia (8-15 min)
Numbness( local to total)( 15 to 30 min)

Question 15

Physiologic effects of thermotherapy?

Answer 15

Vasodilation.
Increased metabolic rate.
Pain control. (increases pain threshold.
increases extensibility of soft tissue.
increases circulation
increases nerve conduction velocity.

Question 16

Indications for thermotherapy:

Answer 16

1. Pain
2. Stiffness/ poor ROM
3. (want to) accelerate healing
4. psoriasis
5. sub acute/ chronic inflammation

Question 17

Contraindication for thermotherapy:

Answer 17

hemorrhage
thrombophlebitis
impaired sensation
impaired mentation
malignant tumors

Question 18

Why use a hot pack?

Answer 18

Cheap. Easy to apply. can cover large, broad areas.

Question 19

Precautions of thermotherapy:

Answer 19

Acute injury or inflammation
pregnancy
edema
impaired circulation/ thermoregulation
open wound
topical agents/ transdermal medications
cardiac insufficiency

Question 20

What’s a drawback for a hotpack?

Answer 20

You can’t see the tx area. No good for small, or contoured areas

Question 21

IR Radiation: Pro

Answer 21

Targets deeper tissues

Question 22

Fluidotherapy: Pros

Answer 22

Good for contours.

Question 23

Why use paraffin?

Answer 23

Great for contours. Steady heat to extremities.

Question 24

Cons for paraffin?

Answer 24

Usually requires submersion. Messy.

Question 25

Contrast bath: Pros.

Answer 25

Can generate a pumping effect.

Question 26

Physiologic Effects of Ultrasound?

Answer 26

``` Increase extensibility increase blood flow promote healing factors increase heat reduce pain ```

Question 27

indications for Ultrasound

Answer 27

``` Pain Soft tissue shortening chronic tendonitis and TP dermal ulcers acute tendonittis bone fractures and delayed healing carpal tunnel ```

Question 28

Contraindications for Ultrasound

Answer 28

``` Malignant tumors pregnancy pacemaker thrombophlebitis eyes and reproductive organs ```

Question 29

Precautions for Ultrasound.

Answer 29

Acute inflammation breast implants ephypseal plates.

Question 30

What is the therapeutic temperature range?

Answer 30

104* C to 113*C

Question 31

How long does it take for 145F water to scald?

Answer 31

3 seconds.

Question 32

A frequency of 1MHz will target what tissue depth?

Answer 32

2.3-5 cm

Question 33

A frequency of 3 MHz will target what depth of tissue?

Answer 33

.8 - 1.6 cm

Question 34

Rank plasma, nerve, water, fat, muscle, and blood in therms of their absorbance? Low to High

Answer 34

Water, plasma, good, fat, muscle, nerve

Question 35

What is one reason why you should be extra cautious around nerves?

Answer 35

They absorb (nearly) twice as much energy as much.

Question 36

Rank fat, muscle, nerve, blood, plasma, and water in terms of penetration? (low to high)

Answer 36

nerve, muscle, fat, blood, plasma, water

Question 37

Why then therefore would you use water as a medium for US?

Answer 37

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.

Question 38

What's the treatment area?

Answer 38

Appx. 2x the size of the ERA. | The smallest possible treatment area is 1.25x the ERA.

Question 39

What are thermal effects of US?

Answer 39

``` increased collagen extensibility increase blood flow increase tissue extensibility heat reduce pain ```

Question 40

What are the non thermal effects of UltraSound?

Answer 40

1. stable cavitation 2. accoustic steaming? 3. microstreaming i. e. the optimum environment for wound healing?

Question 41

Thermal Duty Cycle?

Answer 41

100% continous

Question 42

Non thermal duty cycle?

Answer 42

20% pulse