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Quizzes Flashcards

1
Q

All physicians follow the same protocol for postoperative conditions?

A

False

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2
Q

Motivation may affect the person’s adherence for wearing an orthosis, and thus determining the person’s motivational level is an important task for the therapist?

A

True

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3
Q

The resting hand posture is 10 to 20 degrees of wrist extension, 10 degrees of ulnar deviation, 15 to 20 degrees of metacarpophalangeal (MCP) flexion, and partial flexion and and of the thumb.

A

True

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4
Q

Proximal musculature never affect distal musculature

A

False

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5
Q

Therapists should encourage persons to carry their affected extremities in guarded or protective positions to ensure that no further harm is done to the injury?

A

False

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6
Q

A general guideline for evaluating orthotic fit is to have the person wear the orthosis for 20 min and then remove the prothesis. If no reddened areas are present after 20 min of orthosis removal, no adjustments are necessary.

A

True

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7
Q

All orthoses require 24 hrs of wearing to be most effective

A

False

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8
Q

Every person should receive an orthotic wearing schedule in written and verbal forms

A

True

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9
Q

For infection control purposes, persons and therapists should use extremely hot water to clean orthoses

A

False

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10
Q

Strength of a healing tendon is stronger when the tendon is immobilized rather than mobilized

A

False

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11
Q

A red wound is a healthy wound

A

True

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12
Q

A score of 10 on a verbal analog scale (VeAS) indicates that pain does not need to be addressed in the intervention plan

A

False

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13
Q

Strapping, padding, and thermoplastic materials may cause a skin allergic reaction in some persons

A

True

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14
Q

Assessments of function include the Nine Hole Peg Test and the Semmes-Weinstein Monofilament Test

A

False

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15
Q
  1. Ultrasound waves have similar characteristics to Electrical Waves. However, ultrasound waves are measure as_____________. *
    5 points

Transverse Waves
Longitudinal Waves

A

Longitudinal Waves

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16
Q

Body tissues change as the ultrasound waves pass through them. Body tissue can become compressed or spread apart. What is the name of the wave region/ tissue area that is spread apart? *

Reflection
Refraction
Retraction
Rarefaction

A

Rarefaction

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17
Q

Ultrasound travels through the body tissues at different speeds. Acoustic Impedance is defined as the amount of resistance encountered as an ultrasound beam passes through tissue. The denser the tissue the more resistance. Pick the tissue with the highest acoustic impedance. Bracciano 129-130. *

Subcutaneous Fat
Rotator Cuff Tendon
Muscles of the forearm
Peripheral Nerves
Lateral Epicondyle
A

Lateral Epicondyle

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18
Q

Attenuation is the reduction of the amplitude of the ultrasound beam as it travels. As the sound wave travels through the body it actually loses energy. What frequency allows the sound wave to travel deeper into the tissue? (Red and Orange Ball) *

High frequency
Low frequency
It doesn’t matter

A

Low frequency

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19
Q

Ultrasound waves can be transmitted (travels through), absorbed (heats up the tissue), reflected back towards the transducer (incident and off angle reflection), and refracted (scatter). Bracciano pg. 129-130. What is the interface that almost all sound waves are reflected back towards the transducer? *

Skin: muscle
Fat: bone
Muscle: tendon
Skin: nerve
Nerve: joint capsule
Joint capsule: ligament
A

Fat: bone

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20
Q

When the reflected wave reverses course and returns toward the transducer on the same path it took into the tissue (blue ball in the video); it may interact with the sound waves that are traveling away from the sound head down into to the tissue causing the energy to SUMMATE creating an area of INTENSE ENERGY in the tissue. When this summation effect occurs, it is known as a standing wave. A shear wave can adversely affect the outer covering of the bone. How do therapists avoid a standing or shear wave that can occur at the bone? *

Tip the ultrasound head to an angle to cause “off angle reflection”

Keep moving the ultrasound head to avoid a summation effect of the original wave and the reflected wave.

