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BOARDS: Modalities > Physical Agents > Flashcards

Physical Agents Flashcards

1
Q

T/F: Hot packs and paraffin are examples of convection physical agents in the transfer of heat.

A

false, conduction

  • heat transfer froma warmer object to cooler object by means of direct interaction
  • convection = movement of air/fluid from a warmer area to a cooler area
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2
Q

What are the physiological effects of general heat application? (BP, etc)

A

aka whirlpool

decreased BP
Increased vasodilation
decreased stroke volume
increased cardiac output
increased HR
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3
Q

What is cardiac output determined by?

A

CO = HR x SV

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4
Q

What fibers are inhibited through local heat application? (think gait theory of pain)

A

A delta and C fibers inhibited

- via activation of A beta fibers (gait theory)

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5
Q

How does heat reduce muscle spasm?

A

decreased afferent firing of muscle spindle (aka communication that muscle is stretched) and increased firing of GTO fibers (inhibiting fibers) that reduce alpha motor neutron activity

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6
Q

How many towels should be between a patient and a hot pack?

A

6-8 layers

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7
Q

Why would you administer paraffin?

A
  • pts with chronic inflammatory condition (arthritis)

- joint stiffness

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8
Q

What are contraindications to paraffin?

A

open wound, allergic rash, recent scars/sutures, skin infections

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9
Q

What are contraindications to the use of superficial thermotherapy?

A

acute inflammatory condition, decreased circulation, DVT, impaired cognition, malignant tumor, decreased sensation

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10
Q

T/F: Whirlpool should be used for wound management.

A

false

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11
Q

T/F: Pregnancy is a contraindication for using heat.

A

false, just a precaution

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12
Q

Why does edema result from local/general heat application?

A

causes increased capillary permeability so fluid leaks into interstitial space

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13
Q

T/F: Cardiac output and stroke volume both decrease with use of cryotherapy.

A

false, both increase

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14
Q

T/F: Hypertension is a precaution to cryotherapy.

A

true, not a contraindication

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15
Q

T/F: It’s a precaution to use cryotherapy over regenerating nerves, like at the end of a residual limb.

A

false, contraindication: shouldn’t use cold over regenerating peripheral nerves

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16
Q

You are about to give an ice massage to your patient’s lateral epicondylitis. What will you explain to them about what they feel, in order?

A

cold, burning, aching, then numbness

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17
Q

When doing ice massage, what should you be sure not to massage over?

A 
bony prominence
superficial nerve (peroneal)
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18
Q

Your patient has peripheral vascular disease and requests use of a cold pack for their back. What do you tell them?

A

It’s contraindicated, sorry bud

- it will constrict your vessels even more leaving you ischemic

19
Q

What is vapocoolant spray typically used for?

A

used for reducing muscle spasm, desensitize trigger points

20
Q

What should be done to the muscle while applying vapocoolant spray?

A

passive stretch

- then have pt perform active exercise after spraying

21
Q

What are contraindications of cryotherapy?

A

PVD, cold hypersensitivity, raynauds, over regenerating peripheral nerves, paroxysmal cold hemoglobinuria

22
Q

What are contraindications of thermotherapy?

A

acute/early subacute inflammatory conditions, decreased circulation, DVT, impaired cognition, malignant tumor, decreased sensation

23
Q

For a patient with an acute issue that’s swelling and all that, how long would you tell them to ice it?

A

ice for 20min on, 20 min off

- body vasodilates to prevent “loss” of body part from the vasoconstriction you’re doing

24
Q

When might you use a contrast bath with a patient?

A

anytime stimulation of peripheral limb circulation is indicated
- PVD, sprains/strains, trauma (after acutity of situation is down)

25
Q

What are contraindications to use of contrast bath?

A

advanced atherosclerosis
loss of sensation to heat/cold
arterial insufficiency

26
Q

T/F: Continuous ultrasound provides thermal effects.

A

true

- pulsed US = NO thermal effects

27
Q

How can you mitigate the effects that occur from the US intensity not being uniformly distributed over the transducer?

A

moving soundhead

go to pulsed US

28
Q

When might pulsed US be more desired than continuous?

A

for acute soft tissue injuries where you’ve still got inflammation and don’t want to add heat to the mix

29
Q

What is the Beam nonuniformity ratio for ultrasound? (BNR) Why is it important?

A

BNR = ratio of spatial peak intensity to spatial average intensity
- lower the BRN, the more uniform the energy distribution, so decreased risk of tissue damage

30
Q

What is the duty cycle set at for pulsed US?

A

<50%

- 100% or close to that is continuous US

31
Q

T/F: It’s a precaution to use US over healing fractures or breast implants.

A

true

- precaution: breast implants, healing fractures, acute inflammation, open epiphyses

32
Q

At the 1MHz level, this is able to hit what kind of structures, deep or superficial?

A

deep

- superficial structures hit at 3MHz

33
Q

For TMJ to reduce chronic pain, what settings for duty cycle and frequency would you want?

A

frequency: 3MHz (since superficial)

duty cycle: close to 100% so it’s continuous for the heat

34
Q

Should you use US on the back of a patient that’s had a laminectomy?

A

absolutely not b/c potential cavitations

- contraindication to do US over unprotected spinal cord

35
Q

How large should your treatment field be for US?

A

2x the transducer head

36
Q

What would the purpose of using pulsed ultrasound be?

A

1) improve rate of healing
- increased circulation, increased rate of fibroblast synthesis for tissue repair, increase macrophage activity, increase cell membrane permeability to dec. swelling

2)

37
Q

Can you use US in the back of a pregnant woman?

A

no

- nor uterus, pelvic, abdomen area (duh)

38
Q

What does the treatment intensity value look like for ultrasound?

A

.5-2.5 w/cm^2

  • lower intensity for superficial
  • higher intensity for thicker tissue (low back)
39
Q

If a patient complains of periosteal pain during an ultrasound treatment, what parameter should you change?

A

intensity: lower it (remember normal is .5-2.5)

also make sure you’re adequately moving the transducer

40
Q

How long is typical treatment time for US?

A

3-10min

41
Q

What are contraindications to short wave diathermy?

A 
pregnancy
pacemakers
any implanted device (insulin pump)
metal, including jewelry
malignancy
42
Q

What are the thermal vs nonthermal benefits of SWD?

A

thermal: increased joint ROM, pain management, increased tissue healing
nonthermal: pain control, decreased edema, resolution of acute/chronic infections, wound control, soft tissue healing

43
Q

What should you watch for in the environment when giving SWD to make sure everyone in the environment is safe?

A
  • have those with metal implants, pacemakers, pregnancy all steer clear
  • should make sure obese pt isn’t getting SWD since their fat may heat excessively

BOARDS: Modalities (3 decks)

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