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Physical Agents > Test 1 > Flashcards

Test 1 Flashcards

1
Q

Current is measured in?

A

Amperes

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2
Q

Materials that impede free electron movement?

A

Air, wood, glass, rubber, etc.

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3
Q

Definition of Volt?

A

The difference in electron electrical potential between the two poles.

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4
Q

Disease’s that impede healing?

A

Diabetes, HIV, arthritis, endocrine disease, connective tissue disease, carcinoma, renal disease, hepatic disease, cardiovascular disease, and autoimmune disease.

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5
Q

Cryotherapy in adj. w/ Modalities help by?

A

Controls, swelling, reduces secondary hypoxic injury, and creates analgesia for pain control

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6
Q

What part of the healing phase should you start exercising the patient?

A

Proliferation Phase

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7
Q

Modalities to use during the remodeling phase?

A

Deep heat agent, electrical stimulation, and exercise.

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8
Q

Electricity displays

A

Magnetic, chemical, mechanical, and thermal effects

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9
Q

3 types of current

A

Monophasic, Biphasic, Polyphasic

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10
Q

Which electrical pole stimulates the skin better?

A

Negative pole

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11
Q

Resistance is measured in?

A

Ohms

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12
Q

Ohms Law is?

A

Voltage = Current * Resistance

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13
Q

Bigger curve =

A

Greater electricity

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14
Q

Amplitude definition

A

Highest point of each pulse phase and is referred to as voltage and current intensity measured in milliamps (mA)

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15
Q

Duration definition

A

The time of the pulse from beginning to end of all phases measured in microseconds

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16
Q

Frequency definition

A

number of pulses in one second

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17
Q

Pulse definition

A

An individual waveform with one or two phases

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18
Q

Pulse period definition

A

Sum of the pulse duration and the interpulse interval

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19
Q

Phase definition

A

Portion of the pulse which rises above or below the isoelectric line

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20
Q

Burst definition

A

An interrupted train of pulses

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21
Q

Burst or Low frequency waves are produced by?

A

High or medium frequency stimulators

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22
Q

What is the range of pps that humans can feel?

A

1-200 pps

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23
Q

Duty Cycle definition?

A

Sum of “on-time” or stimulation pulse delivery and the “off-time” or duration of recovery.

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24
Q

What is Modulation? and what does it include?

A

Alterations or variations in pulse amplitude or duration and includes continuous , interrupted burst and ramped.

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25
Q

Interrupted Modulation is commonly used for?

A

Muscle re-education, muscle strengthening, and range of motion techniques.

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26
Q

A pulsed current in a packet of 3 or more pulses are delivered and then shut off briefly are what type of electrical stimulation?

A

Russian

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27
Q

What size ramp is better for e-stim?

A

small ramp = better ramp (most are at 2)

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28
Q

The best conductors in the body?

A

nerve, muscle, blood

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29
Q

Series circuit works by?

A

allowing the electrical current to flow and at any point be the same at any point on the path. The resistance of current flow is the sum of all resistors in the circuit.

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30
Q

In a series circuit how is the energy dissipated?

A

The electrical energy used to direct current through the resistors is dissipated as heat and the voltage decreases as it passes through each resistor.

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31
Q

What is the physiological response to e-stim?

A

The cells should respond to the electrical energy in a manner similar to how the cell functions or grows.

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32
Q

The biological tissue response depends on?

A

length of the pulse, rate of rise and decay, length of time between pulses, modulation of pulses, and amplitude of the pulse.

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33
Q

What 4 things can e-stim accomplish in rehab?

A

1) Facilitate muscular contractions through nerve or muscle excitation. 2) Pain control through sensory nerve stimulation. 3) Tissue healing by creating an electrical field. 4)Use of electrical field on skin surface to drive ions, beneficial for healing, through the skin.

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34
Q

What are the 4 classifications of changes due to e-stim?

A

1) cellular level, 2) Tissue level, 3) Segmental level, and 4) systematic level.

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35
Q

What happens at the cellular level of change?

A

Excitation of nerves, changes in cell membrane permeability, protein synthesis, stimulation of fibroblast & osteoblast, and modification of microcirculation

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36
Q

What happens at the tissue level of change?

