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USAHS Methods II > Unit 3: Superficial Heat > Flashcards

Unit 3: Superficial Heat Flashcards

1
Q

Heat Transmission

A

-Conduction
-Radiation
-Convection

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2
Q

Conduction (heat transmission)

A

Exchange of thermal energy between two surfaces in direct physical contact (ex. hot pack, paraffin)

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3
Q

Radiation (heat transmission)

A

Transfer of energy through electromagnetic waves from the source to the body (ex. laser therapy)

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4
Q

Convection (heat transmission)

A

The conveyance of heat by movement of heated particles (ex. whirlpool, fluidotherapy)
-Heat and movement together produce greater blood flow than heat alone

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5
Q

Superficial Heating Agents

A

-Penetrate 1-2cm after 15-30 minutes (deeper structures after 20 minutes)
-Absorbed only in the epidermis and dermis
-Capable of increasing intra-articular temperature at digits

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6
Q

Biophysical Effects of Superficial Heating Agents

A

-Metabolic effects
-Changes in nerve conduction velocity
-Increased pain
-Altered tissue extensibility

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7
Q

Biophysical responses to Heat

A

Increases:
-Blood flow
-Rate of cell metabolism
-Oxygen consumption
-Capillary permeability
-Inflammation
-Muscle contraction velocity

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8
Q

Decreases: Biophysical responses to Heat

A

-Fluid viscosity
-Pain
-Muscle spams (by reducing pain and ischemia)

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9
Q

Metabolic Effects of Superficial Heating Agents

A

-Increase metabolic rate
-Increase blood flow and oxygen
-Facilitate greater number of antibodies, enzymes, leukocytes, and nutrients
-Benefit all stages of wound healing (except inflammation)

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10
Q

Nerve Conduction Velocity from Superficial Heating Agents

A

-Increased nerve conduction velocity
-Increases pain threshold= Analgesic effect (Gate Theory)
-Decreased muscle spasm via decreased gamma efferent activity
-Decreasing gamma activity decreases stretch on the muscle spindle; Reducing afferent firing from the muscle spindle hence indirectly decreasing alpha motor neuron firing (interrupts pain-spasm cycle)

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11
Q

Pain Control of Superficial Heating Agents

A

-Increased activity of cutaneous thermoreceptors (Inhibitory gating effect on the transmission of the sensation of pain)
-Increased vasodilation with increased blood flow can decrease pain created by ischemia
-Psychosocial effects-may influence patient’s perception of pain
-Decreasing muscle spasms, accelerating healing, and altering in nerve conduction can also help reduce pain

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12
Q

Alter Tissue Extensibility (Superficial Heating Agents)

A

-Increased soft tissue temperature has been shown to increase extensibility
-Collagenous tissue (tendon, ligament, scar tissue, joint capsule)
-If heat is applied to collagenous tissue prior to or with stretching, the tissue can reach a state of Plastic Deformation
-If not heated first will only reach Elastic Deformation

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13
Q

Plastic Deformation (Alter Tissue Extensibility: Superficial Heating Agents)

A

When the tissue is taken to a length and most of the lengthening is retained after cooling.

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14
Q

Elastic Deformation (Alter Tissue Extensibility: Superficial Heating Agents)

A

The tissue is lengthened - however, the length does not remain after the force is removed.

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15
Q

Increasing Joint Motion/Reducing Stiffness (Superficial Heating Agents)

A

-Increased tissue temperature facilitates tissue extensibility
-Maximum increased length with the lowest risk of injury
-Low load- prolonged stretch during or immediately after heat

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16
Q

Superficial Heat Clinical Indications

A

-Decrease pain
-Decreases muscle spasm
-Decreased viscosity (soften thick/brawny edema)
-Cutaneous vasodilation
-Increased elasticity, extensibility, and flexibility of tissues
-Increased metabolism in tissues

