Midterm Review - In Class Activity

Question 1

The first phase of the healing process is:

Answer 1

inflammatory

Question 2

a patient comes to clinic with ankle swelling s/p injury, an appropriate assessment tool for the edema would be:

Answer 2

volumetrics or circumferential measurements

Question 3

conduction is

Answer 3

transfer of heat by direct interaction

Question 4

an example of indirect coupling for ultrasound is

Answer 4

water immersion

Question 5

factors influencing a patient’s response to cold therapy is

Answer 5

type and size of cooling agent, and pre-temperature of the area being cooled

Question 6

ACE wraps should be applied in a figure 8 pattern because:

Answer 6

reduces risk for creating a tourniquet

Question 7

modalities are used to improve or relieve alterations in body function such as

Answer 7

loss of ROM, pain and tissue damage

Question 8

PRICE stands for

Answer 8

protection, rest, ice, compression, elevation

Question 9

the outermost layer of the skin is

Answer 9

epidermis

Question 10

when applying ice massage the patient should be education to expect the following sensations:

Answer 10

“cold beer always nice”
intense cold
burning sensation
aching
numbness

Question 11

one of the contraindications to cryotherapy is placing it

Answer 11

directly over a regenerating peripheral nerve

Question 12

does fluidotherapy provide superficial or deep thermotherapy

Answer 12

superficial

Question 13

in neonates or elderly, they are at increased risk of skin tears because

Answer 13

epidermal dermal junction is flatter

Question 14

a disadvantage of using a moist heat pack over paraffin is

Answer 14

a moist heat pack does not retain heat for duration of treatment (20ish mins)

Question 15

decision to use cryo or thermotherapy is based on

Answer 15

stage of injury/disease
medical status
patient preference

Question 16

main function of the dermis is

Answer 16

tensile strength
support
moisture retention
blood and oxygen to the skin

Question 17

3MHz ultrasound is used to treat what level of tissue

Answer 17

superficial tissue (1-2cm)

Question 18

the strength or intensity of the ultrasound treatment is recorded as

Answer 18

W/cm^2

Question 19

ERA stands for

Answer 19

effective radiating area

Question 20

cold whirlpools are not the best option in the acute phase of healing because

Answer 20

it puts the limb in a dependent position, encouraging edema in the distal extremity

Question 21

an apprpriate BNR is

Answer 21

less than 6:1

Question 22

the cardinal signs of inflammation are

Answer 22

edema (swelling)
redness (erythema)
pain
warmth
loss of function

Question 23

physiological effects of pulsed ultrasound are proposed to be achieved through

Answer 23

stable cavitation and acoustic streaming

Question 24

cold induces vasodilation can start to occur after how long of an application of cryotherapy

Answer 24

> 15 mins

Question 25

when treating a patient in the maturation /remodeling phase of healing, what mode of ultrasound is appropriate

Answer 25

continuous (100% duty cycle)

Question 26

the ratio of time for hot:cold in contrast bath is

Answer 26

4:1 (end in cold if goal is edema reduction)

Question 27

if tap water is used as ultrasound medium, the intensity of the ultrasound should be increased by

Answer 27

0.5W/cm^2

Question 28

pain that is activity related, and can last 4-6 weeks after injury is related to what type of inflammation

Answer 28

sub-acute

Question 29

electromagnetic waves differ from sound waves (u/s) in transmission in that

Answer 29

they do not require a medium

Question 30

scar tissue is made out of what substance

Answer 30

collagen

Question 31

the type of diathermy mostly utilized in the US is

Answer 31

short wave diathermy

Question 32

other than tissue injury, what are causes of edema

Answer 32

CHF, venous insufficiency, impaired nutrition, fluid overload

Question 33

a complication that can occur from application of intermittent pneumatic compression is

Answer 33

swelling in other areas

Question 34

superficial thermotherapy can be used as prep for

Answer 34

e-stim massage PROM or AROM ultrasound

Question 35

the proposed mechanism of action for infrared therapy is

Answer 35

nitric oxide release

Question 36

what are the recommended locations for circumferential measurements to the LE

Answer 36

metatarsal heads 5cm prox to lateral malleolus 10cm distal to tibial plateau

Question 37

these 2 items should be used as guides for progression of controlled mobility after an injury

Answer 37

pain and increased swelling

Question 38

when applying a hot pack to a patient - this many layers of toweling should initially be applied between a hot pack and a patient

Answer 38

6-8

Question 39

how long after cryptherapy application should patients be instructed to avoid stressing the area to avoid potentially reinjuring or aggravating the injury

Answer 39

1-2 hours

Question 40

treatment area of ultrasound should be

Answer 40

2-3x that of the ultrasound head or ERA

Question 41

why do you want to elevate the extremity when using the dip and wrap method for paraffin

Answer 41

vasodilation d/t heat - may result in edema

Question 42

if you were performing continuous ultrasound with water as a medium, what temp of water would you want to use

Answer 42

warm water

Question 43

a patient comes to you with the c/o LE edema. would you place that patient in a compression garment the first day

Answer 43

no - edema should be reduced first

Question 44

these two heating modalities also allow active movement/exercise/ROM during treatment time

Answer 44

hydrotherapy and fluidotherapy

Question 45

an effect of cryotherapy of a peripheral nerve is

Answer 45

slowed NCV

Question 46

why is it important to determine if your patient has a disease such as PVD before applying a thermal modality (hot or cold)

Answer 46

to ensure that there is adequate perfusion to avoid thermal tissue injury (dissipation of heat and cold)

Question 47

does every patient who clinically presents with edema require cryotherapy

Answer 47

no - need to determine cause of edema. medically related edema will not be imrpved with cryotherapy

Question 48

what is the advantage of using warm/hot water whirlpool over paraffin for increasing the tissue temperature in the hand

Answer 48

AROM can be performed while heat is being applied with WP

Question 49

a patient is 1 month s/p TKA. patient has limited knee extension. palpation finds tightness in distal hamstring and post capsule of the knee. what is the most appropriate modality for addressing the impairment

Answer 49

hot pack

Question 50

patient with lateral ankle sprain that accurred 1 hour ago presents to clinic. what is the most appropriate treatment at this point

Answer 50

ice pack, secured with ACE wrap and elevation during application

Question 51

what is the advantage of ACE wraps as compared to imtermittent pneumatic compression for reducing edema

Answer 51

ACE wraps allow patient to be mobile and perform exercises

Question 52

T/F: when a commercial ice pack is applied to tissue, the area will achieve numbness

Answer 52

F: protective layers should be applied between the tissue and the ice pack and the ice pack heats up over the duration of the application period

Question 53

when applying a hot pack - which type of protective layer will allow the patient to feel the temp increase sooner? wet or dry towels?

Answer 53

wet towels - water transfers heat more efficiently than air. the same is true for cold

Question 54

what are the possible modalities used for an acute injury

Answer 54

cryotherapy compression LLLT ultrasound (20%) E-stim

Question 55

prior to application of any modality, but especially ones that are re-usable, it is important to assess what?

Answer 55

the skin - need to evaluation for any skin alterations, especially something that is easily transmissible

Question 56

the erythema to the skin when applying a cold modality is caused by what

Answer 56

histamine release

Question 57

high working load and low resting load defines what kind of compression wrap

Answer 57

short stretch bandages

Question 58

two opposing pressures that regulate capillary and interstitial fluids are

Answer 58

hydrostatic and osmotic pressure gradients