S1_L1: Introduction to Physical Agents Flashcards
_______ is the process of using information, experience, and judgments to decide which clinical interventions will most likely improve the problems identified in the examination
Clinical Decision-Making
Source: Michlovitz
TRUE OR FALSE: Therapeutic modalities are also known are physical agents.
True
TRUE OR FALSE: Physical agents are the mainstay treatment for rehabilitation. It consists of energy and materials applied to patients to assist in rehabilitation.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
D. Only the 2nd statement is true
NOTE: it is only used as an adjunct/additional treatment
The following statements are considered thermal agents, EXCEPT:
A. Hydrotherapy
B. Paraffin wax bath
C. Intermittent pneumatic compression
D. Ultrasound
E. None of the above
C. Intermittent pneumatic compression
Match the following modality to its corresponding category.
- Fluidotherapy
- Mechanical Traction
- Diathermy
- Vapocoolant spray
- LASER
A. Thermal Agents
B. Mechanical Agents
C. Electromagnetic Agents
D. A & B
E. B & C
- D
- B
- E
- A
- C
Determine the kind of physical modality.
Transfer of energy to a patient to increase or decrease tissue temperature
A. Thermal Agents
B. Mechanical Agents
C. Electromagnetic Agents
A. Thermal Agents
Determine the kind of physical modality.
Apply energy in the form of electromagnetic radiation or an electric current
A. Thermal Agents
B. Mechanical Agents
C. Electromagnetic Agents
C. Electromagnetic Agents
Determine the kind of physical modality.
Use of mechanical forces to increase or decrease pressure in the body
A. Thermal Agents
B. Mechanical Agents
C. Electromagnetic Agents
B. Mechanical Agents
This kind of thermal agent only influences outer layers of tissues of body or subcutaneous area. What is it called?
Superficial Heating Modalities
This kind of thermal agent influence layers such as deep dermis, muscles and joint layer. What is it called?
Deep Heating Modalities
TRUE OR FALSE: PWB is a deep heating modality.
False
Enumerate the methods of heat energy transfer.
- Conduction
- Convection
- Evaporation
- Conversion
Determine the method of heat energy transfer described.
Liquid is converted into vapor
A. Conduction
B. Convection
C. Evaporation
D. Conversion
C. Evaporation
Determine the method of heat energy transfer described.
From relatively warm surface to relatively cool surface
A. Conduction
B. Convection
C. Evaporation
D. Conversion
A. Conduction
Determine the method of heat energy transfer described.
Directly in contact w/ the body part
A. Conduction
B. Convection
C. Evaporation
D. Conversion
A. Conduction
Determine the method of heat energy transfer described.
Direct or indirect piezoelectric effect
A. Conduction
B. Convection
C. Evaporation
D. Conversion
D. Conversion
Determine the method of heat energy transfer described.
Happens in moving fluid particles
A. Conduction
B. Convection
C. Evaporation
D. Conversion
B. Convection
Determine which physical modality is the example of heat transfer.
- Cold whirlpool
- Vapocoolant spray
- Diathermy
A. Conduction
B. Convection
C. Evaporation
D. Conversion
- B
- C
- D
Determine which physical modality is the example of heat transfer.
- HMP
- Cold Packs
- Ultrasound
A. Conduction
B. Convection
C. Evaporation
D. Conversion
- A
- A
- D
TRUE OR FALSE: Tanks may also fall under thermal energy, rather than mechanical energy, depending on the temperature used
True
Which mode will be selected when thermal and mechanical energy is desired to be used in an ultrasound?
continuous mode
Cryotherapy or Cooling Modalities transfer heat ______ from the body part
away
NOTE: “Cold” cannot be created, heat is just removed/transferred.
TRUE OR FALSE: According to Michlovitz, Physical agents use of physical energies such as thermal, mechanical, electromagnetic, or light but fails to include the purpose or intention of their application.
True
This modality is used to create continuous pressure or shocks on different body parts. It is used to destroy nodules, calcifications, or stimulate muscles. What is this modality?
Extracorporeal shockwave therapy (ESWT)
TRUE OR FALSE: According to Michlovitz, the term therapeutic modalities is used to describe the ability of interventions to provide therapeutic benefits in the patient care management model
True
This therapeutic modality is used to decrease pain, increase range of motion, improve functional ability, increase blood flow, and reduce muscle guarding. It utilizes the presence of distractive force to lessen or reduce compression.
What is this modality?
