Tuttle-base Flashcards
What are modalities that cause deep heating?
US
SWD
MWD
What are modalitites that cause superficial heating?
Hydrocolator IR UV Parrifin Whirlpool LVG
What modalities are non-heat producing?
Sine wave stim. Pulsed US therapy Pulsed SWD IF HVG EMS TENS MENS
List the tissues from best conductor to worse conductor
Muscle - 72-75% water Fat -14% water Nerves - 5-16% water Bones - 5-16% Skin - 5-16%
What are the physiological effects of heat?
Increased metabolic rate (BMR) Increased capillary flow & filtration Increased nutrient supply to tissue Increased WBC & phagocytic activity Increased local perspiration rate Increased lymph flow along w/ blood flow
What are specific local effects of heat?
Increased threshold to pain receptors (analgesia)
Superficial BT(?) increase doesn’t mean deep BT(?) increase
Increased pain threshold of peripheral nerves
Decrease muscle spindle response to stress-relaxes myospasm
What are systemic effects of heat?
General increased perspiration via hypothalamus mechanism
Increased cardiac output & blood flow
Increased plasma volume
Decreased diastole blood pressure
Increased renal filtration –> increased urine loss
What advantage does moist heat have over dry heat?
More penetration
Low skin resistence
What are the 4 types of energy transfer?
Conduction
Convection
Conversion
Radiation
Type of energy transfer that requires physical contact, i.e. one warm body next to a cool body. Hot moist pack, ice pack, paraffin, etc.
Conduction
Type of energy transfer that requires a medium for transfer (air, water, etc.). Paraffin, whirlpool, etc.
Convection
Type of energy transfer that transforms one form of energy into another form of energy. US
Conversion
Type of energy transfer that uses heat through space w/o aid of media. UV, IR
Radiation
What are four types of hydrotherapy?
Regular whirlpool
Hubbard tanks - whole body immersion
Sitz bath
Contrast bath - residual bath (start w/ heat & end w/ heat)
What temp range is considered cold?
55-65f
What temp range is considered cool?
65-80f
What temp range is considered tepid?
80-93f
What temp range is considered warm?
93-98f
What temp range is considered hot?
98-105f
What temp range is considered very hot?
105-115f
What temp range is considered scalding?
> 120f
What are contraindications for whirlpool?
Heart disease
Past cerebral vascular accident
Acute circulatory disease
Bladder & bowel dysfunction
What are methods of cooling?
Conduction
Convection
Evaporation
What are contraindications of cryotherapy?
Raynaud’s
Hypersensitive to cold
Frost bite
What are the physiological effects of cryotherapy?
Decrease blood flow & muscle spasm
Vasoconstriction
If you tx w/ cryotherapy for longer than 20 mins what happens?
Hunting Reflex
What is the tx protocol for ice massage?
Time - 3-5mins
Speed 4” per second
What is the order of sensation felt w/ cryotherapy?
CBAN Cool Burn Aching Numbness
What are the two types of vapocoolant spray?
Flourimethane (tuttle’s spelling) - nonflammable, nontoxic, nonexplosive, not a general anesthetic
Ethyl Chloride - Flammable, toxic, explosive, can cause temporary blindness, local anesthetic
What are the 3 general effects of US?
Chemical
Physical
Thermal
Where in the body is US felt?
Interface b/w tissue (muscle & bone)
What are the types of crystals used in the transducer head of US?
Quartz (stable & best to use)
Barium Titanite (M/C)
LiSo4
What is the penetration range for US?
2.5cm - 8cm
How fast should you move the US head during tx?
2.5cm/1” per sec
What are potential problems w/ US?
Tissue cavitation
Soften bone
Periosteal burning
What are contraindications for US?
Epiphyseal growth plate open Reproductive organs Pregnant uterus Malignancy Acute infection Metallic implant
What is the tx time for US on acute conditions? chronic?
Acute - 5 mins
Chronic - 10 mins
What are the type of conducting media used w/ US?
