Midterm

Question 1

what are contraindications to cryotherapy?

Answer 1

(1) Cold sensitivity / intolerance (cold urticaria, cryoglobulinemia, Raynaud’s phenomenon, paroxysmal cold hemoglobinuria)
(2) compromised circulation
(3) peripheral vascular disease
(4) areas of nerve regeneration
(5) pregnancy (L/S and abdominal region)

Question 2

what are precautions to cryotherapy?

Answer 2

(1) HTN
(2) aversion to cold
(3) thermoregulatory disorders
(4) over superficial nerves
(5) open wounds
(6) areas of poor sensation
(7) poor cognition
(8) very young or very old

Question 3

why can cryotherapy cause an increased BP?

Answer 3

causes local vasoconstriction of the arterioles which can increased BP

Question 4

what temperature should a cold pack be at for cryotherapy treatment? what should the total treatment time be?

Answer 4

(1) <32 degrees

(2) 20-30 minutes

Question 5

what temperature should the water be in a cold compression device for cryotherapy treatment? what should the total treatment time be?

Answer 5

(1) 50 degrees

(2) 10-20 minutes

Question 6

what temperature should the water be for a cold whirlpool for cryotherapy treatment? what should the total treatment time be?

Answer 6

(1) extremity: 50-65 degrees
(2) whole body: 65-80 degrees
(3) 10-20 minutes

Question 7

what temperature should an ice massage be for cryotherapy treatment? what should the total treatment time be?

Answer 7

(1) <32 degrees

(2) 5-10 minutes

Question 8

what temperature should an ice bag be at for cryotherapy treatment? what should the total treatment time be?

Answer 8

(1) <32 degrees

(2) 20-30 minutes

Question 9

how should vapocoolant spray be applied for cryotherapy treatment?

Answer 9

3-5 slow sweeps; held 12 inches away when applying

Question 10

what are contraindications to therapeutic heat?

Answer 10

(1) decreased sensation to heat
(2) vascular insufficiency
(3) hemorrhage
(4) burns
(5) infection / open wounds / inflammation
(6) cancer
(7) areas where biofreeze agents were recently applied
(8) pregnancy
(9) skin rashes / recent grafts (for paraffin)

Question 11

what are precautions to cryotherapy?

Answer 11

(1) impaired circulation
(2) thermoregulatory diseases
(3) DVT
(4) subacute / chronic edema
(5) scar tissue and recently healed wound (paraffin)
(6) impaired cognition
(7) very young / very old

Question 12

how many layers are required for a MHP? what should the hydrocollator temperature be set at?

Answer 12

(1) 6-8 layers PRONE (towel counts as one layer, thick wrap counts as two)
8-10 layers SUPINE
(2) 158-167 degrees

Question 13

how many layers of paraffin wax should be applied for treatment? what temperature should the wax be set at?

Answer 13

(1) 8-10 layers

(2) 113-129 degrees

Question 14

what temperature should the water be for a warm whirlpool for a theraputic heat treatment?

Answer 14

102-118 degrees

Question 15

what are contraindications to compression?

Answer 15

(1) acute pulmonary edema
(2) CHF
(3) recent or acute DVT
(4) acute fracture
(5) uncontrolled HTN

Question 16

what are precautions to compression?

Answer 16

(1) recent skin graft
(2) acute local dermatological infections
(3) impaired sensation
(4) cognitive impairment

Question 17

what are the two main types of compression?

Answer 17

(1) elastic wraps

2) intermittent pneumatic compression (IPC

Question 18

what parameters should be followed for the use of intermittent pneumatic compression (IPC)?

Answer 18

(1) 30-70 mmHg (40-50 mmHg more common in clinic)
(2) 1:1 inflation to deflation ratio
(3) 20-60 minutes of total treatment time

Question 19

what amount of poundage should be used to cervical traction treatment? what degree if cervical flexion should be used?

Answer 19

(1) 10-25 lbs
(2) C1-C2: 0-5 degrees
(3) C3-C4: 10-20 degrees
(4) C5-C7: 25-30 degrees

Question 20

how long should traction treatment be applied for static and intermittent interventions?

Answer 20

(1) static: 5-8 minutes

2) intermittent: 10-20 minutes (1:1 ratio

Question 21

what conditions would static treatment using traction be optimal?

Answer 21

(1) HNP

(2) muscle hypertonicity

Question 22

what conditions would intermittent treatment using traction be optimal?

Answer 22

(1) stenosis
(2) DDD
(3) facet joint hypomobility

Question 23

what amount of poundage should be used to lumbar traction treatment?

Answer 23

1/3 to 1/2 the patient’s body weight

Question 24

what are contraindications to traction?

Answer 24

(1) acute C/S trauma (whiplash)
(2) connective tissue diseases
(3) rheumatological disorders (ex. RA)
(4) joint instability
(5) ankylosing spondylitis
(6) osteoporosis / penia
(7) hx of steroid use
(8) post surgical stabilization or decompression, spine implants (discs)
(9) pregnancy (L/S)
(10) spinal malignancies
(11) non-mechanical pain

Question 25

what are precautions to traction?

Answer 25

(1) claustrophobia (2) COPD (3) pregnancy (C/S)

Question 26

why is cervical traction a precaution for pregnant women?

Answer 26

during pregnancy, the relaxin hormone is prevalent causing significant ligament laxity

Question 27

what are contraindications to ultrasound?

Answer 27

(1) cancer (2) pregnancy / reproductive organs (3) anterior neck (4) myositis ossificans (5) DVT / thrombophlebitis (6) pacemaker (7) impaired sensation (8) acute skin injury / epiphyseal plates (Contraindication for continuous but precautions for pulsed)

Question 28

what are precautions to ultrasound?

Answer 28

(1) plastic /. cemented implants (2) spinal cord (3) superficial or regenerating nerves (4) areas of infection

Question 29

what is the difference between 1 MHz and 3 MHz US? how deep do each reach?

Answer 29

(1) 1 MHz reaches 6cm | (2) 3 MHz reaches 2.5cm

Question 30

what parameters should be used for A-Thermal Ultrasound?

Answer 30

- Duty Cycle: 20% or LESS - Frequency: 1 or 3 MHz (depending upon depth of tissues) - Intensity: 0.5 - 2 W/cm2 - Total Treatment Time: 5-10 minutes

Question 31

what parameters should be used for Thermal Ultrasound?

Answer 31

- Duty Cycle: >20% (100% continuous preferred) - Frequency: 1 or 3 MHz (depending upon depth of tissues) - Intensity: 0.5 - 2 W/cm2 - Total Treatment Time: 10 minutes

Question 32

how large should the treatment area be for US?

Answer 32

2-4x the ERA

Question 33

what is the average BNR of an ultrasound unit?

Answer 33

5-6