Never ultrasound over bone

Keep the treatment duration to under 5 minutes

A

Keep moving the ultrasound head to avoid a summation effect of the original wave

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21
Q

Intensity for TENS and NMES is measured in milliamps and turned up by the patient. Intensity for Ultrasound is measured in Watts/ CM2. The therapist determines the intensity level for the patient based on a desired therapeautic effect. As a general rule, the higher the intensity (amplitude of the wave) the more heating that will occur in the tissue. *

True
False

A

True

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22
Q

List the 10 variables that may affect the Dosage of Ultrasound Delivered to the Target Tissue.

A

ultrasound frequency; wavelength;
intensity;
effective radiating area of the transducer;
BNR; continuous or pulsed administration;
coupling medium used; composition and structure of the targeted tissue; movement and angle of the transducer;
frequency and duration of the application

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23
Q

Ultrasound Duty Cycles can be compared to Electrical Therapy Duty Cycles. Both are used to describe the “on” “off” time of the wave. Pick the duty cycle that would provide the LEAST amount of acoustical energy/ heating of the tissues? *

Continuous 100% duty cycle
Pulsed 50% duty cycle
Pulsed 25% duty cycle
Continuous 80% duty cycle

A

Pulsed 25% duty cycle

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24
Q

Your patient has a diagnosed rotator cuff tendonitis. She is 3 months pregnant. Can you perform ultrasound on her shoulder? *

Yes
No
Only positioned in upright sitting

A

Yes

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25
Q

Your patient has a distal radius fracture with an open reduction internal fixation. Can you perform ultrasound on the area to improve stretching / ROM? *

Yes
No

A

No

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26
Q

Your patient a 10 year old boy that recently fractured his proximal humerus mountain bike riding and is referred for increasing ROM at the glenohumeral joint. Can you perform ultrasound on his arm/ shoulder? *

Yes
No

A

No

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27
Q

What is the frequency band for therapeutic ultrasound? Bracciano pg. 126 *

500,000 Hz- 100,000 Hz
20 Hz- 200,000 Hz
1,000,000 Hz to 6,000, 000 Hz
800,000 Hz to 3,000,000 Hz

A

800,000 Hz to 3,000,000 Hz

28
Q

Ultrasound has a physiological effect on body tissues. Pick the correct statement regarding ultrasound. *

Ultrasound only heats up the tissues with a Thermal Effect

Ultrasound can be programmed to heat the tissues “thermal effect” and not heat tissues “mechanical effect”

Ultrasound only provides a nonthermal mechanical effect on the tissues with acoustical streaming

Ultrasound combined with phonophoresis will create a physiological effect based on the medicine pushed through the tissue.

A

Ultrasound can be programmed to heat the tissues “thermal effect” and not heat tissues “mechanical effect”

29
Q

List the 6 Clinical Effects of Thermal Ultrasound

A

increase blood flow, reduction in muscle spasm, decrease chronic inflammation,
decrease joint stiffness, decrease pain

30
Q

Ultrasound is commonly used as an adjunct treatment to stretching out tissue. What is the therapeutic window (window of opportunity to stretch) after the application of Ultrasound? *

The treated tissue stays heated for approximately 8-10 minutes.

The treated tissue stays heated for approximately 15- 20 minutes.

The treated tissue stays heated for approximately 20- 30 minutes.

The therapeutic window doesn’t matter; you can stretch the tissue any time after ultrasound application.

A

The treated tissue stays heated for approximately 8-10 minutes.

31
Q

Methods of Heat Exchange What is the correct statement regarding “Conduction” as a heat exchange method? *

Conduction is the conveyance of heat by the movement of heated particles over a body part (example is whirlpool and fluidotherapy)

Conduction is the transfer of heat from radiant energy in the air (example is Heat Lamp- fast food kitchen)

Conduction is direct contact of one surface with another surface and the resulting transfer of heat. (example hot packs)

Conduction is the use of sunlight to heat up areas of the body by radiation and exposure.

