Review for Exam 1 Flashcards
ice increases viscosity true or false
true
prolonged ice increases spasticity true or false?
false
Why would you use thermo therapy?
increase extensibility, cause vasodilatation, increase metabolic rate, increases the pain threshold.
Would you do a manual muscle test after a hotpack?
no strength would be questionable
Ultra sound reflects off of bones true or false?
true, that means it will heat the periosteum
When deciding what modality to use, what three factors come into play?
pt. preference, quality research, and clinician experience.
What is the temp of hydrocollator
158-167
What is the temperature of paraffin
113-122
What is the temp for fluidotherapy
100-118
when setting up a contrast bath for someone who is hypersensitive what parameters would you use?
64-100 the more narrow numbers
How does ultrasound work?
the pieso electric effect
what are the parameters for ultrasound tissue healing?
duty cycle 20%
it will increase cell permeability
1 mgtz goes how deep?
5cm
Does metal get rapidly heated by ultrasound?
no
How should you respond to adverse effects during phonophoresis treatment?
stop treatment wash it off check the vital signs get the supervising PT Documenting adverse effect
What type of diathermy is used in the united states?
short wave diathermy
Capacitive plates reflect off what tissue?
fat tissue
Are metal implants a precaution for diathermy?
yes
What are the indications for thermotherapy?
- Pain Control
- Via gait control pain theory
- Indirectly by dec muscle spasm, rec ischemia
Inc ROM
- Due to soft tissue extensibility
- Inc extensibility & viscoelasticity of periarticular structure
Accelerate healing
*Via inc circulation, enzymatic activity & availability of oxygen to
What are the contraindications for thermotherapy?
Recent or potential hemorrhage
Thrombophlebitis
Impaired sensation
Impaired mentation
Malignant tumor
IR irradiation of eyes
What are the precautions for thermotherapy?
Acute (First 72 Hours) injury/inflammation
Edema - (may do contrast bath for chronic)
Pregnancy
Impaired circulation
Poor thermoregulation
Cardiac insufficiency
Metal in area
Over open wound
Over area where topical counterirritant applied
Demyelinated nerves
Thermotherapy Physiological Effects are:
Vasodilation Neuromuscular Effects Inc Pain Threshold Dec Muscle Strength Inc Metabolic Rate Effects Altered Tissue Extensibility
Cryotherapy Physiological Effects are:
Vasoconstriction Inc blood Viscosity Delayed - Inc blood flow Dec Nerve Conduction velocity Inc Pain Threshold Altered Muscle Strength Dec Spasticity Facilitate muscle contraction Decrease Metabolic Rate Effects
What are the application parameters for cold pack?
10-20min for pain, inflammation, edema
30 min for spasticity
23F
Gel ice stays cold longer
What are the application parameters for ice massage?
5-10min
23 degrees F
What are the parameters for Controlled Cold Compression?
Temp of water 50-59F
Cold consistent throughout
Various types of units - gain ready unit
What is Vapocoolant Spray used for?
Used to relieve pain from trigger points
Facilitate stretching
What are indications for cryotherapy?
Control inflammation Reduce pain (acute) Reduce edema Reduce spasticity (slows nerve conduction) Control symptoms of MS Facilitate movement (quick ice)
What are contraindications for cryotherapy?
Cold Hypersensitivity (vascular skin rxn)
Cold Intolerance (Severe pain, numbness, color changes)
Cryoglobulinemia (Disorder results in impaired circulation w. Exposure to cold)
Paroxysmal cold hemoglobinuria(RBC in urine in response to cold)
Raynaud’s phenomenon (Significant blanching)
Over Regenerating peripheral nerves
Over area w. Compromised circulation
What are the precautions for cryotherapy?
Over superficial main branch of nerve (elbow, face, hand)
Ex. Median Nerve
Over open wound.
Contamination issue and possible disrupt new tissue growth
Hypertension
Esp. for large sections of the body
Poor sensation or mentation
Poor sensation - be very mindful (vascularly compromised?)
Distress vs Benefit
Very young or very old
Cant regulate temperature very well
What are ultrasound indications?
Phonophoresis
- Enhance transdermal topical meds
- anti-inflam. Meds
- ex. Hydrocortisone, dexamethasone, salicylates,lidocaine
Inc soft tissue extensibility
Pain control via gait control, modification of underlying condition
Accelerate healing
*Surgical incisions
Tendon Injuries
- Promotes healing
- Dec inflammation
Ligament Injuries
*Accelerate healing
Bone fx
*Due to piezoelectric effect of bone on low dose US
What are contraindications to ultrasound?
Malignant Tumor
Pregnancy (abdomen, low back, & pelvis)
CNS tissue
Joint cement
Plastic components
Pacemaker
Thrombophlebitis
Eyes
Reproductive Organs
What are precautions for ultrasound?
Acute Inflammation
*Cld cause inc bleeding, pain, swelling
Epiphyseal Plates
*Xrays would need to determine if growth complete
FX
*High level US over fx is painful, may impair healing
Breast Implants
*Could rupture implant
What are some adverse reactions to look for during ultrasound treatment?
Usually occur when US is contraindicated or not applied correctly
Burns - high intensity US or stationary application
Cross contamination/infection - 27% contaminated w.
Pain to periosteum
What are they thermal effects of diathermy?
Vasodilation Inc. nerve conductivity Elevation of pain threshold Alt. muscle strength Alt. enzymatic activity Inc. soft tissue extensibility
What are the non thermal effects of diathermy?
Tissue Healing
Inc healing process via inc microvascular perfusion
Inc local circulation, inc tissue oxygenation, inc nutrient availability & phagocytosis
Alter cell membrane function (similar to US non-thermal)
Bone Healing
What are indications for non-thermal diathermy?
Non-thermal Control pain & edema Soft tissue healing Nerve healing Bone healing OA symptoms
What are contraindications to diathermy?
- Implantable devices - ie pacemakers
- Pregnancy
Thermal Diathermy Metal implants (different than US) Growing Epiphyses Malignancy Eyes Testes
What are the precautions for diathermy?
Obesity Copper IUD Skeletal immaturity For PT/PTA Therapist should be 1-2m away from cont. Diathermy application 30-50cm away from PSWD
What are some adverse effects to look out for when performing diathermy?
Fat tissue likely burned with capacitive plates
Pt’s skin must be kept dry, wrap with towel to avoid burns
What is the method for heat transfer for hydrotherapy?
convection
What temperature in necessary for cold induced vasodilation?
tissue temp of 50 degrees.
What is the hunting response?
alternating vasoconstriction and dilation after 15min of prolonged ice.
What type of fibers are most effected by cold temperature?
A- delta fibers because they are myelinated and small in diameter.
