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Physical Agents > Unit 1 > Flashcards

Unit 1 Flashcards

Basics of inflammation, cryotherapy, thermotherapy, US

1
Q

T/F: Physical agents are a stand alone treatment.

A

False

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2
Q

What are the 3 major types of physical agents?

A

Thermal
Electromagnetic
Mechanical

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3
Q

What thermal modalities are considered deep heat?

A

Ultrasound
Diathermy

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4
Q

Which modalities are considered mechanical?

A

Compression
Traction
Hydrotherapy
Ultrasound - sound waves

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5
Q

Why are modalities applied to hemorrhagic conditions contraindicated?

A

May disrupt platelet plug formation and cause uncontrolled bleeding

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6
Q

What are the 3 phases of tissue healing?

A

Inflammation, proliferation, remodeling

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7
Q

How long does the inflammation phase last?

A

0 hrs to 2 weeks – peaks at 2-3 hours

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8
Q

How long does the proliferation phase last?

A

4-22 days – peaks at 2-3 weeks

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9
Q

How long does the remodeling phase last?

A

Few days to 2 years

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10
Q

What are the 3 stages of healing?

A

Acute, subacute, chronic

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11
Q

How long does the acute phase last?

A

Onset to 7-10 days

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12
Q

How long does the subacute phase last?

A

10 days to 6 weeks

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13
Q

How long does the chronic phase last?

A

6 weeks to months/years

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14
Q

What are the 5 cardinal signs of inflammation?

A

Pain, redness, swelling, heat, loss of function

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15
Q

Why is it important to control inflammation early?

A

Inflammation inhibits muscle function

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16
Q

What is the treatment goal of the acute phase?

A

Protection

PRICEM
Protection, rest, ice, compression, elevation, manual therapy, early motion

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17
Q

What occurs during the subacute/proliferation phase?

A

Capillary growth and granulation tissue formation
Fibroblast proliferation with collagen synthesis
Increased macrophage and mast cell activities
Development of wound tensile strength
Characterized by decrease in pain and swelling, and increase in mobility

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18
Q

What are the treatment goals of the subacute phase?

A

Controlled motion
Increase mobility within a safe range
Promote healing through gradual and progressively applied forces to healing tissue

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19
Q

What are the treatment goals of the chronic phase?

A

Return to function:
Progressive strengthening & endurance exercises
Maximize independence

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20
Q

What modalities should be used during the acute stage of healing?

A

Cryotherapy
Compression
E-STIM
Pulsed US (non-thermal)
Iontophoresis

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21
Q

What modalities should be used during the subacute and chronic stages of healing?

A

Thermotherapy
US
E-STIM
Iontophoresis
Diathermy

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22
Q

What is the safe & effective thermal therapy temperature range?

A

104-113 degrees Fahrenheit

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23
Q

What are examples of superficial heat modalities?

A

Moist hot packs
Paraffin wax
Fluidotherapy
Warm whirlpool
Air activated heat wraps
Electric heating pads

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24
Q

How is the level of oxygen available for tissue repair increased with thermal therapy?

A

Through vasodilation- more oxygenated blood flow to the area

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25
Q

T/F: Exercise & superficial heat together have a greater effect than used in isolation.

A

True

26
Q

What are the neuromuscular effects of heat?

A

Elevate pain threshold
Break the pain-spasm-pain cycle
Alter nerve conduction velocity
Change muscle spindle firing rate
Pain relief
Decrease muscle tone, guarding, and spasm
Reduce DOMS

27
Q

What are the connective tissue effects of heat?

A

Increased elasticity & muscle flexibility
Decreased viscosity & joint stiffness
Improve ROM

28
Q

T/F: Adipose tissue cannot increase risk for burns with superficial heat.

A

False – adipose tissue acts as an insulator

29
Q

Which tissues have the greatest temperature change with heat?

A

Skin & subcutaneous tissue
6-8 mins

30
Q

How long does it take for muscle to reach peak value with heat exposure?

A

15-30 mins

31
Q

What is conduction?

A

Direct transfer of heat from one object to another in direct contact

32
Q

What is convection?

A

Heat transfer occurs as movement of molecules in liquid or gas form encounter an object or body tissue and transfers energy

33
Q

What is radiation?