Water (best)
Aquasonic gel
Polysonic Cream
Mineral oil (not to be used w/ ems)
What US settings do you use for Acute thin skin?
0.5-1.0 W/sq cm
What US settings do you use for Acute thick skin?
1.0-1.5 w/sq cm
What US settings do you use for chronic thin skin?
1.0-1.5 w/sq cm
What US settings do you use for chronic thick skin?
1.5-2.0 w/sq cm
When tx under water w/ US, how do you adjust the wattage & where do you place the sound head?
Raise the wattage by 0.5 per sq cm & hold sound head .5-1” away from tx area
What is the mixture in a paraffin bath?
1lb paraffin to 1oz mineral oil (7:1 ratio - straight from tuttle’s notes, doesn’t make sense b/c there are 16ozs in 1lb)
What is the temp range of paraffin?
125-130F
What are contraindications for paraffin?
Open wounds
Inflamed arthritis
Same as all heat modalities
What is the tx time for paraffin?
20-30 mins
What are the different application methods for paraffin?
Dip & wrap
Dip & leave
Painting
What is the depth of penetration for infrared?
2mm-10mm
What are the two types of sources for infrared heat?
Hydrocolators, whirlpool, paraffin, etc.
Lamp
What is the tx time for infrared?
20-40 mins
What are the effects of high volt stimulator (galvanic?)?
Decrease muscle spasm Decrease edema Decrease pain Increase circulation Muscle re-education Trigger point Tissue healing
What are contraindications for a high voltage stimulators?
Pacemaker Carotid sinus area Transcaranaly (I have no idea) Pregnancy Malignancy Impaired circulation
Type of opiates that are long acting, from pituitary, 3-5pps w/ muscle twitch.
Endorphins
Type of opiates that are short acting & released at 70-150pps
Enkephalins
What pole do you use for an acute condition?
Positive (more comfort to pt)
What pole do you use for chronic conditions?
Negative
What pps setting causes a muscle twitch?
<20pps
What pps setting causes motor tetany, non-fatiguing i.e. pumping effect, rehab, edema
20-70pps
How much airspace is need for SWD tx?
2”
What are the different grades of dosage for SWD?
Grade 1 - little to no sensation
Grade 2 - Warm comfortable sensation
Grade 3 - Intense
Grade 4 - Burning
How much airspace is used for MWD?
5-6”
What are two situations where you can’t use MWD?
Pregnant women
Can’t use on sinus (retinal detachment)
What are different types of traction?
Intermittent (10-30 mins) Constant (a minute to all day) Sustained or static Gravitational Positional Intersegmental
What is the angle of pull used in c-spine traction?
25-30 degrees (except C0-C1 which is 0 degs)
Type of UV that is bacteriocidal
UVC
Type of UV that is needed for Vit. D conversion
UVB
Type of UV that causes cancer
UVA
Pink coloring which appears 4-8 hours after UV test
MED (minimal erythemal dose)
What are the effects of the positive pole (anode) of LVG?
Attracts oxygen Acid environment Hardens tissue Dehydrates tissue Non-irritating Vasoconstricts Sedates Bacteriocidal
What are the effects of the negative pole (cathode) of LVG?
Attracts hydrogen Alkaline environment Softens tissue Liquefies Vasodilator Causes hyperemic reaction
How much larger should the dispersal pad be than the active pad w/ LVG?
dispersal pad is 3-5x active pad size
What is the ratio of milliamps to pad size w/ LVG?
1 milliamp per 1 sq. inch
In iontophoresis, what do you use Mg+ to tx?
DJD Disc RA Myositis Neuritis
In iontophoresis, what do you use Zinc (+) to tx?
Fungal
Allergies
Rhinitis
Acne otitis (I don’t know if he meant “acne” & “otitis media”. I don’t think there is something called acne otitis)
In iontophoresis, what do you use Histamine (+) to tx?
