Flashcards in Electrotherapy for Tissue Healing Deck (87)
1
What occurs during the inflammatory stage of wound healing (4)
1. Hemostasis
2. Phagocytosis
3. Autolysis
4. Fibroblast migration
2
What is hemostasis
Blood clotting due to platelets
3
What is phagocytosis
Breakdown and elimination of foreign substances and bacteria
4
What is autolysis
Breakdown of other cellular debris so it can be removed from the area
5
What is fibroblast migration
Bringing fibroblasts into the area
6
What occurs during the proliferation stage of wound healing (4)
1. Collagen synthesis
2. Angiogenesis
3. Epithelialization
4. Wound contraction
7
What is angiogenesis
Development of new blood vessels
8
What occurs during the maturation stage of healing (2)
1. Collagen lysis
2. Collagen replacement
9
What is collagen lysis
Laying down and breaking apart of collagen
10
True or False:
The 3 stages of wound healing can overlap each other
True
11
What are the factors that impede wound healing (8)
1. Some systemic medications
2. Some topical medications
3. Malnutrition
4. Prolonged pressure or stretch
5. Infection
6. Immunodeficiency
7. Smoking
8. Dryness or necrotic tissue
12
What should you assess about chronic wounds (4)
1. Size
2. Description of wound base
3. Assessment of periwound tissue
4. Wound drainage
13
What should you assess about wound size (3)
1. Surface area
2. Depth
3. Volume
14
What are 4 types of chronic wounds
1. Pressure sores
2. Arterial insufficiency ulcers
3. Venous insufficiency ulcers
4. Diabetic ulcers
15
What is a pressure sore
Area of local tissue loss due to prolonged tissue compression between boney prominences and external surfaces
16
What are the common locations of pressure sores (5)
1. Sacrum
2. Heels
3. Ischial tuberosity
4. Greater trochanter
5. Malloeli
17
What causes a pressure sore
Compression of tissues reduces blood perfusion in tissues and produces necrosis
18
How many stages of pressure sores are there
4
19
What is a stage I pressure sore
Non-blanchable erythema of intact skin
20
What is a stage II pressure sore
Partial thickness skin loss to epidermis, dermis, or both
21
What is a stage III pressure sore
Full thickness skin loss including damage to subcutaneous tissue
22
What is a stage IV pressure sore
Full thickness skin loss with destruction or damage to muscle, bone, or support structures
23
What is an arterial insufficiency ulcer
Area of local tissue loss due to arterial blood supply deficiency
24
What are the common locations of arterial insufficiency ulcers (4)
1. On the foot
2. Over malleoli
3. Toe joints
4. Lateral foot border
25
What causes arterial insufficiency ulcers (3)
1. Arteriosclerosis
2. Arterial occlusion
3. Arterial disruption
26
What is a venous insufficiency ulcer
Area of local blood loss due to deficiency in venous drainage
27
What are the common locations of venous insufficiency ulcers (2)
1. Above the ankle
2. Medial lower leg
28
What causes venous insufficiency ulcers (2)
1. Sustained venous hypertension
2. Venous valvular dysfunction
29
What is a diabetic ulcer
Area of local tissue loss due to sensory neuropathy and arterial blood supply deficiency
30
What are the common locations for diabetic ulcers (4)
1. Plantar surface of foot
2. Over the heel
3. Lateral border of the foot
4. Plantar surface of metatarsal heads
31
What causes diabetic ulcers (2)
1. Tissue trauma in insenate tissue
2. Peripheral vascular disease (PVD)
32
What is the electrochemical effect at the negative electrode
2Na+2H2O to 2NaOH+H2
33
Is the negative electrode increase acidity or alkalinity
Alkalinity
34
What is the electrochemical effect at the positive electrode
2Cl+2H2O to 4HCl+O2
35
Is the positive electrode increase acidity or alkalinity
Acidity
36
What is electrokinetic
Ionic movement
37
What is an example of electrokinetics
Depolarization of an excitable membrane
38
What is the electrothermal effect of electricity
Microvibration of charged particles produces heat
39
What is the equation for heat produced electrically
H=0.24*I^2*R*t
40
What does I equal
RMSa current
41
What does R equal
Impedance of tissue
42
What does t equal
Time
43
What causes an increased thermal effect of electricity
High RMSa, high skin impedance, and prolonged treatment time
44
What are the physiologic effects of E-stim that benefit wound healing (7)
1. Galvanotaxis
2. Collagen synthesis
3. Proliferation of fibroblasts
4. Angiogenesis and wound microperfusion
5. Bacterial
6. Enhanced rate of epithelialization
7. Enhanced blood flow to the wound
45
What is galvanotaxis
The movement of an organism or any of its part in a particular direction in response to an electrical current
46
During the inflammatory stage of wound healing which organisms move because of the electric current and which electrode do they move toward (2)
1. Macrophages: negative
2. Inactive neutrophils: negative
47
During the proliferation stage of wound healing which organisms move because of the electric current and which electrode do they move toward (1)
1. Fibroblasts: positive
48
During the maturation stage of wound healing which organisms move because of the electric current and which electrode do they move toward (3)
1. Myofibroblasts: positive
2. Keratinocytes: positive
3. Epidermal: negative
