EPA Flashcards
(111 cards)
1
Q
Benefits of heat ? (5)
A
- pain relief
- reduces muscle spasm and joint stiffness
- promotes relaxation
- increases blood flow
- facilitates fine movement and increases ROM and exercise tolerance in some patients
2
Q
Generally elevate tissues to __ - __ degree for therapeutic effect
A
40-45
3
Q
Benefits of cold?
A
- decreases swelling after injury / surgery chronic edema and joint effusions
- decreases muscle spasm / spasticity
- mild cooling enhances muscular isometric contracture and endurance
- decrease pain
4
Q
Infra-red heats via _____ heat transfer
A
radiation
5
Q
Whirlpool heats via _____ heat transfer
A
convection
6
Q
Parafinn wax heats via _____ heat transfer
A
conduction
7
Q
US / diathermy heats via ______ heat transfer
A
conversion
8
Q
Greatest effect of heat / cold in tissues is at __- __ mm, after that only about a 1 degree change
A
1-2
9
Q
What MUST you test prior to Rx w/ heat / ice?
A
sensation! (hot / cold)
10
Q
Paraffin wax usually kept b/w __ - __ degrees Celsius
A
42-52
11
Q
Hot pack: use __ - __ cm or __ - __ towels between skin and hot pack
A
1-2;4-6
12
Q
Hot packs: skin takes ~ __ minutes to reach max test, do an objective and subjective test at __ minutes, leave heat on for 15-20 minutes
A
8; 10
13
Q
Constrast baths: increases blood flow to skin and provides considerable sensory stim, tubs at __ - __ degrees and __ - __ degrees , repeat 3-4x, __ - __ mins total
A
38-44; 10-18; 20-30
14
Q
Whirlpool = mechanical stimulation + thermoreceptors, can help with wound ______
A
debridement
15
Q
CI’s to use of thermal agents (heat)? (8)
A
- acute inflammation
- skin conditions
- altered thermal sensation
- hemorrhagic disease
- malignancies
- gonads
- open wounds
- unreliable pt
16
Q
Check for allergic reactions to cold after __ minute and again after __ minutes
A
1;5
17
Q
CI’s / dangers to the use of cold?
A
- ice burn
- peripheral nerve damage
- frostbite
- reduced peripheral blood supply
- cold sensitivity (Reynaud’s, cold urticaria)
18
Q
EMG feedback = use for ___ _____ testing; estimated velocity of depolarization along ____ ____ neuron
A
nerve conduction; alpha motor
19
Q
Normal skeletal mm EMG feedback = usually ____ at rest
A
silent
20
Q
EMG feedback: reduced insertional activity seen in ____ or severely _____ muscles when needle is inserted
A
fibrotic; atrophied
21
Q
Abnormal EMG activity at rest suggests _____ or _____
A
neuropathy; myopathy
22
Q
Neuropathy of myopathy EMG recordings will be indicated by what 3 things?
A
- fibrillation potentials
- positive sharp waves
- fasciculation potentials
23
Q
______ EMG provides info about mm activity in order to up train or down train avidity
A
surface
24
Q
Surface EMG is used as a tool, not a treatment (T/F)
A
TRUE
25
Use _____ for acute and chronic pain, muscle twitch, muscle strengthening and spasticity management
TENS
26
TENS ______ setting = segmental mechanism gaiting at SC
conventional
27
TENS _______ mechanism = release of opiod and serotonin receptors
1extra-segmental
28
Parameters for conventional TENS?
- 80-150 Hz
- 60 microseconds
- intensity to comofortable tingle
- electrodes over site of pain / bracketing
- 30 mins, immediate pain management
29
Parameters for AL TENS?
- 10 Hz
- 200 microseconds
- intensity to muscle twitch
- electrodes on motor point
- duration 40-60 mins
- prolonged pain management
30
CI's to TENS? (8)
1. electronic devices
2. low back or abdomen of pregnant women
3. malignancy
4. DVT or thromboembolism
5. infected tissues
6. impaired sensory awareness
7. cognitive or communication impairments
8. cardiac disease or arrhythmias
31
Use _____ for pain, produce muscle twitch, increasing muscle strength and spasticity management
NMES
32
Parameters for pain for NMES?
same as TENS
33
Parameters for edema management NMES?
- over extra-articular edema
- 5-10 Hz
- 200 microseconds
- motor intensity to twitch
34
Parameters for muscle strengthening NMES?
1. >35 < 65 Hz
2. intensity to tetany
3. rise and fall (2 s ramp up, 1 sec off, 6 s contraction = 9s in total)
4. on/ off depending on strength of muscle
5. 12 - 15 contractions
35
On/off periods for NMES based on muscle grades?
1. Gr I = 1:5
2. Gr III = 1:3
3. Gr IV = 1:1
36
CI's to NMES?
