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PT 6221: Therapeutic Procedures > Superficial Cold & Heat > Flashcards

Superficial Cold & Heat Flashcards

1
Q

Cryotherapy is the use of ____ modalities for therapeutic purposes as an adjunctive tool in rehab of ______ and _____ dysfunctions and is grounded in ______ responses that occur when tissue temp decreases

A

cold
musculoskeletal and neuromuscular
physiological

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2
Q

Cryotherapy considerations

A

be mindful of metals in or on the body such as shrapnel, body piercings, jewelry

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3
Q

Change in tissue temp over time: rank which tissues drop from fastest to slowest/most constant:

  1. Subcutaneous
  2. Muscle
  3. Skin
A
  • Skin drops the fastest
  • Subcutaneous drops steadily
  • Muscle stays relatively constant but does drop slightly
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4
Q

Cryotherapy response factors - clinical considerations (7)

A
  1. Temperature differences b/w agent and tissue
  2. Time of exposure
  3. Thermal conductivity of tissue
  4. Type and size of agent
  5. Total body surface area cooled
  6. activity level of client
  7. ability of agent to maintain temperature
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5
Q

Physiological Effects of Cryotherapy

CHANT-M

A
  1. Hemodynamic
  2. Metabolic
  3. Analgesic
  4. Neuromuscular
  5. Cardiovascular
  6. Tissue Extensibility
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6
Q

Hemodynamic Effects of Cryotherapy

A
  1. Vasoconstriction
    - increase in vascular smooth muscle tone
    - reduction of vasodilating neurotransmitters
    - stimulation of dorsal root ganglion
  2. Increased blood viscosity
  3. Results in decreased blood flow in cooled area
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7
Q

The hemodynamic effects of cryotherapy start with decreased ____ and ____, increased ________ and _____ stimulation

A
  1. Histamine & Bradykinin
  2. Smooth Muscle Tone
  3. DRG
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8
Q

After increased smooth muscle tone occurs with cryotherapy, there’s increased vaso-____ combined with increased blood ____ which results in an overall decrease in blood ______

A

vasoconstriction; blood viscosity; blood flow

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9
Q

Metabolic Effects of Cryotherapy include a decrease in _____, ______ and _________

A

metabolic rate, cellular activity, cellular oxygen demand

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10
Q

Over the metabolic effects of cryotherapy are decreased _______ and ___ in cooled area

A

inflammation; edema

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11
Q

The analgesic effects of cryotherapy include a decrease in the __ nerve conduction velocity and increased threshold for _____ which causes an overall decreased nociceptive afferent input effect (LESS pain)

A

peripheral; depolarization

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12
Q

It’s important to be mindful of especially lean patients with cryotherapy because the decrease in peripheral nerve velocity affects both ____ AND _____ nerve conduction velocities, which can subsequently lead to failure (nerve ____)

A

sensory AND motor NCVs

nerve block

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13
Q

The neuromuscular effects of cryotherapy include (3)

A
  1. Muscle Performance Effects
  2. Proprioception Effects
  3. Spasticity Effects
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14
Q

Overall, cryotherapy decreases the muscle ____ due to decreased peripheral NVCs and decreased _____ input necessary for reflex integration and neuromuscular control

A

force; somatosensory

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15
Q

Why should you be mindful of using cryotherapy in populations you are trying to do performance tasks for?

A

Results in transient performance effects in strength, balance and agility tasks

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16
Q

The effect of spasticity from cryotherapy results from a:

decrease in ___-motor neuron activity
increase in __-motor neuron activity
decrease in sensitivity and activity of the muscle ___
and decrease in reaction to change in muscle ___

A

gamma-motor

alpha-motor

muscle spindle

muscle length

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17
Q

Cardiovascular Effects of Cryotherapy include whole body cooling from (4)

A
  1. Generalized vasoconstriction
  2. Increased blood pressure
  3. Decreased heart rate
  4. Decreased respiration
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18
Q

In cardiovascular compromised patients, you should use caution and

A

keep the rest of the body warm

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19
Q

The tissue extensibility effects of cryotherapy include (2)

A
  1. Decrease in tissue extensibility

2. Increase in tissue stiffness

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20
Q

If a muscle is ____ and _____, you should NOT use cold therapy

A

shortened; tight

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21
Q

What are the general physiological effects of superficial heating that INCREASE? (5)

A
  1. Increased tissue temp
  2. Increased local metabolism/nutrition
  3. Increased blood flow/vasodilation
  4. Increases local swelling
  5. Increases body temp, respiratory & pulse rates
22
Q

What are the general physiological effects of superficial heating that DECREASE?

