NBS Flashcards
(175 cards)
0
Q
What are contraindications to all modalities?
A
Hemorrhage
Infection w/ suppuration
Malignancy (except TENS)
1
Q
The therapeutic application of forces & substances that induce a physiological response & use &/or allow the body’s natural processes to return to a more normal state of health
A
Physiotherapy
2
Q
What are contraindications to all heating modalities?
A
Diabetes Mellitus Encapsulated Swelling Active TB Decrease thermal sensations Edema Abdomen or low back during pregnancy Acute conditions
3
Q
What stage of injury/healing is up to the 1st 72 hours?
A
Acute
4
Q
Stage of injury/healing that is 72 hours or early phases of ds. Swelling is limited but debris & discoloration prevents healing. Pump, (alternating vasodilation & vasoconstriction) is beneficial
A
Subacute
5
Q
Stage of injury/healing that is 2 wks longer than anticipated
A
Chronic
6
Q
What are contraindications for all electrical modalities?
A
Brain Eyes Heart Carotid Sinuses Pacemaker Anesthesia (Except high volt) Pregnancy - low back (except TENS) Open wounds
7
Q
Tx of acute conditions uses the acronym PRICES. What does it stand for?
A
Protect Rest Ice Compression Elevate Support
8
Q
What type of EMS freq. reverses charge?
A
Ultra Low, <1Hz, (MENS)
9
Q
What is the Hz range for low freq. EMS?
A
1-150 Hz (Contraction)
10
Q
What is the Hz range for med. freq. EMS?
A
1,000-10,000 Hz (Depth)
11
Q
What is the Hz range for high freq. EMS?
A
1 million Hz (Heating)
12
Q
What EMS modalities are considered low freq.?
A
HVG LVG Sine Faradic Interference (IF & RS) TENS
13
Q
What EMS modalities are considered med. freq.?
A
IF (4,000Hz)
RS (2,000Hz)
14
Q
What types of high freq. EMS modalities cause superficial heat?
A
IR
UV
15
Q
What types of high freq. EMS modalities cause deep heat?
A
MWD
SWD
US
16
Q
Which type of wave form is symmetrical?
A
Sine
17
Q
Which type of wave form is asymmetrical (sporadic)?
A
Faradic
18
Q
Which type of wave form is composed of two sine waves?
A
Interferential
19
Q
Which type of wave form has a twin, pulsed peak (“M” spiked peak)?
A
High Volt
20
Q
How are pad size and mA related?
A
1mA per sq in. of pad size
21
Q
What are the 3 types of pad placement?
A
Monopolar (dispersal pad & active pads)
Bipolar (small muscle group, dispersal & active pads are equal size)
Quadripolar (Crisscross pattern)
22
Q
Continuous EMS is used for what?
A
Pain
23
Q
Surge EMS is used for what?
A
Exercise
24
Pulsed/tetanizing EMS is used for what?
Fatigue/spasm
25
Modulation settings in EMS help to avoid what?
Accommodation
26
What low freq. pps setting do you use to release endorphins?
1-20pps
27
What low freq. pps setting do you use to release enkephalins?
70-150pps
28
What low freq. pps setting do you use for edema?
3-5pps
29
What low freq. pps setting do you use for exercise?
15-25pps
30
What low freq. pps setting do you use to fatique?
~50pps
31
This is when one object produces electromagnetic property in another
Electro-induction
32
Measurement of charge?
Coulomb
33
This is assoc. w/ pulse width, interpulse width, & freq.
Waveform
34
Magnitude/depth of an electric charge
Amplitude
35
Electricity that flows (number of electrons)
Current
36
This increases or decreases volts
Transformer
37
Ability to store up electrical energy
Capacitance (Ohm)
38
Property of substance to oppose current. Measured in Ohms.
Resistance
39
Difference in force b/w two objects. Measured in Volts.
EMF (Electromagnetic force)
- greater the charge = increase EMF
- greater the distance = decrease EMF
40
Slows down (dampens) electric charge.
Impedance
41
The time necessary for contraction when the rheobase is doubled
Chronaxie
42
The minimum volts necessary to excite a nerve
Rheobase (threshold)
43
Type of EMS you should assoc. w/ "paralyzed muscle", "weak muscle", or "research"
Faradic
44
Galvanic & Faradic current are compared to determine extent of damage & prognosis of nerve damage to muscle.
