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Passive Care > Test 1 > Flashcards

Test 1 Flashcards

1
Q

Electro physical agents

A

Electrophysical and biophysical energies for the purpose of treatment and prevention of impairments, activity limitations and participation restrictions

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2
Q

Examples of mechanical energy

A

Massage
Traction
Continuous passive motion

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3
Q

Top reasons people go to chiropractors

A

Low back/pelvis
Neck
ADLs
Overuse/repetitive injuries

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4
Q

What are the 4 stages of healing

A

He most asks
Inflammatory
Proliferation
Remodeling/maturation

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5
Q

3 stages of healing

A

Inflammation
Repair
Remodel

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6
Q

Inflammatory phase

A

Aka Acute phase
Immediate to a few days after
Defending against foreign intruders and remove damaged tissue

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7
Q

How is the inflammation stages characterized

A

Vasodilation
Increased capillary permeability
Phagocytosis by neutrophils and macrophages

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8
Q

What inflamamatory chemicals cause pain

A

Bradyokinin, prostaglandins, and serotonin

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9
Q

Secondary enzymatic injury

A

Lysosomal enzymes released
Non-specific
Healthy tissue damaged

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10
Q

Secondary hypoxic injury

A

Hemorrhage, clotting, edema, spasms, hematoma
Deceased o2 and nutrition
Damage surrounding uninsured tissue

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11
Q

PRICE and what’s its goal

A 
Protect
Rest
Ice
Compress
Elevate

Preserve ROM

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12
Q

Proliferative phase

A

Aka repair phase
Angiogenesis
Fibroblasts, chondroblasts and osteoblasts

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13
Q

Goals in the proliferation/repair phase

A

Decrease swelling, pain
Increased pain free ROM
Provide protective support
Encourage proliferation

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14
Q

Remodeling phase

A

Aka maturation phase
Scar contraction and loss of ROM
Decrease BV
Type III collagen replaced by Type I

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15
Q

Goals in remodeling phase

A

Regain full strength
Normal biomechanics
Protect and strengthen

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16
Q

Tension on CT causes

A

Increased collagen diameter, # fibrils, # cross-linking and density

Organized in parallel fashion

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17
Q

Care done during remodeling/maturation phase

A

Stretching
Strengthening
Proprioceptive training
Task specific skills

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18
Q

What are some things electrical stimulation can do

A 
Decrease pain
Decrease spasm
Reduce edema
Simulate contraction
Healing
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19
Q

What does electricity require

A

Source of electrons
Driving force (imbalance)
Path (conductor)

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20
Q

Voltage is like a what?

A

Waterfall

As height increases potential energy increases

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21
Q

What are the two types of currents

A

Monophonic and biphasic

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22
Q

Monophonic current

A

One direction

Aka DC current/Galvanic current

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23
Q

Aka galvanic current

A

Monophonic current

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24
Q

Biphasic current

A

Flow of electrons changes directions regularly

Aka AC current

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25
Q

What shape is Monophysite current wave

A

Square

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26
Q

What shape is biphasic current

A

Sinusoidal, square, rectangular, triangular

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27
Q

Phase duration

A

Time it takes current to leave isoelectric line to when it returns

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28
Q

Phase duration for monophasic current

A

Phase duration and pulse are the same

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29
Q

Phase duration for biphasic (AC)

A

Two phase durations for each pulse

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30
Q

What do tissues respond to? Phase or pulse?

A

Phase duration

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31
Q

What are A-B fibers?

A

Light touch sensation
“Tingly” feeling
Close to skin and has lower threshold so stimulated first

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32
Q

Does tissue pay more attention to average current or to peak current?

A

Average

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33
Q

Strength duration curve

A

Relationship between amplitude and duration

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34
Q

Why is the strength-duration curve important?