PVD
myospasm
In iontophoresis, what do you use hydro-cortisone (+) to tx?
RA
Bursitis
In iontophoresis, what do you use Hyaluronidase (+) to tx?
Edema
In iontophoresis, what do you use Salicylate (-) to tx?
RA
Myalgias
In iontophoresis, what do you use Iodine (-) to tx?
Adhesions
Fibrositis
What are the effects of massage?
Reflex - sedation
Mechanical - assists blood flow & lymph flow
What are contraindications of massage?
Vascular problems Infection Malignancy Skin ds Burn pts Acute conditions
What are the different strokes of massage?
- Effleurage - light to heavy stroking
- Petrissage - kneading/squeezing & friction
- Percussion/Tapoment - respiratory pts, trendelenburg position
- Friction, transfriction massage
- Trigger points
- Stretching, pnf, post isometric
Type of dynamic patellar brace, knee brace
Pulumbo
Type of brace used for an ACL injury. Worn 4-8 wks at 40-60 deg. flex.
Thompson splint
Type of brace used for ACL & PCL problems
Leroy Hill
Type of brace used for MCL & LCL problems
Anderson
What does “SAID” principle used in rehab stand for?
Specific
Adaptation to
Imposed
Demands
Type of exercise where there is muscle contraction w/o joint movement. Used for immobilized pts & for early rehabilitation. Least effective for increasing strength & bulk
Isometric
Type of exercise where there is muscle contraction w/ joint movement at a fixed weight
Isotonic
Two types of isotonic contractions?
Eccentric - negative work - muscle lengthens
Concentric - positive work - muscle shortens
Type of exercise where there is muscle contraction w/ joint movement at a constant speed
Isokinetic
Manual or mechanical resistance applied to cause inherent mechnical change during arc of motion & to coincide w/ skeletal layer system. Resistance increases as mechanical advantage increases
Variable resistance exercise (Nautilus)
Bodily movement to correct body impairment, improve musculoskeletal function or maintain state of well-being. Used for prevention of adhesions
Therapeutic exercise
What are 4 causes of adhesions?
Immobilizations
Edema
Trauma
Impaired circulation
What are the 4 types of ROM
Passive
Active Assistive
Active
Active Resistance
What are the 4 main categories of therapeutic exercise?
- Active - tone, circulation, improve structural dislocation
- Passive - early rehabilitation
- Convalescent - active & passive range of motion for bed-ridden pt
- Neuro-muscle reeducation - discrete control of primary mover is rehabilitated under direct consciousness(?) of pt
Any therapeutic maneuver designed to lengthen pathologically shortened tissue to increase range of motion
Stretching
Decrease in length of soft tissue, decrease in range of motion, decrease mechanical elasticity
Contracture
Tension developed in muscle w/ shortening or lengthening
Contraction
Permanent loss of flexibility, surgery required
Irreversible contracture
Ligament injury
Sprain
Muscle, tendon injury
Strain
Type of exercise used for LBP. Primarily causes flex. Ex: Knee to chest, Pelvic tilt, Crunch sit-up
Williams exercises
Type of exercise used for LBP. Primarily causes ext. Ex: Prone on elbows press ups
McKenzie exercises
Type of exercises used for pts w/ peripheral vascular ds
Beurgers-Allen exercise
Shoulder extension exercise (pendulum)
Codman’s excerises
Type of progressive resistive exercise
DeLorme’s exercises
Which quad muscle undergoes the quickest atrophy?
VMO (Terminal knee extension exercise important)
What grade of sprain is a moderate sprain consisting of incomplete or partial rupture w/ obvious swelling, ecchymosis, & difficulty in ambulation?
Grade II
What grade of sprain is a mild sprain w/ no actual lig. tear. Mild tenderness w/ some swelling may be present
Grade I
What grade of sprain is a complete tear of a lig. w/ swelling, hemmorhage, ankle instability, & inability to ambulate?
Grade III