PHYSMOD: 2nd Shifting Flashcards
This is the magnitude of the stimulus and is the factor determining the strength of stimulation
Current
A modulation that involves grouping together a finite series of pulses
Burst modulation
In naming currents, you should start with what?
Waveform
If the treatment goal for using ES is scar tissue remodeling, what should be used?
a. Sensory level stimulation
b. Noxious level stimulation
c. Motor level stimulation
d. Non-excitatory stimulation
d. Non-excitatory stimulation (subliminal
stimulation)
If the treatment goal for using electrical
stimulation is to increase muscle contractile force, what should be used?
a. Sensory level stimulation
b. Noxious level stimulation
c. Motor level stimulation
d. Non-excitatory stimulation
c. Motor level stimulation
This is the opposition to movement of direct current:
a. Current
b. Voltage
c. Charge
d. Resistance
d. Resistance
A modulation that involves a gradual rise and decline in the intensity of a finite series of pulses:
a. Amplitude modulation
b. Burst modulation
c. Frequency modulation
d. Duration modulation
a. Amplitude modulation
In naming currents, you should end with what?
a. waveform
b. symmetry
c. type of current
d. number of phases
c. type of current
Excitation of the peripheral nerves occurs at the
a. cellular level
b. segmental level
c. tissue level
d. systemic level
a. cellular level
If the treatment goal for using electrical
stimulation is to decrease pain via the gate
control theory, what should be used?
a. sensory level stimulation
b. microcurrent level stimulation
c. noxious level stimulation
d. motor level stimulation
a. sensory level stimulation
In which type of current bellow will polarity effects be least evident
a. Unbalanced biphasic pulsed current
b. Interrupted direct current
c. Monophasic pulsed current
d. Surged direct current
a. Unbalanced biphasic pulsed current
This is the pattern created by the rise and fall of current in a wave
a. Phase
b. Waveform
c. Frequency
d. Symmetry
b. Waveform (shape)
The driving force that makes particles move.
a. Current
b. Voltage
c. Charge
d. Resistance
b. Voltage
The period of no electrical activity between pulses
a. Pulse duration
b. Interpulse duration
c. On time
d. Decay time
b. Interpulse duration
You would like to stimulate the right peroneus muscles of an ectomorph 25 y/o patient who demonstrates weakness of the ankle evertors. You would use:
a. Monopolar technique with the smaller
electrode on the peroneus muscles and the bigger electrode on the gastrocnemius
muscle.
b. Bipolar technique using two small
electrodes on the peroneus muscles
c. Monopolar technique with the bigger
electrode on the peroneus muscles and the smaller electrode on the gastrocnemius muscle.
d. Bipolar technique using two large electrodes on the peroneus muscles
b. Bipolar technique using two small
electrodes on the peroneus muscles
Notes:
- C. = Only applicable to motorpoints of
the face & intrinsic muscles of hands & foot
- Monopolar technique = Motorpoint, with active & dispersive electrodes to “allow circulation of current”
- Peroneals: hindi malaking muscle, hindi rin maliit para gamitan ng motorpoint. Kung malaking electrodes gagamitin, other
muscles may be recruited.
In naming currents, you should end with what?
a. Symmetry
b. Type of current
c. Waveform
d. Number of phases
e. Shape
b. Type of current
Analgesic effects d/t neurotransmitters is a
physiologic effect of electrical stimulation that occurs at the
a. Cellular
b. Segmental
c. Tissue
d. Systemic
d. Systemic level
Contraction and relaxation of smooth muscles d/t electrical stimulation occurs at the
a. Cellular
b. Segmental
c. Tissue
d. Systemic
c. Tissue level
When the adhesive tape securing the electrode placement was loosened, the patient did not report any increase in intensity. This is probably due to
a. The machine is defective
b. The machine is set to a constant voltage
mode
c. The patient has high tolerance for pain
d. The current intensity was unchanged during the treatment
e. Any of these
b. The machine is set to a constant voltage
mode
*Advantage of constant voltage: It’s constant, current adjusts.
A: Wrong bc may kuryente pa ring nararamdaman
C: Pain tolerance doesn’t matter
D: You’ll only know that this is true if you know that the ES has constant current
To decrease tissue impedance when using ES, which of the following can be done?
a. Apply HMP prior to ES
b. Decrease skin temperature with ice massage before applying ES
c. Smaller electrodes must be used
d. The target area to be treated must be
elevated
a. Apply HMP prior to ES
*moist skin decreases impedance
B: decreases sensitivity of pt
D: only for swelling
The use of cheater plugs is not advocated for electrotherapy primarily because
a. These lessen the power supply of the skin
b. Such devices can lead to machine
breakdown and malfunction
c. Leaked current will not be absorbed and
transmitted to the ground
d. It increases usage of electricity per kilowatt-hour
e. All of these
c. Leaked current will not be absorbed and
transmitted to the ground
Which of the following is true about the
application of Ohm’s Law in electrotherapy?
a. If resistance is low, the flow of current is
impeded
b. Voltage will change if you adjust the mA
knob
c. The current intensity needed will be
higher if the skin is dry
d. An increase in current intensity leads to an increase in resistance
e. None of the above
c. The current intensity needed will be
higher if the skin is dry
*Dry skin, lesser current can enter; need to
increase intensity to see effect
B: When adjusting the mA knob, the voltage (mV) won’t change but the current.
