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Physical agents > Week 2: E-stim > Flashcards

Week 2: E-stim Flashcards

1
Q

What is an electric current?

A

A flow of charged particles. Can be electrons or ions

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2
Q

Electric current exert their physiological effects by ____

A

depolarizing nerve membranes, thereby producing action potentials.

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3
Q

What is an action potential?

A

The message unit of of the nervous system

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4
Q

Nerves conducting information towards the spinal cord and brain are ____ nerves

A

Sensory nerves

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5
Q

Nerves conducting information away from the spinal cord and brain are ____ nerves

A

Motor nerves

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6
Q

The positive side of an electrode is called an ___ and is electron/ion ___

A
  • Anode

- deficient

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7
Q

The negative side of an electrode is called an ___ and is electron/ion ___

A
  • Cathode

- Rich

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8
Q

A direct current is most commonly used for ___

A

Iontophoresis, high volt pulse stimulation

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9
Q

What is a direct current?

A

A continuous unidirectional flow of charged particles

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10
Q

Electrodes in a direct current ___ their polarity and is used to ___. Can help induce ___

A
  • Maintain.
  • transfer ions
  • Chemical reactions
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11
Q

Direct current is ___ effective at activating denervated muscles

A

More effective

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12
Q

What is an alternating current?

A

A continuous bidirectional flow of charged particles

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13
Q

The electrodes in an alternating current ___ their polarity

A

Constantly change their polarity above and below the isometric line(the 0 line)

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14
Q

An alternating current results in ___, and ___ chemical reactions

A
  • No net charge

- No chemical reactions being built up

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15
Q

Most common form of an alternating current

A
  • Transcutaneous electric nerve stimulation
  • Innerferential current for pain control
  • NMES
  • Russian (used for muscle contractions)
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16
Q

What is a phase duration?

A

Activity above or below the isometric line. Ends as soon as the current comes back to the isometric line.

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17
Q

What is a pulse?

A

When the current immediately moves in the opposite direction and back toward the isometric line after a phase duration

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18
Q

___ is seen most commonly with AC current

A

A pulse

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19
Q

What is the interpulse interval?

A

When there is a pause, and there is no electrical activity for any given period of time

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20
Q

An AC current is also called an ___ current

A

biphasic current

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21
Q

Direct current is also called a ___ current

A

monophasic

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22
Q

What is a current amplitude?

A

determines how strong a stimulation is going to be

23
Q

Frequency of an e-stim is counted in

A

pulse/sec

24
Q

Frequency is set up to determine ___

A

The type of stimulation response a patient gets

25
Q

The higher the frequency the ___ stimulation a patient gets

A

More

26
Q

A strength duration curve represents the

A

The amount of electricity required to produce an action potential, depending on the nerve type

27
Q

The y-axis on a strength duration curve is ___

The x-axis on a strength duration curve is ___

A
  • Current strength

- Time of pulse

28
Q

What is a ramp up/ramp down time?

A

When the stimulation gradually increases or decreases till it gets to a certain set amplitude

29
Q

What is accommodation?

A

The creation of variations with the form of e-stim a patient feels to help prevent them from becoming used to the machine

30
Q

What are ways to prevent accommodation?

A
  • Amplitude modulation
  • Pulse duration modulation
  • Frequency modulation
31
Q

What is amplitude modulation?

A

When the machine increases and decreases the amplitude it produces based on the preset measures

32
Q

What is a pulse duration modulation?

A

When the pulse duration over time gets shorter and longer, but stays at a set amplitude. Same as frequency modulation

33
Q

What is orthodromic?

A

the propagation of an impulse along a conduction system (for example, nerve fiber) in the direction it normally travels

34
Q

What is antidromic

A

the propagation of an impulse along a conduction system (for example, nerve fiber) in the direction opposite to that which it normally travels

35
Q

In sensory nerves, orthodromic flow moves from __ to ___

A

Distal to proximal.

