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PhyMod > ultrasound & shockwave > Flashcards

ultrasound & shockwave Flashcards

1
Q

Ultrasound frequency Is higher than sound human can hear. T or F.

A
  • True
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2
Q

What is the ultrasound frequency?

A
  • 20,000 cycles per second or hertz
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3
Q

What is seen at the inner end of the transducer head?

A
  • piezoelectric head
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4
Q

AC stands for

A

Alternating current

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5
Q

Ultrasound is produced through ____ through ______

A
  • Reverse piezoelectric effect
    • Through application of high frequency AC to a piezoelectric crystal
    • Causes mechanical change to piezoelectric crystal
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6
Q

Most commonly used piezoelectric material

A
  • Plumbium zirconium titanate
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7
Q

All types of piezoelectric material used

A
  • Plumbium zirconium titanate
    • Quartz
    • Barium titanate
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8
Q

When crystal expands

A
  • It compresses material in front of it
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9
Q

When crystal compresses

A
  • It rarefies the material
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10
Q

Alternating compression-rarefaction is

A
  • Ultrasound wave
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11
Q

Outside crystal is the

A
  • Plate
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12
Q

Fresnel zone is the

A
  • Near field
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13
Q

Describe the fresnel zone

A
  • Absence of divergence

- Maxima and minima are close to each other

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14
Q

Length of near field depends on

A
  • Diameter of treatment head

- Frequency

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15
Q

Fraunhofer zone is the

A
  • Far field
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16
Q

Describe the fraunhofer zone

A
  • More divergent
    • Nearly absent interference that gradually decreases with increasing distance to transducer
      ○ Decreased with increasing distance to transducer
      ○ Practical application: underwater technique
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17
Q

Body tissue should be in which field

A
  • Between near and far field
    • Has nicest sound wave
    • Not too divergent or convergent
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18
Q

Ultrasound is attenuated in the tissue by

A
  • Absorption, reflection, refraction
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19
Q

Attenuation

A

Decreasing US intensity as wave travels through tissue

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20
Q

Attenuation is greatest with

A
  • High collagen content

High US frequencies

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21
Q

Critical angle of Ultrasound

A
  • 15 degrees
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22
Q

Ultrasound heats tissues with

A
  • High collagen content

- High absorption coefficient

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23
Q

What are tissues with high collagen content

A
  • Tendons
    • Ligaments
    • Joint capsules
    • Fascia
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24
Q

Ultrasound is ideal for muscles. T or F.

A
  • False
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25
Q

For thermal effects, US should be in what mode?

A
  • Continuous
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26
Q

Thermal effects of US

A
  • Increase metabolic rate
    • Reduction of pain and spasm
    • Inc nerve conduction velocity
    • Inc in blood flow
    • Inc tissue extensibility
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27
Q

Non thermal effects is given in what mode?

A
  • Pulsed mode
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28
Q

Non-thermal effects

A
  • Inc cell membrane permeability
    • Inc intracellular calcium ions
    • Promotes macrophage responsiveness
    • Inc protein synthesis by fibroblasts
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29
Q

Acoustic streaming

A
  • Steady circular flow of cellular fluids induced by US
    • Reason for US being used in phonophoresis
      ○ US pushes meds into body
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30
Q

Cavitation

A
  • Formation, pulsation and growth of gas-filled bubbles
    • Responsible for cell permeability
    • Macrophages and fibroblasts
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31
Q

Micromassage

A
  • Microscopic movement or oscillation of body fluids and tissues
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32
Q

Indications for thermal

A
  • Pain
    • Before stretching shortened soft tissues
    • When needs increase of blood flow
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33
Q

Indications for non thermal

A
  • Accelerate tissue healing
    ○ Ulcers, surgical skin incisions, tendon injuries, bone fractures
    • Phonophoresis/sonophoresis
      ○ Transdermal localized drug delivery
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34
Q

Mild thermal effects increase body temp by

A
  • 1 degree
35
Q

Mild thermal effects are for

A
  • Subacute injury hematoma
36
Q

Moderate thermal effects inc body temp by

A

2 deg

37
Q

Moderate thermal effects are for

A
  • Chronic inflammation
    • Pain
    • Trigger points
38
Q

Vigorous thermal inc body temp by

A
  • 4 degrees
39
Q

Vigorous thermal is for

A
  • stretching
40
Q

Patient shouldn’t feel anything during US. T or F.

A
  • False, pt should feel warmth
41
Q

Parameters of US

A
  • Frequency
    • Intensity
    • Duty cycle
    • Treatment duration
    • Effective radiating area
42
Q

Duty cycle for continuous is

A
  • 100%
43
Q

3 mhz is used for

A
  • Superficial
44
Q

Max temp achieved is higher in

A
  • 3 mhz

- Because nearer and more concentrated target area

45
Q

High frequency usually partnered with

A

Low intensity

46
Q

Higher temperatures in achieved in tissues with

A
  • High collagen content
47
Q

Depth of penetration for 3mhz

A

1 to 2 cm deep

48
Q

Depth of penetration for 1 mhz

A

Up to 5 cm deep

49
Q

In near field, energy distribution is uniform or not uniform?

