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Passive Care > Test 2 > Flashcards

Test 2 Flashcards

1
Q

Starting with cryotherapy

A

N

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2
Q

Conduction

A

Direct contact

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3
Q

Examples of conduction

A

Ice massage
Cold pack
Ice bath
Cold water

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4
Q

Convection

A

Air or water particles move across the body part causing cooling

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5
Q

Example of convection

A

Cold whirlpool

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6
Q

Evaporation example

A

Vapocoolant spray

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7
Q

Cryotherapy

A

Application of cold for therapeutic purposes

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8
Q

Cryokinetics

A

Combination of cold and exercise

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9
Q

CIVD-cold induced vasodilation aka?

A

Hunting response (hunting-Lewis response)

Cold induced vasodilation

Increased tissue temperature during cold therapy approx. 15 minutes into treatment then alternates. But never above baseline

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10
Q

Goals of cryotherapy

A
  • relieve of decrease pain
  • decrease blood flow and metabolism
  • protect injured tissue
  • decrease muscle spasm
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11
Q

Contraindications to cryotherapy

A
  • impaired cold sensation
  • cold-induced urticaria (allergy)
  • Raynaud’s disease
  • cryoglobulinemia
  • paroxysmal cold hemoglobinuria
  • open wounds
  • peripheral vascular disease
  • confused/unreliable patients
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12
Q

Cryoglobinemia

A
  • abnormal clumping of plasma proteins stimulated by cold application
  • leads to skin discoloration and dyspnea
  • associated with multiple myeloma
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13
Q

What is cryoglobinemia associated with

A 
Multiple myeloma
Walden storm macroglobulinemia
Chronic liver disease
Infections
Coexistence connective-tissue diseases like SLE, Sjogren syndrome
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14
Q

Aka for cold induced hemoglobinuria and info

A

Paroxysmal cold hemoglobinuria

  • cold activates antibody to to RBCs causing lysis and excess hemoglobin is excreted in the urine
  • dark urine and back pain

Acute disease MC in young child ex: URI
Chronic disease MC in elderly ex: neoplastic or infectious

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15
Q

Risks of cryotherapy

A 
Impaired circulation
Thoracic area in patients with CAD
HTN patients
Cardio disorders (take BP before, after, during)
Superficial peripheral nerves
Hemiplegic
Very young/old
Obesity( increased risk of frostbite)
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16
Q

How does ultrasound work (type of waves)

A

Uses sound waves at high frequencies to heat muscles, tendons, ligaments etc.

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17
Q

What is the Mc deep heating modality

A

Ultrasound

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18
Q

How does ultrasound work

A

Electrical current passed through a crystal causing it to vibrate. Vibration generates sound waves

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19
Q

What type/thickness of crystal used in ultrasound

A

Quartz, lead etc. very thin. 2-3mm

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20
Q

Frequency of ultrasound

A

~1 million HZ (1MHz-3.3Mhz)

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21
Q

What is duty cycle

A

Time sound is delivered by divided by total treatment time

100% continuous
50%/20% are Mc pulsed duty cycles

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22
Q

When it continuous ultrasound used

A

Tissue healing

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23
Q

When is pulsed ultrasound used

A

Mechanical/non-thermal effects

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24
Q

Piezoelectric effect

A

Mechanical deformation of a crystal causes and electrical current to form

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25
Q

Reverse piezoelectric effect (indirect)

A

Alternating current is passed through a crystal resulting in fast contraction and expansion of the crystal

—> produces high frequency sound waves

*requires high voltages

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26
Q

Near field aka and distance

A

5cm into tissues
Treatment area
Fresnel zone

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27
Q

Far field and aka for ultrasound

A

Fraunhofer zone
2ndary Tex affect

Deeper than 5cm/tissue

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28
Q

Spatial peak intensity

A

Peak intensity of max intensity

Watts/cm2

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29
Q

Spatial average intensity

A

Average intensity

Isp x duty cycle

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30
Q

ERA (effective radiating area)

A

Area of the sound head that produces sound energy (smaller than ultrasound head)

*ideally only a bit smaller

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31
Q

Beam nonuniformity ratio (BNR)

A

Amount of variability of the beam

Ratio between the peak intensity of the ultrasound mean divided by the average intensity sound beam

Used to compare quality between machines

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32
Q

What is ideal BNR (beam nonuniformity ratio)