49
What are macrophages, inactive neutrophils, fibroblasts, myofibroblasts, and keratinocytes used for
Macrophages: phagocytosis
Inactive neutrophils: autolysis
Fibroblasts: collagen formation
Myofibroblasts: wound contraction
Keratinocytes: epithelialization
50
What is the amplitude, treatment duration, treatments per day, and treatment days per week of low intensity DC
Amplitude: 200-800 mA
Treatment duration: 1-2 hours
Treatments per day: 1-3
Treatment days per week: 5-7
51
What is low intensity DC
Unidirectional flow of current with a low amplitude that continues until you turn of the machine
52
What is the pulse amplitude, pulse duration, pulse frequency, mode, treatment duration, treatments per day, and treatment days per week for high voltage pulsed current (HVPC)
Pulse amplitude: 100-150 V peak
Pulse duration: 100-200 usec
Pulse frequency: 30-130 pps
Mode: Continuous
Treatment duration: 30-60 minutes
Treatments per day: 1-2
Treatment days per week: 5-7
53
What is HVPC
Twin peak monophasic pulse
54
True or False:
HVPC is a pair of monophasic spike like waveforms
True
55
True or False:
In HVPC there is almost an instantaneous rise followed by exponential decline
True
56
What is the pulse amplitude, pulse duration, pulse frequency, mode, treatment duration, treatments per day, and treatment days per week for rectangular monophasic pulsed current (RMPC)
Pulse amplitude: 30-35 mA peak
Pulse duration: 150 usec
Pulse frequency: 64-128 pps
Mode: Continuous
Treatment duration: 30 minutes
Treatments per day: 2
Treatment days per week: 7
57
What is monophasic rectangular pulsed current
Unidirectional flow of a finite pulse followed by a rest period
58
What is the pulse amplitude, pulse duration, pulse frequency, mode, treatment duration, treatments per day, and treatment days per week for biphasic pulsed current (rectangular asymmetric)
Pulse amplitude: Strong sensory just below motor threshold
Pulse duration: 100 usec
Pulse frequency: 50 pps
Mode: Continuous
Treatment duration: 30 minutes
Treatments per day: 3
Treatment days per week: 5-7
59
What is the charge of the outside of the skin
Negative
60
What is the charge of the inside of the skin
Positive
61
What happens to the charge of the inside and outside of the skin with injury
Polarity shifts so outside is positive and inside is negative
62
How many protocols are there for wound healing
4
63
What is protocol 1
Cathode over wound days 1-5
64
What is protocol 2
Cathode/anode over wound if infected
65
What does the wound need to be infected with for the cathode to be placed over the wound (2)
1. E coli
2. P aeruginosa
66
What does the wound need to be infected with for the anode to be placed over the wound (1)
1. S aureas
67
What is protocol 3 based on
The type of healing the clinician wants to induce
68
What are the 2 types of healing the clinician could want induce caused by
1. Anode
2. Cathode
69
What type of wound healing does the anode induce (1)
Attract macrophages and neutrophils to stimulate phagocytosis and autolysis
70
What type of wound healing does the cathode induce (3)
1. Attract fibroblasts to increase granulation tissue
2. Stimulate myofibroblasts to increase wound contraction
3. Stimulate keratinocytes to increase rate of re-epithelialization
71
What is protocol 4 based on
Electrochemical response in tissues being stimulated
72
What are the 2 types of electrochemical response in tissue being stimulated caused by
1. Cathode
2. Anode
73
What electrochemical response in tissue being stimulated does the cathode induce (3)
1. Solubilize
2. Liquefy
3. Soften tissue
74
What electrochemical response in tissue being stimulated does the anode induce (1)
1. Stimulate epithelialization
75
Is the cathode the positive or negative electrode
Negative electrode
76
What are the therapeutic effects under the cathode/negative electrode (5)
1. Increased blood flow
2. Galvanotaxic
3. Enhances growth of granulation tissue
4. Induces epidermal cell migration
5. Antimicrobial
77
What is galvanotaxic
Movement of an organism or any of it's parts in response to to an electric current
78
What is the cathode/negative electrode galvanotaxic for (6)
1. Activated neutrophils
2. Fibroblasts
3. Lymphocytes
4. Plateletes
5. Mast cells
6. Keratinocytes
79
Is the anode the positive or negative electrode
Positive electrode
80
What are the therapeutic effects of the anode/positive electrode (6)
1. Galvanotaxic
2. Promoted growth and reorganization of epithelial cells
3. Decreases mast cells in healin gwounds
4. Vasoconstriction
5. Decreased blood flow
6. Antimicrobial
81
What is the anode/positive electrode galvanotaxic for (3)
1. Macrophages
2. Epidermal cells
3. Inactive neutrophils
82
True or False:
Electrotherapy can reduce edema formed with acute injury and inflammation
True
83
How does electrotherapy reduce edema formed with acute injury and inflammation
Negative pole theories
84
What are the negative pole theories (3)
1. Repel negatively charged serum proteins
2. Reduce microvessel diameter
3. Reduce pore size
85
How does the negative pole reducing microvessel diameter decrease edema
Reduce the leakage of fluid into the interstitial space
86
What is the waveform of electrotherapy that causes edema reduction
HVPC
87