Mechanical Traction
The following are uses of an Intermittent Pneumatic Compression (IPC), EXCEPT:
A. prevent, attenuate, or reverse swelling
B. alter / minimize formation of scar tissue during the proliferation phase of scarring
C. alter / minimize formation of scar tissue during the maturation phase of scarring
D. All of the above
E. None
E. None
This is the visual representation of energy is transmitted by oscillatory motion
Electromagnetic Wave
TRUE OR FALSE: If an EM wave is moving in free space, it must be more than the velocity of light
False
It is EQUAL.
What is the velocity of light?
300,000 km/s
TRUE OR FALSE: Short term exposure to radiowaves are harmful. Prolonged UV rays are harmful.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
D. Only the 2nd statement is true
Explain why ionizing radiation are harmful.
These radiations remove electrons from atoms that could affect our tissues & could cause teratogenic effect (cancerous effect)
TRUE OR FALSE: A shorter wavelength will have a lower frequency of oscillation
False
It is inversely proportional
This modalities uses electrical current to induce muscle contraction, changes in sensation, edema (swelling) reduction and tissue healing. What is it called?
Electrical Stimulation
Enumerate the phases in a tissue’s healing process.
- Inflammatory phase
- Proliferation phase
- Maturation/remodeling phase
TRUE OR FALSE: Inflammatory phase lasts for 1-3 days. Proliferation phase starts within 1st 3 days and lasts for ~20 days
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
D. Only the 2nd statement is true
NOTE: Inflammatory phase lasts for 1-6 days
TRUE OR FALSE: If there is more deposition, the wound becomes brittle can be easily wounded again. If there is more resorption, scar formation occurs.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
B. Both statements are false
NOTE: Interchange deposition and resorption.
TRUE OR FALSE: Physiologic processes of healing are fueled by enzymes. Collagen fiber orientation must be parallel with each other to be stronger.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
A. Both statements are true
TRUE OR FALSE: The phases of the tissue healing process overlaps with each other. All phases depends on type and extensivity of injury.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
A. Both statements are true
TRUE OR FALSE: Reduced circulation happens in the inflammatory phase. Epithelialization happens in the remodeling phase.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
C. Only the 1st statement is true
NOTE: Epithelialization happens in the proliferation phase
Determine which stage would the following goals of treatment would be seen.
Control scar tissue formation, Regain or maintain flexibility and strength
A. Initial injury
B. Chronic inflammation
C. Remodeling
C. Remodeling
Determine which stage would the following goals of treatment would be seen.
Control pain and increase circulation
A. Initial injury
B. Chronic inflammation
C. Remodeling
B. Chronic inflammation
Determine which stage would the following goals of treatment would be seen.
Clean open wound and prevent further injury or bleeding
A. Initial injury
B. Chronic inflammation
C. Remodeling
A. Initial injury
Determine which stage would the following goals of treatment would be seen.
Prevent/decrease joint stiffness and progress to proliferation stage
A. Initial injury
B. Chronic inflammation
C. Remodeling
B. Chronic inflammation
Enumerate the 5 Cardinal Signs of Inflammation.
- Pain/ Dolor
- Redness/ Rubor
- Swelling/ Tumor
- Palor/ Change in color
- Functional limitation/ Functio laesa
This theory states that pain is modulated by endogenous opioid-like peptides called opiopetins or endorphins.
What theory is being described?
Endogenous Opioid System
Match the description to its corresponding pain receptor.
- Myelinated
- Unipolar at dorsal root ganglia
- Dull, throbbing, aching, burning
- Slow
- Small
A. A-delta fibers
B. C fibers
C. Both
D. Neither
- A
- C
- B
- B
- A
NOTE: C fibers are the smallest
Match the description to its corresponding pain receptor.
- 30 m/s
- Localized
- Diffusely localized
- Sharp, stabbing, pricking
- Unmyelinated
A. A-delta fibers
B. C fibers
- A
- A
- B
- A
- B
How fast is the transmission of action potential of C fibers?
1-4 m/s
Arrange the fibers from FASTEST to SLOWEST in terms of transmission.
A. C fibers
B. A-beta
C. A-delta
BCA
What will be the goal of treatment for spasticity?
Decrease tone
What will be the goal of treatment for flaccidity?
Increase tone
What does cryotherapy transfer?
It transfers HEAT AWAY from the body part
Where are hot moist packs kept?
Hydrocollator tanks
Inverse piezoelectric effect converts what kind of energy to what kind of energy?
Electrical to mechanical energy
What 2 modalities uses the inverse piezoelectric effect?
US and diathermy
What are IPCs used for?
reduce swelling by draining excess fluids from interstitial space to blood vessels, then back to the heart
TRUE OR FALSE: External compression increases hydrostatic pressure
True
This is the concept of using IPC.
