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Flashcards in cryotherapy Deck (80)
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1

what is cryotherapy

the therapeutic application of any material or substance that results in WITHDRAWAL of HEAT from the body,

2

Withdrawal of heat from the body causes

lowering tissue temp locally and, under some specific applications, the whole-body core temp.

3

modes of heat transfer

conduction
convection
evaporation

4

What are considerations with application

-type of agent
-method of delivery
-dosimetry
-precautions/ contraindications

5

What are types of cryotherapy

ice packs, ice cups, gel packs, chemical packs, cyropressure units/cryocuff, vapocoolant sprays, cryohydrotherapy, cooling suits

6

indications for cryotherapy

abnormal tone, acute or chronic pain, acute or subacute inflammation, bursitis, muscle spasm, musculoskeletal trauma, myofascial trigger points, tendonitis, tenosynovitis

7

local skin temperature is used to what?

estimate stage of healing and use of cold

8

If skin temp. elevated equals what

use of cold

9

normal skin temp equals

cold discontinued to prevent impeding healing process/ impair circulation

10

If the skin temp is elevated greater then 72 hour what should you suspect

infection... refer to MD

11

uses of cryotherapy

-inflammtion control
-edema control
-pain control
-modification of spasticity- prolonged icing
-symptom management in MS- cooling vest
-facilitation
-cryokinetics and cryostretch

12

Applying cold immediately after injury or during acute inflammatory phase of healing to control what?

bleeding
edema
pain
accelerate recovery

13

Applied after clotting has occurred and therefore has no effect on what ?

hemorrhaging

14

can limit and reduce edema formation if applied soon after injury (<5 min) occurs by?

slowing of metabolic rate and decrease secondary tissue damage

15

if provided later than 5 mins post trauma the effect on inflammatory process is

no effect

16

if provided later than 5 mins post trauma the effect are

counterirritant and antispasmotic agent

17

how is cryotherapy a counterirritant ?

-increased cold receptor activity
-decrease nerve conduction velocity
-decreased pain

18

how is cryotherapy a antispasmotic agent

-decreased gamma motoneuron activity
-decreased muscle spindle activity
-decreased spasm/spasticity

19

what are the causes of warmth and redness

inflammation

20

causes of coolness & pallor

poor circulation

21

how to control edema with cryotherapy?

-cold for 15 mins (20 on extremities)
-applications at least an hour away

22

edema control with acute inflammation includes

RICE
compression with elastic wrap & elevation above heart

23

decrease in tissue temp by cryotherapy can indirectly/directly do what

decrease sensation of pain

24

CT directly & rapidly modifies sensation of pain by

gating pain transmission through activity of cutaneous thermal receptors producing analgesic effect

25

used in conjunction with joint mobs to

reduce possibility of pain and swelling

26

used in conjunction with deep friction massage before and after to

reduce pain and irritation

27

used in conjunction with electrical

stimulation

28

used in conjunction with exercise to

decrease residual swelling

29

used in conjunction with RICE to

decrease swelling

30

hemodynamic effects of cold

initial decrease in bold flow

31

Neuromuscular effects of cold

-decreased nerve conduction velocity
-increased pain threshold
-altered muscle strength
-decreased spasticity
-facilitation of muscle contraction

32

metabolic effect of cold

decreased metabolism & enzyme activity

33

during hemodynamic, cold causes activation of cutaneous cold receptors by directly stimulating ?

smooth muscle of the blood vessel walls to contract

34

hemodynamic triggers reflex activation/depolarization of

sympathetic adrenergic nerve fibers

35

hemodynamic leads to the release of neurotransmitter

norepinephrine, on the adrenergic receptors of smooth muscles surrounding blood vessels

36

during hemodynamic there is a decrease in production of

vasodilator mediators (histamine & prostaglandin)

37

during hemodynamic, cold causes a decrease in

cell metabolism

38

Cold induced vasodilation

initial decrease in blood flow, later increase in blood flow

39

during hemodynamic there a decreased in what after trauma/injury

secondary cell hypoxia

40

during hemodynamic cold causes an increase or decrease in blood viscosity

increase

41

how is there an increase in blood viscosity during hemodynamic

-reduced flow protects other areas from excessive decreases in temp and stabilizes core body temp