Peripheral tissues to the bran

36
Q

In motor nerves, orthodromic flow moves from __ to ___

A

Proximal to distal

Brain to peripheral tissues

37
Q

____ Occurs artificially during electrical stimulation based on location of stimulation on nerve

A

Antidromic

38
Q

What is current density?

A

Current per size of electrode

39
Q

Settings that can be manipulated/changed on an e-stim

A
  • Frequency
  • Pulse Duration (sometimes pre-programmed based on frequency)
  • AC vs DC (this is often decided automatically based on machine we choose)
  • If DC, which electrode is “active” (Iontophoresis / High-volt)
  • Active vs Dispersive pad
  • On/off time (mostly just with NMES/Russian Stim.)
  • Ramp up/down (mostly just with NMES/Russian Stim.)
  • Modulation
  • Total treatment time
  • Intensity
40
Q

Reasons to use transcutaneous electrical nerve stimulation (TENS) & Interferential current (IFC)

A

• Control/ relieve pain
• Reduce the amount of and dependency on pain
medication
• Provide the patient a more active role in their pain
management
• Increase functional movement and mobility with less discomfort

41
Q

Characteristics of a conventional TENS setting

A

• High frequency: 100-150 Hz (tingling response)
• Pulse Duration – 50-80 µsec
• Amplitude – “strong but comfortable”
• Treatment Duration – 20-30 minutes, up to 24 hours
• Mechanism of Action: Gate Control
• Analgesia Duration – immediate relief with little
residual effect (comes back quickly when turned off)
• Modulate to prevent accommodation

42
Q

Characteristics for low-rate/acupuncture-like TENS setting

A

• Brief sharp pain through repetitive muscle twitches
and stimulation of A-delta fibers
• Frequency – 2-10 Hz
• Pulse Duration – 200-300 µsec
• Amplitude – strong, visible muscle contraction
• Treatment Duration – 20-30 minutes
• Mechanism of Action: Endogenous Opioids Release
(Endorphin Release)
• Analgesia Duration – up to 5 hours

43
Q

Types of electrode placement for TENS

A
  • Crisscross
  • Parallel
  • Bracket
  • Unilateral
44
Q

Where to avoid placement of electrode placement for TENS?

A
  • Trans-cranial

* Over genitalia

45
Q

What creates an interferential current?

A

Two medium-frequency AC currents interfering with each

other.

46
Q

What is heterodyne?

A

Blending 2 different carrier frequencies that are out of phase. The resulting difference in the two frequencies is the treatment/beat frequency

47
Q

Characteristics of IFC

A
  • Beat Frequency can be modulated in device
  • Settings mimic TENS modes
  • Thought to be more comfortable and cover a larger area – Conflicting research
48
Q

Ways to prevent accommodation with IFC

A

Sweep and scan

49
Q

What is sweep in IFC accommodation prevention?

A

Frequency Modulation

• One carrier frequency fluctuates ±150 Hz within the same ideal treatment frequency, while the other stays the same

50
Q

What is scan in IFC accommodation prevention?

A

Amplitude Modulation

• Can Treat a larger tissue area as the scan increases

51
Q

IFC placement

A

Minimum of 2 leads and 4 electrodes, and always use criss-cross pattern

52
Q

What is premodulated IFC?

A

Instead of sending currents into the tissues at higher frequencies, the machine will create interference within itself and send the it down. (avoids having to use criss cross)

53
Q

Precautions of TENS or IFC

A
  • Cardiac Disease
  • Impaired Sensation
  • Malignant Tumors
  • Skin irritation or open wounds
54
Q

Contraindications of TENS or IFC

A
  • Pacemakers, heart conditions (unstable arrhythmias)
  • Over the carotid sinus
  • Venous or arterial thrombosis or thrombophlebitis
  • Pelvis, abdomen, trunk, and low back during pregnancy (especially 1st trimester), can be used for pain control during delivery

Physical agents (7 decks)

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