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PTI II > Thermal Physiology and Modalities > Flashcards

Thermal Physiology and Modalities Flashcards

1
Q

Decision making process

A

asses the pt

look at your toolbox of multiple modalities

determine the most appropriate modality

be sure to check the precautions and contraindications for the modality you are considering

check the parameters

is the modality cost effective?

will the modality allow for safety?

does the pt understand what the goals of the modality are?

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2
Q

indications for thermotherapy

A

sub-acute/chronic conditions

pain

decreased ROM

resolution of edema (post inflammatory phase)

myofascial trigger points

muscular conditions

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3
Q

could you use heat during the inflammatory phase

A

NO

most of the time use cold

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4
Q

contraindications of thermotherapy

A

acute musculoskeletal conditions (if the injury just occurred)

impaired circulation

vascular disease (PVD)

skin anesthesia (they can’t feel the heat)

open wounds or skin conditions

acute DVT

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5
Q

why don’t you want to use heat on an acute DVT

A

you don’t want to dislodge a clot and move it

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6
Q

physiological effects of local superficial heating on tissues

A

dilation –> increased circulation (blood flows throughout the body more efficiently)

reduction of sympathetic impulses –> increase blood flow to venous plexuses

increased metabolic rate

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7
Q

consensual heat vasodilation

A

remote vasodilation in response to heating

is a good response

joint/musculoskeletal tissue loosens, more effective when we use interventions

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8
Q

2 types of penetration

A

deep

superficial

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9
Q

what would we use to penetrate heat to deeper tissues

A

diathermy or ultra sound

increase tissue temp w/ increased blood flow

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10
Q

what would we use to penetrate heat to superficial tissues

A

hot pack

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11
Q

effects of heat

A

increase local temp

increased local metabolism

vasodilation

increase BF

increased release of leukocytes and phagocytes

increased capillary permeability

increased lymph and venous drainage

increased removal of metabolic waste

analgesia

decrease mm tone

decrease spasm

increased tissue elasticty

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12
Q

methods to apply therapeutic heat

A

hot pack (conduction)

paraffin bath (conduction)

fluidotherapy (convection)

infared (radiation)

hydrotherapy (convection)

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13
Q

what is conduction

A

heating up locally

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14
Q

what is convection

A

moving particles around

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15
Q

hot pack unit temp

A

166-175 F

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16
Q

how long does the heat pack stay on

A

15-20 minutes

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17
Q

how many layers of toweling for hot packs

A

6-12

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18
Q

what do we want to avoid with hot packs

A

the pt lying on the hot pack directly

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19
Q

what temp should the paraffin unit be at

A

126 F

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20
Q

how much more heat does paraffin provide than water

A

6x

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21
Q

what is the equipment used for paraffin

A

unit

towels

plastic bags

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22
Q

what’re the methods for applying paraffin

A

dipping

painting

submersion

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23
Q

how many layers do we apply of paraffin

A

6-10

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24
Q

how long do we use paraffin

A

20 minutes

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25
Q

how do we prepare the pt for paraffin treatment

A

ensure the body part is cleansed and dried (could use gel hand sanitizer)

inspect for any cuts, irritation, sensitivity or redness

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26
Q

can we reuse paraffin

A

yes

cleaner to just throw out and replace

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27
Q

what is the standard formula for infrared lamps

A

20 in for 20 minutes

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28
Q

equipment for IR

A

lamp

dry toweling

moist toweling

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29
Q

fluidotherapy machine

A

through convection

heats up a joint

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30
Q

physiologic effects of cold

A

decreased local temp

decreased metabolic rate

local vasoconstriction

decreased nerve conduction velocity

depressed excitability of free nerve endings and peripheral nerve fibers

control of pain

control of edema

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31
Q

in what stages of healing can we use cold

A

all 3 stages

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32
Q

how do we determine the extent of cooling to use

A

type of cooling method

duration of treatment

thickness of the surface its on

body part

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33
Q

cold physiology

A

initial response to cold is vasoconstriction

hunting’s response

hypothalamus induces shivering

arterial vasoconstriction result in increased blood pressure and heart rate

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34
Q

hunting’s response to cold

A

prevents local tissue damage secondary to vasoconstriction

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35
Q

indications to use cold

A

acute pain

edema

myofascial trigger points

muscle guarding and spasm

acute muscle strain

bursitis

tendinotis

DOMS

spasticity

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36
Q

contraindications of cold

A

impaired circulation

vascular disease (PVD)

hypersensitivity to cold

skin anesthesia

open wounds or skin conditions

infection

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37
Q

purpose of cutaneous circulation

A

nutrition

temp regulation

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38
Q

cutaneous blood vessel types

A

subcutaneous venous plexus

arteriovenous anastomoses

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39
Q

subcutaneous venous plexus

A

conduct heat to the skin surface

40
Q

arteriovenous anastomoses

A

maximal constriction at 59 F

below 59F, dilation caused by local effects of cold of the vessels

this produces paralysis of the contractile mechanism of the vessel wall or blockage of nerve impulses into internal vessels

always check on our pateints

41
Q

where are col, warm and pain receptors found

A

subendothelially

42
Q

what happens to pain receptors at extreme temps

A

transmit in response to possible tissue damage

43
Q

how do warm and cold receptors react

A

they readily adapt

44
Q

what happens when larger surface areas are treated

A

vasomotor centers and the hypothalamus are activated

45
Q

summary of the effects of cold

A

decreased local temp

decreased metabolism

vasoconstriction

decreased blood flow

decreased nerve conduction velocity

decreased mm extensibility

extreme anesthesia effects

46
Q

what are contrast baths used for

A

used for sub-acute swelling and pain

47
Q

what are contrast baths

A

having a hot and cold bath

going back and forth

48
Q

what does a contrast bath do

A

desensitizes and creates vasodilation/vasoconstriction response

49
Q

equipment for contrast baths

A

2 large containers

thermometer

towels

ice chips

50
Q

what is the hot contrast bath set to

A

80-104 F

51
Q

how long do you stay in the hot bath

A

at first 3-4 minutes, then 2-3 minutes every time, last time should be 5 minutes (end with it)

52
Q

what is the cold contrast bath set to

A

55-67F

53
Q

how long do you stay in the cold bath

A

2-3 minutes

54
Q

what do we do upon completion

A

check girth of skin

has the swelling gone down?