A

Skeletal muscle contraction, smooth muscle contraction and tissue regeneration.

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37
Q

What happens at the segmental level of change?

A

Modification of joint mobility, pumping to alter circulation and lymph flow, alteration of the micro-vascular system, and increased movement of charged proteins in the lymph system.

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38
Q

What happens at the systematic level of change?

A

Analgesic effect as endogenous pain suppressor are released, and analgesic effect from the stimulation’s of neurotransmitters to control pain stimuli (enkephlans)

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39
Q

What is resting potential?

A

The potential difference between the inside and outside of the cell which the cell maintains as its homeostatic environment.

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40
Q

Definition of Action Potential?

A

a recorded change in electrical potential between the inside and outside of a nerve cell resulting in muscular contraction.

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41
Q

Which electrode is deemed the dispersive electrode?

A

Anode electrode

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42
Q

Which electrode is the active electrode?

A

Cathode (negative)

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43
Q

What is the absolute refractory period?

A

The time after cell excitation and depolarization which nerve is unable to transmit a second impulse

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44
Q

What is tetany?

A

It is when intensity is great enough to have all muscle fibers contract synchronously

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45
Q

Explain the strength-duration curve?

A

Stimuli of short duration require greater current amplitude to reach nerve and muscle cell threshold. (Have a non-linear relationship)

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46
Q

What is Rheobase?

A

It is the minimum amount of intensity of the current needed for tissue excitation when given for maximum duration

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47
Q

What is Chronaxie?

A

It is the duration necessary for a current twice the intensity of rheobase to cause tissue excitation (use so we can get treatments to stimulate faster and higher intensity)

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48
Q

Do greater intensities beyond threshold improve excitation?

A

False, it will not improve it.

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49
Q

T or F: Stim can help provide a better environment for mitochondria to produce to make ATP.

A

True

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50
Q

Compression causes what type of potential?

A

Negative

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51
Q

Distraction causes what type of potential?

A

Positive

52
Q

The bio-electrical field of the CNS is?

A

positive

53
Q

The bio-electrical field of the PNS is?

A

negative

54
Q

T or F: Epidermis is negative compared to a more positive dermis

A

True

55
Q

T or F: Having a larger anode electrode will have a higher density in the anode.

A

False: Having a larger cathode will allow for higher density in the anode electrode

56
Q

T or F: Small amplitude DC currents are intrinsic to the ways the body works to grow and repair.

A

True

57
Q

When the electrodes are different sizes, which electrode will have the greater current intensity?

A

The smaller, active, electrode

58
Q

T or F: A large, dispersive, electrode disperses the current over a larger area decreasing the current density

A

True (combo)

59
Q

T or F: When trying to accomplish muscle contraction the active electrode should be positive

A

False: should be negative

60
Q

What level of frequency should you use to gain a stronger contraction? pumping effect?

A

Higher frequency for a stronger contraction

Lower frequency for a pumping effect

61
Q

Do low voltage simulators usually have a preset pulse duration?

A

No, they usually have an adjustable duration. Whereas High Volt stimulators have a preset pulse.

62
Q

Monophasic (DC, Galvanic) Currents are said to enhance?

A

Enhance the movement of charged proteins into the lymph channels

63
Q

What are the parameters for e-stim on edema?

A 
Current: LV monophasic
Intensity: High but w/o muscle contraction
Frequency: 120 pps
Pulse Duration: As short as possible
Tx Time: 30 min - continuous
Negative electrode must be distal
64
Q

Does e-stim do anything when there is already swelling?

A

No, when edema is present, it cannot be effectively treated with e-stim.

65
Q

During the Gate system which fibers are evoked?

A

Peripheral large-diameter A beta sensory fibers

66
Q

What do A-beta sensory fibers activate in the gate system?

A

They activate inhibitory interneurons in the substantia gelatinosa of the dorsal horn.

67
Q

When a-beta sensory fibers are inhibiting interneurons, what cells does it effect?

A

The effect occurs on the T-cells to close to the gate and nociceptive input is able to send signals to the brain.

68
Q

What should the intensity feel like to open the gate system?

