Test 1 Flashcards
1
Q
Current is measured in?
A
Amperes
2
Q
Materials that impede free electron movement?
A
Air, wood, glass, rubber, etc.
3
Q
Definition of Volt?
A
The difference in electron electrical potential between the two poles.
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.
5
Q
Cryotherapy in adj. w/ Modalities help by?
A
Controls, swelling, reduces secondary hypoxic injury, and creates analgesia for pain control
6
Q
What part of the healing phase should you start exercising the patient?
A
Proliferation Phase
7
Q
Modalities to use during the remodeling phase?
A
Deep heat agent, electrical stimulation, and exercise.
8
Q
Electricity displays
A
Magnetic, chemical, mechanical, and thermal effects
9
Q
3 types of current
A
Monophasic, Biphasic, Polyphasic
10
Q
Which electrical pole stimulates the skin better?
A
Negative pole
11
Q
Resistance is measured in?
A
Ohms
12
Q
Ohms Law is?
A
Voltage = Current * Resistance
13
Q
Bigger curve =
A
Greater electricity
14
Q
Amplitude definition
A
Highest point of each pulse phase and is referred to as voltage and current intensity measured in milliamps (mA)
15
Q
Duration definition
A
The time of the pulse from beginning to end of all phases measured in microseconds
16
Q
Frequency definition
A
number of pulses in one second
17
Q
Pulse definition
A
An individual waveform with one or two phases
18
Q
Pulse period definition
A
Sum of the pulse duration and the interpulse interval
19
Q
Phase definition
A
Portion of the pulse which rises above or below the isoelectric line
20
Q
Burst definition
A
An interrupted train of pulses
21
Q
Burst or Low frequency waves are produced by?
A
High or medium frequency stimulators
22
Q
What is the range of pps that humans can feel?
A
1-200 pps
23
Q
Duty Cycle definition?
A
Sum of “on-time” or stimulation pulse delivery and the “off-time” or duration of recovery.
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.
25
Interrupted Modulation is commonly used for?
Muscle re-education, muscle strengthening, and range of motion techniques.
26
A pulsed current in a packet of 3 or more pulses are delivered and then shut off briefly are what type of electrical stimulation?
Russian
27
What size ramp is better for e-stim?
small ramp = better ramp (most are at 2)
28
The best conductors in the body?
nerve, muscle, blood
29
Series circuit works by?
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.
30
In a series circuit how is the energy dissipated?
The electrical energy used to direct current through the resistors is dissipated as heat and the voltage decreases as it passes through each resistor.
31
What is the physiological response to e-stim?
The cells should respond to the electrical energy in a manner similar to how the cell functions or grows.
32
The biological tissue response depends on?
length of the pulse, rate of rise and decay, length of time between pulses, modulation of pulses, and amplitude of the pulse.
33
What 4 things can e-stim accomplish in rehab?
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.
34
What are the 4 classifications of changes due to e-stim?
1) cellular level, 2) Tissue level, 3) Segmental level, and 4) systematic level.
35
What happens at the cellular level of change?
Excitation of nerves, changes in cell membrane permeability, protein synthesis, stimulation of fibroblast & osteoblast, and modification of microcirculation
36
What happens at the tissue level of change?
Skeletal muscle contraction, smooth muscle contraction and tissue regeneration.
37
What happens at the segmental level of change?
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.
38
What happens at the systematic level of change?
Analgesic effect as endogenous pain suppressor are released, and analgesic effect from the stimulation's of neurotransmitters to control pain stimuli (enkephlans)
39
What is resting potential?
The potential difference between the inside and outside of the cell which the cell maintains as its homeostatic environment.
40
Definition of Action Potential?
a recorded change in electrical potential between the inside and outside of a nerve cell resulting in muscular contraction.
41
Which electrode is deemed the dispersive electrode?
Anode electrode
42
Which electrode is the active electrode?
Cathode (negative)
43
What is the absolute refractory period?
The time after cell excitation and depolarization which nerve is unable to transmit a second impulse
44
What is tetany?
It is when intensity is great enough to have all muscle fibers contract synchronously
45
Explain the strength-duration curve?
