L5 Ultrasound

Question 1

How does ultrasound work?

Answer 1

electrical current into sound head transducer
causes metal plate to vibrate
sound energy is directed out of transducer

thermal and non-thermal effects

Question 2

Thermal effects

Answer 2

most common due to absorption of vibrational energy

Question 3

Non-thermal effects

Answer 3

cavitation increasing permeability of the cell membrane

Question 4

When should you use ultrasound?

Answer 4

inflammatory phase
proliferative phase
remodeling phase

Question 5

Inflammatory & ultrasound

Answer 5

optimizes quality of response w/out increasing the duration or amplitude
does not have an anti-inflammatory effect

Question 6

Proliferative phase & ultrasound

Answer 6

stimulates cellular growth by increasing protein synthesis and proliferation of growth factors

Question 7

Remodeling phase & ultrasound

Answer 7

enhances the collagen maturation process which increases it tensile strength

Question 8

Thermal effects

Answer 8

heats things up
increased blood flow and tissue extensibility

Question 9

Non-thermal benefits

Answer 9

increasing cell membrane permeability
increase intracellular calcium levels
increase mast cell degranulation
nitric oxide synthesis in endothelial cells

Question 10

Contraindications of ultrasound

Answer 10

active bleeding
pregnancy
malignancy
lack of sensation
thrombus
pacemaker

Question 11

precautions of ultrasound

Answer 11

acute inflammation
epiphyseal plates
fractures
breast implants

Question 12

Indications of ultrasound

Answer 12

acute pain
wound healing
osteoarthritis
carpal tunnel syndrome

Question 13

What impairments should you not use ultrasound for?

Answer 13

rotator cuff tendinopathy
chronic LBP
plantar heel pain

Question 14

Wound healing

Answer 14

helps with lack of vascularity and physiologic responses

second-order effects of non-thermal ultrasound may help

increases histamine release and mast cell degranulation. Enhances inflammation phase to make it more effective. Creates new blood vessels, attracts fibroblasts.

enhances wound contraction

Question 15

1 MHz depth

Answer 15

2.5 cm or greater depth
bigger muscles

Question 16

3 MHz depth

Answer 16

1.5 cm or less
smaller muscles

Question 17

Duty cycle dictates…

Answer 17

thermal or non-thermal

more acute is a lower duty cycle
more chronic is higher duty cycle

Question 18

Intensity of ultrasound

Answer 18

.1 - .5 for acute conditions
>1.0 for chronic conditions

Question 19

Application of ultrasound

Answer 19

water for small bony areas
1-2x the sound head
max of 15 min
small slow circles

3-5 min after treatment, heat dissapates

Question 20

LIPUS

Answer 20

low intensity pulsed ultrasound
increases cell upregulation during proliferative phase increase expression of stem cells.

Lower intensity and frequency. 20% duty cycle, 2-20 min

Question 21

LIPUS indications

Answer 21

fractures that are non-operative
better for upper limb

Question 22

Shockwave

Answer 22

controlled explosion of increasing air pressure
possibly helps to break up scar tissue
greater peak pressure (1000x)
only non thermal

focused = deeper, higher mPa

Question 23

Application of shockwave

Answer 23

higher frequency = more comfortable
use gel
3 tx a week
not a standalone treatment

Question 24

indications for shockwave

Answer 24

plantar fasciopathy
tendinopathies
prostatitis
eretile dysfunction

Question 25

ultrasound waves are created by

Answer 25

electrical current vibrating a metal plate in the transducer

Question 26

Shockwave is ____x pressure than ultrasound

Answer 26

1000
more painful but maybe more effective

Question 27

In order to maximize the depth of penetration of ultrasound energy, you should combine what?

Answer 27

Set frequency to 1MHz and move the sound head slowly in small circles

Question 28

When attempting to help a non-union or delayed fracture in the healing process, LIPUS appears to be MOST helpful when using which of the following duty cycles?

Answer 28

20%

Question 29

ultrasound documentation

Answer 29

ultrasound applied at (frequency) and (intensity), (duty cycle) for (time) to the (area of body) for thermal effects, (how patient reacted)