Pt boards Flashcards
which is the only heat modality okay to use for an acute injury?
PULSED ultrasound
What is considered Acute injury
up to 72 hours
when is an injury considered subacute
when swelling is limited but debris and discoloration prevents healing
What is considered an chronic injury
What are contraindications to ALL modalities
- Hemorrhage
- Infection
- Malignancy (except TENS)
HIM
what is the only modality that can be used with a malignancy
TENS
what are some contraindications to ALL heating modalities
- Diabetes Mellitus
- Encapsulated swelling
- Active TB
- Decrease thermal sensations
- Edema
- Abdomen or low back during pregnancy
- Acute conditions
what are some contraindications to ALL electrical
- Brain
- Eyes
- Heart
- Carotid Sinuses
- Pacemaker
- Anestheis (expect High Voltage)
- Pregnancy - low back ( except TENS
- Open wounds
pretty much anything that has a synapse or a rhythm
What is the gold standard treatment for acute conditions
PRICES protect Rest Ice Compression Elevate Support
When treating a muscle issue, what type of frequency modality would one use?
High (heating) Heat = muscle
when treating deep tissue which frequency modality would one use
Medium
Medium is used for Depth
which frequency is used for muscle contraction type of therapy
Low frequency = contraction
which modality is used for cellular healing
Ultra low
how many hertz is used for ultra low frequency
<1
how many hertz are used for Low Frequency
1-150
how many hertz are used for medium frequency
1,000-10,000
how many hertz are used for high frequency
1 Million
Which modalities are used for superficial heat
infrared
Ultra violet
which modalities are used for Deep heat
Diathermy
Ultrasound
what type of current is AC
Biphasic
what typeof current is DC
Monophonic
which types are AC current
Sine
Faraday
Inferential
which types are DC current
Galvanic
High Volt
Which pulsatile wave forms is symmetrical and is known to be the best contractor
SINE
which Palasatile wave forms is considered to be asymmetrical
Faraday
Which Pulsatile wave forms is a combination of two sine waves
inferential
which pulsatile wave forms is a make and break pattern
Galvanic
which Pulsatile wave form is a twin pulsed peak pattern
High Volt
In regards to electrical current modalities, the higher the frequency , the ____ penetration
deeper
in regards to electrical current modalities, medium frequency leads to ________
decreased skin impedance
in regards to ultrasound , the _____ the frequency , the ____ the penetration
lower
deeper
( opposite from electrical therapy)
to isolate a muscle ____ pad is needed
only 1
when a muscle is weak ____ pads are need
2 pads on either side of muscle belly
what is the pad rule
1 Ma per square inch of pad size ( 3 square inch pad= 9mA)
what are the 3 different types of treatment procedures with pads
- Monopolar
- Bipolar
- Quadripolar
with monopolar, there is a ___ pad that is large and ___ pad that is mall
Dispersal
Active
Bipolar treatment pads are used for ___ muscle groups and are ___ size
small
equal
______ treatment pads are crisscross pattern and are used for Russian Stim or interferential
Quadripolar
when using the monopolar pads and if the patient feels a tingling sensation on the dispersal pad … what do you think the problem is ?
either the dispersal pad is too small or the active pad sites are too large
when using electrical stem for the muscles what is duty cycle and why is it important
its the ratio between the amount of stimulation and rest period …. depending on what you are trying to treat, the duty cycle will change
when using Electrical muscle stimulation … what type of pattern is used when pain is the factor?
Continuous pattern is used for pain
when a muscle is weak due to injury or post surgery, what type of muscle stimulation pattern would you use and what would the duty cycle be
- use a surge pattern
- duty cycle 1:3 ( need more rest for a weaker muscle)
when a muscle is in spasm like torticollis , what type of electrical muscle stimulation pattern would you use and what would the duty cycle be?
- Pulsed/tetanizing pattern
- 1:1 duty cycle ( the goal is to fatigue the muscle to get the spasm to relax)
In regards to electrical stimulation therapy, is mA is increase (amps) _____ would increase
muscle contraction
what do you have to consider and be careful when using electrical stimulation
- don’t burn the patient
amps= burns people
Name the 4 type of electrical studies
- Strength duration curve
- Reaction of degeneration
- EMG
- NCV
out of the 4 type of electrical studies what are 2 that you may use in practice?