A

The intensity should produce tingling w/o a muscular contraction

69
Q

What are stronger pain relievers than endorphin’s?

A

Dekephalines

70
Q

How does the Opiate system work?

A

When the negative feedback loop is activated through the T-cells and the descending endogenous opiate system.

71
Q

Parameters for the Opiate System?

A

Current: HVP currents best but LVP works also to stimulate A-delta and C fibers.
Intensity: High, somewhat uncomfortable, muscle contraction
Frequency: Low
Pulse duration: High
going to need current and lots of it

72
Q

What is the current for central biasing?

A

Low frequency, high intensity is best

73
Q

What should the intensity be for central biasing?

A

High; muscle contraction is not desired and small areas for point stimulators

74
Q

What should frequency and pulse duration be for central biasing>

A

Frequency: Low

Pulse duration: Moderate

75
Q

3 methods the TENS unit can be used for

A

Sensory, Motor, and Brief Intense

76
Q

What can the sensory method on a TENS unit be used for?

A

acute (sub-acute) pain relief

77
Q

What are the parameters of sensory method on a TENS unit?

A 
Placement: on painful area
Intensity: Pleasant tingling
Frequency: 80-200 pps
Pulse duration: 80-100 microsec.
Rate: N
Tx Time: 30 mins - 2 hours
78
Q

What fibers does the TENS unit activate in sensory method?

A

A-beta fibers gate system

79
Q

What is the motor method on a TENS unit used for?

A

Chronic pain- trying to fatigue the muscle

80
Q

What are the parameters of the motor input on a TENS Unit?

A 
Placement: Over trigger points
Intensity: To tolerance, slight muscle twitch
Frequency: 1-5 pps
Pulse duration: 150-250 microsecs.
Rate: B
Tx Time: 15-30 mins
81
Q

What fibers does the TENS unit activate during the motor input?

A

A-delta and C fibers, activating the central biasing and Opiate systems (last 6+ hours)

82
Q

What is the brief intense input used for on a TENS unit?

A

Pain prior to exercise

83
Q

What are the parameters for the brief intense input for a TENS unit?

A 
Placement: Over motor points/trigger points
Intensity: Intense; want muscle tetany
Frequency: Variable
Pulse Duration: >250 microsecs
Rate: M
Tx Time: 10-20 mins
84
Q

What fibers does the brief intense input on a TENS unit activate?

A

A-beta, A-delta, and C-fibers (lasts <30 mins)

85
Q

Contraindications for the TENS unit?

A

1) over lower abdominal & pelvic area during pregnancy

2) Over anterior transcervical area and 3) over heart transthoracic area

86
Q

Precautions for the TENS unit?

A

Pacemaker, electronic implants or mental confusion

87
Q

What is interferential current?

A

It is two medium frequencies (3000-5000 Hz) sinusoidal currents in which are generated by independent oscillatory circuits

88
Q

If two currents interfere with each other but are in phase with one another are said to be__________ and ________?

A

Summative and constructively interfering

89
Q

If two currents have phases opposing one another the waves will cancel each other out and are considered _________________________?

A

Destructively interfering

90
Q

What can IFC be used for?

A

Acute pain control, chronic pain control, muscle spasm, bone healing, and edema control

91
Q

Parameters for acute pain control in using IFC?

A

Rate: 80-150 pps
Intensity: Pleasant tingling
Carrier frequency: 4000-5000 Hz
Placement: Criss-cross painful area 10-30 mins

92
Q

Parameters for chronic pain using IFC?

A

Rate: 1-10 pps
Intensity: Pleasant/ moderate tingling
Carrier Frequency: 2500 Hz
Placement: Criss-cross painful area 10-30 mins

93
Q

Parameters for muscle spasm using IFC?

A

Rate: 4 pps
Intensity: Visible muscle contraction
Carrier frequency: 2500 Hz
Placement: Criss-cross trigger points 10-30 mins

94
Q

Parameters for edema control using IFC?

A

Rate: 50 pps
Intensity: To tolerance/strong contraction
Carrier Frequency: 4000-5000 Hz
Placement: Criss-cross swelling 10- 30 mins

95
Q

What is stereodynamic interferential method?

