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Practical Flashcards

1
Q

Order of Practical

A

Introduce
Explain procedure
Contraindications
Permission
Position/Draping
Set Up
Treatment
Check in w/ Pt
Check Skin
Clean Up

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2
Q

Containdications for Massage

A

-skin infections/open
-thrombosis/embolism or phlebitis, severe varicose veins
-new tendon transplant
-fracture/non union
-acute inflammation
-cellulitis
-synovitis
-absesses
-cancer
-fever

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3
Q

Rules of Massage

A

-table height (knuckles at table)
-build trust before touching
-draping
-position
-continuous muscle contact
-distal to procimal towards heart
-not over bones

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4
Q

Order of Massage

A

-skin rolling (no lotion)
-Light effleurage
-Deep effleurage
-Petrissage
-Friction (or other technique)
-petrissage
-Deep effleurage
-light effleurage

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5
Q

Skin Rolling

A

-evalutes skinn conectivity and underlying restrictions
-no lotion
-lifting skin

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6
Q

Light Effleurage

A

-warm up and cool down
-light, continuous pressure
-get used to contact

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7
Q

Deep Effleurage

A

-medium, continuous pressure distal (light) to heart (deeper)
-promotes relaxation
-decreases pain
-searching for spasms

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8
Q

Petrissage

A

-kneading, deeper
-grasp and lift muscle and skin toward heart
-push waste to increase lymphatic and venous return
-loosen tissue and increase elasticity

Effect:
-spreads fibers
-tension of connective tissue
-proprioceptive input
-reduce collagen cross-linking

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9
Q

Friction

A

-deep, circular or transverse mmts
-no skin mmt, move underlying tissues
-where a trigger point, adhesion or scar is felt
-realign collagen fibers

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10
Q

Transverse Friction

A

-intense perpendicular to tendon
-should be painful, explain
-used for chronic tendon inflammation

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11
Q

Trigger Point Massage

A

-related to acupressure
-find point until pain or jump sign
-press on point and maintain pressure (will increase pain then lessen)

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12
Q

Myofascial Release

A

-mid pressure and stretch
-move in direction of restriction
-superficial to deep
-relieves soft tissue from abnormal grip of tight fascia

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13
Q

Active Release Technique

A

-deep tissue to break down fibrotic adhesions that restrict movement and scar tissue
-apply pressure in direction of fibers while pt actively elongates muscle

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14
Q

ROM Contraindications

A

-disruptive to healing process (precautions)
-response or condition is life threatening

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15
Q

Russian Currents

A

-muscle strengthening*
-muscle re-education*
-increasing ROM
-Slow atrophy
-Edema control (via muscle)

-2,000-10,00z frequency
-burst mode
-fast oscillating AC current, burst

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16
Q

Interferential Currents

A

-IFC
-pain control*
-muscle stimulation
-2 bipolar configurations (relief where they cross)
-4000-4100Hz frequencies
-120usec pulse width

Sweep Mode: frequencies modulated to avoid accommodation

Scan Mode: amplitude can be modulated
-for poorly localized pain

Target Mode: move with finger

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17
Q

High-Volt Pulsed Current

A

-HVPC
-reducing edema
-muscle pump 1:1
-wound healing

-twin peaked monophasic
-unequal electrodes, small over treatment

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18
Q

Transcutaneous Electrical Nerve Stimulation: Conventional

A

-TENS
-acute pain relief; surgical, labor*
-gate control theory; A-Beta*
-asymmetric biphasic
-tingle with no contraction*

Settings:
-75-150msec Duration/Width
-80-125pps Frequency
-continuous*
- Starting: 100p/100f*
-30mins, til pain is gone*

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19
Q

Iontophoresis

A

-low volt, continuous direct current
-drive ions into body
-medicine
-less than 30min on big machines
-longer with home devices

Doses:
-40mA-min= 4.0 current x 10min
-40mA-min= 2.0 current x 20min

Meds:
-Acetate, -, calcium depositis
-Dexamethasone, -, tendonitis/bursitis
-Lidocaine, +, trigeminal neuralgia