EMG= used to test muscle NCV= used to test the nerves
Name this law
energy of modality has to be absorbed by the body to stimulate physiological response
Arndt- Shcultz Principle
Name this law
inverse relationship between penetration and absorption of energy (ultrasound)
Law of Grothus- Draper
In regards to icing an injured area, why is so important not leave in on greater than 20 minutes
This leads into a pumping rx (AKA Hunting-Lewis reaction) …. this will cause the body to vasodilate and to vasoconstrict
what does the acronym CBAN stand for when icing
cold burn ache numb this relates to the stages of icing... first 5 min is cold then next 5 is burn ... then another 5 is ache and the last 5 is numb
True or false
convection is the transfer of heat through a substance often heating up a solid ..modalities include : Hydrocollater, paraffin bath, ice and infrared
FALSE
this is called conduction
_______ is the transmission of heat and liquids by circulation of heat particles
Convection
what are some modalities used with convection
hot or cold baths, infrared
Transmission of heat without intervening medium getting warm is know as ______
Radiation
what are some radiation modalities
LAMPS: UV, Infrared, Medium wave Diathermy
_____ of electrical energy into heat or mechanical energy
Conversion
what is the only modality that uses conversion
Ultrasound
True or False
the ideal temperature for using heat baths such as hot tubs is from 105-115
FALSE
will burn the patient
ideal temp is from 96-104
Cold therapy will increase of decrease the viscosity of connective tissue
increase
ice therapy will increase or decrease metabolism
decrease
True or false
ice therapy will decrease a muscle spasm such as torticollis
false
heat will have that affect
ice will decrease trigger points
what are some results with infrared therapy
vasodilation perspire decreased BP increased blood and lymph flow decreased spasm phagocytosis Erythema - redness / mottled skin
what could be a bad result from infrared therapy
Erythema Ab igne - mottled skin in area habitually exposed or one prolonged exposure
what are the indications for infrared therapy
- Musculoskeletal - any type of it is
Catarrhal - bronchitis, sinusitis, laryngitis
Infectious- furnace, burns , ulcers
other- folliculitis, conjunctivitis, neuritis , Bell’s Palsy , Ranaud’s
what are some contraindications to infrared therapy
to heat: pregnancy diabetes mellitus thermal sensitivity active TB encapsulated swelling over metal fair skin contacts fever recent scar skin rash
what is the difference between short wave and long wave infrared therapy
short wave= lamps
long wave= baths or hyrocollator heat pads
what are some indications for a hydrocollator
tension headaches
prior to adjustments
- fibromyalgia
spasm
what are some contraindications to a hydrocollator
acute conditions recent scars fair skin myofascial syndrome trigger points decrease circulation
What is the time limit for a Sitz bath
2- 10 minutes
what are some indications for a Sitz bath
hemorrhoids cystitis dysmenorrhea coccydynia prostatitis post - pardum distress constipation urinary retention sciatica
what are some contraindications for a Sitz bath
infertility on the balls
what type of infrared therapy would be ideal for someone who had the following conditions ; chronic arthritis amputee strains increase ROM dystonia open wounds
Dry whirlpool aka fluidotherapy
what is the paraffin: mineral oil ratio for paraffin bath
7:1
Paraffin uses ______
conduction
Cold laser therapy AKAs
low laser
soft laser
When using cold laser the patient and the doctor have to consider what safety precautions
- both need to wear glasses to cover eyes
what is cold laser therapy’s actions
photo modulation and intracellular stimulation of mitochondrial activity
what are the results from cold laser therapy
photostimulation = wound healing
photo inhibition = pain management
what are some indications with cold laser therapy
- open lesions decubitus ulcers lacerations burns acute and chronic pain bursitis tendinitis decrease ROM Tic Douloureux fibromyalgia trigger points
what are some contraindications for cold laser therapy
tattoos open growth plates over the eyes pregnant uterus photosensitivity medications epilepsy thick eschar testicles regions over infections, dry skin , malignancy , pace maker and thyroid