A

1:1 within the range of 2:1-8:1 acceptable

**peak intensity: avg intensity

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33
Q

A lower BNR means what

A

more uniform the intensity of the sound wave

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34
Q

Benefits of lower BNR

A

Eliminate hot spot
Higher dosage without discomfort
Greatest comfort/safety

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35
Q

PAMBNR (peak area of the maximum beam nonuniformity ratio)

A

Area of sound head covered by peak intensity

Large: larger area of sound head; less uniform heating
Small: small area

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36
Q

Why is gel used in ultrasound

A

It prevents reflection of sound waves by air bc air is a poor conductor

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37
Q

More watts during ultrasound causes what

A

More heating NOT greater penetration

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38
Q

In ultrasound what does frequency affect

A

Depth

Time required to cause increase in tissue temperature

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39
Q

High and low frequency for ultrasound effects and indications

A

High: 3.3MHz- absorbed more rapidly affects superficial tissues

Low: 1.1MHz-absorbed slower and affects deeper

40
Q

Continuous US

A

More sound energy delivered and absorbed so treated tissue healing

41
Q

Scattering affect with ultrasound

A

When US encounters a boundary between tissues energy scatters by reflection or refraction

42
Q

Reflection

A

Reversal of direction of ultrasound wave at soft-tissue-bone interface and leads to increased heating

**tissues close to bone receive increased dose

43
Q

Refraction

A

Change of ultrasound wave from a straight path when passing obliquely from one medium to another

Lead to concentrations of US at point of refraction ex: tendon joints bone

44
Q

Effects of ultrasound

A

-tissue healing due to increase in metabolic activity and blood flow

45
Q

Increase in 1, 2-3 and 4 C effects with ultrasound

A

1- increased metabolic activity
2-3: reduction of muscle spasm, increased blood flow, reduced chronic inflammation
4: alters viscoelastic properties of collagen

46
Q

Relationship with ultrasound and treatment time and tissue healing

A

Longer time needed when lower intensity used

47
Q

Therapeutic effect of ultrasound

A
  • increase extensibility of collagen of tendons/j-capsule and synthesis
  • increased blood flow
  • increased cell metabolism
  • decreased joint stiffness and muscle spasm
  • enhanced tendon, lig, and muscle healing
48
Q

Non thermal effects of ultrasound

A

Pulsed ultrasound

  • stimulation of fibroblast activity
  • increased blood flow
  • increased proteins associated with injury repair

Through acoustical streaming and stable cavitation

49
Q

Acoustical streaming

A

Movement of fluids along cell membranes due to mechanical pressure exerted by sound waves

Movement is in direction of sound waves
-increased cell membrane permeability

50
Q

Cavitation

A

Formation of gas filled bubbles from pressure changes in tissue fluids

51
Q

Stable vs. unstable cavitation

A

Stable: rhythmic expansion and contraction of bubbles during repeated pressure changes over many acoustic cycles

Unstable: collapse of gas bubbles that may cause tissue damage. Associated with low frequency, high intensity ultrasound (not therapeutic)

52
Q

Contraindications of ultrasound

A 
Malignancy
Hemorrhage
Ischemia
Thrombus
Infection
Gonads
Eye
Pelvic abd, lumbar/pregnant
Eye
Spinal cord after laminectomy
Plastic and cemented implants (metal ok)
Near/over electronic implant
Unknown etiology
53
Q

Risks of ultrasound

A 
Bony prominence (use indirect/smaller head)
Epiphyseal plate
54
Q

What intensity not to exceed in ultrasound

A

8.0 W/cm2

55
Q

Treatment area of ultrasound

A

2-3x of the size of ERA

56
Q

Phonophoresis

A

Aka sonophoresis

Uses energy to drive medication into tissue

Medication doesn’t require charge

57
Q

Ultrasound and E-stim (combo)

A 
Useful potentially for:
Trigger point
Epicondylitis
Superficial pain areas
Decrease adhesions

Ultrasound head becomes the treated electrode when used with dispersal pad

**premod is used for pain relief in combo with mechanical pulsed/continuous US

58
Q

Low intensity pulsed US use?

A

Stimulation of fracture healing

59
Q

Noncontact low-frequency ultrasound (NCLFUS)

A

Would cleaning and debridement

Propels sterile saline across wound and stimulates healing

60
Q

What phase is targeted with 100%/continuous with heat for ultrasound

A

Repair phase

61
Q

What phase is targeting with 50%-pulsed-no heat with ultrasound

A

Acute phase

62
Q

What settings are used with repair phase with ultrasound

A

Continuous (100%) with heat

63
Q

What settings are used for acute phase for ultrasound

A

Pulsed (50%) no heat

64
Q

Chronic tendonopathies such as lat. epicondylitis and Achilles tendonosis are painful with ischemic and fibrotic changes of the tendon that may benefit from what treatment?