A

Charge must overcome the capacitance of a nerve fiber to depolarize just like if amplitude is too low, no depolarization will occur no matter the duration

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35
Q

Pt reports tingling but no muscle twitch

A

Alpha-beta fibers are exceeded

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36
Q

Patient reports muscle contraction

A

Alpha motor neurons exceeded

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37
Q

Burning, meddling sensation

A

Exceeded alpha-delta fiber capacitance

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38
Q

Rheobase

A

Minimum amplitude needed to depolarize a nerve fiber when phase duration is infinite

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39
Q

Corona is

A

Time or phase duration required to depolarize a nerve fiber when the peak current is twice rheobase

Aka twice the amplitude needed to depolarize a nerve fiber

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40
Q

What is the rate limiting factor of the number of impulses that can be generated by a nerve

A

Absolute refractory period

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41
Q

Summation

A

Force from two twitches with no relaxation after 1st twitch

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42
Q

What frequency do you get fused tetanus

A

50pps

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43
Q

What frequency do you target slow twitch fibers

A

35pps

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44
Q

Frequency that there is no pain in nerves and stops depolarizing

A

> 1000pps

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45
Q

What frequency does IF generate

A

4000-5000hz

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46
Q

What frequency does Russian current generate

A

2500hz

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47
Q

Unequal size electrodes will concentrate current in which electrode>

A

The smaller electrode

Gives an “intenser” feeling

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48
Q

When pads are placed close together current is most concentrated where?

A

Superficial tissues

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49
Q

When pads are placed further away from each other where is current concentrated?

A

Deeper tissues

50
Q

Types of interferential current

A

True interferential
Premodulated
Vector scan
Sterodynamic

51
Q

How many electrodes for IF?

A

4 electrodes

52
Q

Heterdyne

A

Combo of constructive and destructive that leads to a wave with a “beat” effect

53
Q

Determine frequency of heterodyne?

A

Difference between the two waves

54
Q

Compare and contrast IF vs premod as far as interference

A

Interference occurs in machine in pre-mod

55
Q

What is pre-mod good for?

A

Pain relief of small area

Ex: one muscle/group

56
Q

Indications for IFC

A

Pain reduction
Muscle strengthening/re-education (pelvic floor)
Slow bowel transit*

57
Q

Frequency/beat for IFC for acute

A

80-150

58
Q

Beat frequency for chronic for IFC

A

1-15

59
Q

Amplitude for IFC

A

“Patient comfort”

60
Q

What fibers are targeted in acute pain with IFC

A

AB fibers
80-150hz
No muscle contraction

61
Q

What fibers are targeted in chronic IFC

A

A-delta fibers
1-15hz
Some muscle twitch

62
Q

Frequency for sub-acute IFC

A

1-150hz

63
Q

Time for IFC

A

15-20 min

64
Q

What fibers are targeting in sub-acute pain for IFC

A

Ab and alpha-delta fibers

65
Q

How does Russian current work?

A

Makes use of duty cycles to cause muscle contraction for muscle strengthening

66
Q

Indications for Russian stimulation

A

Muscle re-education
Retard atrophy
Muscle strengthening
Decrease spams via fatigue

67
Q

Burst frequency for Russian current

A

50hz—temporal summation

Means wave is interrupted 50 times per second

68
Q

Burst frequency for muscle strengthening

A

10sec on/50 sec off

69
Q

Burst frequency for muscle fatigue

A

10:10

70
Q

16.7% duty cycle for what>

A

Russian current for
Reduce atrophy
Re-educate muscle
Muscle strengthening

71
Q

Ramp time for Russian current

A

0.5-2 seconds

72
Q

Electrode placement for Russian current

A

Along fibers of same muscle/group

73
Q

Describe co-contract in regards to Russian current use

A

2 channels, 4 electrodes

For muscles that contract together ex: paraspinals

74
Q

Describe reciprocal contraction in regards to Russian current

A

2 channels, 4 elcectrodes
Agonist/antagonist muscles
1 channel on one muscle group, another on the other

75
Q

What is the duration of Russian current for strengthening muscle

A

10 minutes

76
Q

What is the duration for Russian current for fatiguing muscle

A

20 minutes

77
Q

What is the intensity for Russian or biphasic pulsed current?

