Ultrasound

Question 1

What tissues does ultrasound effect the most?

Answer 1

Tendons
Ligaments
Joint capsules
Fascia

Question 2

What’s the difference between pulsed and continuous ultrasound?

Answer 2

Continuous-Used for thermal effects

Pulsed-produces nonthermal effects

Question 3

What are the units of measurement for US?

Answer 3

Intensity - W/cm2
Frequency - MHz
Duty cycle - % or ratio
Effective radiating area (ERA) - cm2

Question 4

What are some effects of Thermal US?

Answer 4

Affective for heating smaller areas
Can increase the tissue temperature by : 
-Tissue type
-Intensity
-Frequency

Question 5

What depth do the different US frequencies go to?

Answer 5

1 MHz - Up to 5 cm deep

3 MHz: 1 - 2 cm deep

Question 6

What are some effects of nonthermal US?

Answer 6

Cavitation, microstreaming, acoustic streaming
Increased intracellular calcium
Promotes cell function

Question 7

What are some clinical applications for US?

Answer 7

Soft tissue shortening
Pain control
Dermal ulcers
Surgical skin incisions
Tendon and ligament injuries
Bone fractures
Carpal tunnel syndrome
Phonophoresis

Question 8

What are US contraindications?

Answer 8

Malignancy
Pregnancy
CNS tissue
Joint cement
Plastic
Pacemaker
Thrombophlebitis
Eyes and reproductive organs

Question 9

What are some precautions for US?

Answer 9

Acute inflammation
Epiphyseal plates
Fractures
Breast implants

Question 10

What are some adverse effects of US?

Answer 10

Burns (Worse in areas of poor circulation, keep head moving)
Standing waves (cause blood cell stasis)
Cross-contaminations and infection (clean transducer before and after each use)

Question 11

What are the parameters for US?

Answer 11

Frequency
-1MHz = 5 cm deep
-3MHz = 1-2 cm deep
Duty Cycle
-100% = thermal
-20% = nonthermal
Intensity (thermal)
-1MHz = 1.5-2W/cm2
-3MHz = .5 W/cm2
Intensity (nonthermal)
-0.5-1W/cm2
Duration
-5-10 min

Question 12

What all do you need to document with US?

Answer 12

Area treated
US frequency
US intensity
US duty cycle
Treatment duration
If underwater
Response to intervention

Question 13

What is Diathermy?

Answer 13

Means through heating

Uses shortwave or microwaves to produce gentle heat in large areas

Question 14

How do you determine the temperature with diathermy?

Answer 14

Field intensity
Tissue type
Duty cycle
Distance from patient

Question 15

What are some types of diathermy?

Answer 15

Inductive Coils - shortwave
Capacitive plates - shortwave
Magnetron - Microwave

Question 16

What are some traits of the inductive coils?

Answer 16

Uses magnetic field and can heat superficial and deep structures
(greatest in superficial structures)

Question 17

How do Capacitive plates work?

Answer 17

High frequency alternating electrical current flows from one plate to the other through patient. (poor heating for deeper structures)

Question 18

When is the magnetron type of diathermy most useful?

Answer 18

Best when there’s only a small area of tissue. (most heat is superficial)

Question 19

What are the diathermy clinical indications?

Answer 19

Thermal
-Pain control
-Accelerated tissue healing
-Decreased joint stiffness
-Increased joint ROM
Nonthermal
-Control pain and edema
-Soft tissue, nerve, and bone healing
-Improvement of OA symptoms

Question 20

What are some contraindications for diathermy?

Answer 20

All Diathermy
-implanted or transcutaneous stimulators, (pacemakers)
-Pregnancy
Thermal
-Metal
-Malignancy
-Eyes
-Testes
-Growing epiphysis
Nonthermal
-Deep tissues/internal organs
Substitute for conventional therapy for edema and pain
-Pacemakers, electronic devices, or metal implants

Question 21

What are some precautions for diathermy?

Answer 21

All
-Near electronic or magnetic equipment
-obesity
-copper bearing IUD
Nonthermal
-Pregnancy
-Skeletal immaturity

Question 22

How far away does the PT need to stance from the applicator?

Answer 22

1-2m and out of direct beam

Question 23

What are some adverse effects of Diathermy?

Answer 23

Burns

• particularly fat layers
• keep skin dry

Question 24

What all do you want to document with diathermy?

Answer 24

Area treated
Frequency range
Average power or Power setting
Pulse rate
Treatment duration
Type of applicator
Patient position and distance from applicator
Response to intervention