Reaction of Degeneration (R.D. Factor)
45
Best method of muscle testing
EMG (Electromyography)
46
Best method of nerve testing
NCV (Nerve Conduction Velocity)
47
Principle that states the energy of modality has to be absorbed by body to stimulate physiological response
Arndt - Schultz Principle
48
Law that notes the inverse relationship b/w penetration & absorption of energy (US)
Law of Grotthus-Draper
49
What are effects of cryotherapy?
Vasoconstriction
Anesthesia
Pumping Reaction
50
What does CBAN stand for?
Cold
Burn
Ache
Numb
51
After "about 20 mins" of cryotherapy, what reaction occurs?
Hunting-Lewis Reaction
52
What are the different tx temps?
```
Cold: 55-65
Cool: 65-80
Tepid: 80-92
Neutral: 92-96
Warm: 96-99 (therapeutic)
Hot: 99-104 (therapeutic)
Very Hot: 105-115
```
53
Transmission of heat in gases & liquids by circulation of heat particles. Baths (hot & cold), IR
Convection
54
Transmission of heat w/o the intervening medium getting warm. Lamps, MWD, IR, UV
Radiation
55
The transformation of electrical energy into heat or mechanical energy. US.
Conversion
56
The transfer of heat through a substance, often heating up a solid. Ice, hydrocollator, paraffin, IR
Conduction
57
What effect does cryotherapy have on circulation?
Vasoconstriction
Decreased blood flow (increase BP)
Decreased edema
58
What effect does cryotherapy have on metabolism?
It decreases it
59
What effect does cryotherapy have on connective tissue?
Increased viscosity
| Decreased ability to stretch
60
What effect does cryotherapy have on pain?
Decreased, after an initial increase, numb (anesthesia)
61
What neuromuscular effects does cryotherapy cause?
Decreased spasticity, trigger points, MFS
Increased or decreased strength
Decreased skilled motor tasks
62
What are indications for cryotherapy?
```
Headaches (migraine)
Urticaria (red wheals)
Spasticity (trigger points)
Sprain/strain
Angiomas
Warts & herpes
```
63
What are contraindications of cryotherapy?
```
Elderly & infants
Hypersensitive to cold
Vascular diseases (Raynaud's)
High BP
Chilblains & frostbite
Tension headaches
Spasm
```
64
What are the different types of cryotherapy?
Ice packs - conduction, moist towel layer
Blue ice - conduction, dry towel layer, reusable
Vapocoolant spray - fluori-methane/ethyl chloride
Ice massage - conduction, direct ice has deepest effect
Ice Immersion - convection
Cryokinetics - conduction, ice 1st, activity 2nd
Ice massage & passive ROM - conduction
65
What are the effects of infrared?
```
Vasodilation
Perspire
Decreased BP
Increased blood & lymph flow
Decreased spasm
Phagocytosis
```
66
Redness or mottled skin is called what?
Erythema
67
Mottled skin in area habitually exposed or one prolonged exposure
Erythema Ab igne
68
What is the difference in distance b/w short wave IR vs. long wave IR?
Short wave = 14-18"
| Long wave = direct contact w/ towel - layers
69
What are the different types of short wave IR?
- Luminous
- Wire bound around porcelain
- Sunlight - Heliotherapy
70
What are the different types of long wave IR?
```
Hydrocollators
Heating pads
Hot water bottle
Baths
Fluidotherapy
```
71
What is the difference in penetration b/w short wave IR vs long wave IR?
Short wave = 10mm
| Long wave = 1-3mm
72
What is the difference in intensity b/w short wave IR vs. long wave IR?
Short wave = 150-1500 watts
| Long wave = Varies
73
What is the difference in wavelength b/w shortwave IR vs. long wave IR?
Short wave = 7,200 - 15,000nm
| Long wave = 15,000 - 150,000nm
74
What is the distance used when treating w/ a hydrocollator?
Six towel layers
75
What temp is used for hydrocollators?
150-170F
76
What temp is used for paraffin?
125-130F
77
What are indications for a contrast bath?
```
Subacute connective tissue injuries
Bruises
Early PVD's *
Raynaud's *
Buerger's
Diabetes Mellitus
```
78
What are contraindications for a contrast bath?
Anesthesia
Advanced arterial compromise
Late PVD's
79
What type of heat transmission does a hydrocollator use?
