Thermotherapy Flashcards

1
Q

True or False:

Humans are hemotherms

A

True

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2
Q

What does being a hemotherm mean

A

We are able to maintain our core temperature at a constant temp

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3
Q

What is the normal core temperature

A

98.6

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4
Q

What is diunral changes

A

Lower core temp in the am vs pm

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5
Q

True of False:

Older people tend to have lower core temperatures

A

True

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6
Q

What is the outside of the body referred to as

A

The shell

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7
Q

What is heat

A

Energy in transit from a higher temperature object to a lower temperature object

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8
Q

What type of energy is kinetic energy

A

Thermal energy

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9
Q

True or False:

Thermal potential energy remains constant so long as the phase of matter does not change

A

True

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10
Q

True or False:

Once water hits 32 the temperature remains the same until all of the water is frozen or melted

A

True

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11
Q

What is latent heat of fusion

A

The amount of heat required to convert a certain unit of a solid into a similar unit of a liquid without changing temperature

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12
Q

True or False:

A gel pack is able to withdraw more heat from the body compared to an ice pack

A

False

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13
Q

Why does an ice pack remove more heat than a gel pack even if the gel pack is colder

A

Due to the phase change of the ice pack

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14
Q

What temperature is considered extremely cold

A

32-55 F

1-13 C

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15
Q

What temperature is considered cold

A

55-65 F

13-18 C

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16
Q

What temperature is considered cool

A

65-80 F

18-27 C

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17
Q

What temperature is considered tepid

A

80-92 F

27-33.5 C

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18
Q

What temperature is considered neutral

A

92-96 F

33.5-35.5 C

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19
Q

What temperature is considered warm

A

96-98 F

35.5-36.5 C

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20
Q

What temperature is considered hot

A

98-104 F

36.5-40.0 C

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21
Q

What temperature is considered extremely hot

A

104-113 F

40-46 C

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22
Q

What is maximum tolerance

A

113-115 F

45-46 C

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23
Q

What is the first law of thermodynamics

A

Energy can neither be created nor destroyed it can only change from one state to another

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24
Q

What is specific heat

A

The amount of energy required to raise the temperature of a given material by 1 C

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25
Q

Specific heat can be seen as an objects ability to what

A

Store heat

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26
Q

What does a higher specific heat mean

A

It can store a higher amount of heat

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27
Q

How long does it take for a hot pack to heat up again

A

30 minutes

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28
Q

What is conduction

A

The exchange of energy between 2 materials at different temperatures due to the direct collision between molecules

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29
Q

When does heat transfer stop

A

When the molecular movements of both objects is the same speed

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30
Q

What does the rate of heat transfer (ROHT) by conduction depend on (4)

A
  1. Temperature difference between materials
  2. Their thermal conductivity (ability to transmit heat
  3. The area in contact
  4. Tissue thickness
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31
Q

What temperature is the water that the hot packs are kept in

A

155-165 F

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32
Q

What is convection

A

The transfer of heat as the result of direct contact between a circulating medium and another material of a different temperature

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33
Q

In convection heat transfer is the thermal agent in constant motion or static

A

Constant motion

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34
Q

Examples of convection heat transfer (5)

A
  1. Whirlpool
  2. Fluidtherapy
  3. Blood
  4. Oven
  5. Central air
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35
Q

What is conversion

A

Converting a non thermal form of energy into heat

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36
Q

What are the 2 types of conversion heat transfer

A

Mechanical and chemical

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37
Q

Examples of mechanical conversion heat transfer (2)

A

Ultrasound and friction

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38
Q

Examples of chemical conversion heat transfer (1)

A

Acid on metal

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39
Q

In conversion heat transfer what does the ROHT depend on

A

Power of the energy source

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40
Q

Does conversion heat transfer require direct contact

A

No

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41
Q

What is radiation heat transfer

A

Direct transfer of energy without direct contact or intervening medium

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42
Q

What does the rate of temperature increase depend on for radiation heat transfer (5)

A
  1. Intensity of radiation
  2. Relative size of the radiation source
  3. Relative size of the radiated area
  4. the distance of the source to the target tissue
  5. The angle of the radiation source to the target tissue
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43
Q

True or False:

A material must absorb energy before it can evaporate

A

True

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44
Q

What is thermotherapy

A

The therapeutic application of heat

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45
Q

How is thermotherapy used in rehabilitation (4)

A
  1. Hemodynamic effects
  2. Neuromuscular effects
  3. Metabolic effects
  4. Altered tissue extensibility
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46
Q

What is hemodynamics

A

What is happening within the bloodstream

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47
Q

What does thermotherapy do to blood vessels

A

Causes vasodilation which increases blood flow

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48
Q

What does stimulation of cutaneous thermal receptors lead to (2)