Stimuli of short duration require greater current amplitude to reach nerve and muscle cell threshold. (Have a non-linear relationship)
46
What is Rheobase?
It is the minimum amount of intensity of the current needed for tissue excitation when given for maximum duration
47
What is Chronaxie?
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)
48
Do greater intensities beyond threshold improve excitation?
False, it will not improve it.
49
T or F: Stim can help provide a better environment for mitochondria to produce to make ATP.
True
50
Compression causes what type of potential?
Negative
51
Distraction causes what type of potential?
Positive
52
The bio-electrical field of the CNS is?
positive
53
The bio-electrical field of the PNS is?
negative
54
T or F: Epidermis is negative compared to a more positive dermis
True
55
T or F: Having a larger anode electrode will have a higher density in the anode.
False: Having a larger cathode will allow for higher density in the anode electrode
56
T or F: Small amplitude DC currents are intrinsic to the ways the body works to grow and repair.
True
57
When the electrodes are different sizes, which electrode will have the greater current intensity?
The smaller, active, electrode
58
T or F: A large, dispersive, electrode disperses the current over a larger area decreasing the current density
True (combo)
59
T or F: When trying to accomplish muscle contraction the active electrode should be positive
False: should be negative
60
What level of frequency should you use to gain a stronger contraction? pumping effect?
Higher frequency for a stronger contraction
| Lower frequency for a pumping effect
61
Do low voltage simulators usually have a preset pulse duration?
No, they usually have an adjustable duration. Whereas High Volt stimulators have a preset pulse.
62
Monophasic (DC, Galvanic) Currents are said to enhance?
Enhance the movement of charged proteins into the lymph channels
63
What are the parameters for e-stim on edema?
```
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
Does e-stim do anything when there is already swelling?
No, when edema is present, it cannot be effectively treated with e-stim.
65
During the Gate system which fibers are evoked?
Peripheral large-diameter A beta sensory fibers
66
What do A-beta sensory fibers activate in the gate system?
They activate inhibitory interneurons in the substantia gelatinosa of the dorsal horn.
67
When a-beta sensory fibers are inhibiting interneurons, what cells does it effect?
The effect occurs on the T-cells to close to the gate and nociceptive input is able to send signals to the brain.
68
What should the intensity feel like to open the gate system?
The intensity should produce tingling w/o a muscular contraction
69
What are stronger pain relievers than endorphin's?
Dekephalines
70
How does the Opiate system work?
When the negative feedback loop is activated through the T-cells and the descending endogenous opiate system.
71
Parameters for the Opiate System?
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
What is the current for central biasing?
Low frequency, high intensity is best
73
What should the intensity be for central biasing?
High; muscle contraction is not desired and small areas for point stimulators
74
What should frequency and pulse duration be for central biasing>
Frequency: Low
| Pulse duration: Moderate
75
3 methods the TENS unit can be used for
Sensory, Motor, and Brief Intense
76
What can the sensory method on a TENS unit be used for?
acute (sub-acute) pain relief
77
What are the parameters of sensory method on a TENS unit?
```
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
What fibers does the TENS unit activate in sensory method?
A-beta fibers gate system
79
What is the motor method on a TENS unit used for?
Chronic pain- trying to fatigue the muscle
80
What are the parameters of the motor input on a TENS Unit?
```
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
What fibers does the TENS unit activate during the motor input?
A-delta and C fibers, activating the central biasing and Opiate systems (last 6+ hours)
82
What is the brief intense input used for on a TENS unit?
Pain prior to exercise
83
What are the parameters for the brief intense input for a TENS unit?
```
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
What fibers does the brief intense input on a TENS unit activate?
A-beta, A-delta, and C-fibers (lasts <30 mins)
85
Contraindications for the TENS unit?
1) over lower abdominal & pelvic area during pregnancy
| 2) Over anterior transcervical area and 3) over heart transthoracic area
86
Precautions for the TENS unit?
Pacemaker, electronic implants or mental confusion
87
What is interferential current?
It is two medium frequencies (3000-5000 Hz) sinusoidal currents in which are generated by independent oscillatory circuits
88
If two currents interfere with each other but are in phase with one another are said to be__________ and ________?