1. electrical devices / implant
2. pregnancy ANYWHERE
3. active DV T of thromboembolism
4. infected tissue
5. chest w/ cardiac disease / arrhythmias / heart failure
6. neck or over eyes
7. impaired circulation
8. unstable (recent Sx, OP, #_
9. intercostal mms or lower abdomen
37
_____ used for pain management via gaiting and/or endogenous opiate release, edema management via muscle twitch, increasing local blood flow, muscle stimulation for strengthening of pelvic floor
IFC
38
IFC = ___ voltage, ____ intensity, 2 _____ waves at alternating current of 4000 Hz
low; medium; sinusoidal
39
IFC: each wave = slightly different ______ and interfere with one another in tissues creating new wave that varies in shapes frequency and amplitude; what is this interference called?
frequencies; linear super-position
40
Series of wave packets in IFC called ?
beats !
41
Is IFC balanced or unbalanced ?
BALANCED!
42
IFC = symmetrical or unsymmetrical? biphasic or triphasic?
symmetrical biphasic !
43
IFC = amplitude ______ , pulse duration of ____ microseconds, phase duration of ___ microseconds
modulated; 250; 125
44
Motor parameters for IFC?
- 1-10 Hx w/ strong but comfortable twitch
| - 40 - 60 minutes
45
Sensory parameters for IFC?
- 80 - 150 Hz w/ strong but comfortable sensation
| - 20-40 mins
46
Motor and sensory parameters for IFC?
- 1-150 Hz for both (less effective for motor though!)
47
Add _____ to IFC to avoid accommodation
sweep
48
IFC can treat large, deep areas (T/F)
TRUE
49
IFC caution: can output __ - __ mA - NO THORACIC APPLICATION over __ mA
50-90
50
Why do you not put IFC over thorax over 50mA?
Bc it might cause ventricular fibrillation!
51
IFC: ____ electrodes increase current density and risk of burns
smaller
52
IFC: ______ current flow and increased risk of _____ if electrodes placed too close together
superficial; burns
53
CI's to IFC?
1. to chest / thorax
2. electronic devices
3. regions of known or suspected malignancy
4. low back or abdomen of pregnant women
5. active DVT or thrombophlebitis
6. actively bleeding tissues or untreated hemorrhagic disorders
7. infected tissues, TB or wounds w/ underlying osteomyelitis
8. recently radiated tissue
9. impaired sensory awareness
10. to the neck or head
11. to areas near reproductive organs or genitalia
12. to areas near or over eyes
13. damaged or at risk skin areas that would result in uneven conduction of current
14. cognition of communication impairments
54
Precautions to using IFC?
1. active epiphysis in children
2. skin disease
3. impaired circulation
4. metal implants
5. fragile skin
55
_____ = used for decreased pain, decreased edema, increased wound healing, mm stim
HVPC
56
HVPC = ___ peak intensity (current), ____ average intensity
high; low
57
HVPC = __phasic
mono
58
Monophasic waves can build up a ______ net charge
bigger
59
HVPC frequency = __-___ Hz, pulse width sized at _- -__ microseconds
1-200; 5-65
60
HVPC: peak current is high (=higher risk of burning) but there is a long _____ _____ so charge has a chance to dissipate, allowing safer application
interpulse interval
61
HVPC: parameters for pain management?
same parameters as TENS
62
HVPC: parameters for wound healing?
- 50 - 100 Hz (submoto!)
- 30-60 minutes
- 3-7 days a weak
63
HVPC for wound healing: polarity is based on ___ of ____
stage of healing
64
HVPC: macrophages / epidermal cells / epithelial cells are all _____, fibroblasts are ______
negative; positive
65
HVPC : one electrode in _____, one __ - __ cm away
wound; 10-20
66
HVPC: parameters for subacute edema reduction?
- 5-20 Hz
67
HVPC edema reduction: want muscle twitch, usually start w/ _____ polarity
negative
68
HVPC edema reduction: 2 possible electrode placements?
1. active red on edema (if set as negative, will push away positive portions)
2. muscle twitch on motor point and nerve trunk for CHRONIC
69
HVPC parameters for muscle stim?
- 35-65 Hz
70
______ = can repel molecules or attract desired cells based on polarity
Galvanotaxis
71
CI's to HVPC? (4)
1. seizure / epilepsy
2. electronic implant
3. neck area
4. inflammation (don't want to add energy to injury)
?
