TENS Flashcards

0
Q

What is the purpose of EStim?

A

To transmit an electrical signal through the skin that will stimulate appropriate nerve fibers that will result in pain relief

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1
Q

What is TENS?

A

Transcutaneous Electrical Nerve Stimulation

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2
Q

Gate Theory of Pain

A

Pain stimuli travels along #1 neuron to the Substantia Gelatinosa in the dorsal horn synapse with #2 neuron that travels and crosses the Spinothalmic Tract and synapses with #3 neuron from the Thalamus to the Cerebral Cortex

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3
Q

Pain Response

A

Stimulus travels down the Corticospinal Tract for motor response. Blocking pain messages is done through stimulation and release of various opiates in the CNS. Those opiates affects the ascending pathways.

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4
Q

How does pain response to Conventional TENS?

A

TENS activates large Ab nerve fibers that facilitate the release of interneuron enkephalins in the Substantia Gelatinosa to block pain fibers input to the transmission cell during pre synaptic inhibition

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5
Q

How is pain blocked?

A

Via EStim by closing gate to pain fibers input

Parameters= high PR (80-100) short PW (50-70)

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6
Q

What three areas release opiates?

A

Pituitary, periaqeductal gray, and Raphe Nucleus

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7
Q

Which opiates does Raphe Nucleus release?

A

Serotonin, Adrenocorticotropic Hormones, norepinephrine, dopamine

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8
Q

Where is the Raphe Nucleus found?

A

Pons and Medulla

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9
Q

Where is the PAG found?

A

Midbrain

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10
Q

Beta endorphins are produced where?

A

Primarily in the anterior pituitary stimulate Ad and C pain fibers via twitch muscle contraction

Parameters= PR (1-5) PW (200)

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11
Q

Internal Microscopic changes to increase pain

A

Decrease circulation, oxygen supply, lymphatic clearing, nutrient supply

Increase metabolism, muscle fatigue, inflammation, edema

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12
Q

Positioning of electrodes

A

Primary sites of pain

  • nerve roots adjacent to spinal column
  • along course of peripheral nerve
  • related motor of trigger acupuncture points
  • points of lowest electrical resistance
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13
Q

Advantages to using EStim

A
Valid method of pain control
Efficient and easy
Non invasive to skin
Portable
Biologically safe
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14
Q

Indications

A
Acute and chronic pain
Edema
Wound care
Muscle strengthening 
Circulation peripheral disorder
Impaired ROM
Muscle dystrophy
Pain
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15
Q

What is tic doloureaux?

A

Painful trigeminal neuralgia

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16
Q

Chronic Conditions treated by EStim

A

Lbk, neck pain, herpes zoster, tic doloureaux, headaches, DJD, Cancer, arthritis

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17
Q

Contraindications

A

Demand pacemaker, over carotid sinus, over any structure that crosses the uterus- pregnancy, cancerous malignancy, thrombosis, crossing the phrenic nerve , H/O cardiac disease

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18
Q

Precautions

A

Secure electrodes, gradually increase intensity, do not change PR or PW while the unit is ON, do not increase PR or PW with high intensity

19
Q

Pulse rate TWITCH

A

1-10 ops

20
Q

Pulse rate TETANY

A

> 15-200 pps

21
Q

Beta Endorphins release

A

2-5 pps

22
Q

Pulse rate NON FATIQUEING TETANY

A

50-100 pps

23
Q

Pulse rate FATIQUEING TETANY

A

80-100 pps up to 5000

24
Q

Pulse rate NEUROMUSCULAR REEDUCATION

A

50 pps

25
Q

Pulse rate MUSCLE SPASM

A

100 pps or 80-120pps sensory intensity

26
Q

How is PW measured?

A

In microseconds

27
Q

What is peak current?

A

Peak current is highest amount of milliamps that can be delivered at peak wave

28
Q

What is average current?

A

Is the average amount of electrical current being delivered during session can be seen on the meter

29
Q

What is the PW for enervated muscles

A

300 Milliseconds

30
Q

What is normal or comfortable range for PW

A

20-200 microseconds

31
Q

Shorter PW requires what?

A

Higher intensity PR

32
Q

Define interpulse?

A

A period between pulse of phase where there is no current delivered

33
Q

Wider PW result in what?

A

Deeper stimulation

34
Q

How do you increase average current?

A

Increase:
current intensity
Pulse duration
Pulse rate

35
Q

Higher peaks ability

A

Ability to reach and affect deeper structures as long as the conductivity of tissue remains the same– no bone in way

36
Q

What is optimal peak current

A

Lowest peak level that can achieve response

37
Q

What is pulse rate

A

Is the amount of pulses being different at a certain period normally measured in seconds

38
Q

If you increase PR what else increase?

A

Average current

39
Q

Good cycle for motor stimulation ?

A

1:5 rise and decay

40
Q

100 pps FATIQUEING muscle at what timeframe?

A

1-2 minutes so rise and decay time is needed

41
Q

Pulse charge or phase charge

A

Amount of electrical energy delivered to tissue with each pulse of phase

42
Q

Pulse charge is measured how?

A

In microcoullombs

43
Q

Formula for microcoullomb

A

Phase charge times number of phases time number of pps

44
Q

Weak stimulator

A

12-15 microcoullombs

45
Q

Moderate microcoullomb

A

20-25 microcoullombs