True about the Russian current:
I. Burst modulated
II. Time modulated
III. Uses a carrier frequency of 2,500 Hz
IV. Is an alternating current with a sinusoidal waveform
a. Only I and III are correct
b. Only II and IV are correct
c. Only I, II, and III are correct
d. Only IV is correct
e. All are correct
e. All are correct
Which of the following correctly describes A-delta nerve fibers?
a. Known as group III efferents
b. Transmits action potential at 1-4 m/s
c. Transmits diffused type of pain
d. Produces sharp or pricking pain
d. Produces sharp or pricking pain
The opioid receptors are found in the
periaqueductal gray matter and raphe nucleus of what part of the brain?
Brainstem
Melzack and Wall introduced the gate control theory. What is the first name of Melzack?
A. James
B. Ronald
C. Patrick
D. Robert
B. Ronald
___ transmit sensation related to vibration
A-beta fibers
Medium frequency alternating current
Russian current
___ is one of the cardinal signs of inflammation, it happens because there is chemical irritation on the injured area
Dolor
TRUE OR FALSE: Analgesia is an effect of opiopeptins
True
What inflammatory cell is considered as the first line of defense during an injury?
Neutrophils
It is current x time
Charge
A patient suffered from mild stroke 2 weeks ago. Patient’s condition is now stable. Upon PT evaluation, you noted foot slapping during gait. You wish to re-educate the muscle during gait. Which of the following is the most appropriate for the case?
A. FES using Russian current
B. NMES using Russian current
C. FES using Galvanic current
D. NMES using Galvanic current
A. FES using Russian current
Galvanic is for wound healing and not muscle stimulation pero can still produce muscle contraction. Uncomfortable sa patients kaya hindi best option.
Russian Current is for Re-education
A patient suffered from axillary nerve injury. The patient presents with atrophied muscles. Which of the following electrical stimulation application are correct for this case?
I. Electrodes over upper trapezius
II. Waveform: Trapezoidal
III. Pulse frequency: 5 Hz
IV. Anode over the motor point of the muscle
A. II and III
B. I and II
C. III and IV
D. I and III
A. II and III
What is the correct electrode placement if you will apply ES for deep peroneal nerve injury?
A. Cathode over tibialis anterior
B. Anode over tibialis anterior
C. Cathode over peroneus longus
D. Anode over peroneus longus
A. Cathode over tibialis anterior
Cathode is prefered and tibialis anterior ang
innervated muscle ng deep peroneal nerve
What is the duty cycle if the on-time is 2 sec and the off time is 3 sec?
40%
Your patient presents with edema of the left leg due to anterior compartment syndrome. You decided to use electrical modality to reduce the edema. Which of the following correctly describes the intervention?
I. Frequency = 10 Hz
II. Duty cycle = 100%
III. Works via muscle pumping effect
IV. Pulse duration = 200 microseconds
A. I and II
B. II and III
C. I and III
D. III and IV
D. III and IV
Contract muscle for edema healing
20 Hz- 40 Hz ang preferred
What is the rationale when using ES for quadriceps femoris weakness after being immobilized due to ACL reconstruction surgery?
A. To decrease spasticity
B. To promote muscle re-education
C. To retard atrophy
D. To increase strength
C. To retard atrophy
A stroke patient presents with weak long wrist extensors with the muscle grade of 2/5. Which of the following is the most appropriate use of electrical stimulation?
A. FES x 150 microseconds x 20 Hz x 16% duty cycle
B. FES x 250 microseconds x 100 Hz x 50% duty cycle
C. ES x 250 microseconds x 20 Hz x 50% duty cycle
D. ES x 150 microseconds x 100 Hz x 50% duty cycle
A. FES x 150 microseconds x 20 Hz x 16% duty cycle
A stroke patient presents with weak long wrist extensors with a muscle grade of 2/5. What is your rationale when you use an electrical modality for this case?
A. To retard atrophy
B. To decrease tightness
C. To reduce muscle spasm
D. To promote muscle re-education
D. To promote muscle re-education
Stroke also causes spasticity. ⅖ ang grade kaya priority ang muscle re-education. Electrical stimulation can’t directly address tightness. Stretching is the one that addresses tightness.
