WK7- TENS, IFC, ES for Wound Healing Flashcards
The use of e-stim to modulate pain is referred to as TENS, TENS stands for:
Transcutaneous Electrical Nerve Stimulation
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 or False
True
In general, the __________ electrode should be used to promote healing of inflamed or infected wounds, and the __________ electrode should be used to promote healing of wounds without inflammation.
negative, positive
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.
HVPC, NMES
___________ uses low-amplitude___________ to facilitate delivery of medications through the skin.
low amp, DC
The guidelines for application of e-stim for wound healing, specify that the electrodes may be placed:
one electrode directly in the wound with a dispersive electrode of opposite polarity placed several inches away on intact skin
two electrodes around the wound (e.g., on either side of the wound)
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, 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.
____________
is generally used during the early inflammatory stage of healing.
____________
is used later to facilitate epithelial cell migration across the wound bed.
negative polarity
positive polarity
When using iontophoresis, the treatment amplitude should be:
to patient tolerance, but no greater than 4mA
For iontophoresis, the drug delivery electrode should have the (same/different) polarity as the active ion of the drug to be delivered.
same
Which type 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
Which of the following may occur with the co-administration of opioid medication and TENS?
analgesic tolerance
Which mode of TENS is best described as eliciting strong sensory paresthesia but without motor activation?
Conventional TENS
Which of the following modes of TENS is best described as using a low-pulse frequency, high intensity to evoke visible muscle contractions?
Acupuncture TENS
Stimulation of large-diameter A-beta afferents to activate local inhibitory circuits in the dorsal horn best describes what analgesic mechanism of TENS?
gate theory of pain control
Which of the following best describes the evidence-supported level of stimulation amplitude, or intensity, to be used when administering TENS?
Current amplitude should be as strong as is tolerated while still comfortable.
Electrode placement for TENS should be selected based on which of the following?
In accordance with the painful area or over the peripheral nerve responsible for the pain
Modulation of the beat frequency when using interferential current is known as which of the following?
Sweep
When selecting small electrodes to administer TENS, which of the following must be considered in regard to the patient’s perception and tolerance of the stimulation?
Current Density
Which of the following modes of TENS is administered with a pulse frequency of 100 Hz and a pulse duration of 100 µsec?
Conventional TENS
All of the following are generally accepted as contraindications to TENS except which one?
Over an epiphyseal plate
What are the TENS parameters for Conventional/High Rate TENS ?
Frequency: 100-150 pps
Pulse Duration: less than or equal to 100 microseconds
Amplitude: sensory level
treatment time: 30 min or less in clinic; 1 hour at a time at home with at least 30 min off prior to repeating
What are the TENS parameters for Low-Rate TENS/ Accupuncture TENS ?
Frequency:less than or equal to 10 pps
Pulse Duration: 200-300 microseconds
Amplitude: motor level; visible contraction
Treatment time: 30 min or less
What are the TENS parameters for Burst TENS ?
Frequency: usually preset in unit; example 100Hz delivered at 2 Hz
Pulse Duration: 150-200 microseconds
Amplitude: motor level; visible contraction
Treatment time: 30 min or less
In IFC what is the relationship between carrier frequency and beat frequency.
in IFC there are two currents interfering which produce ‘beats’
The lower frequency of the two current is termed the carrier frequency and the difference between the frequency of the two currents is termed the beat frequency.
What are the contraindication and precautions to TENS ?
over pregnant uterus, abdomen, or lower back in pregnancy
electrical implants
carotid sinus, eyes, interally or on reproductive organs
over damaged skin
thrombosis
thromboplebitis
Hemorrhage
over malignant tumors
undiagnosed pain
patients with impaired sensation, mentation, and others.
DO NOT USE LOW RATE TENS WHEN MUSCLE CONTRACTIONS MAY DISRUPT HEALING.