A
  1. Vasodilation

2. Increased production and release of histamine, bradykinin, prostaglandins, and nitrous oxide

49
Q

Briefly describe the pathway of a stimulation of a thermal receptor to smooth muscle contraction (5)

A
  1. Stimulated thermal receptor
  2. Projects through dorsal root ganglion
  3. Synpase on interneurons
  4. Inhibits sympathetic activity
  5. Relaxes smooth muscle
50
Q

Why do the blood vessels vasodilate

A

To prevent excessive heating and tissue damage

51
Q

How does vasodilation prevent excessive heating

A

Increased blood flow which removes heat via convection

52
Q

How does thermotherapy effect nerve conduction velocity

A

Increases it by 2m/sec for every 1.8 F (1 C)

53
Q

What is the neuromuscular effects when you increase the muscle temperature to 108 F (42 C) (3)

A
  1. Decreased firing rate of type II muscle spindle efferents and gamma efferents
  2. Increased firing rate of type 1b fibers and GTO
  3. Results in decreased firing rate of alpha motor neuron
54
Q

What does a decrease in alpha motor neuron firing cause

A

Decrease in muscle contraction (spasm)

55
Q

Does thermotherapy increase or decrease pain threshold

A

Increase

56
Q

How does thermotherapy increase pain threshold (2)

A
  1. Directly by activation of spinal gate

2. Indirectly by reduction in ischemia and muscle spasm and facilitation of tissue healing

57
Q

What does thermotherapy do in demyelinated peripheral nerves (1)

A
  1. Shortens the time Na+ channels are open which decreases conduction time
58
Q

True or False:

Thermotherapy causes a decrease in muscle strength for the first 30 minutes after superficial or deep heating

A

True

59
Q

How does thermotherapy effect the firing rate of type 1a muscle spindle efferents and gamma efferents

A

Decreases firing rate

60
Q

How does thermotherapy effect the firing rate of type 1b fibers and GTO

A

Increases firing rate

61
Q

How does thermotherapy effect the firing rate of alpha motor neurons

A

It decreases firing rate which decreases strength

62
Q

After the first 30 minutes what happens to muscle strength during the next 2 hours

A

Returns then increases to above pre-intervention levels

63
Q

True or False:

Thermotherapy causes an increase in endothermic chemical reaction rate including enzymatic biological reactions

A

True

64
Q

How much does enzyme activity increase from 102-109 F

A

13% for every 18 F rise in tissue temp

65
Q

What happens to enzyme activity after 113 F

A

It begins to decrease

66
Q

At what temperature does the enzyme activity cease

A

122 F

67
Q

What does increased oxygen uptake result in

A

Accelerated healing

68
Q

How does thermotherapy effect collagenase

A

It increases the activity of collagenase which may increase destruction of articular cartilage in RA

69
Q

How does heat shift the oxygen hemoglobin dissociation curve

A

To the right which makes more O2 available for healing

70
Q

How does thermotherapy effect altered tissue extensibility (3)

A
  1. Decreases fluid viscosity
  2. Decreases joint and muscle stiffness
  3. Relaxes cross linked collagen fibers
71
Q

How do you achieve plastic deformation in altered tissue extensibility with thermotherapy

A

Increase tissue temperature to 104-113 F for 5-10 minutes

72
Q

What are 3 uses for thermotherapy

A
  1. Pain control
  2. Increase ROM and decreased joint stiffness
  3. Accelerated healing
73
Q

What are 3 types of thermotherapy

A
  1. Moist hot packs
  2. Paraffin bath
  3. Infrared lamps
74
Q

What is the use of moist hot packs

A

Superficial heating of tissue

75
Q

How does a moist hot pack heat tissue and how deep does it penetrate

A

Via conduction and 1 cm max depth

76
Q

What is a moist gel pack made of

A

Canvas filled with silica gel

77
Q

Where are moist hot packs stored and temp of water

A

Hydrocollator at 160 F

78
Q

How long does it take a moist hot pack to heat up

A

20 minutes

79
Q

How long does a moist hot pack retain heat

A

About 20 minutes

80
Q

What is the target temperature you want to heat tissue to with moist hot packs

A

105.8-113 F

81
Q

How long does it take for the moist hot pack to heat the tissue

A

8-10 minutes

82
Q

How long does it take the body to reach thermal equilibrium after application of a moist hot pack

A

30 minutes

83
Q

What is the purpose of moist hot packs (3)

A
  1. Provide analgesia and reduce pain
  2. Increase ROM and decrease joint stiffness
  3. Accelerate healing
84
Q

