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Physical Agents > Physical Agents Final Review > Flashcards

Physical Agents Final Review Flashcards

1
Q

What is the minimum amount of electrodes you need for a closed current?

A

at least two

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2
Q

What is the positive side of an electrode

A

Anode

ion deficient

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3
Q

what is the negative side of an electrode

A

Cathode

ion rich

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4
Q

What type of current has one electrode positive as the other stays negative?

A

Direct

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5
Q

Which type of current has the electrodes swtiching between positive and negative

A

Alternating

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6
Q

Which type of current is constantly changing direction of flow?

A

alternating

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7
Q

Which type of current moves in the same direction at all times?

A

Direct

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8
Q

How many phases = a pulse in biphasic current

A

2 phases = 1 pulse

once the current crosses isoelectric line it becomes a new phase therefore the charges are canceled out

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9
Q

What type of current is high volt?

A

Monophasic

1 phase= 1 pulse

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10
Q

What is monophasic current used to treat?

A

can decrease edema from the build up of charge

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11
Q

What is the unit for how strong the current is?

A

amplitude

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12
Q

What tends to be a more comfortable frequency for the patient?

A

HIGHER

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13
Q

How do you stimulate denervated muscles?

A

must directly stimulate muscle because there are no nerves

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14
Q

What is the order of recruitment on the strength- duration curve when increasing the pulse duration?

A
  • A beta sensory
  • motor
  • A delta sharp pain
  • C dull pain
  • denervated muscle
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15
Q

What is the x- axis on the curve measuring?

A

pulse duration

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16
Q

What is the y-axis on the curve measuring?

A

amplitude

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17
Q

What does accommodation do?

A

Prevents you from having to keep turning up the e stim in order to feel e-stim.
Make sure you stay in the correct therapeutic range.

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18
Q

What is propagation of an impulse along a conduction system in the SAME direction it normally travels.

A

Orthodromic

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19
Q

What is propagation of an impulse along a conduction system in the OPPOSITE direction it normally travels.

A

Antidromic

can occur artificially during estim

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20
Q

How to calculate the current density?

A

Current density: current ÷ size of electrode

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21
Q

What size electrodes does AC current use?

A

sAme size so they have the sAme current density

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22
Q

What size electrodes does DC current use?

A

uses Different sizes

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23
Q

Indications for TENS

A

Pain control/relief
Reduce dependency on pain medication
Increase functional movement and mobility with less discomfort
Give patient active role in pain management

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24
Q

Contraindications for TENS

A

Pacemaker
Unstable arrhythmia
Over carotid sinus, arterial/venous thrombus
Pregnancy over trunk

25
Q

Precautions for TENS

A

Cardiac disease
Impaired sensation/mentation
Malignancy
Skin irritation/open wound

26
Q

Adverse effects of TENS

A

Burns
Skin irritation
Pain

27
Q

TENS conventional parameters

A 
Gate-control
Immediate pain relief, little residual effect
No muscle contraction
Frequency:  100-150 pps
Pulse duration: 50-80 usec
28
Q

TENS acupuncture parameters

A 
endogenous opioids mechanism
longer pain relief; 5 hours after
twtich muscle contraction
frequency: 2-10 pps
pulse duration: 200-300 us
29
Q

IFC paramters

A

Two medium-frequency currents interfering with each other
Difference between carrier frequencies = beat frequency
Mimic TENS modes
May be more comfortable, cover larger area → controversial evidence
Conventional or acupuncture
Criss-cross 4 electrodes

30
Q

Sweep accommodation is for what type of modulation

A

frequency

one carrier frequency flucutaes 150 Hz

31
Q

Scan accommodation is for what type of frequency

A

amplitude

can treat a larger tissue area

32
Q

What to do if pt. is getting an inappropriate response?