A patient suffered from mild stroke 2 weeks ago. Patient’s condition is now stable. Upon PT evaluation, you noted foot slapping during gait. You wish to re-educate the muscle during gait. What waveform is most appropriate for this case?
A. Trapezoidal PC
B. Sawtooth PC
C. Biphasic PC
D. HVPGC
C. Biphasic PC
Biphasic is the best pero pwede ‘yung Russian and Galvanic.
Which of the following is correct about electrically-induced muscle contraction?
A. Delayed onset of fatigue
B. Relies on nerve innervation
C. Activates first the fast-twitch muscle fibers
D. Recruits smaller to larger motor units
C. Activates first the fast-twitch muscle fibers
Weak gastrocsoleus (MMT = 2+/5) after casting due to tibial fracture
A. NMES
B. FES
C. ES
D. Both A and B
E. All of these
F. None of these
A. NMES
NMES kasi konting movement muna kay
gastrocsoleus dahil fracture. Hindi agad
maintegrate sa ambulation and FES since
hindi pa mapapalakad patient.
TRUE OR FALSE: During NCV testing, the cathode is placed closer to the recording electrode
True
TRUE OR FALSE: Ground electrodes are used to minimize crosstalk
False
Proper placement is the solution to
minimize crosstalk.
TRUE OR FALSE: A complete reaction of degeneration manifests with no visible muscle contractions when Faradic
and Galvanic currents are applied
False
TRUE OR FALSE: When using the SD Curve, the rheobase is always identified prior to the chronaxie
True
Progressive large-amplitude potentials
A. EMG at rest
B. EMG w/ mild contraction
C. EMG w/ maximal contraction
B. EMG w/ mild contraction
Stepwise increased interference pattern
A. EMG at rest
B. EMG w/ mild contraction
C. EMG w/ maximal contraction
C. EMG w/ maximal contraction
Insertional activities are observed
A. EMG at rest
B. EMG w/ mild contraction
C. EMG w/ maximal contraction
A. EMG at rest
Biphasic muscle action potential
A. EMG at rest
B. EMG w/ mild contraction
C. EMG w/ maximal contraction
B. EMG w/ mild contraction
No muscle action potential
A. EMG at rest
B. EMG w/ mild contraction
C. EMG w/ maximal contraction
A. EMG at rest
Evaluates the integrity of the neuromuscular system
A. NCV only
B. SD Curve only
C. RD Test only
D. EMG only
E. NCV, SD Curve, RD Test
F. All of these
G. None of these
F. All of these
An assessment for lower motor neuron
lesions
A. NCV only
B. SD Curve only
C. RD Test only
D. EMG only
E. NCV, SD Curve, RD Test
F. All of these
G. None of these
F. All of these
Used as a primary intervention for muscle
weakness
A. NCV only
B. SD Curve only
C. RD Test only
D. EMG only
E. NCV, SD Curve, RD Test
F. All of these
G. None of these
G. None of these
Uses electrical stimulator to stimulate the
nerve
A. NCV only
B. SD Curve only
C. RD Test only
D. EMG only
E. NCV, SD Curve, RD Test
F. All of these
G. None of these
E. NCV, SD Curve, RD Test
Checks for orthodromic and antidromic
responses
A. NCV only
B. SD Curve only
C. RD Test only
D. EMG only
E. NCV, SD Curve, RD Test
F. All of these
G. None of these
A. NCV only
During EMG data management, ______ is a
process involving transformation of negative values to positive values
Signal rectification
Least amount of intensity to elicit muscle
contraction
Rheobase
TRUE OR FALSE: The median nerve has a faster NCV as compared to anterior
interosseous nerve
True
more proximal and larger in diameter
An SD curve that shifts to the ___ indicates that the nerve re-innervated already
Left & downward
What electrodiagnostic procedure records
evoked potentials from the clicks that were heard by the patient?
Brainstem Auditory Evoked Potential (BAEP)
A ballet dancer sustained grade 2 right adductor strain yesterday. Pt ℅ 7/19 pain and claims that the area is tender upon palpation. You decided to use conventional TENS. Which of the following is correct about CONVENTIONAL TENS?
I. Uses biphasic AC
II. Cathode is the active electrode
III. Pulse duration of 150 microseconds
IV. Patient in right sidelying during treatment
A. I and III
B. III and IV
C. I, II, III
D. All of the above
B. III and IV
- Biphasic pulsed current not alternating current
- In TENS, there is no such thing as active electrode because TENS uses the biphasic current technique and kasi both of them
are active na. Both active = Bipolar
Which of the following is/are considered as an absolute contraindicstion for TENS?
