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exam and Intervention II > Superficial heat > Flashcards

Superficial heat Flashcards

1
Q

superficial heat includes

A

hot packs, paraffin wax bath, contrast bath, fluidotherapy, infrared lamps, whirlpool

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2
Q

indications for using superficial heat

A
  • Promotes soft tissue healing
  • Promotes general relaxation
  • decrease joint stiffness
  • decrease /control pain
  • skin conditions
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3
Q

way superficial heat is transfer

A

convection
conduction
radiation

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4
Q

examples of Convection superficial heat

A

fluidotherapy

whirlpool

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5
Q

examples of conduction superficial heat

A

hot packs, paraffin, contrast baths, cold pack

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6
Q

examples of radiation superficial heat

A

infrared lamps

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7
Q

Optimum dosage of therapeutic range

A

Skin temp, between 104-113 F

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8
Q

effects of heat include

A

hemodynamic effects
Neuromuscular effects
Increased metabolic rate
increase tissue extensibility

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9
Q

Hemodynamic effects

A

vasodilation

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10
Q

during hemodynamic effects, application of heat to an area will trigger what

A

local response of vasodilation

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11
Q

How does vasodilation occur

A

depolarization of sympathetic cholinergic nerve fibers through cutaneous thermoreceptors

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12
Q

what neurotransmitters are released during vasodilation

A

acetylcholine
bradykinin
nitrous oxide

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13
Q

nitrous oxide acts as

A

vasoactive mediators on the cholinergic receptors of smooth muscles surrounding blood vessels

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14
Q

indirect effect of heat through cutaneous thermoreceptors

A

project via dorsal root ganglion to synapse with interneurons in dorsal horn gray matter of spinal cord

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15
Q

Indirect effect of heat by interneurons

A
  • synapse with sympathetic neurons in lateral gray horns of thoracolumbar segments of spinal cord
  • inhibit their firing
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16
Q

indirect effects of heat causes a reduction in what

A

smooth muscle contraction resulting in vasodilation both at site of heat application and in cutaneous vessels of the distal extremities

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17
Q

What is the benefit of thermotherapy and distal vasodilative effect

A

-increase cutaneous blood flow to area difficult or unsafe to apply heating agent directly

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18
Q

neuromuscular effect

A
  • change in nerve conduction velocity

- Changes in firing temp rate at temp

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19
Q

An increase in temp causes what to nerve conduction velocity

A

and increase

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20
Q

An increase in temp causes a decrease in what

A

conduction latency in sensory and motor nerves

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21
Q

An increase in temp causes a decrease in firing rate of

A

type II muscle spindle efferent & gamma efferents

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22
Q

increase in firing rate of type Ib fibers from golgi tendon organs causes a decrease in

A

muscle spasm and relaxation of muscle contraction

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23
Q

superficial heat causes increased pain threshold by

A

an increase activation of cutaneous thermoreceptors

24
Q

superficial heat increases cutaneous thermoreceptors (increase pain threshold) by

A

a direct and IMMEDIATE REDUCTION OF PAIN ,by inhibition of spinal gating mechanism to spinal cord level and an indirect, later, and more prolonged decrease of pain by , DECREASE OF ISCHEMIA (decrease in blood flow) AND MUSCLE SPASM OR FACILITATION TISSUE HEALING

25
Q

There is a decrease in muscle strength and endurance for how long after application of heating agent?

A

30 minutes

26
Q

why is there changes in muscle strength

A

changes in firing rates of type II muscle spindles efferent, gamma efferent, and type Ib fibers from golgi tendon organs

27
Q

When is there a gradual strength after heating an area

A

next 2 hours

28
Q

When should you measure muscle strength and endurance?

