Midterm

Question 1

What is the goal for a modalities during the inflammatory stage?

Answer 1

-Reduce blood flow and decrease cellular metabolism to lessen the formation of edema

Question 2

What is the goal of a modality during the proliferation stage?

Answer 2

-enhance blood flow and cellular activity

Question 3

What is the goal of a modality during the maturation phase?

Answer 3

-facilitate collagen maturation and organization

Question 4

What type of pain receptors respond to high intensity mechanical and thermal stimuli and conduct the signal very quickly to create a withdrawl response?

Answer 4

-A delta fibers

Question 5

what pain receptors condunt more slowly, and are related to dull or achy pains?

Answer 5

-C fibers

Question 6

What type of neurons are nociceptor specific?

Answer 6

-High threshhold fibers

Question 7

What type of neurons receive input from nociceptors and other afferent fibers?

Answer 7

-Wide dynamic

Question 8

What is increased responsiveness to noxious stimuli and non-noxious stimuli, increased receptive field and decreased activation threshold?

Answer 8

-Central sensitization

Question 9

What is the most commonly used theory to explain pain inhibition using modalities?

Answer 9

-The Gate control theory

Question 10

What does the gate control theory propose?

Answer 10

-that stimulation of large diameter A beta fibers activate local inhibitory circuits in the dorsal horn of the SC, thereby preventing nociceptive input from reaching the brain

Question 11

What two modalities are thought to stimulate A beta fibers?

Answer 11

-ESTIM and superficial heat

Question 12

What does central inhibition propose?

Answer 12

-the pain is modulated by the activation of descending inhibitory pathways projecting into the spinal cord

Question 13

When applying a modality to a patient in the acute stage what position should they be in?

Answer 13

-The most comfortable position (loose pack)

Question 14

What is the transfer of heat by the direct interaction of the molecules?

Answer 14

-conduction

Question 15

How can you facilitate conduction?

Answer 15

-add pressure

Question 16

What is the transfer of heat caused by the movement of air of water molecules?

Answer 16

-convection

Question 17

What is the transfer of heat due to the evaporation of liquid into a gas?

Answer 17

-Evaporation

Question 18

What is the transfer of heat via electromagnetic waves?

Answer 18

-thermal radiation

Question 19

As the temperature gradient increases, what happens to the cooling effect?

Answer 19

-it increases

Question 20

What is the main effect of cryotherapy?

Answer 20

-it decreases blood flow

Question 21

How does cryotherapy cause blood flow to decrease?

Answer 21

-it causes vasoconstriction of cutaneous blood floow and reduces vasodilating transmitters

Question 22

At what tempurate will there be a reflexive cyclical vasodilation/constriction response?

Answer 22

-50 degrees

Question 23

Lower tissue tempuratures also decrease what?

Answer 23

-metabolic rate and oxygen demand (prevent hypoxia_

Question 24

What does cryotherapy do to nerve conduction?

Answer 24

-slows it

Question 25

How does cryotherapy decrease spacticity?

Answer 25

-it results in a reflexive decrease in gamma-motor neuron activity, and decreases muscle spindle discharge

Question 26

What effect does cryotherapy have on strength?

Answer 26

-it decreases it after only 10 minutes of cold exposure (MMT grades my not be reliable)

Question 27

What effect does cryoptherapy have on joint proprioception?

Answer 27

-it decreases it (be aware of activity after)

Question 28

What temperatures should a conventional cold pack be?

Answer 28

-below 32 degrees

Question 29

How long can you apply a cold pack?

Answer 29

-twenty to thirty minutes

Question 30

What type of cryotherapy is good to use on small areas?

Answer 30

-ice massage

Question 31

how long should you apply an ice massage?

Answer 31

-10 minutes

Question 32

What temperature should whirlpools be if used on a distal extremity?

Answer 32

-50-65 degrees

Question 33

What temperature should a whirlpool be is used on the whole body?

Answer 33

-65 to 80 degrees

Question 34

How long should an ice bath/whirl pool be applied?

Answer 34

-10 to 20 minutes

Question 35

What is the order of sensations a patient will feel with cryotherapy?

Answer 35

-CBAN (cold, burning, aching, numbness)

Question 36

How does compression improve edema?

Answer 36

-It increases the tissue hydrostatic gradient that is thought to favor edema

Question 37

50% pull and 50% overlap of an elastic wrap can create pressures of what?

Answer 37

-40 to 50 mmHg

Question 38

Intermittent compression devices create pressures of what?