what is the usual wave length of cold laser therapy
630-1200mm
how long do you use cold laser for on a patient
3-5 minutes or until benefit is reached
cold laser -______
neon helium gases
photophoresis is what
chemical driven by the light into treatment area
is you hold the laser too long on an area , what are some irreversible affects that can happen
protein coagulation
thermolysis and evaporation
what is the actions for ultraviolet therapy
thermal and photochemical (radiant)
what are the results from ultraviolet therapy
- vasodilation
- bactericidal
- photo taxia
- Erythema
- increase vit D
- improves skin and muscle tone, elasticity , secretory functions
- stimulates metabolism
- ## increases reticulocytes
what some indications to use ultraviolet therapy
Skin Conditions- fungal, herpes zoster, dermatological conditions, burns, psoriasis, carbuncles wounds, decubitus ulcers
Bone Conditions- Rickets, osteomalacia
What are some contraindications with Ultraviolet
HIM - Hemorrhage - Vascular changes - tetracycline - supportive lesions SLE
what is usual dose for Ultraviolet therapy
- MED ( minimal erythemal dose)
what is the max timing for ultraviolet therapy
3 minutes at 18 inches
what are the 3 types of UV devices
- Hot Quartz
- Cold Quartz (Orficial)
- Wood’s Lamp
_______ lamp is used to diagnose fungal infections
Wood’s
what is the action for Diathermy therapy
thermal
what are the results from Diathermy therapy
Increases- temp, pulse, respiration, BMR, lymph flow, elimination, nutrition, vasodilation, glandular secretions, endocrine changes
Decreases- blood pressure, nerve pain, muscle cramps, muscle spasms
Diathermy units must be _____ feet from any other electrical modality
8-10
Diathermy treatments on individuals must be ___ feet from hearing aids, fridge work
4
Short wave Diathermy is a local heater
True or False
False
its a general heater
Micro wave Diathermy is a ___ heater
local
Short wave Diathermy will go through ___ first
fat
Microwave goes through muscle first
what are the indications for diathermy
- deep muscle
- thoracic cavity
- bronchitis
- joints
- PID
- prostatitis
- Sinitus
- algia neuritis
amneorhhea - Otitis media
what is the difference between pulsed and continuous diathermy
pulse is used when message is desired without heat
what are some bad effects if the ultrasound is used for too long
- cavitation
- sharing
- depth
1 mHz of ultrasound =
more depth and less heat
3mHz of ultrasound =
Less depth and more heat
Which Electrical muscle stimulation is low frequency and used for muscle contraction
- EMS
- High Volt
- Low Volt
- Sine
- Faradic
- Interferential
- TENS
What is the frequency for Cellular healing
Ultra low
Which modality is used for Cellular healing
MENS
What are some low volt modalities
galvanic
Direct current
iontophoresis
What is the action for low volt modalities
Electrochemical and Electrokinetic
What are the results from low volt therapy
depends not the polarity use :
for more acute stuff= Positive pole since it acts like ice
For more chronic= Negative Pole since it acts like Heat
Positive pole Low volt therapy results in what:
- vasoconstrict
- produces acid reaction on the skin
- Rpels alkaline
- Attracts oxygen
- Repels hydrogen
- Causes ischmeia
- Hardens tissue
- Pain relief
- Astringent
Negative Pole Low Volt results in what:
- Vasodilates
- Produces alkaline reaction in skin
- Repels acid
- Repels oxygen
- Attracts oxygen
- Hyperemia
- Softens tissue
- Relieves chronic pain
- increases digestion
Wave form for Low Volt therapy
- Direct current
Indications for low volt therapy
any “it is, disease or injuries
also can be electrodiagnostic
what are the contraindications for low volt therapy
- sensory impairment
- recent scar tissue
- open wound
- Pregnancy
- pacemaker
Where are the pads place for Low Volt therapy
DIRECTLY ON THE SKIN
what is the intensity for Low volt therapy when used for more electrochemical (sensory issues)
- 5-100 mA
what is the intensity for Low Volt therapy when used for more Electrokinetic ( motor issues)
-0-5 mA
the frequency for Low volt therapy is low which means _____
minimal (whimsy contractions)
with low Volt therapy , ____% solution mixture is used
2%
with High Volt therapy what type of wave form is used
Direct current and Twin peak pulsed
