Chapter 15 - Using Therapeutic Modalities Flashcards Preview

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Flashcards in Chapter 15 - Using Therapeutic Modalities Deck (114)
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1
Q

electromagnetic energy

A

electrical stimulation, shortwave & microwave diathermy, ultraviolet therapy, laser therapy

2
Q

electromagnetic energy travels

A

without a medium

3,000,000 m’s in a vacuum

in a straight line

3
Q

conduction

A

heat is transferred from a warmer object to a cooler one

4
Q

skin temperature influenced by

A

type of heat or cold medium

conductivity of tissue

quantity of blood flow in the area

speed at which heat is being dissipated

5
Q

high temperature limit

A

116.6 degrees farenheit

at 113 degress - should not go longer than 30 min

6
Q

types of modalities using conduction

A

MHP, paraffin, electric heating pads, ice/cold packs

7
Q

Convection

A

transference of heat through the movement of fluids or gases

ex. whirlpool bath

8
Q

radiation

A

heat energy is transferred from one object through space to another object

9
Q

types of radiation modalities

A

shortwave/microwave diathermy, infrared heating, ultraviolet therapy

10
Q

Conversion

A

generation of heat from another energy form such as sound, electricity, and chemical agents

11
Q

types of conversion modalities

A

ultrasound, diathermy, liniments/balms

12
Q

ultrasound

A

mechanical energy into heat energy at tissue interfaces

inaudible, acoustic vibrations of high frequency that may produce thermal or non-thermal physiological effects

13
Q

diathermy

A

heat produced by applying electrical current of specific wavelengths to skin

14
Q

liniments/balms

A

create heating sensation through counterirritation of sensory nerve endings

15
Q

Extent of tissue cooling

A

depends on type of cold medium, length of exposure, and conductivity of tissue

16
Q

38.8 degrees farenheit

A

muscle temperatures can be reduced as deep as 4 cm

17
Q

which tissue are good conductors

A

muscle is good, fat is poor conductor

18
Q

vasoconstriction occurs when

A

cold for 15-30 min at 50 degrees

19
Q

hunting response

A

slight increase in temperature during cooling (not vasodilation)

20
Q

physiological effects of cold

A

increased blood viscosity, decrease in release of chemical mediators, decreased capillary permeability

decreased secondary hypoxic death

decreased muscle spasm

21
Q

frostbite occurs at what temp

A

26.6-24.8 degrees farenheit

22
Q

raynaud’s phenomenon

A

cold exposure causes vasospasm of digital arteries lasting for 2 minutes to hours

23
Q

possible contraindications of cold

A

hypersensitivity

cold allergies

over superficial nerves

uncovered, open wounds

circulatory insufficiency

already decreased sensation

24
Q

ice massage

A

32 degrees

10-15 cm area, 5-10 min

25
Q

cold/ice water immersion

A

50-60 degrees

10-15 min

26
Q

ice bag

A

34-36 degrees

wet ice packs are best
15-20 min

27
Q

vapocoolant sprays

A

fluori-methane

reduce spasm, increase ROM, treat trigger points

28
Q

Cryokinetics

A

cryotherapy and exercise

ice until dumb (12-20 min)

exercise 3-5 min

ice until numb 3-5 min

repeat 3-5x

29
Q

effective tissue temperature for thermotherapy

A

100-113 degrees farenheit
or
40-45 degrees celcius

30
Q

thermotherapy effects

A
increased extensibility
increased viscosity
decreased joint stiffness
reduced pain
reduced muscle spasm
increased nerve conduction velocity
reduce inflammation, edema, exudate
increased blood flow, venous return, and lympathic drainage
assist inflammation
31
Q

superficial heat

A

infrared modality
indirectly heats deeper tissues by circulation and conduction

moist heat is greater than dry heat

32
Q

contra-indications of heat

A

acute inflammation, impaired circulation, poor thermal regulation, anesthetic areas, infections, malignancy, neoplasm, low back/abdomen during pregnancy

33
Q

moist heat packs

A

160-170 degrees
silicate gel in cotton pad
6 layers of toweling
break pain-spasm cycle (sedative)

34
Q

whirlpool baths

A

100-110 degrees

convection and conduction

35
Q

paraffin

A

126-130 degrees
glove methond: 6-12 dips, paraffin cools in between, wrap in plastic bag, rest for 30 min

immersion: submerge for 20-30 min,

36
Q

contrast bath

A

100-110; 50-60 degrees farenheit

3:1 or 4:1 warm:cold for 19-20 minutes

37
Q

attenuation

A

sound scatters and is absorbed as it penetrates tissue - energy transferred is decreased

38
Q

1 MHz or 3 MHz

A

one/three million cycles per second

absorption increases with increase in frequency

39
Q

US equipment

A

high-freq generator provides current through a co-axial cable to a transducer inside the applicator US head

(crystal - barium titanate, zirconate titanate)
2-3 mm thick and 1-3 cm diameter

40
Q

Reverse piezoelectric effect

A

alternating current passing through crystal causes expansion contraction of crystal (produces acoustic energy)