A
  1. Decrease pulse duration.
    1. Increase frequency.
    2. Last resort: use reduced amplitude.
      → Will lose therapeutic effect!
33
Q

indication for NMES

A

Produce muscle contraction
Prevent atrophy
Neuromuscular re-ed
Promote movement to decrease edema

34
Q

contraindications for NMES

A

Pacemaker
Unstable arrhythmia
Over carotid sinus, arterial/venous thrombus
Pregnancy over trunk

35
Q

precautions for NMES

A

Cardiac disease
Impaired sensation/mentation
Malignancy
Skin irritation/open wound

36
Q

strengthening parameters for NMES

A 
Amplitude to >10% MVC for injured tissue
Frequency: 35-80pps
Pulse duration: 150-200 (small)
                          200-350 (large)
On:off time: 10sec on/50sec off
37
Q

spasm/edema pump NMES parameters

A 
Spasm / edema pump
Amplitude to visible tetanic contraction
Frequency: 35-50 pps
Pulse duration: 150-200 (small)
                          200-350 (large)
On:off time: 5sec on/5sec off
38
Q

indications for ionto

A

Alternate method of drug delivery

Unidirectional flow of ions into a site of tissue injury

39
Q

contraindications for ionto

A 
Allergy to drug
Unstable arrhythmia / pacemaker
Over carotid sinus
Pregnancy over trunk
Metallic implants
40
Q

precautions for ionto

A

Cardiac disease
Impaired sensation/mentation
Malignancy
Skin irritation/open wound

41
Q

current density parameters for ionto

A

Max current density

Cathode:

42
Q

how is dose calculated for ionto

A

intensity X time

40-80 mA min

43
Q

current amp for ionto

A

4 mA minimum
Safe amplitude: current density = current amplitude / surface of electrode
**Be able to calculate maximum safe amplitude

44
Q

electrode placement for ionto

A

Delivery electrode over target area, dispersive electrode over remote location (generally proximal)

45
Q

what does a cathode do?

A

Repels negative ions
Decrease edema
Sclerolytic effect: decreases protein density (repels proteins)
Decreasing protein density decreases edema

46
Q

what does an anode do?

A

Repels positive ions
Sclerolytic effect: increases protein density (attracts proteins)
Helps build tissues

47
Q

what is EMG?

A

Quantifies muscle tone.
Records electrical activity of muscles using surface or fine wire/needle electrodes.
During muscle contraction, record will show deviations away from straight isoelectric line.
Number and size of deviations show amount of muscle tissue that is electrically active.

48
Q

Advantages of EMG

A

Can adjust sensitivity to detect very low levels of activity that are not palpable.
Timing of contraction and relaxation can be recorded.
Can use as biofeedback.
Provides pt’s with a way to learn how to initiate contraction or relaxation.
Small machine that provides auditory feedback.
Can differentiate between neural and biomechanical muscle tone.

49
Q

what type of muscle tone is relaxed muscle demonstrates resistance to passive stretch but no electrical activity (no EMG reading).

A

Biomechanical

50
Q

what type of muscle tone is relaxed muscle demonstrates resistance to passive stretch and electrical activity (EMG reading).

A

Neural

51
Q

disadvantages of EMG

A

Measures only local area of tissue under electrodes (surface or internal).
Requires specialized equipment and training.
Not available in most clinical settings.
May need to rely on palpation skills and clinical reasoning.

52
Q

What is nerve conduction velocity

A

Measures speed of electrical impulse through a nerve.
Can determine if there is nerve damage or destruction.
Two electrodes are placed over a nerve.
Electrodes can be surface or internal.
One electrode stimulates nerve → sends mild impulse through nerve → other electrode receives and records this impulse.

53
Q

how is nerve velocity calculated?

A

Distance between electrodes ÷ conduction time.

54
Q

what type of nerve will transmit the fastest?

A

a larger nerve with greater amount of myelination

55
Q

what is the normal range of NCV?

A

50-60 m/s

56
Q

what will be impeded with nerve damage?

A

speed and intensity of the nerve signal

57
Q

conditions indicating NCV testing

A 
Carpal Tunnel Syndrome
Cubital Tunnel Syndrome
Cervical or lumbar radiculopathy
Chronic inflammatory polyneuropathy (d/t diabetes or alcoholism)
Peripheral nerve injuries
Guillain-Barre
Charcot-Marie-Tooth
Unexplained pain, weakness, numbness, tingling.
58
Q

precautions and contraindications for NCV

A

Decreased skin sensation
Anti-coagulation medications

Skin conditions in area of testing
Decreased cognition
Pacemaker, cardiac defibrillator
Fear of needles
Electrodes should not be placed over the eyes (duh)
59
Q

implications for PT and NCV

A

NCV testing rarely performed by physical therapists.
Can be board certified.
Physical therapists often not provided with NCV test results unless requested.
NCV test results can support our clinical hypothesis.
Results may or may not change our course of action.
Treat the impairments.

Physical Agents (3 decks)

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