Electrical Stimulation For Pain Relief - Modalities (Lecture 1) Flashcards
In the picture below name what 1 and 2 are. What is 3
What is the net charge / polarity
1 = phase (just one little one)
2 = pulse (the two of them going back and forth)
3 = peak amplitude
* can have peak amplitude in the positive or negative direction
Because they’re equal the net charge or polarity is 0
What is the thing between the phases
Intra pulse duration
What is 5? what about 6
5 = inter pulse duration
6 = intra pulse duration
What is a sinusoidal wave?
Wave the oscillates up and down or side to side
Is this alternating or direct current?
Alternating (going back and forth from positive to negative)
Is this Aussia or russian?
Russian
What is the gap that the arrow pointing to called?
Interpulse duration
Is this high or low frequency? Why?
Low because of the large inter pulse duration
However, it makes up for this by having a high amplitude
What is this kind of pulse called?
On our modalities quiz there are going to be pictures like this that we have to identitfy what kind of current it is
High voltage pulse current
When current 1 and current 2 crisscross what kind of current is this called?
Interferintial current
IFC
Brust frequency
How often bursts happen
Carrier frequency
How frequent the pulses are within the burst
What are the 3 pain types?
Acute: when tissue damage first occurs this is the bodies way of letting us know
Chronic: inflammatory process thtas triggered by the acute process is now over. If that pain presists that can lead to sentiziation of neural pathways (keep it lit up)
Referred
Old reffered pain theory
Tissues utero (neural tube) are close and for some reason are linked that way
Explain covergence theroy of reffered pain
Cutaneous, visceral, skeletal muscle tissue all converge togerther on a common nerve root –> dorsal horn.
Sometimes the messaging gets coonfused on where the pain is coming from
Does the peripheral pain pathway have a high or low threshold for activation. What does this mean?
high threshold for activation - this means that it needs a large stimulus to activate it
“If I poke you it wont hurt you - you need lots of input”
The peripheral pain pathyway has a high threshold for activation. What can lower this threshold?
If theres already inflammation that threshold can be lowered (takes less to bring on pain)
* think hitting your toe a second time after its already been stubbed and theres inflammation in there
KNOW: 3 pain pathways:
* Peripheral pain pathywa
* C-fibers
* A-delta fibers
What kind of pain comes from C-fibers?
Dull achy pain, burning, long lasting
Do C-fibers hvae a high or low threshold? Do they have a Low or high conduction velocity?
Does this activation come more w/ acute or chronic pain
High threshold for activation (takes a lot)
Low conduction velocity
* this is why its that dull achy pain - longer lasting
Comes on more w/ chronic pain (turns into that dull toothyachy pain - makes sense)
Do A-delta fibers have a high or low threshold for activation? How fast is their conduction velocity?
What is the pain like with these?
High threshold (takes a lot)
Fast conduction velocity
Pain = sharp, stabbing, shooting pain
* make your body quickly on red alert
What is out central pain pathway?
A delta and C fibers –> interneurons –> second order neurons in the dorsal horn –> then goes up
What are the two kinds of second order neurons and what do they do?
* which ones can tell us about more than just pain?
High threshold second order neurons:
* Recives input from peripheral nociceptors only
* These are the ones that say “hey, somethings been injuired, somethings not right - we go pain
Wide-dynamic range
* input from peripheral nociceptors AND non-nociceptors
* They give us the general feeling of that area, since they have nociceptors and non-nociceptors they can tell us about more than just pain (can do temperature sensation as well)
What is considered the main pain pathy in the body?
Spinothalamic tract
TENS = Transcutaenous Electrical Nerve Stimulation
* Used for pain modulation (not trying to move muscles)
NMES neuromuscular electrical stimulation is for muscle activation / strengthening
* Neuromuscular electrical stimulation
* Both are transcutaneous
Inital theories of how the TENs mechanism worked were based on the gate control theory. What is the gait contorl theory?
What is the current theory on the TENs mechanism?
Large afferent nerve input blocked smaller diameter nociceptive input (which blocked those pain signals)
Current = Activation of opioid receptors in both PNS and CNS
Does TENS have one waveform / type of current?
Nope
TENS could be IFC / alternating current / direct current etc..
Which waveform is this?
Symmetrical biphasic pulsed current
Which waveform is this?
Asymmetrical biphasic balanced pulsed current
Which has no charge, symmetrical biphasic or asymmetrical biphasic current?
Symmetrical
Why might we use a Burst Instead of a Concentional TENS for sensory habituation?
A burst has the same frequency and distance strength as a conventional except it has a large inter pulse duration. So this will constanitly re remind your body that you’re wearing it
What is this
Conventional tens
What is this
Burst TENS
What is this
Acupuncture like
What is this?
Brief intens TENSE
highest tolerable
it is continuous
Why is the treatment time on Brief intens TENS low?
Because it is continuous
Which gets a depper area - large electrodes or small electores?
Large get a deeper, broad area
Small ones get a more superficial specific area
KNOW: If I want to deliver a lot of current I would use a larger one to decrease the current in a select area
All TENS units require 2 electrodes EXCEPT
IFC
I also have Lisas video
