written PAMS Flashcards by Micayla Harris

always get what before using PAMs

pt history

How well did you know this?

Not at all

Perfectly

what are general precautions for PAMs

impaired:
sensation, cognition, circulation, communication abilities and certain rehab protocols associated with tissue healing/repair

How well did you know this?

Not at all

Perfectly

what are superficial thermal modalities

hot packs, fluidotherapy, and parafin

How well did you know this?

Not at all

Perfectly

what are deep thermal modalities

continuous ultrasound

How well did you know this?

Not at all

Perfectly

contraindications for thermal e-stim and ultrasound are

pregnancy, cancer, and electrical implants

How well did you know this?

Not at all

Perfectly

precautions for thermal modalities

open wound
staples/external hardware
pregnancy (low back, pelvis, abdomen)
cardiac insufficency
edema
impaired circulation
acute injury/inflammation

How well did you know this?

Not at all

Perfectly

contraindications for thermal modalities

hemorrhage, DVT, malignancy, and impaired sensation

How well did you know this?

Not at all

Perfectly

superficial heat transfer methods

conduction and convection

How well did you know this?

Not at all

Perfectly

deep heat transfer methods

conversion

How well did you know this?

Not at all

Perfectly

what is conduction

tranfer of heat from one object to another through direct contact
ex. hot packs or pariffin
tissue penetration 1-2 cm

How well did you know this?

Not at all

Perfectly

what is convection

transfer of heat through forced movement/air
ex. fluidotherapy
tissue penetration 1-2cm

How well did you know this?

Not at all

Perfectly

what is conversion

transfer of heat through mechanical energy of sound waves
ex. continuous ultrasound
tissue penetration 2-5cm

How well did you know this?

Not at all

Perfectly

difference between pulsed and continuus/non-pulsed ultrasound

pulsed is non-thermal, continous is thermal

How well did you know this?

Not at all

Perfectly

clinical benefits of heat

promotes healing
decreases tissue tightness/joint stiffness
pain relief
decrease muscle spasms
increase blood flow
facilitates tissue healing

How well did you know this?

Not at all

Perfectly

mild heat

98-101 degrees F
decreases mild inflammation and increases metabolism

How well did you know this?

Not at all

Perfectly

moderate heat

101-103 degrees F
decreases pain and muscle spams

How well did you know this?

Not at all

Perfectly

vigourus heat

103-113 degrees F
increase tissue compliance to stretch

How well did you know this?

Not at all

Perfectly

ultra-sound methods are readily absorbed by

collagen-rich tissues (ligaments, tendons, fascia)

How well did you know this?

Not at all

Perfectly

duty cycle for continuous ultrasound is

100%

How well did you know this?

Not at all

Perfectly

duty cycle for pulsed ultrasound is

10, 20, 50%

How well did you know this?

Not at all

Perfectly

pulse rate scale

continous 100%
1:1 50%
1:2 33%
1:3 20%
1:4 10%

How well did you know this?

Not at all

Perfectly

the lower % pulse rate means what type of injury

acute injury

How well did you know this?

Not at all

Perfectly

what is pulsed ultrasound used for

tissue healing and transdermal drug delivery

How well did you know this?

Not at all

Perfectly

___ and ___ have higher water content which means what

blood and fat; lower absorbtion rate

How well did you know this?

Not at all

Perfectly

ultrasound frequency determined by

target tissue depth

for superficial ultrasound what is the depth and mHz

penetrates less than 2cm and is 3mHz (faster rate)

for deep ultrasound what is the depth and mHz

2-5cm and 1mHz

ultrasound intensity is the power of

sound energy

hand intensity is unlikey to be greater than

0.8 W/cm2

elbow/forearm intensity is unlikely to be greater than

1.0 W/cm2

acute, subacute, and chronic intensity rates

acute= 0.1-0.3 subacute 0.2-0.5 W/cm2 chronic= 0.5-1.0

what is ERA

effective radiating area

treatment is what for ERA

2x size of sound head which is more effective for smaller tx areas

what is the stretching window

3-7min most optimal tissue temp for strentching and elongation

superficial structures ___ heat faster than deep structures

faster

ultrasound requires ___ and what must be removed from it

coupling agent; air bubbles bc air is a poor conducter

how fast should the ultrasound head be moving

4cm/sec

ultrasound treatment time

5-10minxERA but varies hand is no more than 8 min

indications for ultrasound are

pain management tissue/bone healing edema reduction deep heat for stretching and circulation

TENs is used for and is unique for

used for pain management and unique for pulse duration and intensity

gate control theory is used for what injury type and what is the pulse duration and frequency

post-op/acute injury 50-150usec 80+pps

tx time for gate control theory is

20-60 min

gate control theory must NOT ___ and used for what diagnoses

no muscle contraction sprains, fx, soft tissue trauma, tendon/ligament repairs

opiate pain control theory pulse duration and frequency

pulse duration: 200usec frequency: 1-5pps

tx for opiate pain control theory is

20-60 minutes

action potentials propogated along

motor nerves

muscle fibers innervated become ___ and contract

depolarized

physiologically stimulated contraction are ___ nerve fibers and smaller ___ twitch type __ muscle fibers which are activated ___

small; slow; 1; first

slow twitch type 1 muscles are more ___ and ___ resistant

fatigue and atrophy

electrically stimulated contractions are ___ diameter nerve fibers and larger ___ twitch type ___ muscle fiber

largest; fast; 2

type 2 fast twitch muscle fibers are faster and stronger but

fatigue quickly

monophasic current flows in

1 direction

biphasic current flows in

two opposing directions

most common waveform used for muscle recruitment is

symmetrical and biphasic

anode is

red + electrode (indifferent)

canode is

black - electrode (active)

amplitude is

intensity or strength of electrical current

pulse is

flow of electrical current

pulse frequency

rate (pps or Hz)

pulse duration is

amount of time pulse is available

shorter duration used for

pain control (less recruitment)

longer duration used for

muscle recruitment

sensory nerves are most ___ and stimulated ___

senstive; 1st

motor nerves are stimulated

2nd

estim recruitment vs voluntary muscle contraction recruitment

fast type 2 recruited first in estim but voluntary slow type 1 recuited first

which fibers are stimulated last

pain fibers

fiber order of recruitment in estim

sensory nerves, motor nerves, pain nerves

for NMES electrodes should be at least ___ inches apart

1-2 inches

electrodes placed further apart recuits ___ fibers whereas electrodes placed closed together recruits ___ fibers

deep; superficial

NMES motor point is where electrical stimulus will produce the greates ____ w the least amount of ___

contraction; electricity

electrode 1 in NMES is placed where and electrode 2 is placed where

1 is motor point of muscle (muscle belly) and 2 is parrell to muscle fibers

NMES symmetrical biphasic is good for ___ motor recruitment

gross

NMES assymmetrical biphasic is best used for ___ muscles

smaller

NMES the black - electrode is placed where you want to produce what

stronger muscle contraction

which NMES method is used most often

symmetrical biphasic

asymmetrical biphasic waveform in NMES is better when trying to ____ and stimulate specific muscles

isolate

NMES uses:

strengthening muscle reeducation promote tendon excursion decrease spasticity decrease muscle atrophy promote normal movement patterns