Physical Agents Flashcards
Conduction
Heat transfer from a warmer object to a cooler object by means of direct molecular interaction of objects in physical contact
Conductive modalities
Hot pack
Paraffin
Convection
Heat transfer by movement of air or fluid from a warmer area to a cooler area or moving past a cooler body part
Convection modalities
whirlpool
fluidotherapy
Radiation
transfer of heat from a warmer object to a cooler object by means of transmission of electromagnetic energy without heating of an intervening medium
Infrared waves absorbed by a cooler body
Radiation modality
infrared
Impact of general heat application - what increases
CO Metabolic rate Pulse rate RR VD
Impact of general heat application - what decreases
BP mm activity Blood to internal organs Blood to resting mm SV
Precautions with superficial thermotherapy
Cardiac insufficiency Edema Impaired circulation Impaired thermal regulation Metal in tx site Pregnancy Demyelinated nerves Open wounds
Contraindications with superficial thermotherapy
Acute and early subacute traumatic and inflammatory conditions Dec circulation Dec sensation Deep vein thrombophlebitis Impaired cog function Malignant tumors Very young and very old
Superficial heating physical agents
Hot pack Paraffin bath Fluidotherapy Infrared Hydrotherapy Nonimmersion irrigation device
Superficial heating physical agents - hot pack
A canvas pack filled with silica gel, heated by immersion in water between 165 and 170 F
Superficial heating physical agents - hot pack - method of head transmission
conduction
Superficial heating physical agents - hot pack - the hot pack will reach peak heat when
5 minutes - so check skin
Superficial heating physical agents - hot pack - treatment duration
usually 20-30 min
Superficial heating physical agents - paraffin
therapeutic application of liquid paraffin to a body part for the transmission of heat
Thermostatically controlled unit that contains a paraffin wax and mineral oil mixture
Superficial heating physical agents - Paraffin - method of transmission
conduction
Superficial heating physical agents - paraffin treatment time
generally 15-20 min
Superficial heating physical agents - paraffin indications
Painful joints
joint stiffness
Superficial heating physical agents - paraffin contraindications
allergic rash
open wounds
recent scars or sutures
skin infections
Superficial heating physical agents - hydrotherapy
whirlpool - partial or total immersion baths in which water is agitated and mixed with air to be directed against or around the affected part
Superficial heating physical agents - hydrotherapy - method of transmission
convection
Superficial heating physical agents - hydrotherapy treatment time
20 minutes
Superficial heating physical agents - hydrotherapy - indications
subacute and chronic musculoskeletal conditions
Superficial heating physical agents - hydrotherapy contraindications
NOT FOR WOUND MANAGEMENT
Superficial heating physical agents - non immersion irrigation device is what
small hand held electric water pump that produces water jet to create a shearing force to loosen tissue debris
Superficial heating physical agents - non immersion irrigation device - treatment time
5 to 15 min once a day
Cryotherapy - Abstraction
The removal of heat by means of conduction or evaporation
Cryotherapy - conduction
transfer of heat from a warmer object to a cooler object by means of direct molecular interaction o fobjects in physical contact
Cryotherapy - conduction modalities
cold pack
ice pack
ice massage
cold bath
Phys effects of general cold application - what dec
metabolic rate
pulse rate
RR
venous BP
Phys effects of general cold application - what inc
Blood flow to internal organs
CO
SV
Arterial BP
Cryotherapy - evaporation
Highly volatile liquids that evaporate rapidly on contact with warm object
Cryotherapy - evaporation modalities
vapocoolant spray
Contraindications with cryotherapy
cold hypersensitivity cold intolerance cryoglobulinemia PVD Impaired temp sensation Raynauds Paroxysmal cold hemoglobinuria over regenerating peripheral nerves
Cryotherapy procedures
Cold packs Ice packs Ice massage Vapocoolant spray Contrast baths
Cryotherapy - cold packs
vinyl casting filled with silica gel or sand slurry mixture
Packs maintained in unit at 0-10F
Cryotherapy - cold packs - treatment time
10 to 20 min
Cryotherapy - ice packs
crushed ice folded in moist towel or placed in plastic bag covered by moist towel
Cryotherapy - ice packs treatment time
10-20 minutes