Answer 38

-30 to 75 mmHg

Question 39

what pressure is neccesary to be above capillary pressure and encourage the absorption of edema?

Answer 39

-30 mmHg

Question 40

What is the main reason to use superficial heat as a modality?

Answer 40

-to increase tissue extinsibility

Question 41

What temps should be used for vigorous heating?

Answer 41

-104 to 113 deg

Question 42

applying heat to a large amount of tissue can cause what systemic effects?

Answer 42

-increased HR, BP and pulmonary alterations

Question 43

What type of heat particulary notes cutaneous vasodilation?

Answer 43

-moist heat

Question 44

What does superficial heat block pain?

Answer 44

-by the gate control theory, and alter nerve conduction

Question 45

What should the temperature range be for MHP?

Answer 45

-158 to 167

Question 46

What type of superficial heat therapy can be used to to descencitize hypersensitive skin?

Answer 46

-fluidotherapy

Question 47

What increases tissue temperature more than MHP, paraffin or warm whirl pool?

Answer 47

-fluidotherapy

Question 48

What type of cervical traction is most commonly used?

Answer 48

-intermittent

Question 49

What amount of flexion should the patient be place in to apply traction to c1-c2?

Answer 49

-0-5 degrees

Question 50

What amount of flexion should the patient be place in to apply traction to c3-c4?

Answer 50

-10-20 deg

Question 51

What amount of flexion should the patient be place in to apply traction to c5-c7?

Answer 51

-25 to 30 deg

Question 52

What poundage should be used on traction for c1-c2?

Answer 52

-10 lbs

Question 53

What poundage should be used on traction for c3-c3?

Answer 53

-10 to 15 lbs

Question 54

What poundage should be used on traction for c5 to c7?

Answer 54

-15-20 lbs

Question 55

Cervical static traction may be better used to treat what?

Answer 55

-HNP or muscle spasm

Question 56

To treat HNP or muscle spasm with traction, what should the parameters be?

Answer 56

-static for 5-8 minutes

Question 57

To treat cervical stenosis, DDD or facet dysfunction with traction, what parameters should you use?

Answer 57

-intermittent for 10-20 minutes (on/off: 20/20)

Question 58

How long should you ask the patient to remain flat on the table after the treatment?

Answer 58

-4 to 5 minutes

Question 59

What is the most notable reason to use lumbar traction?

Answer 59

-to treat HNP

Question 60

What poundage should you use for lumbar traction?

Answer 60

-Start with 1/2 of the patient body weight and then go up to 1/3

Question 61

What frequencies should you use to treat deeper structures with US?

Answer 61

-1 Mhz; treats up to 6 cm

Question 62

What frequency should be used to treat more superficial structures with US?

Answer 62

-3 Mhz; treats up to 2.5 cm

Question 63

How large can the treatment area be for US?

Answer 63

-4 to 5 times the size of the ERA

Question 64

What are the most common diathermy devices?

Answer 64

-pulsed short wave diathermy

Question 65

Pulsed short wave diathermy devices use what kind of frequencies?

Answer 65

-Low range/ Radio waves

Question 66

electromagnetic waves pass through human tissue and interact with the tissues radiant energy and increases what three things?

Answer 66

-energy absorption, tissue temperature and local circulation

Question 67

What does the Grotthuss Draper Law state?

Answer 67

-different wave lengths produce different effect and the extent of those effects is dependent on the amount of energy absorbed in the tissue. (deeper= more absorption)

Question 68

What foes the inverse square law state?

Answer 68

-the intensity of waves varies inversely with the square distance of the source of radiant energy. (if distance is decreased by half, the intensity is increased by 4)

Question 69

What does the cosine law state?

Answer 69

-The the max absorption occurs when the source is at a right angle with the absorbent tissue

Question 70

What is the primary mechanism of action of which light therapy affects tissue with its non-thermal effects?

Answer 70

-photobiostimulation

Question 71

What is temporal coherence?

Answer 71

-when the photons of light are moving in a wave like pattern in phase with eachother

Question 72

What is spatial coherence?

Answer 72

-When reflecting mirror effects the light by focusing lenses to amplify light into a concentrated beam

Question 73

What affect does light therapy have on inflammation?

Answer 73

-It increases it

Question 74

How does light therapy increase inflammation?

Answer 74

-it increases vasodilation by increasing histamine and NO2 level, and increases profusion, and nutrient transport- over all increases healing

Question 75

How does light therapy improve tissue repair?

