Lab Final

Question 1

general contraindications

Answer 1

pacemaker, anterior neck, eyes, brain, heart, testicles, ovaries, pregnancy, neoplasm, infection, phlebitis/thrombophlebitis, active hemorrhage, menstruation, decreased sensitivity, inability to communicate, recent or heavy scarring, tumors, tuburculosis, osteomyelitis, metal implants

Question 2

low voltage galvanism (iontophoresis) – indications

Answer 2

introduce therapeutic ions locally in a noninvasive manner, allows for prolonged treatment effects

Question 3

low voltage galvanism (iontophoresis) – contraindications

Answer 3

general contraindications, damaged or open skin lesions, known sensitivity to therapeutic ions, impaired sensation to heat or pain, recent scarring, metal embedded close to skin in treatment area, electronic implants

Question 4

low voltage galvanism (iontophoresis) – physiological effects

Answer 4

transmembrane transport of ions, increased cell permeability, upregulate ATP

Question 5

low voltage galvanism (iontophoresis) – set up

Answer 5

two unequal pads (monopolar technique), small active pad soaked in ionic medicine placed over treatment area, large dispersive pad (at least twice the size) placed over broad, flat area at least 6-8in away. (If a bath is used, use the largest dispersive pad) The polarity of the active pad must match the polarity of the medicine.

Question 6

low voltage galvanism (iontophoresis) – What is the rule for maximum intensity when applying continuous LVG at the active pad?

Answer 6

Miliamperage rule – to ensure that the reaction isn’t too strong the maximum amount of current is limited to 0.5-1.0 mA/in2

Question 7

low voltage galvanism (iontophoresis) – What is the initial treatment time? Why? Subsequent time?

Answer 7

Start with 3-4min and check skin for reactions before continuing. Usually 10-20min total.

Question 8

low voltage galvanism (iontophoresis) – What is the typical mA range for iontophoresis?

Answer 8

40 mA*min – usually 1-5mA for 10-20min

Question 9

low voltage galvanism (iontophoresis) – How is the dosage calculated?

Answer 9

mA * T

Question 10

low voltage galvanism (iontophoresis) – How is the polarity of the active electrode decided?

Answer 10

same polarity as the ion beign dispersed

Question 11

low voltage galvanism (iontophoresis) – what is the polarity of water?

Answer 11

either positive or negative

Question 12

low voltage galvanism (iontophoresis) – what is the indication for water as a therapeutic substance?

Answer 12

hyperhydrosis

Question 13

high voltage pulsed current – indications

Answer 13

pain, edema, hypertonicity, spasm, tissue healing, muscle re-education

Question 14

high voltage pulsed current – contraindications

Answer 14

general contraindications

Question 15

high voltage pulsed current – physiological effects

Answer 15

increased cell permeability, upregulates ATP, general increase in cell activity

Question 16

high voltage pulsed current – acute muscle strain set up

Answer 16

Rationale – gate control
Frequency – 80-150 pps
Intensity – sensory
Pad placement – either side of treatment area
Continuous mode for 15-20min

Question 17

high voltage pulsed current – chronic muscle hypertonicity set up

Answer 17

Rationale – muscle fatigue
Frequency – 80-150 pps
Intensity – motor
Pad placement – over muscle to be treated
Continuous mode with wide pulse duration for 15-20min

Question 18

high voltage pulsed current – acute edema

Answer 18

Rationale – negative pole repels plasma
Frequency – 80-150 pps (100 does the job)
Intensity – sensory
Pad placement – either side of treatment area
Continuous mode for 15-20min

Question 19

high voltage pulsed current – chronic edema

Answer 19

Rationale – muscle contraction to move large proteins into lymph
Frequency – 1-15pps
Intensity – motor
Pad placement – either side of treatment area
Continuous mode OR surge mode with 10sec on 10 sec off for 15-20min

Question 20

low voltage alternating current (sine/biphasic) – indications

Answer 20

pain, chronic edema, hypertonicity, spasm, tissue healing, strengthening

Question 21

low voltage alternating current (sine/biphasic) – contraindications

Answer 21

general contraindications

Question 22

low voltage alternating current (sine/biphasic) – physiological effects

Answer 22

increased cell permeability, upregulates ATP, general increase in cell activity

Question 23

low voltage alternating current (sine/biphasic) – delayed onset muscle soreness set up

Answer 23

Pad placement – either side of treatment area
Frequency – 40-50pps
Intensity – motor to patient tolerance
Pulse mode at 5pps OR surge mode at 3-6 surges per minute for 15-20min

Question 24

low voltage alternating current (sine/biphasic) – chronic muscle hypertonicity set up

Answer 24

Pad placement – either side of treatment area
Frequency – 80-150pps
Intensity – motor to patient tolerance
Tetanize mode for 15-20min