Cryotherapy - cold and ice packs - method of tranmission
conduction
Cryotherapy - ice massage
ice cylinder formed by freezing water in a paper or styrofoam cup
salt can be added to create a colder slush mixture
Cryotherapy - ice massage - pt will experience what sequence of feelings
Cold
Burning
Aching
Numbness
Cryotherapy - ice massage treatment time
5-10 minutes or until analgesia occurs
Cryotherapy - ice massage - DO NOT
go over superficial nerve or bone
Cryotherapy - vapocoolant spray
A nontoxic, noninflammable volatile liquid that produces rapid cooling when a fine spray is applied to the skin
Cryotherapy - vapocoolant spray - used primarily for what
to reduce mm spasm
desensitize trigger points
Cryotherapy vapocoolant spray application
spray at 30 degree angle
let evaporate before next sweep
mm should be passively stretching during application
have pt perform active exercise after
Cryotherapy vapocoolant spray treatment time
10-15 min
Cryotherapy - contrast bath
the alternating immersion of a body part in warm and cold water to produce vascular exercise through active VD and VC of BVs
Cryotherapy - contrast bath - application
Usually start in warm to hot (100-111F)
Warm water for 4 min and then cold (55-65F) for 1 min
Continue like this and end in warm
Cryotherapy - contrast bath - tx time
20 to 30 min
Cryotherapy - contrast bath indications
anything requiring stimulation of peripheral circulation
Cryotherapy - contrast baths - contraindications
advanced arteriosclerosis
arterial insufficiency
loss of sensation to heat and cold
US - Spatial average intensity
the total power divided by the area of the transducer head
this is usually what is documented
US - beam nonuniformity ratio
the ratio of spatial peak intensity to spatial average intensity
lower the BNR, the more uniform the energy distribution and the less risk of tissue damage
BNR should be between 2:1 and 6:1 (ideal 1:1 is not feasible)
US - continuous vs. pulsed
continued will give thermal effects
pulsed when nonthermal effects are desired
US - duty cycle
the fraction of time the US energy is on over one pulse period
Duty cycle of less than 50% is considered pulsed
Continuous is 100%
US - temporal peak intensity
the peak intensity of US during the on time phase of the pulse period
US - temporal average intensity
the US power avg over one pulse period
US - attenuation
the reduction of acoustical energy as it passes through soft tissue
US - absorption is highest where
in tissues with high collagen and protein content
mm, tendons, ligaments, capsules
US - depth of penetration
3-5 cm
at 3MHz greater heat production in superficial layers caused by greater attenuation of sound waves
ex - TMJ
US - Effects of US - Thermal
Produced by continuous sound energy of sufficient intensity
Range from 0.5-3 w/cm
US - effects - nonthermal
generated by very low intensity or pulsed sound energy
typically 20-50% duty cycle
US - nonthermal - cavitation
Alternating compression (condensation phase) and expansion (refraction phase) of small gas bubbles in tissue fluids caused by mechanical pressure waves
US - nonthermal - cavitation - stable
gas bubbles resonate without tissue damage
US - nonthermal - cavitation - unstable
Sever collapse of gas bubbles during compression phase of US and can result in local tissue destruction due to high temp
US - nonthermal - cavitation - unstable - acoustic streaming
movement of fluids along the boundaries of cell membranes resulting from mechanical pressure wave
US - contraindications
Impaired circulation, cog function, sensation, malignant tumor, thrombophlebitis, over the brain, ear, eye, heart, cervical ganglia, carotic sinus, reproductive organs, spinal cord, pacemaker, pelvis with pregnancy
US - DO not use US for
reducing swelling, promoting joint healing, long term pain relief
US - direct contact - intensity
0.5-2.5
Lower for acute/thin tissue
Higher for chronic/thick tissue
Phonophoresis
The use of US to drive medications through the skin into deeper tissues
lidocaine or dexamethazone for ex
Phonophoresis - mode, tx time, intensty
pulsed mode 20%
tme is 5-10 min
0.5-0.75
Shortwave diathermy
deep heating within the tissues
Shortwave diathermy - indications with theraml
Inc joint ROM
pain management
inc tissue healing
Shortwave diathermy - indications with non thermal
Pain control
dec edema
resolution of acute or chronic infection
wound control and soft tissue healing
Shortwave diathermy - contraindications
pregnancy
cardiac pacemaker, neural stimulator or any implanted device