TRUE OR FALSE: Direct piezoelectric effect converts mechanical energy to electrical energy
True
What physical modality uses pressure as its mechanical agent?
Extracorporeal shockwave therapy (ESWT)
What kind of energy does an ultrasound make in pulsed mode?
mechanical energy
TRUE OR FALSE: Based on the concept of Endogenous Opioid System, pain relief takes place immediately and is longer-lasting than the Gate Control Theory.
False
Pain relief takes much longer as it is transmitted by the blood.
The following are general contraindications or precautions when using physical modalities, EXCEPT:
A. Malignancy
B. Impaired mentation
C. Impaired sensation
D. Pacemaker
E. None
E. None
TRUE OR FALSE: A physical modality is contraindicated to be applied on the feet of a pregnant woman.
False.
it is only a relative contraindication if applied on the hand
TRUE OR FALSE: If pt is already in terminal stage/palliative care (on his last days), physical agents can be done to relieve some of the pain/discomfort, even if pt presents with tumors.
True
Why are impaired sensation and mentation a relative contraindication or precaution?
There will be NO accurate feedback from the pt
TRUE OR FALSE: Using quick icing on agonistic muscles of a spastic patient will be beneficial. Using prolonged cryotherapy on a hypertonic muscle in a spastic patient will be beneficial.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
D. Only the 2nd statement is true
TRUE OR FALSE: Quick icing is used on the agonistic muscles of a hypotonic muscle to increase tone. Motor ES is used on the agonistic muscles of a hypotonic muscle to increase tone.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
A. Both statements are true
TRUE OR FALSE: A functional ES is used to decrease tone. A motor ES is used on the antagonists to relieve fluctuating tone.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
B. Both statements are false
NOTE: Interchange the modality.
Choose the letter/s that may be used as an effective agent based on the PT’s goal.
Prevent further injury or bleeding
A. Cryotherapy
B. Hydrotherapy
C. Thermotherapy
D. Motor ES
E. Compression
A & E
NOTE: Compression must be static
Choose the letter/s that may be used as an effective agent based on the PT’s goal.
Clean open wound
A. Cryotherapy
B. Hydrotherapy
C. Thermotherapy
D. Motor ES
E. Compression
B. Hydrotherapy
Choose the letter/s that may be used as an effective agent based on the PT’s goal.
Progress to proliferation stage
A. Cryotherapy
B. Pulsed ultrasound
C. Thermotherapy
D. ES
E. Pulsed Short Wave Diathermy (PSWD)
B, D, E
Choose the letter/s that may be used as an effective agent based on the PT’s goal.
Regain or maintain flexibility
A. Cryotherapy
B. Pulsed ultrasound
C. Thermotherapy
D. ES
E. Pulsed Short Wave Diathermy (PSWD)
C. Thermotherapy
Choose the letter/s that may be used as an effective agent based on the PT’s goal.
Increase circulation
A. Compression
B. Hydrotherapy
C. Thermotherapy
D. ES
E. Cryotherapy
A, B, C, D
NOTE: Hydrotherapy must have pt immerse in water and performing exercises
Choose the letter/s that may be used as an effective agent based on the PT’s goal.
Control scar tissue formation
A. Compression
B. Hydrotherapy
C. Thermotherapy
D. ES
E. Cryotherapy
E. Cryotherapy
NOTE: PT must use brief ice massage
Choose the letter/s that may be used as an effective agent based on the PT’s goal.
Prevent/decrease joint stiffness
A. Compression
B. Hydrotherapy
C. Thermotherapy
D. ES
E. LASER
B, C, D
Choose the letter/s that may be used as an effective agent based on the PT’s goal.
Control pain
A. Compression
B. Hydrotherapy
C. Thermotherapy
D. ES
E. LASER
C, D, E
Choose the letter/s that may be used as an effective agent based on the PT’s goal.
Regain or maintain strength
A. Compression
B. Hydrotherapy
C. Thermotherapy
D. ES
E. LASER
B, D
This is an unpleasant sensory and emotional experience that signals actual or potential injury to the body
Pain
TRUE OR FALSE: Pain is a reliable indicator of the location, but not the severity of tissue damage
False
It is reliable in both aspects
Based on the Gate Control Theory, treating pain is often directed at stimulating what nerve fibers?
large A-beta fibers
What brain structure do the A-beta fibers control/activate?
substantia gelatinosa/ Lamina 2
This occurs to strike a balance in blood control by creating blood clots.
Hemostasis
In which stage of tissue healing does the process of forming collagen and new blood vessels occur?
