Week 7 Review Flashcards
The use of e-stim to modulate pain is referred to as TENS, TENS stands for:
Transcutaneous Electrical Nerve Stimulation
There are two big types of TENS. High-rate and low-rate TENS. While they are both used for pain control, there are important differences between these two types of TENS. For each of the following, please indicate whether it is a characteristic of high-rate or low-rate TENS.
-provides sensory-level stimulation
-provides motor-level stimulation
-also known as conventional TENS
-also known as acupuncture-like TENS
-primarily controls pain by stimulating the production and release of endogenous opioids
-primarily controls pain by gate control
-controls pain only when the device is on
-controls pain for 4-5 hours after a 20-30 minute treatment
-is recommended when a longer duration of pain control is desired and muscle contraction is likely to be tolerated
-is recommended when sensation, but not muscle contraction, will be tolerated such as after a recent injury when inflammation is present or tissues may be damaged by contraction
high; low; high; low; low; high; high; low; low; high
Interferential current (IFC) is a sensory-level (conventional) TENS with a pulsed biphasic waveform which is produced by two interfering alternating currents. For this type of e-stim application to be effective, the channels must be crossed as in the image below. In order to deliver IFC TENS, the e-stim machine MUST have an IFC setting. Meaning, simply crossing the channels does NOT automatically make the TENS IFC, you must push the IFC “button” on the machine AND cross the channels as shown in the picture. Look at the picture below and answer the following questions:
The carrier frequency for this current set-up is ____ Hz , and the beat frequency is ____ Hz
5000, 100
Premodulated current is like IFC, BUT it only requires 1 channel (two electrodes). In order to provide this type of sensory-level high-rate (conventional) TENS, the machine must have a premodulated setting.
true
In general, the ____ should be used to promote healing of inflamed or infected wounds, and the ____ should be used to promote healing of wounds without inflammation.
negative electrode; positive electrode
Electrical stimulation may be used to treat edema caused by inflammation or by lack of motion. The current applied and subsequent mechanism for controlling edema is vastly different between these two types of edema.
The type of current used to control edema caused by inflammation is ____ which is a type of sensory-level e-stim.
The type of current used to control edema caused by lack of motion is simply
____ which is a motor-level e-stim.
High-volt pulsed current (HVPC); NMES
____ uses low-amplitude ____ to facilitate delivery of medications through the skin.
iontophoresis; direct current (DC)
The guidelines for application of e-stim for wound healing, specify that the electrodes may be placed (select all that apply):
-two electrodes around the wound (e.g., on either side of the wound)
-one electrode directly in the wound with a dispersive electrode of opposite polarity placed several inches away on intact skin
When e-stim is applied to promote tissue healing (for a wound), a ____ waveform recommended to be used. Specifically ____ is the current that evidence shows to be the most effective.
monophasic; High-volt pulsed current (HVPC)
The polarity of an electrode on or nearest to the wound is selected according to the types of cells required to advance a particular stage of wound healing and the presence or absence of infection or inflammation in the wound.
____ polarity is generally used during the early inflammatory stage of healing.
____ polarity is used later to facilitate epithelial cell migration across the wound bed.
negative; positive
If using e-stim for wound healing, most studies recommend treating for at least ____ days each week, with treatment lasting ____
5; 45-60 min
When using iontophoresis, the treatment amplitude should be:
to patient tolerance, but no greater than 4 mA
For iontophoresis, the drug delivery electrode should have ____ as the active ion of the drug to be delivered.
the same polarity
Which of the following types of pain is the result of real tissue damage caused by infection, trauma, or the progression of a metabolic disorder or degenerative disease?
acute
What is the correct term for the amplification of neural signaling within the central nervous system resulting in an increased perception of pain?
Central sensitization