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20
Q

Transcutaneous Electrical Nerve Stimulation: Low-Frequency/Acupuncture/Motor-Level

A

-TENS
-chronic pain relief*
-Descending Pain control theory: modulation; enkephalin*
-asymmetric biphasic
-tingle AND contraction*

Settings:
-100-600msec Duration/Width
-<20pps Frequency
-Duty cycle: 30-60s*
- Starting: 180p/18f*
-15-60min*
-over motor point

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21
Q

Transcutaneous Electrical Nerve Stimulation: Noxious- Level

A

-TENS
-hyperstimulation analgesia
-chronic pain relief*
-Endogenous opiate pain control theory*
-asymmetric biphasic
-high intensity to noxious level; muscle contraction acceptable*

Settings:
-100-1000msec Duration/Width
-1-5pps Frequency
-Duty cycle: 30-45s
- Starting: 250p/2f*
-15-60min*
-over trigger point, until pain is no longer percieved

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22
Q

Transcutaneous Electrical Nerve Stimulation: Brief Intense

A

-TENS
-fast pain relief during procedure*
-Descending: peripheral and central anagelsia theory*
-asymmetric biphasic
-muscle fasciculation to sustain contraction*

Settings:
-100-600msec Duration/Width
-100 pps Frequency
-Duty cycle: 30-45s
- Starting: 250p/100f*
-15min*
-around wound

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23
Q

Premodulated (Bipolar)

A

-2 currents switch within the device
-only 2 electrodes
-pain control
-muscle stimulation/reeducation
-slow atrophy

-2 bipolar configurations (relief where they cross)
-duty 10:10, ramp 1-2s, 10-20min
-200-400usec pulse width

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24
Q

E-Stim Contraindications

A

-pacemaker/defib
-internal stimulators
-chest or heart area
-carotid
-thrombosis/vascular or arterial disease
-confusion
-seizure
-infection
-open wounds (unless treatin)
-cancer
-pregnancy
-high level SCI