A
  • Not uniform
50
Q

In far field, energy distribution is

A
  • Uniform but more divergent
51
Q

For non-thermal effects duty cycle usually starts at

A
  • 20% for acute stage
52
Q

If targeting thermal effects, pt should feel

A
  • Warmth that is very mild
53
Q

Usual intensity in clinics is

A
  • 1.5 W/cm2
54
Q

Beam non-uniformity ratio is

A
  • Ratio of spatial peak intensity to spatial average intensity
55
Q

Spatial average intensity is

A
  • What you set on machine
56
Q

If BNR is 6:1, and you set US to 1.5 w/cm2 what is the spatial peak intensity?

A
  • 9 W/cm^2
57
Q

When shortened soft tissues, what setting will you do

A
  • 0.5-1.0 W/cm^2, 3mhz, 5-10 mins

- 1.5-2.5 W/cm^2, 1 mhz, used for 5-10 mins

58
Q

Stretching is recommended to be applied during heating and maintained for 5-10 mins after US. T or F.

A

True

59
Q

For painful areas, setting is

A
  • 0.5-3.0 w/cm^2, 1 or 3 mhz, for 3-10 mins
60
Q

For wound healing, setting is

A
  • 0.5-1.0 w/cm^2, 3mhz, 20% duty cycle for 3-10 mins
    • Surrounding wound
    • Can be underwater technique
61
Q

For acute tendon and ligamental repair, setting is

A
  • 0.5-1.0 w/cm^2, 3 mhz, pulsed mode

- Accelerates tissue healing

62
Q

For chronic tendon and ligamental repair, setting is

A
  • High enough intensity to increase tissue temp in continuous mode
    • To address tissue shortening
63
Q

For bone fracture, setting is

A
  • 0.15 w/cm^2, 1.5 mhz, pulse mode 20% duty cycle, 15-20 mins
64
Q

For carpal tunnel syndrome, setting is

A
  • 0.5-1.0 w/cm2, 1 mhz, pulsed 1:4 for 5-15 mins
65
Q

For phonophoresis

A

0.5-1 w/cm2, 3mhz, 20% duty cycle for 5-10 mins

66
Q

Duration is dependent on

A
  • Effective radiating area
67
Q

Usually 5-10 mins is for

A
  • each treatment area that is 2x the ERA
68
Q

If era is 10 cm2 and area of body is 20 cm2, time should be

A

5-10 mins

69
Q

If era is 10mc2 and area of body part is 40 cm2, duration should be

A
  • 10-20 mins
70
Q

Duration is generally increased when

A
  • Lower intensities or lower frequencies are used
    • Areas larger than twice the era
  • Heating effects are desired
71
Q

If area of body is more than twice the era, intensity is higher. T or f.

A
  • False
72
Q

Methods of application

A
  • Direct
    • Glove or balloon technique
    • Underwater
73
Q

Glove technique used for

A
  • Irregular surface areas
74
Q

Rate of moving US head

A
  • Between 2 and 8 cm/sec
75
Q

Strokes overlapping half of era is not recommended. T or F.

A
  • F
76
Q

Properties of gel

A
  • Non staining
    • Not irritating to skin
    • Ease of application
    • Cost
77
Q

Examples of gel

A
  • Soni gel
    • Degassed water
    • Aquasonic gel and mineral oil
78
Q

Can we apply HMP before US?

A
  • Yes
79
Q

What’s the effect of applying HMP before US?

A
  • Increase temp of skin while not affecting deeper tissue layers
80
Q

Can we apply cryo before US?

A
  • If US for thermal effects, no.
81
Q

Contraindications (8)

A
  • Tumor
    • Pregnancy (not near abdomen)
    • CNS tissue (4 inches away)
    • Joint cement or plastic components of arthroplasty
    • Pacemaker (cannot apply near chest, 6 inches away)
    • Thrombophlebitis
    • Over the eyes
    • Reproductive organs
82
Q

Precaution

A
  • Acute inflammation (use pulse mode)
    • Epiphyseal plates in children
    • Fractures (use very low dose)
    • Breast implants (can pop)
83
Q

documentation

A 
- US duty cycle
		○ Continuous or pulse mode
	- Size of head
	- Frequency
	- Intensity
	- Duration in mins
	- Area of body
		○ Laterality
		○ Body part
	- Patient position
		○ If you stretched an area, etc.
	- Method of application
	- Goal or rationale

PhyMod (12 decks)

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