Question 25

TENS (conventional and low frequency) – indications

Answer 25

pain

Question 26

TENS (conventional and low frequency) – contraindications

Answer 26

general contraindications

Question 27

TENS (conventional and low frequency) – physiological effects

Answer 27

increased cell permeability, upregulates ATP, general increase in cell activity

Question 28

TENS (conventional and low frequency) – acute radicular pain set up

Answer 28

Frequency – 85pps Pulse width – 75 microseconds Intensity – sensory Pad placement – 2 pads on either side to make a cross that meets at target treatment area Treatment time – 15-20min in office, up to 20hrs at home

Question 29

TENS (conventional and low frequency) – chronic pain set up

Answer 29

``` Frequency – 5pps Pulse width – 200 microseconds Intensity – mild motor Pad placement – 2 pads on either side to make a cross that meets at target treatment area or placed at acupuncture points Treatment time – 15-20min ```

Question 30

TENS (conventional and low frequency) – What is the purpose of burst mode or modulation mode?

Answer 30

To prevent nerve accommodation

Question 31

TENS (conventional and low frequency) – What's the difference between burst mode and modulation mode?

Answer 31

Burst mode – 5-10 pulses in bursts of ¼ sec on and off | Modulation mode – pulse rate and pulse width change by 50%

Question 32

interferential (quadripolar) – indications

Answer 32

swelling, spasm, pain

Question 33

interferential (quadripolar) – contraindications

Answer 33

general contraindications, nearby diathermy machine (15-20')

Question 34

interferential (quadripolar) – physiological effects

Answer 34

increased cell permeability, upregulates ATP, general increase in cell activity

Question 35

interferential (quadripolar) – chronic pain set up

Answer 35

Pad placement – four points of a square around the treatment area, the negative and positive pads of each channel placed diagonally from each other Rationale – opiate release Frequency – 5bps Intensity – mild motor Turn on vector sweep and frequency sweep on, treat for 15-20min

Question 36

interferential (quadripolar) – acute pain set up

Answer 36

Pad placement – four points of a square around the treatment area, the negative and positive pads of each channel placed diagonally from each other Rationale – gate control Frequency – 80-150bps Intensity – sensory Turn on vector sweep and frequency sweep on, treat for 15-20min

Question 37

interferential (bipolar) – how is premodulated different from quadipolar?

Answer 37

There is only one channel (2 pads), premodulated will effect all of the tissue on the way to the target tissue so it's better for superficial treatment, quadipolar is better for deep treatment

Question 38

Ultrasound – indications

Answer 38

tissue healing, soft tissue contracture, scar tissue, pain, muscle spasm, neuralgia, bursitis, tendonitis, calcium deposits

Question 39

Ultrasound – contraindications

Answer 39

general contraindications (except for metal implants), thrombosis, severe arterial disease, over spinal column after leminectomy, bony prominences, epiphyseal growth plates before maturity

Question 40

Ultrasound – physiological effects

Answer 40

increased cell permeability, upregulates ATP, general increase in cell activity

Question 41

Ultrasound – set up

Answer 41

Keep sound head moving to prevent hot spots (standing waves), don't move too fast, sound head parallel to the body surface. Use gel (direct), a water bath (indirect), or a bladder (indirect) to transmit through. 2-3 times the size of soundhead

Question 42

Ultrasound – direct technique

Answer 42

contact with gel Acute conditions – less than 0.5 W/cm2 pulsed Chronic conditions – less than 1.0 W/cm2 continuous

Question 43

Ultrasound – indirect technique

Answer 43

underwater or through a bladder or cushion Add 0.5 to direct technique Acute conditions – less than 1.0 W/cm2 pulsed Chronic conditions – less than 1.5 W/cm2 continuous

Question 44

Ultrasound – treatment time

Answer 44

Acute – 3-5min | Chronic – 8-10min

Question 45

diathermy (inductive) – indications

Answer 45

pain, relieve sinus pressure

Question 46

diathermy (inductive) – contraindications

Answer 46

metal in treatment area, water, pregnancy, cancer, synthetic materials must be insulated, electrical devices within 15ft, remove hearing aids, moisture, fluid filled cysts, remove contact lenses, peripheral vascular disease, systemic edema, menstruation, testicles, sensory deficits, bony prominences, epiphyseal centers in children, osteoporosis

Question 47

diathermy (inductive) – physiological effects

Answer 47

increased cell permeability, upregulates ATP, general increase in cell activity

Question 48

diathermy (inductive) – dosages

Answer 48

I – athermic (non-detectible warmth) II – barely perceptible warmth III – pleasant warmth IV – maximum tolerable warmth

Question 49

diathermy (inductive) – set up

Answer 49

Place head parallel to treatment area close enough that the 2ft sphere of influence includes the treatment area. Heat will penetrate 5cm. Frequency is 27,000,000pps

Question 50

diathermy (inductive) – precautions

Answer 50

If someone feels too hot, you may have already caused tissue damage. Make sure you insulate with a towel to prevent moisture from accumulating and causing superficial burns.