72
Precaution to HVCP?
impaired cognition
73
______ = treatment method using current flow b/w two electrodes to push ions through the skin barrier
iontophoresis
74
Iontophoresis: current is _____
direct
75
Anode = ____ electrode
positive
76
Iontophoresis: possible ______ reaction under anode, = skin hardening over time (_____)
acidic ; sclerosis
77
Iontophoresis: possible _____ reaction under cathode, = softening and ____ of skin
alkaline; burning
78
Iontophoresis: keep the ____ larger ! Current ______ is therefore lower and skin is less likely to burn
cathode; density
79
Iontophoresis: current density is limited to __ mA/cm^2 under the anode and __ mA/cm^2 under the cathode
1; 0.5
80
______ is used for hyperhidrosis, MSK inflammatory disorders, plantar fasciitis, TMJ disorders, ischemic skin ulcer, fungal infections, bursitis and tendonitis
iontophoresis
81
CI's to iontophoresis?
1. over damaged skin or open lesions
2. allergy to therapeutic ions
3. impaired sensation
4. over electric implants
82
3 features of laser?
1. monochromaticity
2. coherence
3. collimation
83
_______ = all photons have a single wavelength
monochromaticity
84
_____ = all photons travel in same phase and direction
coherence
85
_____ = minimal divergence over distance
collimation
86
_____ = used to increase tissue healing, decrease pain, decrease inflammation (wound management)
laser
87
Laser head = based on ___ of lesion
depth
88
Red - near infrared laser = _- __ mm, near - mid infrared = __ - __mm
1-5;5-10
89
Dose of lase: acute __J/point, chronic __ J/point
2;4
90
Frequency of laser: acute = < ____ kHz, wavelenght of __ - ___ nm, chronic = > ____ kHz, wavelengths of _____ - _____ nm
1000; 600-1000; 1000; 1000-1350
91
Laser can be continuous or pulsed, and non-contact is preferred over contact (T/F)
FALSE - contact preferred over non-contact !
92
CI's to laser? (8)
1. over eyes (WEAR GOGGLES!)
2. known or suspected malignancy
3. low back or abdomen of pregnant women
4. hemorrhage or severe vascular disease
5. tissue infected by TB of virulent bacteria
6. actively bleeding tissues o untreated hemorrhagic disorders
7. active DVT of thrombophlebitis
8. reproductive tissues
93
Precautions to laser?
1. recently radiated tissues
2. infected regions (compromised immune function)
3. anterior neck
4. photosensitive areas
5. cognitive impairments
6. epiphyseal plates in children
94
5 BCCDC LASER safety guidelines ?
1. use in a controlled area
2. laser eye protection is required ***
3. only authorized personnel must occupy the area
4. the area must have appropriate warning sign
5. any windows, doorways openings etc must be either covered or restricted !
95
____ therapy = treat psoriasis, eczema, vitiligo, pruritus (secondary to liver / kidney disease), acne, photodermatoses, wound healing, atopic dermatitis
UV
96
UV dosage based on _____
MED
97
UV dosage: start at __% MED, then work up by __ -__ % as tolerated
70; 5-10
98
UV therapy = combo of both UVA and UVB (T/F)
TRUE
99
CI's to UV therapy ?
1. photosensitivity
2. skin cancer
3. CT disorder
4. on eyes (wear protection!)
100
UV on eyes can cause _____ or ______ (inflammation of the cornea) - cataracts are cursed by chronic exposure to UV
conjuntivitis; photokeratitis
101
____ = accelerates inflammatory phase to make it as efficient as possible, alters membrane permeability and released wound healing factors
US
102
Thermal effects of ultrasound? (4)
1. decreased pain
2. decreased joint stiffness
3. improved blood flow
4. promote healing
103
Non thermal effects of ultrasound?
1. wound healing
2. inflammation and soft tissue healing
3. altered scar tissue formation
4. stimulation of collagen synthesis
5. angiogenesis
6. repair of articular cartilage
104
US parameters: frequency = __ Mz for deep, __ MHz for superficial
1; 3
105
US intensity: __ - __ W/cm^2 inflammatory phase; __ - __ W/cm^2 proliferation phase; up to __ W/cm^2 during remodelling phase
0.1-0.5; 0.5-0.8; 2.5
106
US: ___ for acute, ____ for chronic
pulsed; continuous
107
US: apply to area nor larger than __ - ___ x ERA
2-2.5
108
US ERA = areas producing __% or more of max power output
5
109
CI's to US? (15)
1. implantable devices
2. abdomen and pelvis if pregnant
3. malignancy
4. bleeding disorder
5. acute sepsis or infection
6. TB of lungs or bone
7. active DVT or thrombophlebitis
8. myositis ossificans
9. fracture
10. impaired circulation or sensation
11. pelvis and lumbar spine if menstruating
12. radiotherapy
13. gonads
14. abscess
15. areas of acute inflammation (if using continuous as it generates heat)
110
Precautions to US? (4)
1. SC or superficial nerves
2. regenerating nerves
3. epiphyseal plate unfused
4. implants (metal ok if used pulsed!)
111
Can leave tape on for __ - __ days, or take off if it increased pain, is red or itchy, etc
2-3