A

Thermotherapy with US in combination with premod

Decrease pain and increase circulation

65
Q

When is indirect/underwater ultrasound used

A

When the head won’t contact the skin flat

66
Q

What is pulsed, no heat used with ultrasound

A

Goal of increase healing in an acute patient

67
Q

When is continuous with heat for ultrasound used?

A

Goal of decrease muscle spasm, chronic pain, and increase healing

68
Q

When is combo US and premod IF used

A

Chronic tendonosis, trigger points or acute or chronic pain

69
Q

Depth of 1MHz and 3.3 MHz

A

1: 2-5cm

3. 3: 1-2cm

70
Q

Types of diathermy

A

Shortwave (MC) and microwave

71
Q

What is diathermy

A

High frequency electromagnetic energy

72
Q

Arndt-schultz law

A

Dose vs response

73
Q

Grotthuss-Draper law

A

Absorption vs therapeutic effect

74
Q

Inverse square law

A

Dose vs divergence

1/4 as much heat with 2x the perpendicular distance

75
Q

Indications of short wave diathermy

A 
Osteoarthritis
Neck/back pain
Ankle pain
Dermal wounds
Other musculoskeletal injuries/pain
76
Q

Contraindications (11) of short wave diathermy

A 
Loss of sensation
Electronic implants
Surgically implanted metal
Metal in contact with skin
Cancerous areas
Pregnant patients
Hemorrhagic areas
Ischemic areas
Testes
Eyes
Open growth plates
77
Q

Precautions with short wave diathermy

A 
Prenant operator shouldn’t be around daily and remain 3 feet away
Copper IUDs
Other patients keep 10 foot distance
Other EPA devices-10 feet
Mentally confused
78
Q

Types of electrodes with diathermy

A

Capacitive or inductive

79
Q

Capacitive electrode with diathermy

Targets what?

Use for who?

A

Produces electrical field

Targets low electrolyte/water content tissues such as adipose

Use on things patients are areas with low subQ fat like: knee, foot, hand, shoulder

80
Q

What areas should you use capacitance technique of diathermy

A

Low subQ fat—knee, foot, hand, shoulder

81
Q

Induction electrode with diathermy

Targets

Use on who

A

Produce a magnetic field

Greatest absorption in high electrolyte and high dipole tissue such as deep muscle, tendon, joint

Use on patients with more subQ fat/obese patients

82
Q

When should you use inductive technique for diathermy

A

Obese patients

Targets muscle, tendons, joints

83
Q

Clinical goals of diathermy

A

Decrease pain
Increase joint mobility
Increase would healing

84
Q

Application of diathermy

A

Test warm/cold sensation first
Remove jewelry
2-3cm layer towel between electrode and skin

85
Q

DIATHERMY LOOK UP

A
  1. 4 LAWS

2. CONTINUOUS VS PULSED INDICATIONS

86
Q

Light is transmitted as _____ and is packaged in “_____”

A

Waves

Photons

87
Q

Giving up energy is called?

A

Spontaneous emission

88
Q

Adding energy to electrons causes them to do what? The atom is in an ________ state. An excited atom will then do what? If that ______ interacts with another _____ _____ it will do what?

A

Move to higher orbit
Excited state

Excited atom releases a photon
If photons interacts with another excited atom, it will release another photon

89
Q

Population inversion

A

Number of excited atoms outweighs the number at ground state

90
Q

Pumping

A

Application of external source of power that causes population inversion

91
Q

Explain steps in production of laser

A 
Pumping of active medium
Population inversion
Spontaneous emission 
Stimulated emission
Amplification
92
Q

Coherence in laser

A

Same wavelength and all in phase

Light emitted in an organized fashion

93
Q

Monochromatic

A

Single color

AKA same wavelength

94
Q

Collimation in cold laser

A

Photons move in parallel fashion, they don’t diverge

95
Q

What wavelength gives deeper penetration

A

Longer—lower frequency gives deeper penetration

96
Q

As concentration of melanin or hemoglobin increase the depth of penetration of laser of the light _____?

A

Decreases

Passive Care (7 decks)

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