A

Patient TOLERANCE

78
Q

NMES goal

A

Stimulate alpha motor neurons causing strong contraction to retrain lost muscle function, decrease atrophy, or decrease spasm

79
Q

Physiological vs electrical muscle fiber contractions

A

Physiological: slow twitch are contracted first with asynchronous firing to produce a continuous contraction. Slow to fatigue

Electrical: large diameter fast twitch fibers recruited first because of their lower capacitance. Recruited synchronously. Fast to fatigue

80
Q

What currents are used for NMES

A

Russian current and biphasic pulsed current and interferential (pelvic floor muscles only)

81
Q

What is the waveform with Russian current

A

Sine wave

82
Q

What is the waveform with biphasic pulsed current

A

Square wave

83
Q

What does TENS stand for

A

Transcutaneous electrical nerve stimulation

84
Q

What is TENS

A

Stimulation of nerves through the skin

85
Q

What is TENS used for

A

Modification of neurological aspects of pain

86
Q

Sensory level TENS

A

Targets AB fibers (acute)
Tingling
Pain

87
Q

Duty cycle for TENS sensory

A

None

88
Q

Motor level TENS

A

Depolarization of alpha-motor neurons
For subacute and CHRONIC
No duty cycle

89
Q

Noxious level TENS

A

Stimulates C-fibers
Elicits pain relief through endogenous opiates
Often used on trigger points in brief-intense mode
Phase duration: 10-20ms

Thx time: 30 seconds per point to maximum tolerable
8-10 points per session

90
Q

Indication for ESTHR (electrical stimulation for tissue healing and repair)

A

Stimulate healing

91
Q

Indications for hi volt

A

Stimulate healing
Reduce edema
Decrease spasm/guarding

92
Q

Galvanotaxis effect

A

Induce cell migration

93
Q

What cells are attracted in the galvantotaxis effect/cell migration

A 
Fibroblasts
Epidermal cells
Keratinocytes
Macrophages 
Neutrophils
94
Q

What polarity do you want during proliferative phase/repair phase?

A

Negative (cathode)

95
Q

What cells does a negative/cathode attract?

A

Fibroblasts
Epidermal cells
Keratinocytes

96
Q

What polarity do you want during acute/inflammatory phase?

A

Positive (anode)

97
Q

What cells are attracted to a positive polarity (anode)

A

Neutrophils

Macrophages

98
Q

What can you use for edema reduction?

A

HiVolt

99
Q

What is the polarity in HiVolt for edema reduction

A

Negative

100
Q

How do you set up electrodes for edema reduction on HiVolt

A

2electrodes

Around edema with dispersal pad proximal

101
Q

What is the preferred treatment for muscle spasm reduction

A

Russian current

102
Q

What is preferred for pain reduction

A

Interferential

103
Q

What is the frequency for HiVolt

A

1-200hz

104
Q

Does the dispersive pad attract cells?

A

No

105
Q

Mono polar electrodes in HiVolt

A

Active pad and dispersal pad

106
Q

Bipolar electrode placement for Hivolt/Microcurrent

A

2 electrodes that each attract cells

107
Q

What is a unique contraindication for HiVolt/ESTHR

A

Osteomyelitis

108
Q

In monophasic current for ESTHR, does positive polarity attract acids or bases?

A

Acids

Cl-/HCl

109
Q

Negative polarity attracts acids/bases?

A

Bases (Na+/NaOH)

110
Q

Low volt current polar and vasomotor responses

A

Acids attracted to positive pole

Bases attracted to negative pole

111
Q

Iontophoresis

A

Local transfer of ionized substances such as drugs across the skin

112
Q

Relationship of charge of active electrode and dissolved substance for iontophpresis

A

Polarity of active electrode should be the same as that of the dissolved substance

113
Q

Dosage in iontophoresis

A

Amplitude x treatment time

114
Q

Phase

A

Current flow in one direction

115
Q

Pulse duration

A

Equal to phase duration for DC current and 2x phase duration for AC current

116
Q

Burst

A

Series of successive pulses of cycles over a period of time

117
Q

Burst duration

A

Time between beginning of 1st and end of last cycle or pulse

118
Q

Beat

A

The resulting current waveform when 2 or more sinusoidal waves intersect with each other

119
Q

Train

A

Continuous series of pulses, cycles, or bursts or beats over time

120
Q

Modulation

A

Changes in amplitude, pulse duration, pulse frequency or a combination of these for prevent nerve accommodation to stimulation

Passive Care (7 decks)

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