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17
Q

Precautions for Superficial Heating Agents

A

-Acute injury of inflammation
-Very young or very old
-Topical counter irritants (i.e. biofreeeze)
-Demylinated peripheral nerve
-Pregnancy
-Impaired circulation
-Poor thermal regulation
-Edema
-Cardiac insufficiency
-Metal in the area
-Open wounds

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18
Q

Contraindications for Superficial Heating Agents

A

-Recent or potential hemorrhage (i.e. bruising)
-Thrombophlebitis (heat can dislodge clot)
-Areas of impaired circulation
-Impaired mentation/communication
-Infrared irritation to eyes
-Area where these is malignancy (Don’t want to increase circulation or metabolic rate in this area)

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19
Q

Clinical Reasoning with Precautions/Contraindications for Superficial Heating Agents

A

-Acute Injury/Inflammation
-Recent or Potential Hemorrhage
-Thrombophlebitis

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20
Q

Acute Injury/Inflammation (Clinical Reasoning with Precautions/Contraindications for Superficial Heating Agents)

A

-Increased temperature will cause vasodilation, which can further increase edema level limiting recovery/function
-Determine when injury occurred
-Assess skin temperature, color, and edema location

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21
Q

Recent or Potential Hemorrhage (Clinical Reasoning with Precautions/Contraindications for Superficial Heating Agents)

A

-Increased temperature will provoke or worsen injury causing increased bleeding into interstitial tissue
-Inspect for ecchymosis/discoloration
-Inquire when injury occurred/mechanism of injury

22
Q

Thrombophlebitis (Clinical Reasoning with Precautions/Contraindications for Superficial Heating Agents)

A

Superficial heat can cause a blood clot to dislodge and move to vital organs

23
Q

Ask patient: (Clinical Reasoning for Superficial Heating Agents)

A

-Hx of blood clots
-Assess for edema and tenderness/calf
-Ask about and test sensation
-Assess cognitive abilities
-Skin integrity, open wounds, bruising, signs of infection etc.

24
Q

Adverse Effects of Superficial Heating Agents

A

-Burns: Excessive heat can lead to tissue death
-Fainting: Inadequate cerebral flow due to peripheral dilation
-Bleeding: Aggressive bleeding due to increased blood flow

25
Q

Choosing the correct modality depends on… (Superficial Heating Agent)

A

-Objective of modality
-Location and surface of involved structure
-Desired dosage/tissue temperature
-Desired depth of penetration
(If the depth of penetration is greater than1 cm, then another medium will need to be used –i.e. ultrasound)
Additional Considerations: Moist or dry heat; Position of extremity; Active or passive participation

26
Q

Types of Methods (Superficial Heating Agents)

A

-Whirlpool/Hydrotherapy
-Fluidotherapy
-Hot Packs
-Contrast Baths
-Warm Water Soaks
-Paraffin Bath

27
Q

Treatment Time: Whirlpool/Hydrotherapy

A

10-20 minutes

28
Q

Temperature: Whirlpool/Hydrotherapy

A

Don’t exceed 110°F, typically 92-96°F

29
Q

Advantages: Whirlpool/Hydrotherapy

A

AROM. control of temp, able to see body part during tx

30
Q

Pressure: Whirlpool/Hydrotherapy

A

Maintained between 4-15 PSI

31
Q

Disadvantages: Whirlpool/Hydrotherapy

A

Dependent position, possible edema. sterilize/disinfect between each use, time to set up/clean up

32
Q

Special Concerns: Whirlpool/Hydrotherapy

A

-Wounds extremely painful (sensory nerves)
-Medications for pain
-Close Monitoring
-Risk of Infection

33
Q

Contraindications: Whirlpool/Hydrotherapy

A

-Maceration
-Bleeding

34
Q

Precautions: Whirlpool/Hydrotherapy

A

-Impaired sensation
-Infection
-Confusion/Impaired Cognition
-Skin grafts

35
Q

Infection Control/Safety: Whirlpool/Hydrotherapy

A

-Infection: Whirlpool cleansing protocol; Universal precautions
-Safety: Tank grounded, Turbine/water in tank