A
  1. Decreased pain
  2. Decreased muscle spasm
  3. Decreased blood pressure
  4. Reduced skin resistance
  5. Reduced joint stiffness (prepares for exercise)
  6. Sedation of nerve endings (similar to #1)
23
Q

What are the big 3 in the Normal Healing Process? (hint: IPR)

A
  1. Inflammation
  2. Proliferation
  3. Remodeling
24
Q

Inflammation

A

redness, warmth, pain, swelling, loss of function

25
Q

Proliferation

A

48-72 hours after injury

26
Q

Remodeling

A

can last over a year

27
Q

In the Normal Healing Process, when should you use heat?

A

AFTER 72 hours because you do not want to agitate the inflammation period (better to use cold therapy)

28
Q

Vasodilation results from 3 proposed factors, which are

A
  1. Axon Reflex
  2. Release of Chemical Mediators (like histamine, prostaglandins)
  3. Local Spinal Cord Reflex
29
Q

In the metabolic effects of superficial heating, the metabolic rate ___ 2-3x for each ___deg C rise in tissue temperature

A

increases; 10

30
Q

In the metabolic effects of superficial heating, oxygen uptake ____ in the tissues to gain ___ nutrients available for tissue healing

A

increases; more

31
Q

In the neuromuscular effects of superficial heating, the elevation of pain threshold causes an ____ effect which reduces ____

A

analgesic; pain

32
Q

In the neuromuscular effects of superficial heating, the altered nerve conduction velocity ___ pain due to muscle spindle firing rates ____ and GTO ______

A

decreases; decreasing; increasing

33
Q

Thermal Gate Theory states

A

that if the sensation pathway gate is closed, the perception of pain is decreased (pain relief)

34
Q

In perception of temperature, the sensation is carried by which tract?

(hint: sensation is key word!)

A

Anterolateral (spinothalamic)

35
Q

In the anterolateral tract, the fibers that mediate include

A
  1. Somatic Pain
  2. Visceral Pain
  3. Crudely Localized Touch
  4. Temperature
36
Q

In the perception of temperature, what are the 2 primary fiber types? Describe overall characteristic

A
  1. Types III
  2. C fibers

*Slow conducting, non-myelinated

37
Q

Gate control mechanism states that there is a _____ in non-myelinated ___ fiber activity which inhibits the nociceptive signals in the spinal cord

A

decreased; C

38
Q

In the connective tissue specifically, what are the superficial heating effects (4)?

(____ elasticity; ____ viscosity; ____ stiffness; ____ flexibility)

A
  1. Increased elasticity
  2. Decreased viscosity
  3. Decreased joint stiffness
  4. Increased muscle flexibility
39
Q

In connective tissue superficial heating, plastic deformation is

A

residual elongation of connective tissue AFTER the stretch is applied and THEN released

40
Q

In connective tissue superficial heating, permanent elongation is (3)

(hint: constant ___ + rapid ____ + constant ____ = permanent elongation)

A
  1. Constant Load - of enough magnitude
  2. Rapid Stretch - by a period of holding in that position
  3. Constant Rate - of stretching using a slow, steady stretch
41
Q

What are the variables in superficial heating that need to be considered?

A
  1. Extent of temp. rise
  2. Rate energy is added
  3. Volume of tissue exposed
  4. Composition of tissue
  5. Capacity of tissue to dissipate heat/vascularity
  6. Compression
42
Q

What is the therapeutic range for superficial heat?

A

104-113F

43
Q

What temperature should you NOT exceed for risk of burn?

A

113F

44
Q

What temperature is the minimum required for heat therapy (anything less is too cool and considered non-therapeutic)?

A

104F

45
Q

The therapeutic range for superficial heat is reached within how many minutes?

A

8-10 minutes

46
Q

Within how many minutes do the muscles reach thermal equilibrium?

A

30 minutes

47
Q

What are the main advantages of superficial heat (3)?

A
  1. Decrease in pain, stiffness, muscle spasms
  2. Increase in tissue extensibility
  3. Good for subacute AND chronic care
48
Q

What are the main disadvantages for superficial heat? (3)

A
  1. May cause increased swelling; burn risk
  2. Decreases BP and CO; HR may increase
  3. Not appropriate for everyone
49
Q

What are the main advantages for cold therapy? (3)

A
  1. Decreased pain, inflammation, swelling and muscle spasms
  2. May prevent FURTHER swelling (esp. after injury)
  3. Good for ACUTE care
50
Q

What are the main disadvantages of cold therapy? (4)

A
  1. Increased stiffness/Decreased tissue extensibility
  2. Increased BP, decreased HR and respiration
  3. Decreased strength and proprioception
  4. Not appropriate for everyone

PT 6221: Therapeutic Procedures (7 decks)

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