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25
Muscle Re-education
-Russian, NMES -following surgery -CNS inhibition of muscle -improve motor control -200-600 usec/ 35-55 pulse -15min -Duty 1:1
26
Muscle Pump Contractions
-HVPC, Russian, NMES -increase circulation -mimic normal contractions -200-600usec/ 35-55 pulse -comfortable muscle contraction -20-30min -duty 1:1 -elevatte the body part (can use AROM)
27
Edema Control
-HVPC -elevate extremity* -space electrodes far apart* -negative polarity distal to swelling* -driving forve to move plasma away -30min -best results immediately after injury -80-120Hz/ low frequency* -intensity as needed >60*
28
Muscle Strengthening
-Russian, NMES -200-600usec/ 50-85pps -gradual ramp -duty 1:5 -to muscle fatigue 60% MVIC -pt working with estim
29
Increasing ROM
-Russian, NMES -200-600usec/ 35-55pps -strong contraction -interrupted current with gradual ramp -antagonist muscles to joint contracture -90min -duty 1:1 -pt passive
30
Denervated Muscle
-lost peripheral nerve supply -if reinnervation doesnt occur in 2 years connective tive replaces contractile elements so recovery not possible -1st week <1ms duration -2 weeks >10ms duration -NMES
31
Slow Muscle Atrophy
-Russian, MNES, HVPC -200-600usec/ 50-86pps -15-20mins -duty 1:5 -to muscle fatigue -pt working with estim
32
IONTO Indications
-analgesia -bone spurs -ulcers -edema reduction -fungal infections -sweating -muscle spasms -tendonitis
33
IONTO Contraindications
-estim rules -impaired skin sensation -allergy -recent scar -broken skin -metal
34
Ultrasound Contraindications
-active bleeding -decreased sensation to temp -decrease circulation -DVT -infecion -malignancy -breast implants -carotid -epiphyseal plates in young -heart, eyes, genitalia -cement or plastic -pelvic and thrunk of pregnant -pacemaker -vascular insufficiency
35
ERA
-effective radiating area -energy output is greatest at center, small than transducer Treatment area= 2-3x ERA
36
Non-Thermal Ultrasound
Acute Injury, Edema, Healing Ultrasound -superficial and deep (3-1MHz) -non-thermal and pulsed -20% Duty Cycle -1 Intensity/ 8-10mins
37
Mid Thermal Ultrasound
Subacute Injury or Hematoma Ultrasound -increase 1deg C -continuous Superficial (3MHz) -0.5 in/ 3 mins Deep (1MHz) -1 in/ 5min
38
Moderate Thermal Ultrasound
-chronic injury, inflammation, pain, trigger points -increase 2 degree C -continuous Superficial (3MHz) -0.5 in/ 6min Deep (1MHz) -1 in/ 10min -1.5 in/ 6min -2 in/ 5min
39
Vigorous Thermal Ultrasound
-stretching collagen, joint contractures -increase 4 deg C -continuous Superficial (3MHz) -1 in/ 6min Deep (1MHz) -2 in/ 10 min
40
Ultrasound Frequency
0.75-3MHz -tissue depth 1Mhz= greater depth, 5cm 3MHz= superficial 1-3cm Higher frequency= faster heating= shorter treatment
41
D1 UE
-putting a seatbelt on Flexion: reaching for seatbelt -Shoulder: add, ER -Scap: UR, abd -Forearm: sup -Wrist: flex, rad dev -Fingers: flx, add Extension: buckling it -Shoulder: abd, IR -Scap: DR, add -Forearm: pronation -Wrist: ext, ulnar dev -Fingers: ext, abd
42
D2 UE
-Sword and waiter Flexion: waiter holding a tray -Shoulder: flx, abd, ER -Scap: elevat, UR, abd -Forearm: sup -Wrist: ext, rad dev -Fingers: ext, abd Extension: reaching for sword -Shoulder: ext, add, IR -Scap: depress, DR, add -Forearm: pronation -Wrist: flex, ular dev -Fingers: flx, add
43
D1 LE
-hacky sack and ballet Flexion: hackey sack -Hip: flx, ER, add -Knee: flx -Ankle: DF, inv -Toes: extension Extension: Ballet -Hip: ext, ITR, abd -Knee: ext -Ankle: PF, ev -Toes: flx
44
D2 LE
-dog peeing and curtsey Flexion: dog peeing -Hip: flx, IR, abd -Knee: flx -Ankle: DF, ev -Toes: extension Extension: curtsey -Hip: ext, ER, add -Knee: ext -Ankle: PF, inv -Toes: flx
45
Rhythmic Initiation
-PT guiding through ROM -for pts with difficulting initiating -improves controlled mmts -AROM, PROM, AAROM
46
Repeated Contractions
-jerking motions -PT stretches in jerks pt while going through the RROM -strengthens weak agonists -need AROM and RROM
47
Slow Reversal
-kind of reversal of antagonist -function changes in agonist to antagonist mmt -contant resistance applied through ROM -strong concentric of agonist followed by less strong eccentric of antagonist
48
Slow Reversal Hold
-kind of reversal of antagonist -function changes in agonist to antagonist mmt -contant resistance applied through ROM with isometric hold at end of range -better detection of joint/space tension
49
Alternating Isometrics
-most common -isometric hold of agonist then antagonist -alternatting resistance to opposite muscles -no ROM, inproves stabilization
50
Rhythmic Stabilization