36
Q

Whirlpool/Cleansing Effects

A

-Rehydration
-Softening
-Debridement of necrotic tissue
-Removal of wound debris
-Increased circulation
-Promotes a moist rather than dry wound to promote wound healing

37
Q

Whirlpool Documentation

A

-Type of agent used
-Patient position or activities
-Temperature
-Duration of treatment
-Outcome of response to treatment
-Fluid pressure
-Water additives

38
Q

Fluidotherapy

A

-Fine particles suspended in hot air steam
-Particles made of ground corn husks
-Temperature controlled by thermostat
-Frequency of speed controlled in blowing mechanism
-For distal extremities
-Preheat: 105-118
-Treatment time: 15-20 minutes
-Beneficial for arthritis, desensitization

39
Q

Prior to Fluidotherapy treatment…

A

-Remove jewelry, pull up sleeves prior to entering machine
-Secure sleeve tightly before, during, and after treatment
-Treatment time: 15-20 minutes

40
Q

Advantages of Fluidotherapy

A

-Patient can before AROM/PROM in heat
-Temperature can be easily adjusted
-Material can be soothing and help with desensitization
-Low risk of burns

41
Q

Disadvantages of Fluidotherapy

A

-Expensive
-Dependent Position

42
Q

Hot Packs

A

-Provides moderate to vigorous moist heat
-Many sizes, stored in hydrocollator
-158-167° F /Hydrocollator
-104-113° F (hot packs cooler than water in unit they are stored in)
-Hot packs cool as treatment progresses
-Padding with at least 6 layers of toweling (terry cloth covering equivalent to 3 layers)
-Check skin after 5 minutes
-Do not weight bear on hotpacks
-Treatment time: 15-20 minutes
-Good modality for increasing tissue extensibility using coban tape for stretch

43
Q

Advantages of Hot Packs

A

Easy to use, can apply passive stretch, inexpensive

44
Q

Disadvantages of Hot Packs

A

Body part in static position, can be difficult to conform, risk of burns if not applied correctly

45
Q

Hot Pack Documentation

A

-Area of body treated
-Type of heating agent used
-Treatment duration
-Response to treatment
-The number and type of insulation used
-The patient’s position or activity

46
Q

Materials for Contrast Baths

A

-Two large containers (4-6” deep)
-Hot and cold water
-Canning or candy thermometer

47
Q

Procedure for Contrast Baths

A

-Fill one container with warm water (100-110 degrees F)
-Fill the second container with cold water (59-70 degrees F)
-Test temperatures with thermometer
-Put extremity completely into warm water (3-4 minutes) then cold (1 min); alternate back and forth 4-5 times
-Start and end with warm water
-Treatment up to 30 minutes

48
Q

Warm Water Soak

A

-Used for mobilizing digits and increasing ROM
-Treatment temperature: 99-110° F
-Treatment time: 15-20 minutes

49
Q

Paraffin Bath

A

-Remove clothing/jewelry from area being treated
-Wash and completed dry extremity being treated
-Provides high degree of heat to smaller joints
-Composed of mineral oil and paraffin
-Temperature: 118-135° F
-Lower specific heat than water
Treatment time: 20 minutes

50
Q

Advantages of Paraffin Bath

A

-Even distribution of heat
-Allows for passive stretch in heat
-Contours, moistens, low specific heat
-Can be purchased for home use

51
Q

Disadvantages of Paraffin Bath

A

-No mechanism to control temperature
-Practical for only distal extremities
-Cannot be used over wounds
-Body part is static during application

52
Q

Client Interaction for Superficial Heating Agents

A

-Introduce Yourself
-Ask about contraindications
-Inspect the area
-Check sensation
-Explain procedure and benefits
-Explain to the patient what they should feel
-Obtain permission
-Reassure patient that you are available if needed

USAHS Methods II (5 decks)

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