What are the physiological effects of moist hot packs (5)

A
  1. Muscle relaxation via effects on muscle spindle and GTO
  2. Sedation of sensory nerve endings
  3. Increased capillary pressure and cell permeability
  4. Increased extensibility of connective tissue
  5. Increased body temp, pulse, and decreased BP
85
Q

What are the indications for moist hot packs (4)

A
  1. Impairments associated with sub acute and chronic conditions
  2. Tissue contractures/adhesions
  3. Joint stiffness
  4. Stimulate perspiration to improve conductivity
86
Q

What are contraindications for moist hot packs (9)

A
  1. Acute inflammatory disorders
  2. Fever
  3. Malgnancies
  4. Active bleeding
  5. Cardiac insufficiency
  6. Older patients and children under 4
  7. Peripheral vascular disease (PVD)
  8. Existing edema
  9. Tissues devitalized by x-ray therapy
87
Q

What are the advantages to moist hotpacks (2)

A
  1. Relatively safe

2. May effectively treat local areas

88
Q

What are the disadvantages to moist hotpacks (2)

A
  1. Weight of some MHP

2. Treatment area is not readily visible

89
Q

What is the maximum depth of heat penetration of paraffin baths

A

1 cm

90
Q

What is a paraffin bath

A

Tank containing a mixture of medical paraffin wax and mineral oil

91
Q

How are the 2 ingredients of a paraffin bath mixed

A

5lbs wax to 1 pint of oil

92
Q

What is the melted wax temperature kept at

A

125-127 F

93
Q

Is the specific heat of paraffin high or low

A

Low

94
Q

The therapeutic purpose, physiological effects, indications, contraindications are the same as moist hot packs

A

PERFECT

95
Q

What are the advantages to paraffin baths (2)

A
  1. Useful in treating chronic orthopedic conditions of the distal extremities
  2. Aid in softening skin
96
Q

What are the disadvantages of paraffin baths (3)

A
  1. Provides 6 times the amount of heat in water increasing risk of burns
  2. Can be messy
  3. Cleaning tank is difficult
97
Q

What is the max depth of heat penetration for infrared lamps

A

1 cm

98
Q

Where is most of the heat generally absorbed

A

first 1-3 mm

99
Q

What are the 3 classifications of infrared lamps

A
  1. IR-A (most common)
  2. IR-B
  3. IR-C
100
Q

What are the wavelengths of IR-A (short or near IR)

A

770-1400 nm

101
Q

What are the wavelengths of IR-B (middle IR)

A

1400-3000 nm

102
Q

What are the wavelengths of IR-C (long or far IR)

A

3000-10 to the 6th

103
Q

What is the IR generated by luminous lamps

A

IR-A

104
Q

What are the IR generated by nonluminous lamps (2)

A
  1. IR-B

2. IR-C

105
Q

What is an infrared lamp

A

Lamp or baker that generates infrared radiation

106
Q

Tissue temperature rise (TTR) is proportional to what (5)

A
  1. Amount of radiation absorbed
  2. Power and wavelength of source
  3. Distance of the source to the tissues
  4. Angle of incidence of the radiation
  5. Absorption coefficient of the tissue
107
Q

Most infrared lamps deliver power in a range of what

A

50-1500 watts

108
Q

What is clinically used wavelength

A

780-1500

109
Q

What wavelength does human skin allow maximal penetration

A

1200 nm

110
Q

What types of tissue absorbs IR radiation best high or low absorption coefficient

A

High absorption coefficient

111
Q

What color skin has a higher absorption coefficient

A

Dark skin

112
Q

How is heat produced in a luminous lamp

A

By the resistance to an electric current as it passes through a tungsten or carbon filament

113
Q

What type of light does a luminous lamp produce

A

Visible bright white light (IR-A)

114
Q

What is the power output of luminous lamps

A

60-1500

115
Q

Is there a warm up period required for a luminous lamp

A

Nope

116
Q

Therapeutic purpose, physiologic effects, indications, and contraindications are the same as moist hot packs

A

PERFECT

117
Q

What are the advantages of infrared lamps (2)

A
  1. Does not require contact with the patient

2. Can see the area being treated during the session

118
Q

What are the disadvantages of infrared lamps (3)

A
  1. Ensuring uniform heating is difficult
  2. Glare may irritate patient
  3. Hard to localize a treatment area
119
Q

What are the reasons to use thermotherapy as an intervention (6)

A
  1. Increase local blood flow
  2. Relax muscle spasm
  3. Increase tissue temperature
  4. Increase local tissue extensibility
  5. Modulate pain
  6. Promote tissue healing