A

Conduction is direct contact of one surface with another surface and the resulting transfer of heat. (example hot packs)

32
Q

What is the correct statement regarding “ Convection” as a heat exchange method? *

Convection is the conveyance of heat by the movement of heated particles over a body part (example is whirlpool and fluidotherapy)

Convection is the transfer of heat from radiant energy in the air (example is Heat Lamp- fast food kitchen)

Convection is direct contact of one surface with another surface and the resulting transfer of heat. (example hot packs)

Convection is the use of sunlight to heat up areas of the body by radiation and exposure

A

Convection is the conveyance of heat by the movement of heated particles over a body part (example is whirlpool and fluidotherapy)

33
Q

What is a safer form of heat transfer? (Meaning if you were concerned about burning a patient; which one would be less likely to cause a burn) *

Conduction
Convection
Radiation
Conversion

A

Convection

34
Q

Your patient has diabetes type 2 and peripheral neuropathy with decreased sensation in their feet and hands. Outpatient referral for status post flexor tendon repair (zone 2) fourteen days ago; increase passive range of motion. Can you use a hot pack with several layers of towels (6) to the area before passive ROM? *

Yes
No
It depends on the healing phase of the tendon
As long the patient is ok with heat

A

No

35
Q

Your patient is a 75 year old female with osteoarthritis in her hands; otherwise she is healthy. Pick the correct statement regarding your patients advanced age needs and heat modalities. *

Heat will exacerbate the inflammatory response and increase bleeding if she take blood thinners

Vigorous doses of heat may facilitate proteins that exacerbate joint inflammation with Rheumatoid Arthritis

Check to ensure your patient can communicate the sensations of heat, cold, and pain in some meaningful way before applying heat or cold. Does she have dementia?

Even if the patient has intact sensation and is reliable, they may have little subcutaneous fat / fragile skin.

A

Even if the patient has intact sensation and is reliable, they may have little subcutaneous fat / fragile skin.

36
Q

What is an absolute prerequisite before applying Superficial Heat or Cold to this hand? *

Ask if the patient has had prior frost bite in the area.

Check for sensation of the scar, both soft touch and temperature

Check to see if the patient prefers heat or cold

Ask if the patient had a poor response to previous applications of heat or cold

A

Check for sensation of the scar, both soft touch and temperature

37
Q

Correct terminology for “PAMs” in the OTP509 course

A person’s name from your high school

Physical Adjunctive Modalities
Physical Assistance Modalities

Physical Agent Modalities

Physical Assistance Machines

A

Physical Agent Modalities

38
Q

Complete this statement: there are 4 general categories of physical agents; they include ________________. *

Iontophorses, diathermy, TENs, NMES

Superficial thermal agents, Deep thermal agents,
Electrotherapeutic agents, Mechanical Devices

Ice Packs, Ultrasound, E-Stim, Hot packs

Traction, E-stim, Ultrasound, Phonphoresis

A

Superficial thermal agents, Deep thermal agents, Electrotherapeutic agents, Mechanical Devices

39
Q

Pick the modality that is NOT an Electrotherapeutic Agent. *

Neuromuscular Electrical Stimulation (NMES)

Transcutaneous Electrical Nerve Stimulation (TENS)

High-Voltage Galvanic Stimulation (HVGS)

UltraSound (US)

A

UltraSound (US)

40
Q

The exclusive use of PAMs as a therapeutic intervention without direct application to occupational performance is not considered occupational therapy. This statement is ______ *

true; PAMs are always integrated into a broader occupational therapy program.

false; PAMs occasionally are not integrated into therapeutic use of occupations or purposeful activities

true; because it depends on the clinic. Outpatient therapy has a different set of standards for use of PAMs.

false; it depends on insurance reimbursements. Only medicare requires an integrated approach to decrease costs.

A

true; PAMs are always integrated into a broader occupational therapy program.