I. Over painful surgical wound S/P ORIF d/t humeral shaft fracture
II. Over painful area d/t bone cancer
III. Over L shoulder d/t adhesive capsulitis of a pregnant woman at 10th week
IV. Over L gastrocsoleus (+) L Homan’s test
A. II only
B. I and III
C. II and IV
D. I, II, III
E. All of the above
C. II and IV
I: Surgical wound that is s/p means there is no hemorrhage na
III: Adhesive caps of pregnant - caution, not absolute contraindication
IV: Homan’s test is a test for deep venous thrombosis
Mode of TENS that works only at the motor level of stimulation
Brief intense stimulation TENS
Which of the following would attract towards each other if used simultaneously?
a. Salicylate and magnesium
b. Acetate and iodine
c. Zinc and hyaluronidase
d. Lidocaine and copper
a. Salicylate and magnesium
Which condition would you use ES for wound healing with caution?
a. Infected wound
b. Bipedal edema d/t congenital heart failure
c. Immobilized leg that is warmth at touch, red at OI and painful when passive dorsiflexion
d. Lymphedema d/t cancer
a. Infected wound
B: absolute contraindication
C: sign of DVT; absolute
contraindication
D: absolute contraindication
TRUE OR FALSE: An active electrode may be placed directly over the infected wound
True
As long as the electrode and gel is sanitized, there is a sterile pad, and wound should not be tender.
Term used for the phenomenon
by which cells are attracted to electrical charge
Galvanotaxis / Electrotaxis / Galvanotaxic effect / Galvanotaxic phenomenon
TRUE OR FALSE: Modulation increases the analgesic effects of TENS.
False
Modulation is used to address accommodation, not the analgesic
effect of TENS
Which of the following produces short-term pain relief?
a. High-rate TENS
b. Interferential current
c. Electroacupuncture
d. Burst mode TENS
e. Both A and B
f. Both B and D
e. Both A and B
- High-rate & IFC: Gate control theory, short term
- Electroacupuncture & burst mode: Descending Pathway Inhibitory Tract (DPIT), long term
A patient presents with grade 2 pressure ulcer on sacral area. Signs of infection are present upon doing the wound assessment. One physiologic goal is to promote phagocytosis on the wounded
area. Which of the following
parameters/techniques should be used?
I. LIDC at 50% duty cycle
II. Red electrode
III. 150 Hz pulse frequency
IV. Technique: bipolar
A. I and III
B. II and IV
C. I, II, III
D. IV only
E. All of the above
C. I, II, III
- Phagocytosis - acute (main goal: wound
healing), so technique is monopolar for wound healing. - Low-Intensity Direct Current can produce stimulation even beyond sub-sensory level (can produce tingling sensations).
A patient presents with mild peripheral vascular disorder of the right leg and foot. Your goal is to improve the circulation in the area. Which of the following parameters should be used during
electrical stimulation?
I. Waveform: HVPC
II. 2 sec on time and 2 sec off time
III. Cathode over the target area
IV. Amplitude: visible muscle contraction
A. II and III
B. II, III, IV
C. I, II, III
D. IV only
E. All of the above
B. II, III, IV
- Waveform for wound healing: goal is to
improve circulation, target should be motor effect so Low-Intensity Direct Current (or Biphasic pulsed current) and not High Voltage Pulsed Current. - Angiogenesis and increase in circulation are at the proliferative phase hence we can use cathode
You decided to use Endomen M455 on your patient with diffused low back pain 8/10. The 2 circuits used were 4000 Hz and 4100 Hz. What was the value of the carrier frequency of the IFC treatment?
4000 Hz
You decided to use Endomen M455 on your patient with diffused low back pain 8/10. The 2 circuits used were 4000 Hz and 4100 Hz. What was the value of the
amplitude-modulation frequency?
100 Hz
beat frequency = 4100 - 4000
You decided to use Endomen M455 on your patient with diffused low back pain 8/10. The 2 circuits used were 4000 Hz and 4100 Hz. What was the total number of electrodes that were used for this treatment?
4 electrodes
Thus forming 2 circuits
Sensory-level stimulation may be used where ES is used as a biofeedback for motion.
A. NMES
B. FES
C. ES
D. Both A and B
E. All of these
F. None of these
D. Both A and B
We want progress na may volition and goal
is maging biofeedback kaya NMES or FES
Atrophied hip adductors due to obturator nerve injury
A. NMES
B. FES
C. ES
D. Both A and B
E. All of these
F. None of these
C. ES
Demand-type cardiac pacemaker is absolutely contraindicated
A. NMES
B. FES
C. ES
D. Both A and B
E. All of these
F. None of these
E. All of these
Applied over biceps brachii and triceps brachii during cycling
A. NMES
B. FES
C. ES
D. Both A and B
E. All of these
F. None of these
B. FES
Functional ang cycling kaya FES