A

A 3rd sinusoidal current is added and a star-shaped 3-D electrical field is developed w/ 6 different electrodes

96
Q

IFC and Pre-Mod contraindications?

A

Arterial and Venous Thrombus, Malignancy and Hemorrhagic area.

97
Q

Low Intensity Stimulators are also called what?

A

Microcrurrent electrical neuromuscular stimulators

98
Q

What is the pad placement for the Low intensity stimulators?

A

Active negative over wound or fx, and 2nd disperssive is place farther away depending on the depth of the desired tissue penetration

99
Q

What is iontophoresis?

A

It is the transporting of ions through tissues by using a continuous monophasic current.

100
Q

What is a therapeutic window?

A

The plasma concentrations of a drug which falls between a inimum concentration to be effective and a maximum concentration which adverse reactions occur above

101
Q

What is dexamethasone?

A

an animal-based anti-inflammatory medicine

102
Q

What is the primary mode of ion transport in the skin?

A

Sweat glands

103
Q

What is the Tx penetration of Ionto?

A

1-3mm

104
Q

T or F: In Ionto Tx, the electrode with the medication is considered the active electrode

A

True

105
Q

T or F: In Ionto, the second electroe is referred to as the dispersive or return electrode?

A

True

106
Q

T or F: To help avoid burns during Ionto Tx, you want to try and keep the cathode (-) smaller than the anode (+)

A

False, you want the cathode (-) to be larger than the anode (+)

107
Q

Is A.C. or D.C. current better tolerated during Ionto?

A

A.C. shows better promise. D.C. has more alkaline and acidic reactions

108
Q

Ionto indications?

A

Inflammation, analgesia, muscle spasm, ischemia, edema, calcium deposits, and scar tissue

109
Q

Contraindications of Ionto?

A

Skin lesions, sensitivity or allergy to drug, Impaired sensation

110
Q

Precautions of Ionto?

A

Diabetes mellitus and softening of the skin

111
Q

What population could benefit from biofeedback?

A

Anyone who has suffered a neuromuscular injury

112
Q

What is Electromyography (EMG)?

A

It is the recording of electrical activity generated in the muscle for diagnostic purposes. (uses needles)

113
Q

What do Biofeedback units measure?

A

Peripheral skin temp., finger phototransmission, skin conductance activity, and electromyographic activity

114
Q

T or F: During Biofeedback, only difference between the active electrodes will be monitored, common mode rejection ratio (CMRR) since the middle electrode is the reference electrode to absorb the “noise”

A

True

115
Q

While using Biofeedback, what are some considerations regarding the electrodes?

A

prepare skin by removing lotions and oils, place electrodes parallel to muscle fibers, keep on specific muscle so it doesn’t pick up “noise” from other muscles.

116
Q

T or F: Biofeedback has to be isometric

A

False, it does not have to be

117
Q

Contraindications of Biofeedback

A

Any reason the pt should not contract a muscle, i.e. DVT, acute injury, muscle tear, joint instability, pain from unknown source, and Fx.

118
Q

Precautions of Biofeedback

A

Stress Fx, hypertension, anxiety disorder, mental confusion

119
Q

Radiating pain is similar to referred pain except it ?

A

Travels along a nerve

120
Q

What does cutaneous pain feel like?

A

It is sharp, bright and burning with fast and slow onset

121
Q

Where does deep somatic pain originate?

A

Originates in tendons, muscles, joints, peritoneum and blood vessels

122
Q

Where does visceral pain begin?

A

It begins in organs and is diffused at first and may become localized

123
Q

Where is psychogenic pain felt?

A

It is felt by the individual but it is more emotional rather than physical

124
Q

What are some potential causes of chronic pain?

A

Changes in sympathetic nervous system, changes in adrenal activity, reduced production of endogenous opioids and sensitization of primary afferent and spinal cord neurons

125
Q

The structures most sensitive to damaging (noxious) stimuli are?

A

Periosteum, joint capsule, subchondral bone, tendon, ligments, muscle, cortical bone and synovium, articular cartilage

Physical Agents (1 decks)

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