-isometric hold of agonist AND antagonist (co-contraation) -simultaneous multidirectional resistance to opposite muscles -no ROM, inproves rotary stabilization
51
Stretching Time
10-30s hold
52
Stretch: Upper Traps
Postition: Supine Stabilize: Shoulder Movement: LSB, flexion away Home: -flex head and rotate away with one hand
53
Stretch: Levator
Postition: Supine Stabilize: Shoulder Movement: Flex, LSB, Rotate away Home: -flexion and rotation away with one hand -ipsi scap upward rotation and depression with other hannd
54
Stretch: SCM
Postition: Sitting up Stabilize: Clavicular head Movement: -Stand behind pt -Pt actively Ext, LSB away and Rotate toward
55
Stretch: Suboccipital
Postition: Supine Stabilize: C2 Movement: -lumbrical hold on C2 -Stabilize head @ shoulder -touch chin -slowly move back into stretch Home: -chin tuck with one hand -slight flx of head with other hand
56
Hold-Relax
-stretch msucle and maintain stretch -isometrically contract against stetch 1. Stretch muscle 2. Isometrically Contract same muscle (being stretched) 3. Hold and go into further stretch
57
Contract-Relax
-stretch muscle and maintain stretch -isotonically contract against stetch, moving 1. Stretch muscle 2. Isotonically Contract same muscle (being stretched) 3. Hold and go into further stretch
58
Hold-Relax w/ Agonist Contraction
1. Stretch muscle 2. Isometrically Contract same muscle (being stretched) 3. Hold and go into further stretch 4. Concentrically contract antagonist (move in opposite direction)
59
Stretch: Pec Major
Postition: Supine Stabilize: Anterior shoulder at pec insertion Movement: -abduct shoulder while adding pressure to pec insertion Home: use wall to apply pressure and then rotate away for more stretch
60
Stretch: Lats/Teres Major
Postition: Supine Stabilize: Lower ribs and iliac crest (lats), inf angle of scap (teres major) Movement: -abduct shoulder while adding pressure on lat/teres major insertion Home: -Bilateral: prayer hands with elbows on table and sink down -Unilateral: place arm up and adducted against wall, rotate torso in opp for more stretch -Cat stretch with LSB away, ipsi shoulder abducted
61
Stretch: Quadratus Lumborum
Postition: Side lying Stabilize: Ribs and iliac crest with forearms Movement: -Stand in front of pt -break the bread Home: -cat stretch with LSB away, ipsi shoulder abducted
62
Stretch: ITB
Postition: Sidelying Stabilize: Ribs Movement: -Stand behind pt -extend and adduct leg off of table Home: -extend and adduct leg off of table -use roller *also for QL*
63
Stretch: Hip Flexors
Postition: Supine or Prone (eliminates lordosis) Stabilize: Anterior hip or Posterior hip Movement: -Flex contra hip and relax foot on pt -extend ipsi leg off of table and stretch by pushing (or pull if prone) down on knee Home: -flex leg -Lunge and stretch *also for quads*
64
Stretch: Piriformis
Postition: Supine Stabilize: opp side flexed hip (still affect though) Movement: -Stand on opp side of pt -Push flexed knee toward pt Home: -Supine: hip flexed and cross legs over with pressure -Supine 2: hip flexed and foot held for stetch -Prone: hip flexed and knee flexed and use body weight to stretch
65
Stretch: Hamstrings
Postition: Supine Stabilize: N/A Movement: -Stand in front of pt -Flex hip with straight leg and push forward Home: chair, wall, own arm
66
Home Stretch: Scalene
-Cervical extension, rotation towards, and 1st rib depression
67
Home Stretch: Biceps
-extension of shoulder with elbow extension
68
Home Stretch: Triceps
- touch back with hand (simulate washing) -flx shoulder further
69
Home Stretch: Wrist Flexors
-stick arm out and extend elbow and wrist -put more extension force on fingers with other hand
70
Home Stretch: Wrist Extensors
-stick arm out and extend elbow and flex wrist -put more flexion force on fingers with other hand
71
Stretch: Thoracolumbar
Flexion: cat stretch Extension: Cow stretch
72
Stretch: Lumbar
Flexion: Supine, knees to chest Extension: Prone, on elbows and push onto hand
73
Home Stretch: Adductors
-ipsi side proped up while standing on contra leg -drop ipsi pelvic for more stretch or -crossing legs and stretch
74
Home Stretch: Gastroc/Soleus
-Long sit with towel behind foott -stand against a wall tto stick leg out to stretch
75
Stretching Contraindications
-hypermobile -hypomobility provides stability -bony block -non union fracture -inflammation -pain -tissue trauma
76
Balance PNF Techniques
*shoes on with gait belt* Stability: -rhythmic stabilization -alternating isometrics Enhance Dynamic Balance: -Isotonic contractions -Slow and quick reversals

TherEx (25 decks)

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