A

Conversion of heat energy to electromagnetic radiation. Rarely used in rehab

34
Q

What is the general time frame to leave heat on a patient?

A

10-30 mins

35
Q

What temp is the hydrocollator controlled at for moist heat packs?

A

158-167 deg F

36
Q

How many towel layers should be used between the hot pack and the pt?

A

6-8 but if the pt is lying on top of the hot pack, additional layers should be applied

37
Q

How often should you check the pt’s skin when using a moist hot pack?

A

Before, 5 min in, and after treatment

38
Q

What is the melting point for Paraffin Wax?

A

129 deg F

39
Q

Which pt populations benefit from the use of Paraffin Wax?

A

RA
Stable, non-fragile scars & skin grafts
Scleroderma

40
Q

Which treatment duration is appropriate for the given heating agent?

a) Air-activated heat wrap for acute back pain, 4 to 8 hours

b) Moist hot pack to increase blood flow in subacute thigh strain, no less than 45 minutes

c) Fluidotherapy to achieve “vigorous” heating of the hand, 5 minutes

d) Paraffin bath “dip and re immerse” to increase collagen extensibility, 3 minutes after creating wax glove

A

a) Air-activated heat wrap for acute back pain, 4 to 8 hours

41
Q

What temp is maintained for air-activated heat wraps?

A

104 deg F

42
Q

What are the indications for heat therapy?

A

Reduce pain, muscle spasm, & stiffness

Improve ROM & tissue healing

43
Q

What are the contraindications to thermotherapy?

A

Areas lacking intact thermal sensation
Areas of vascular insufficiency
Hemorrhage
Malignant cancer
Acute inflammation
Infection
Over heat rubs

44
Q

What is the difference between wet and dry heat?

A

Wet heat can elevate temp to a slightly deeper level

Dry heat elevates skin surface temp to a greater degree

45
Q

When would you use deep heat?

A

During remodeling phase, for contractures, to heat deep into a joint

46
Q

What are the 3 modes of energy transfer to remove heat with cooling agents?

A

Conduction
Convection
Evaporation

47
Q

T/F: Tissues with higher water content have better thermal conductivity than adipose.

A

True

48
Q

Why should thermal conductivity be considered when cooling areas of poor/altered circulation?

A

Vasoconstriction decreases blood flow even more

49
Q

What is the order of best to worst conductors for human tissues?

A

Bone > Ligaments/tendons/fascia > Muscle > Adipose

50
Q

Why is ice the most effective type of cold therapy?

A

It goes through a phase change from solid to liquid which causes greater heat extraction

51
Q

T/F: It takes a cooled area longer than a heated area to return to resting value.

A

True

52
Q

What is evaporation?

A

Heat energy is removed as a molecule changes from a liquid to a gas, causing a cooling effect

53
Q

What are some positive effects of cold therapy?

A

Decreases bleeding
Reduces inflammation
Elevates the pain threshold
Reduces muscle spasm

54
Q

What are some negative effects of cold therapy?

A

Affects muscle performance
Increase joint stiffness
Increased tissue viscosity and decreased elasticity

55
Q

How can cold cause vasodilation?

A

Cold for long periods of time can cause increased blood viscosity as the body switches from vasoconstriction to vasodilation

56
Q

What is cryotherapy’s effect on peripheral nerves?

A

Decreases conduction velocity and synaptic activity of peripheral nerves which raises pain tolerance/threshold and affects muscle performance

57
Q

What are some muscular performance effects of cryotherapy?

A

Decreased muscle strength and proprioception

58
Q

T/F: Cryotherapy can reduce spasticity.

A

True

59
Q

What are the clinical indications for cryotherapy?

A

Decrease swelling
Reduce pain
Facilitate muscle relaxation
Limit secondary hypoxic tissue injury

60
Q

What are the parameters for intermittent cooling?

A

20 min on, 10 min off & 10 min on (2x)

61
Q

What are the contraindications to cold therapy?

A

Cold urticaria (hives)
Cyroglobulinemia (abnormal blood proteins)
Raynaud’s phenomenon
Paroxysmal cold hemoglobinuria
Over nerve regeneration
Over compromised circulation
Cold intolerance
Over an area of peripheral vascular disease

62
Q
A

Physical Agents (2 decks)

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