Proliferation phase
When a pt presents with spinal radicular pain, what will be the 2 goals of treatment?
decrease nerve root
(1) inflammation and (2) compression
The following agents may be used to treat pain caused by malignancy, EXCEPT:
A. superficial thermotherapy
B. deep thermotherapy
C. cryotherapy
D. ES
E. None
B. deep thermotherapy
What is the BEST agent to be used to treat a spinal radicular type of pain?
A. superficial thermotherapy
B. deep thermotherapy
C. cryotherapy
D. compression
E. traction
E. traction
These are conditions or factors of a patient that make using a specific modality inadvisable
Contraindications
These are findings, circumstances, or factors presented by a patient that require special consideration
Precautions
The following are effective agents to treat bony blocks:
A. Exercise
B. Thermotherapy
C. Cryotherapy
D. ES
E. None
NOTE: You may choose 1 or more letters
E. None
The following are effective agents to treat increase muscle strength:
A. Exercise
B. Thermotherapy
C. Cryotherapy
D. ES
E. None
NOTE: You may choose 1 or more letters
A & D
Water Exercise and Motor ES will be an effective agent for this goal
The following are effective agents to increase tissue extensibility and length:
A. Exercise
B. Thermotherapy
C. Cryotherapy
D. ES
E. None
NOTE: You may choose 1 or more letters
B & C
Brief Ice Massage with stretching should be used
The following are effective agents to control pain and promote tissue healing:
A. Traction
B. Thermotherapy
C. Cryotherapy
D. ES
E. PSWD
NOTE: You may choose 1 or more letters
B, C, D, E
The following are effective agents to control pain only:
A. Traction
B. Thermotherapy
C. Cryotherapy
D. ES
E. PSWD
NOTE: You may choose 1 or more letters
A, B, C, D, E (ALL)
TRUE OR FALSE: When a bony block restricts motion, thermotherapy or brief ice massage and stretch may be used as an effective agent.
True
What will be the goal/s of treatment when pt presents with pain only with motion.
- Control pain
- Promote tissue healing
A PT has a goal to control her pt’s ACUTE pain. What will be the effective agent/s that the PT may use?
A. Cryotherapy
B. Thermotherapy
C. Sensory ES
D. Static Traction
E. Immobilization
A & C
A PT has a goal to control the INFLAMMATION of her pt’s ACUTE pain. What will be the effective agent/s that the PT may use?
A. Cryotherapy
B. Thermotherapy
C. Sensory ES
D. Static Traction
E. Immobilization
A
A PT has a goal to control to PREVENT AGGRAVATION of her pt’s ACUTE pain. What will be the effective agent/s that the PT may use?
A. Cryotherapy
B. Thermotherapy
C. Sensory ES
D. Static Traction
E. Immobilization
D, E
A PT has a goal to control her pt’s REFERRED pain. What will be the effective agent/s that the PT may use?
A. Cryotherapy
B. Thermotherapy
C. Sensory ES
D. Static Traction
E. Immobilization
A, B, C
TRUE OR FALSE: In the inflammatory phase of tissue healing, phagocytosis happens before clot formation. This is a preventive measure to protect wounded tissues from foreign objects
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
D. Only the 2nd statement is true
TRUE OR FALSE: Fibroplasia happens in proliferation phase of tissue healing. Wound contracture happens in remodeling phase of tissue healing
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
C. Only the 1st statement is true
Both happens in proliferation phase
TRUE OR FALSE: Maturation phase assist in remodeling by altering the balance of collagen deposition and resorption. It starts ~9 days and can last up to 2 years
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
A. Both statements are true
TRUE OR FALSE: In proliferation phase of tissue healing, collagen fibers are still disoriented.
True
TRUE OR FALSE: A-delta and c have narrower diameter than a-beta
True
Primary somatosensory area of brain is found in what lobe?
Parietal
Primary somatosensory area of brain is responsible for what?
receiving and feeling the pain
What structure is also known as the secondary somatosensory area of the brain?
hypothalamus or periaqueductal area
The secondary somatosensory area of the brain is responsible for what?
Interpreting pain resulting to a behavioral feeling
This described a relationship between painful sensory input carried by small myelinated A-delta and unmyelinated C fibers versus larger diameter and myelinated A-beta nerve fibers
Gate Control Theory
When the substantia gelatinosa is activated, about how many % of pain signals will be able to reach the thalamus?
only 20%
______ is the main supportive protein of skin, tendon, bone, cartilage, connective tissue, & hair
Collagen
The extensibility of collagen increases in response to increased ______
temperature
Tissues made out of collagen shorten as a result of (1)_____ and could result to (2)_____ and (3)_____
- immobilization
- tightness
- contractures