41
Q

1.0/3.0 MHz - frequency absorption

A
  1. 0: 3-5 cm

3. 0: 1-2 cm

42
Q

effective radiating area

A

surface of transducer that produces sound energy

1MHz is more divergent than 3 MHz

43
Q

transverse wave

A

displacement perpendicular to direction of propagation (solids)

44
Q

longitudinal wave

A

displacement in direction of wave propagation (liquids and solids -soft tissue)

45
Q

beam non-uniformity ratio

A

amount of variability
ideal 1:1
typically 6:1

46
Q

US - intensity

A

w/cm^2

power/ERA

47
Q

types of US

A

continuous - intensity remains constant

pulsed - intensity periodically interrupted

ducty cyle - % of time that US is being generated

48
Q

Biphasic Current

A

alternating current
-direction of current reveres itself once during each cycle

uses: pain modulation or muscle contraction

49
Q

Monophasic Current

A

Direct current
flows only from positive to negative pole

pain modulation, muscle contraction, produce ion movement

most commonly used in AT settings

50
Q

Pulsatile Current

A

3+ pulses grouped together
interrupted and repeat at regular intervals

used in interferential pre-modulated and Russian currents

51
Q

type of current parameters

A
waveform
modulation
intensity
duration
frequency
polarity
electrode setup
52
Q

waveform

A

graphic representation of the shape, direction, amplitude, and direction of a particular electrical currents (sine, square, triangular)

53
Q

modulation

A

ability of the e-stim unit to change the magnitude or duration of a waveform

bursts, continuous, surging (biphasic), monophasic, or pulsatile

54
Q

Intensity

A

voltage output of the e-stim unit.

low voltage - 150 V - monophonic
high voltage - 500 V - biphasic or monophasic

55
Q

Duration

A

length of time that current is flowing
pulse or width duration
normally is preset

56
Q

frequency

A

number of waveforms being emitted by the e-stim unit in 1 second

pules/sec (pps)
cycles per second (cps
Hertz (Hz)

57
Q

polarity

A

direction of current flow

58
Q

electrode set up

A

large pads - dispersive - away from tx area

small pad - active - close as possible to tx area

59
Q

e-stim parameters for gate control

A

intensity adjuted to create tingling

no contraction - with pulse and freq high as possible

60
Q

e-stim parameters for descending pathway control

A

very high intensity, almost painful, 10 microseconds for pulse duration; freq at 80 pps

61
Q

opiate pain control e-stim parameters

A

intensity - as high as can be tolerated
pulse duration - max
freq - 1-5 pps

62
Q

muscle pumping e-stim parameters

A

freq - 20-40 pps
surged mode at 5 seconds each for on/off modes
injured part elevated
active contraction encouraged

63
Q

muscle strengthening e-stim parameters

A
high-freq bi-phasic current
50-60 pps
surging curent at 15 sec on, 50 sec off
10 reps, 3x a week
combined with titanic muscle contraction with maximal active contraction against resistance
64
Q

retardation of atrophy e-stim parameters

A

high-freq bi-phasic
30-60 pps to elicit a tetanic contraction
voluntary isometric contraction

65
Q

muscle re-education

A

intensity increased to comfortable contraction
30-50 pos using interrupted or surged current
15-20 min, several times per day

66
Q

iontophoresis

A

drives ions into the body via electrical current

67
Q

interferential indications

A

pain control, joint pain w/ swelling, neuritis, retarded callus formation following fx, restricted mobility
20-25 pps for muscle contraction and 50-120 pps for pain management

68
Q

shortwave diathermy

A

emits electromagnetic energy that is capable of producing temperature increases in the deeper tissues

69
Q

Laser

A

light amplification by stimulated emission of radiation

Helium-NEon) or (Gallium-Arsenide

70
Q

physiological effects of thermal US

A

increased blood flow, metabolism, enzymatic activity, collagen extensibility,

decreased viscosity, pain, chronic inflammation, muscle spasm, joint stifffness

71
Q

mild heating US

A

1 degrees celcius - accelerates metabolic rate

72
Q

Moderate heating US

A

2-3 degrees celcius - reduces muscle spasm, pain, chronic inflammation, increase blood flow

73
Q

vigorous heating 3-4 degrees celcius

A

decreases viscoelastic properties of collagen

74
Q

physiologic effects of non-thermal US

A

microstreaming

cavitation

separation of collagen fibers

increased extensibility

increased fibroblastic activity

mechanical break-up of metabolites and waste products
reduction of edema and pain

75
Q

microstreaming

A

flow of fluid/tissue components causes mechanical pressure waves - alters cell membrane permeability to Na+ and Ca2+ ions

