13. Non-Pharmacotharapy

Question 1

What is the term for cold thermotherapy

Answer 1

cryotherapy

Question 2

What is the mechanism of cryotherapy for reducing pain

Answer 2

Activation of large A-delta fibers which inhibit pain transmission through C fibers

Question 3

Cold results in vaso (constriction/dilitation)

Answer 3

dilitation

Question 4

Heat thermotherapy is also called

Answer 4

Superficial= Hydrocollator 
Deep= Ultrasound

Question 5

Heat (increases/decreases) nerve conduction velocity

Answer 5

increases

Question 6

heat causes vaso (constriction/dilitation)

Answer 6

dilitation

Question 7

Hydrocollator should be applied for how long

Answer 7

15-20 min

Question 8

What is phonophoresis

Answer 8

when ultrasound is used to help medications penetrate into the tissues

Question 9

Contraindications for phonophoresis are

Answer 9

• Fluid filled organ
• Pregnant uterus
• Eye
• Gonad
• malignant tissues
• Irradiated tissues

Question 10

What is fluorimethane

Answer 10

ethyl chloride

• inhibits reflex contraction –> inhibits pain transmission
• Allows for complete stretching of muscle

Question 11

What does TENS stand for

Answer 11

-Transcutaneous electrical nerve stimulation

Question 12

MOA of TENS

Answer 12

-Inhibition of nerve conduction

Does this by activation of large A-delta fibers which activate inhibitory circuits within the dorsal horn of the SC

Question 13

T/F TENS causes painful paresthesia

Answer 13

F- non-painful paresthesia

Question 14

TENS apparatus consists of

Answer 14

• Pulse generator
• Amplifier
• Electrodes

Question 15

T/F TENS is effective for acute but not chronic pain

Answer 15

F- can be used for both- but is more effective with acute

Question 16

TENS can be used for ionophoresis which is what

Answer 16

similar to phonophoresis

-Use of current to drive medicaments (anti-inflammatories) into tissues

Question 17

Contraindications for TENS are

Answer 17

• Pacemakers/defibrilators
• Anterior aspect of neck (carotid sinus)
• Transcranial
• Direct spine placement

Question 18

Low power laser therapy is hot or cold

Answer 18

cold

Question 19

Soft tissue techniques should be used when there is pain in what structures

Answer 19

fascia. muscle, ligaments and tendons

Question 20

Different between joint mobilization and joint manipulation

Answer 20

Mobilization

• Slow
• Within range of motion
• oscillation movements

Manipulation

• Rapid
• Short amplitude
• beyond normal range of motion

Question 21

T/F Acupuncture sites are all close to the site of pain

Answer 21

f- most points are but some are distant

Question 22

Can acupuncture treat chronic pain

Answer 22

yes

Question 23

MOA of acupuncture

Answer 23

-Release of serotonin from the periaqueductal gray mater which activates descending pain inhibitory pathways

Question 24

What is the acupunture point that can alleviate dental pain

Answer 24

• Hoku

- Between the thumb and index finger

Question 25

If you have dental pain on the right side the acupunture Hoku point should be on the (right/left)

Answer 25

left (contralateral)

Question 26

What are the four types of behavior medicine

Answer 26

- Biofeedback - Relaxation therapy - Psychophysiologic therapy - Hypnosis

Question 27

Biofeedback best treats what conditions

Answer 27

-symptoms caused by muscle hyperactivity

Question 28

What is biofeedback

Answer 28

- Use of monitors to detect excessive muscle activity - Train pateint to recognize the increased muscle tension - Train patient to reduce muscle tension - Wean off the machine

Question 29

What is relaxation therapy

Answer 29

-Taped relaxation instructions (breathing exercises, stretching, etc)

Question 30

Relaxation therapy is worst for patients with

Answer 30

mood disorders (poor psychologic functioning)

Question 31

What is psychophysiologic therapy

Answer 31

combination of biofeedback and relaxation therapy

Question 32

Hypnosis is used to treat

Answer 32

pain and anxiety

Question 33

What are the five steps of hypnosis

Answer 33

- limit sensory input and motor output - Fixation of attention - Monotonous visualization - Rapport and relationship - Gently return

Question 34

Stage I hypnosis

Answer 34

hypnoidal - Flutering eyelids - Physical relaxation - Closing of eyes - Muscle letargy

Question 35

Stage 2 of hypnosis

Answer 35

Light trance - Can't open eyes - Deep and slow breathing - Deepend lethargy

Question 36

Stage 3

Answer 36

Medium trance - Glove type anesthesia - Partial amnesia - Hallucinations

Question 37

Stage 4 hypnosis

Answer 37

Somnambulism - Ability to open eyes without affecting trance - Amnesia - Anesthesia - Lip pallow - Post- hypnotic analgesia and hallucinations