41
Q

Which of the following statements is NOT true regarding occupational therapy education and PAMs. *

Documented professional education regarding the use of PAMs can ONLY occur within the OT academic curriculum.

Integration of PAMs in OT practice must include foundational knowledge in biological and physical sciences

Modality- specific (Example- TENs) includes the biophysical, neurological, and electrophysiological changes as a result for the application.

Education must include indications, contraindications, and precautions for each modality

A

Documented professional education regarding the use of PAMs can ONLY occur within the OT academic curriculum.

42
Q

The AOTA position paper states: “The occupational therapist makes decisions and assumes responsibility for use of PAMs as part of the intervention plan. The occupational therapy assistant delivers occupational therapy services under the supervision of the occupational therapist. Services delivered by the occupational therapy assistant are selected and delegated by the occupational therapist” Therefore, occupational therapists assume responsibility for the application and use of PAMs when delegating delivery of the modality to an occupational therapy assistant. *

True

False

Only an occupational therapist can perform advanced therapeutic modalities (ultrasound, diathermy, HVGS).

There are no state guidelines related to OT’s responsibility and supervision of COTAs.

A

True

43
Q

Complete this statement to make it true. Regulatory agencies that govern the oversight of PAMs education include_____________. *

Who cares, ignorance is an excuse for breaking the law. You can just report not knowing what your state license guidelines are.

once you pass the NBCOT exam you are considered competent to perform all PAMs regardless of the state you practice in.

local, state, and national level; examples include AOTA standards and state licensing boards

A

local, state, and national level; examples include AOTA standards and state licensing boards

44
Q

Pick the true statement about Direct Current (DC)

Direct Current (aka Galvanic Current) always travels in one direction from the negative to positive pole (electrode).

Direct Current (aka Galvanic Current) can travel from both a negative and a positive poles (electrodes) based on the desired result

Iontophoresis is NOT a type of direct current.

Direct current is a safe type of electrical stimulation and will NOT result in a build up of ions under the positive or negative pole, therefore cannot cause an electrical burn.

A

Direct Current (aka Galvanic Current) can travel from both a negative and a positive poles (electrodes) based on the desired result

45
Q

Pick the true statement about Alternating Current.

Alternating Current is NOT a safe type of electrical stimulation because of the excessive build up of ions under the electrical pad (electrical burn)

Alternating Current must be used to stimulate denervated muscle (muscle that has lost the peripheral nerve connection)

An Anode (positively charged pole) and a Cathode (negatively charged pole) site must be determined for Alternating Current.

Alternating Current is any type of current that is characterized by a continuous change in the direction of the electrical flow; meaning the polarity of the electrodes change from positive to negative

A

Alternating Current is any type of current that is characterized by a continuous change in the direction of the electrical flow; meaning the polarity of the electrodes change from positive to negative

46
Q

Interferential Current uses Alternating Current and 2 different frequencies- therefore you need 4 electrodes (2 electrodes per current). The electrical currents are set to cross paths–interfere with each other. Pick the true statement about Interferential Current.

The interference between the two frequencies does nothing to change the electrical current

Interferential and Russian Stimulation terms are interchangeable.

It’s OK to place the 4 electrodes for interferential across the chest, the two frequencies would NOT affect the heart’s electrical physiology

When the two current cross paths and interfere with each other; the resulting wave form is the desired for the clinical need.

A

When the two current cross paths and interfere with each other; the resulting wave form is the desired for the clinical need.

47
Q

Amplitude (aka Pulse Intensity) is the maximum amount of current delivered in a single phase (picture of sine wave above). Amplitude is measured in milliamps/ mA; also known as microamps or millivolts. The patient turns up the intensity knob…not the therapist. Pick the true statement about Amplitude.

Number 1 is the peak to peak amplitude

Number 2 is the peak to peak amplitude

Number 3 represents the frequency

Number 4 represents the amplitude

A

Number 2 is the peak to peak amplitude

48
Q

Frequency also also known as Hertz/ Hz, Rate, or Pulses Per Second. Pick the true statement based on the picture above.