42

effects of neuromuscular causes a decrease in

NCV in proportion to degree and duration of temp changes

43

Therapeutic effect of neuromuscular

-decrease in NCV
-Elevation of pain threshold
-decrease in apsticity
-change in muscle force generation

44

neuromuscular causes elevation of pain threshold by

-decrease sensation of pain
-stim of cold receptors: increased sensory input blood stimuli to brain cortex

45

neuromuscular can cause counter irritation via the gating control mechanism and interrupts what

pain-spasm- pain cycle and decreases muscle spasm, sensory NCV, edema

46

neuromuscular decreases spasticity by

a reflex reaction to stimulation of cutaneous cold receptors

47

neuromuscular decreases spasticity initially by

decrease in gamma motor neuron activity

48

neuromuscular decreases spasticity later by

decrease in afferent spindle and golgi tendon organ activity

49

neuromuscular change in muscle force generation with ice massage <5 min increases in

isometric strength

50

neuromuscular change in muscle force generation with cooling 30+ mins by initial decrease in

isometric force for 1 hour and then increase for > 3 hours to greater than pre-cooling strength

51

strength testing should be performed when to cryotherapy ?

before application

52

Brief application of cold (few seconds) causes

facilitation of muscle contraction

53

Cold facilitates Alpha motor neuron activity to produce

contraction in flaccid muscle which is a result of an upper motor neuron dysfunction

54

Metabolic effects of cold decrease

in rate of all metabolic activities, including those involved in inflammation and healing

55

Should CT be considered for OA and RA

yes

56

During RA, cold decreased what

histamine in blood

57

at joint temp <86, there is a decrease in

activity in cartilage degrading enzymes

58

Cartilage degrading enzymes include

-collagenase
-Elastase
-Hyaluronidase
-protease

59

causes of the primary effects of cooling effects

-vasocontriction
-Increase cold receptor activity
-Decreased gamma motor neuron activity

60

causes of vasoconstriction

-decreases swelling
-decreases nerve compression via reduction in edema formation

61

causes of increased cold receptor activity

-decrease pain
-aids in decreasing spasticity

62

causes decreased gamma motor neuron activity

decreases spasm/ spasticity

63

Contraindication of cryotherapy

-cold allergy/ hypersensitivity aka cold urticaria
-cold intolerance
-raynaud's disease/ phenomenon
-cryoglobulinemia
-paroxysmal cold hemoglobinuria
-over regenerating peripheral nerves
-over areas of circulatory compromise or PVD
-Inability ot discriminate cold

64

Raynaud's disease/ phenomenon

vessels already in chronic state of vasoconstriction/ vasospasm; further application can lead to ischemic necrosis

65

Cryoglobulinemia

aggregation of serum proteins in small distal vessels after cold applications that can impair circulation and cause gangrene

66

Paroxysmal cold hemoglobinuria can be signaled by

blood in urine

67

multiple sclerosis is aggravated by

generalized heating (warm environments/ activities)

68

peripheral cooling for MS

decreases tremor

69

cooling vests for MS improve what and reduce what

improve: strength, visual function, postural stability
reduce: fatigue

70

what demonstrated as much importance as use of cryotherapy in IMMEDIATE post ACL reconstruction edema control

compression

71

what demonstrated a significantly lower tissue temperature than ice pack

ice massage

72

lower temperature was seen in a shorter period of time with what over an ice pack

ice massage

73

What are expected physiological response to cryotherapy

-short term skin redness
-anesthesia
-analgesia

74

Typical sequence of sensation to CT

-intense cold
-burning
-aching
-analgesia
-numbness

75

Precautions

-over superficial main branch of nerves
-hypertension
-very young/old pt
-poor sensation or mentation
-over open wound
-use of vapocoolant sprays- may be inflammable or harmful to ozone layer

76

Adverse effects of cryotherapy

tissue death or dame

77

temp of tissue damage

<15C (59 F)

78

temp of freezing/frostbite

4 to 10 C (39 to 50 F)

79

optimum mins of cryotherapy to achieve vasoconstriction

10-20

80

documentation of cryotherapy include

-area treated
-cooling agent
-treatment duration
-Patient positioning
-response to intervention