Electrotherapy for Tissue Healing Flashcards Preview

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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

What is the pulse duration, polarity, frequency, on/off time, current amplitude, and treatment time for HVPC for edema reduction

Pulse duration: 40-100 usec
Polarity: Negative
Frequency: 100-200 pps
On/off time (mode): Continuous
Current amplitude: Comfortable sensory
Treatment time: 20-30 minutes