The picture above has a 3 Hz
The picture above has a 10 Hz
The picture above has a 30 Hz
You cannot tell the Hz from the picture above

A

The picture above has a 3 Hz

49
Q

ick the true statement about Phase or Pulse Duration/ Pulse Width

Pulse Duration is only measured in Direct Current

Both a longer and shorter Pulse Duration has NO affect the type of tissue being stimulated

Phase Duration is a significant measurement in the amount of electricity being transmitted to the body.

Phase Duration is measured in Milliamps similar to Amplitude

A

Phase Duration is a significant measurement in the amount of electricity being transmitted to the body.

50
Q

Pick the true statement about Duty Cycle/ On-Off times

A longer time “ON” is indicated for Weak and De-conditioned muscles. Example 25 seconds on 5 seconds off

A longer time “OFF” is indicated for Weak and De-conditioned muscles. Example 5 seconds on 20 seconds off

Only Direct Current can have an on/off time. (example iontophoresis)

Only Alternating Current can have an on/off time. (example neuromuscular stimulation)

A

A longer time “OFF” is indicated for Weak and De-conditioned muscles. Example 5 seconds on 20 seconds off

51
Q

Body tissues including Bone and Fat are poor Conductors of Electricity (high impedance). Surface electrodes applied close to areas of bone and fat do not travel as deep because of the high impedance. *

True
False

A

True

52
Q

High water content will decrease the amount of impedance and increased conductivity. Tissues that have high water content are muscle and nerve. *

True
False

A

True

53
Q

Applying a hot pack in the same (body) area as the electrical stimulation (electrodes) will increase the blood flow in the area and decrease the impedance of electricity to the tissues. *

True
False

A

True

54
Q

Skin has the greatest resistive element to the flow of electrical current since it contains very little water, specifically a callous. *

True
False

A

True

55
Q

Your patient has a rash from poison ivy in the same area that an you would like to place an electrode for a TENS unit (pain relief). Is it safe to put the electrodes over the rash while performing functional motions

It’s fine to put the electrodes over the rash as long as the circulation is not altered in the area.

It’s fine to put electrodes over the rash because poison ivy is not considered an open wound.

As long as the patient turns up the intensity knob on the unit, they should be in charge of how much electricity is delivered.

Breaks in skin integrity are contraindicated because electricity follows the least restrictive path.

A

Breaks in skin integrity are contraindicated because electricity follows the least restrictive path.

56
Q

Your patient had surgery with a Metal Implant (screws for fixation of a fracture) in the area you want to place electrodes for a TENS unit. Can you apply electrodes to that area? *

Yes it’s fine because passive metal implants like surgical staples, pins, screws, and joint replacements are not a contraindication for Alternating current E-stim

No it’s not fine because passive metal can heat up with electricity.

A

Yes it’s fine because passive metal implants like surgical staples, pins, screws, and joint replacements are not a contraindication for Alternating current E-stim

57
Q

The forearm trough should be two-thirds the circumference of the forearm
True
False

A

False

58
Q

Short, narrow orthoses apply less pressure to the skin’s surface than long, wide orthoses and are therefore better?

A

False

59
Q

An orthosis should be approximately two-thirds the length of the forearm?
True
False

A

True

60
Q

Avoidance of pressure over a bony prominence is preferable to unequal pressure.
True
False

A

True

61
Q

A person uses a spherical grasp when holding a soda can.
True
False

A

False

62
Q

An orthotic design must accommodate padding thickness
True
False

A

True

63
Q

In joints with flexion contractures, the skin on the dorm of the joint shortens and exerts tension.
True
False

A

False

64
Q

In the orthotic provision for persons with infection, caution is taken to avoid mechanical stress from motion such as mobilization orthoses
True
False

A

True

65
Q

Contour of an orthosis increases its strength
True
False

A

True

66
Q

Shear force results from forces pressing inwardly on an object
True
False

A

False

Modalities (2 decks)

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