76
Q

Cavitation

A

formation of gas-filled bubbles that expand and compress due to pressure changes in fluid

stable: - increased fluid flow around bubbles
unstable: can cause damage

77
Q

monopolar electrode

A

small (active) and large (dispersive) pad

78
Q

bipolar elctrode

A

2 equally sized pads

79
Q

bifurcate electrode

A

dispersive pad, and 2 active pads

80
Q

quadpolar electordes

A

2 sets of electrodes - IFC

81
Q

biofeedback

A

electronic instruments to accurately measure, process, and feed back reinforcing info via auditory or visual signals

82
Q

EMG biofeedback

A

measures electrical activity in muscle fibers - quality of contraction

83
Q

Mechanical response to massage

A

encourage venous and lymphatic drainage

mildly stretch tissue

avoid stagnant edema

84
Q

physiological responses to massage

A

increased: circulation, metabolism, removal of lactic acid

85
Q

Effleurage

A

stroking
light - sedative
deep - compression of soft tissue
hand over hand or cross body methods

86
Q

petrissage

A

kneading
loose and heavy tissues
wrings out muscle, loosens adhesions, squeeze out material in to circulation

87
Q

friction

A

used around joint where tissue is thin or unyielding
circular movement

stretch underlying tissue, develop heat, increase circulation

88
Q

Tapotement

A

percussion

cuping, hacking, pincing

89
Q

vibration

A

produces trebling effect

relax and sooth

90
Q

indications for traction

A

spinal nerve root

impingement

use to decrease muscle guarding

treat muscle strain

treat sprain of spinal ligaments

relax discomfort resulting form normal spinal compression

91
Q

diathermy

A

emit electromagnetic energy capable of producing temperature increases in deeper tissues,

good for larger surface areas

92
Q

shortwave diathermy

A

heats deeper tissue with high freq electrical current

  • through a condenser (electrostatic field heating, patient is part of circuit)
  • electromagnetic/induction field heating (heated by field, patient is not in circuit)
  • pulsed diathermy - output of continuous shortwave diathermy is consistently interuppted
93
Q

shortwave diathermy equipment

A

power amplifier (converts AC-DC)

Applicators: condenser - electrodes
or
inductive coil or drum

94
Q

shortwave diathermy indications

A

bursitis, capsulitis, osteoarthritis, deep muscle spasm, strains

can reach temps of 107

95
Q

Microwave Diathermy

A

lower freq cause less conversion of energy into subQ tissue

easily absorbed

96
Q

microwave diathermy equipment

A

AC–>DC by magnetron oscillator

coaxial cable transports energy from magnetron oscillator to applicator head

97
Q

indications for microwave diathermy

A

fibrositis, myositis, osteoarthritis, bursitis, calcific tendinitis, sprains, strains, post-traumatic joint stiffness,

can penetrate up to 5 cm

98
Q

conductive thermal energy

A

thermotherapy, cryotherapy

99
Q

electrical energy using modalities

A

E-stim currents, iontophoresis, biofeedback

100
Q

sound energy using modalities

A

ultrasound, extracorporeal shockwave therapy

101
Q

mechanical energy using modalities

A

traction, massage, intermittent compression

102
Q

velocity=

A

wavelength x frequency

103
Q

characteristics of electromagnetic radiation:

A
  1. ) produced when sufficient electrical or chemical forces are applied to any material
  2. ) travel readily through space at an equal velocity (300,000,000 meters/sec)
  3. ) Direction of travel is always in a straight line
104
Q

Electromagnetic radiation can be do what when contacting tissue?

A

reflection, transmitted, refracted, absorbed

105
Q

Arndt-Schultz Principle

A

No changes or reactions can occur in the tissues unless the amount of energy absorbed is sufficient to stimulate the absorbing tissues

106
Q

Law of Grotthus-Draper

A

if the energy is not absorbed utmost be transmitted to the deeper tissues

> absorption =

107
Q

Cosine Law

A

the smaller the angle between the propagating radiation and the right angle, the less radiation reflected and the greater the absorption

108
Q

inverse square law

A

the intensity of the radiation striking a surface varies inversely with the square of the distance from the source

“moving the object away from energy source = less absorption”

109
Q

pulsed SWD can cause

A

depolarization in damaged cells correcting dysfunction

110
Q

when should Diathermy be used?

A

if skin/tissue is tender and cannot handle pressure

if SubQ tissue is thick and deep heating is required

if 1 MHz US is contraindicated, Pulsed SWD will produce the same magnitude and depth of muscle heating

if the tx area is a large area

111
Q

when should UV Therapy be used

A

cause chemical changes in skin, that have a bactericidal effect

effects are superficial in nature

treat skin lesions

topical agents are often better options

112
Q

when should low level lasers be used

A

when you do not desire thermal effects
soft tissue and fracture healing
pain management

113
Q

all electrical stimulating currents are classified as what?

A

Transcutaneous Electrical stimulating currents

114
Q

Types of Transcutaneous electrical stimulating currents

A

EMS - Electrical muscle stimulators
TENS - Transcutaneous Electrical Nerve Stimulators
LIS/MENS - Low Intensity Stimulators

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