Answer 75

-it stimulates the mitochondial chromophore, which increases respiratory chain activity, improve ATP synthesis, increases cellular repair and increases the production of mRNA for collagen

Question 76

Light therapy increases when endogenous optiod that will decrease pain?

Answer 76

-beta endorphins

Question 77

infrared light therapy decreases bradykin and kallikrein which are what?

Answer 77

-pro-inflammatory mediators and pain facilitators

Question 78

What type of fibers does light therapy inhibit the depolarization of?

Answer 78

-C fibers

Question 79

Low level laser therapy has a max output of 500 mW or less, this produces what type of effects?

Answer 79

-non-thermal (cold laser)

Question 80

High intensity laser therapy can produce power greater than 500 mW, which creates what type of effect?

Answer 80

-Thermal heating effects

Question 81

helium neon lasers have a smaller wave length, can penetrate how deep below the skin?

Answer 81

-0.5 cm (good for treating chronic skin wounds

Question 82

infrared lasers, such as gallium arsenide produce longer wave lengths and experience less absorbtion and can penetrate how deep below the skin?

Answer 82

-2 to 4 cm

Question 83

What type of pattern should you used for low level laser therapy to treat lager chronic skin wounds?

Answer 83

-Grid

Question 84

When applying a high intensity laser what must you do?

Answer 84

-keep it moving to avoid burns

Question 85

What 5 things can low level laser therapy be used to treat?

Answer 85

-Wound healing, epicondyltis, CTS, Fribromyalgia and myofascial pain, neck pain

Question 86

What 3 things can high intensity laser therapy be helpful in treating?

Answer 86

-TMJ pain, LBP, shoulder pain

Question 87

LED can have a power output of what?

Answer 87

-5 to 40 mW

Question 88

Applications of infrared light for 30 minutes has been shown to increase what?

Answer 88

-plasma nitric oxide levels (increased vasodilation)

Question 89

Infrared light can also produce what effect that an increase the level of ATP in cells?

Answer 89

-irradiate lymptocytes

Question 90

SLED can produce power up to 90 mW which can have what effect on tissue?

Answer 90

-Superficial heating

Question 91

What are the primary indications for LED and SLED therapy?

Answer 91

-similar to low level light therapy: pain relief of shoulder dysfunction, DJD and peripheral neuropathy

Question 92

How far should the applicator be away from the skin with the capacitative method of diathermy?

Answer 92

-1 to 3 inches

Question 93

What type of tissue heats faster with diathermy?

Answer 93

-adipose

Question 94

What is the most clinical application of diathermy?

Answer 94

-to increase tissue temperature of deeper tissues

Question 95

What is one disadvantage to diathermy that other forms of electromagnetic therapy can do?

Answer 95

-they cannot depolarize motor nerves

Question 96

What affect will diathermy have on muscle strength?

Answer 96

-it will decrease it breifly and then increase it for 30 minutes

Question 97

Inductive diathermy is more effective in treating what, than MHP?

Answer 97

-Pain from trigger points

Question 98

Short wave diathermy has been shown to promote an analgesic effect on what condition?

Answer 98

-knee OA

Question 99

Diathermy can be used increase healing in what?

Answer 99

-bone and soft tissue

Question 100

The nonthermal effects of diathermy have been shown to increase what?

Answer 100

-fibroblasts and chondrocyte proliferation, and increase vascular perfusion

Question 101

Diathermy can be used to treat what type of wounds?

Answer 101

-state III and IV ulcers

Question 102

What type of response does dose I diathermy create?

Answer 102

-nonthermal

Question 103

Dose II diathermy is associated with what sensation?

Answer 103

-mild heat

Question 104

Dose III diathermy is shown to cause what type of sensation?

Answer 104

-Moderate heating

Question 105

What does of diathermy is used for vigorous heating?

Answer 105

-Dose IV

Question 106

What is the wattage for dose II diathermy?

Answer 106

-12

Question 107

What is the wattage for dose III diathermy?

Answer 107

-24

Question 108

What is the wattage for dose IV diathermy

Answer 108

-48

Question 109

What can dose I diathermy be used to treat?

Answer 109

-acute injuries

Question 110

What should dose II diathermy be used to treat?

Answer 110

-subacute injuries

Question 111

What should dose III diathermy be used to treat?

Answer 111

-pain, muscle spasm, and chronic conditions

Question 112

To increase tissue extensability, what dose diathermy should you use?

Answer 112

-IV