A

BEFORE heating modality

29
Q

What are the metabolic effects of superficial heat

A

an increase in metabolic rate

30
Q

explain how heat increases the metabolic rate

A

Increase in enzymatic activity = increase rate of cellular biochemical runs = increases oxygen availability and uptake and acceleration of healing of a chronic wound

31
Q

why do you have to use caution in pts with acute inflammatory disorders like RA when using heat

A

heat has been shown to increase the activity of collagenase and may accelerate the destruction of articular cartilage

32
Q

to increase collagen extensibility tissue heat need to be maintain at what temp and for how long

A

104-113 deg for 5-10 mins

33
Q

what are the benefits of increased collagen extensibility

A
  • increase in length after stretch applied
  • Less force required ro achieve lengthening
  • Decreased risk of tissue tearing
  • at tendon, ligament, scar tissue or jt capsule, plastic deformation maintains new length after calling due to reorganization of collagen fibers and changes in viscoelasticity
34
Q

an increase of temp causes what to extensibility

A

increase

35
Q

Duration of application for moist heat packs

A

20 mins. check for redness after 5 mins

36
Q

Temp ranges for moist heat packs

A

158-167 deg F

37
Q

Advantages of Hot packs

A
  • easy & inexpensive
  • brief demand on DPT time
  • low level of skill application
  • can be used to cover large moderate areas
  • safe- cool upon removal
  • available for pt to purchase at home
38
Q

disadvantages of hot packs

A
  • removal necessary to inspect tx area during treatment
  • pt. may not tolerate weight of HP
  • contact may b limited for small/contoured areas
  • active motion during tx not practical
  • hot water cabinet moderately expensive
39
Q

heating temp of paraffin

A

126-134 deg F

40
Q

Optimum tx temp of paraffin

A

125-127 deg F

41
Q

advantages of paraffin

A
  • maintains good contact with contoured areas and skin
  • easy and inexpensive
  • body part can be elevated
  • lubricates and conditions skin
  • can be used at home
42
Q

Continuous immersion/ dip immersion

A

1 dip for coating
dry
immerse up to 20 mins

43
Q

Dip Immersion w/ wrapping

A 
6-10 dips
dry
cover with plastic
elevate extremity 
wrap in towel for 10-15 mins or until cool
44
Q

painting / brushing w/ wrapping

A

-brush melted wax onto tx area 6-10x
dry
cover with plastic
wrap in town for 20 min

45
Q

what is a contrast bath

A

use of alternate immersion hot/cold

46
Q

procedure of contrast bath

A

alternate hot/cold 25-30 mins

-end with warm water

47
Q

what are indications for contrast bath

A
  • subacute trauma/ chronic conditions
  • inflammatory conditions (sprains, strains, tendinitis)
  • reflex sympathetic dystrophy (hypersensitivity/ hyperalgesia )
48
Q

advantages of contrast bath

A
  • promote more vigorous circulatory effect than heat/cold
  • good contact with contoured areas
  • pain control without aggravating edema
  • allows movement with application for increasing circulatory effects
49
Q

disadvantages of contrast bath

A
  • dependent limb position
  • pt might not be able to tolerate cold
  • evidence is lacking
50
Q

contraindications of thermotherapy

A
  • area of recent or potential hemorrhage
  • impaired sensation
  • impaired mentation
  • over malignant area/tumor
  • Thrombophlebitis
  • IR irradiation of the eyes
  • pregnant women: over abdominal, pelvic and low back
51
Q

precautions of thermotherapy

A
  • acute injury or inflation
  • pregnancy
  • poor thermoregulation
  • edema
  • over areas where tropical counterirritants recently been applied
  • demylinated nerve (carpal tunnel, ulnar nerve entrapment)
  • over an area of reduced peripheral blood circulation
  • pts with cardiac insufficiency
  • over body with superficially located implants
  • over superficial closed and open wounds
  • body part resting on hot back decreases cooling
52
Q

when should you reevaluate use of heat or refer to MD for reevaluation

A

pt conditions worsen or there is no improvement after 2-3 treatments

53
Q

adverse effects of thermotherapy

A
  • burns
  • fainting
  • bleeding
  • skin/eye damage from IR
54
Q

what is the 2 cause of malpractice suits

A

burns

55
Q

how to avoid tissue damage when using thermal agents

A
  • use superficial agents that get cooler during their application
  • limit initial temp of agent
  • use enough insulation between the agent and the pt skin
  • provide a means for py to call you, bell
56
Q

documentation of superficial heating agents

A
  • area treated
  • heating agent type
  • treatment parameter(temp/power, insulation/distance)
  • pt positioning
  • response to intervention

exam and Intervention II (6 decks)

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