55
Q

do we always start with a larger degree change

A

no

it should be gradual

56
Q

ice massage

A

apply continuously until numb

watch for dripping water

position carefully

57
Q

how do we apply ice massage

A

in a circular pattern

each stroke should cover 50% of the previous stroke

58
Q

physiologic response to ice massage

A

cold

stinging

pain

numbness

59
Q

cold hydrocollator pack freezer temp

A

10-25 degrees

60
Q

how should we position the pt while using a cold hydrocollator pack

A

w/ protective toweling

body part in elevated position in the acute and subacute phase

61
Q

how long should treatment with a cold hydrocollator pack be

A

20 minutes

the pt has to be still

62
Q

what happens if a cold hydrocollator pack is left on for prolonged periods

A

decrease mm tone

63
Q

ice packs use

A

used for acute injuries to prevent additional swelling following exercise

wouldn’t be put directly on pts skin

64
Q

treatment with an ice pack

A

position pt

secure pack

cover w/ towel to prevent heat loss

up to 20 min

65
Q

what is hydrotherapy

A

“Water healing”

application of water for physical or psychological dysfunction

66
Q

types of hydrotherapy

A

whirlpool

hubbard tank

contrast baths

pool

non immersion irrigation devices

67
Q

indications for hydrotherapy

A

wound treatment

enhanced environments for therex

pain control/reduction

edema

health maitenance

68
Q

properties of water

A

high specific heat

thermal conductivity

buoyancy

resistance

hydrostatic pressure

69
Q

specific heat of water

A

4x that of air

water hold 4x as much thermal energy

things will heat up quicker in water

70
Q

thermal conductivity

A

25x greater than air

71
Q

modes of heat transfer

A

conduction

convection

radiation

72
Q

buoyancy

A

upward thrust on the body opposite to the force of gravity

73
Q

Archimedes principle

A

a body immersed or partially immersed in a fluid at rest experienced an upward thrust = to the weight of the fluid it displaces

different bodily tissue shave different specific gravity values

74
Q

resistance

A

increases in water

occurs against the direction of motion in proportion to the speed of the body’s motion and frontal area of the body in contact w/ the water

variable

75
Q

hydrostatic pressure

A

pressure exerted by a fluid on a body immersed in fluid

pascal’s law

76
Q

pascal’s law

A

fluid exerts equal pressure on all body surfaces at rest at a given depth and this pressure increased in proportion to the depth of immersion

as you get deeper in water, pressure increases

equal pressure on the body on all surfaces at rest

77
Q

uses of hydrotherapy

A

superficial heating/cooling

wound care

pain control

edema control

78
Q

contraindications for hydrotherapy

A

superficial heat and cold anesthesia

maceration around wound

bleeding

79
Q

precautions for hydrotherapy

A

impaired thermal sensation

infection in area to be immersed

impaired cognition/confusion

areas of recent skin grafts

80
Q

full body immersion precautions

A

confusion/disorientation

alcohol ingestion

medications

urinary incontinence

fear

respiratory problems (COPD, asthma)

81
Q

what happens to those with respiratory problems w/ full body immersion

A

extra pressure will be put onto the chest wall in water

82
Q

full body immersion contraindications

A

cardiac instability

possible spread of infection

bowel incontinence

severe epilepsy

suicidal

83
Q

whirlpool equipment

A

tank

agitator

stainless steal

many body part sizes

84
Q

how does cold whirlpool transfer hear

A

convection

85
Q

how will you know to use cold whirlpool

A

it will be indicated when exercise during icing is desired

86
Q

how long does one immerge in a cold whirlpool

A

5-15 minutes

87
Q

what is the temp of the cold whirlpool

A

65-80 degrees

88
Q

what should we be cautious about with cold whirlpool

A

gravity dependent positions can increase swelling

a wet compressive wrap should be put on the part prior to treatment

cover toes for comfort

stay with patient

89
Q

what is the most intense application of cold

A

cold whirlpool

90
Q

whirlpool temp ranges

A

cold whirlpool

tepid

neutral warmth

mild warmth

hot

very hot

91
Q

cold whirlpool

A

32-79F

acute condition

won’t usually go below 65F

92
Q

tepid

A

79-92

cannot tolerate colder

93
Q

neutral warmth

A

92-96F

open wound

94
Q

mild warmth

A

96-98F

burns

relax pt

95
Q

hot

A

99-104F

pain

increases extensibility

96
Q

very hot

A

104-110F

chronic condition

double check pt can tolerate

97
Q

documentation

A

type of modality used

pt position

temp of water

of dips, towels, distance, etc.

duration

outcome of response to treatment

BE SPECIFIC

ADD ANY CAHNGES DURING TREATMENT

PTI II (6 decks)

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