Summative and constructively interfering
89
If two currents have phases opposing one another the waves will cancel each other out and are considered _________________________?
Destructively interfering
90
What can IFC be used for?
Acute pain control, chronic pain control, muscle spasm, bone healing, and edema control
91
Parameters for acute pain control in using IFC?
Rate: 80-150 pps
Intensity: Pleasant tingling
Carrier frequency: 4000-5000 Hz
Placement: Criss-cross painful area 10-30 mins
92
Parameters for chronic pain using IFC?
Rate: 1-10 pps
Intensity: Pleasant/ moderate tingling
Carrier Frequency: 2500 Hz
Placement: Criss-cross painful area 10-30 mins
93
Parameters for muscle spasm using IFC?
Rate: 4 pps
Intensity: Visible muscle contraction
Carrier frequency: 2500 Hz
Placement: Criss-cross trigger points 10-30 mins
94
Parameters for edema control using IFC?
Rate: 50 pps
Intensity: To tolerance/strong contraction
Carrier Frequency: 4000-5000 Hz
Placement: Criss-cross swelling 10- 30 mins
95
What is stereodynamic interferential method?
A 3rd sinusoidal current is added and a star-shaped 3-D electrical field is developed w/ 6 different electrodes
96
IFC and Pre-Mod contraindications?
Arterial and Venous Thrombus, Malignancy and Hemorrhagic area.
97
Low Intensity Stimulators are also called what?
Microcrurrent electrical neuromuscular stimulators
98
What is the pad placement for the Low intensity stimulators?
Active negative over wound or fx, and 2nd disperssive is place farther away depending on the depth of the desired tissue penetration
99
What is iontophoresis?
It is the transporting of ions through tissues by using a continuous monophasic current.
100
What is a therapeutic window?
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
What is dexamethasone?
an animal-based anti-inflammatory medicine
102
What is the primary mode of ion transport in the skin?
Sweat glands
103
What is the Tx penetration of Ionto?
1-3mm
104
T or F: In Ionto Tx, the electrode with the medication is considered the active electrode
True
105
T or F: In Ionto, the second electroe is referred to as the dispersive or return electrode?
True
106
T or F: To help avoid burns during Ionto Tx, you want to try and keep the cathode (-) smaller than the anode (+)
False, you want the cathode (-) to be larger than the anode (+)
107
Is A.C. or D.C. current better tolerated during Ionto?
A.C. shows better promise. D.C. has more alkaline and acidic reactions
108
Ionto indications?
Inflammation, analgesia, muscle spasm, ischemia, edema, calcium deposits, and scar tissue
109
Contraindications of Ionto?
Skin lesions, sensitivity or allergy to drug, Impaired sensation
110
Precautions of Ionto?
Diabetes mellitus and softening of the skin
111
What population could benefit from biofeedback?
Anyone who has suffered a neuromuscular injury
112
What is Electromyography (EMG)?
It is the recording of electrical activity generated in the muscle for diagnostic purposes. (uses needles)
113
What do Biofeedback units measure?
Peripheral skin temp., finger phototransmission, skin conductance activity, and electromyographic activity
114
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"
True
115
While using Biofeedback, what are some considerations regarding the electrodes?
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
T or F: Biofeedback has to be isometric
False, it does not have to be
117
Contraindications of Biofeedback
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
Precautions of Biofeedback
Stress Fx, hypertension, anxiety disorder, mental confusion
119
Radiating pain is similar to referred pain except it ?
Travels along a nerve
120
What does cutaneous pain feel like?
It is sharp, bright and burning with fast and slow onset
121
Where does deep somatic pain originate?
Originates in tendons, muscles, joints, peritoneum and blood vessels
122
Where does visceral pain begin?
It begins in organs and is diffused at first and may become localized
123
Where is psychogenic pain felt?
It is felt by the individual but it is more emotional rather than physical
124
What are some potential causes of chronic pain?
Changes in sympathetic nervous system, changes in adrenal activity, reduced production of endogenous opioids and sensitization of primary afferent and spinal cord neurons
125
The structures most sensitive to damaging (noxious) stimuli are?
Periosteum, joint capsule, subchondral bone, tendon, ligments, muscle, cortical bone and synovium, articular cartilage