Conduction
80
What kind of heat transmission does a contrast bath use?
Convection
81
What kind of heat transmission does a whirlpool bath (hubbard tank) use?
Convection
82
What are 3 results of using a whirlpool bath?
Relax
Vasodilator
Debridement (burns & abrasions)*
83
Which modality can cause a burn & treat a burn?
IR
84
What is the temp of a whirlpool bath?
100-105F (varies, based on desired effect)
85
What kind of heat transmission does a sitz bath use?
Convection
86
How long do you tx w/ a sitz bath?
2-10mins (<20 mins)
87
What kind of heat transmission does a paraffin bath use?
Conduction
88
What temp do you use for a paraffin bath?
125-130F
89
How many times do you dip into a paraffin bath?
7-10 times
90
What is the ratio of paraffin to mineral oil in a paraffin bath mixture?
7:1 paraffin:mineral oil
91
What is another name for Fluidotherapy?
Dry whirlpool
92
What is used for to heat in fluidotherapy?
Solid cellulose
93
What kind of heat transmission does a fluidotherapy use?
Convection
94
What are indications for fluidotherapy?
```
Chronic arthritis
Amputees
Strains
To increase ROM
RSDS aka CRPS (only tx for RSDS)
Dystonia
Open wounds (Unless diabetic)
```
95
What does LASER stand for?
Light amplification by stimulated emission of radiation
96
What wavelength does a cold laser use?
630-1200nm (absorbs best into body rather than skin surface)
97
What type of gas does a cold laser use?
Neon helium gases
98
What are irreversible effects of cold lasers?
Protein coagulation*
Thermolysis
Evaporation
99
Treating w/ UV for too long can cause what?
Erythema ab igne
100
What are contraindications of UV?
```
H.I.M.
Vascular diseases
Suppurative lesions
Hemorrhage
Tetracycline (competes w/ Ca++ absorption)
SLE
```
101
What skin conditions can UV treat?
```
Fungal
Herpes zoster (vesicles)
Burns
Psoriasis
Carbuncles
Wounds
Decubitus ulcers
```
102
Erythema caused by UV is related to what 3 things?
1. Pt sensitivity
2. Intensity vs distance (inverse square law)
3. Angle of radiation (cosine law)
103
What is the tx protocol for UV?
Start at MED. As pt. tolerance increases, increase duration by 15sec/tx to a max of 3 mins. When max time is reached, decrease distance by 2" per tx, approaching no closer than 18"
104
What distance do you start tx w/ a UV lamp?
30-36"
105
What are the different types of UV devices?
1. Hot quartz (Mercury-helium gases, Kromayer lamp)
2. Cold quartz (Neon & mercury, orificial)
3. Wood's lamp aka black light
106
Type of UV device that filters UV light through nickel oxide glass used to dx fungal infections (tinea)
Wood's Lamp aka Black Light
107
How far must a diathermy unit be from any other electrical device?
10ft
108
How far must a diathermy tx on an individual be from hearing aids, bridge work, etc?
4ft
109
Generally speaking, how does SWD tx?
Outside in (general)
110
Generally speaking, how does MWD tx?
Inside out (local)
111
What are some indications for SWD?
Bronchitis
PID
Otitis media
112
What are some indications for MWD?
Otitis externa
| Neuritis
113
What is a major contraindication for both SWD & MWD?
Metal
114
How much space do you use to get 100% heat from SWD?
2" (towel)
115
What are the 3 types of SWD?
Induction
Condensor
Butterfly
116
What is the wavelength for SWD?
11 meters
117
What is the freq. of SWD?
27.12 megacycles
118
What type of tissue does SWD heat first?
Fat
119
What distance do you use when treating w/ MWD?
1-7" (Air space)
120
What is the wavelength of MWD?
2-12cm
121
What is the freq. of MWD?
2450 megacycles
122
What type of tissue does MWD heat first?
Muscle
123
What are some contraindications for US?
Over spinal cord
Over epiphyseal growth plates (look at the age in questions)
Laminectomy
124
In LVG, what effects does the positive pole (anode) have?
```
"Anode acts like ice"
Vasoconstricts
Produces acid reaction in skin
Repeals alkaline
Attracts oxygen
Repels hydrogen
Causes ischemia
Hardens tissue
Pain relief
Astringent
```
125
What are the M/C solution mixtures used w/ LVG?
2% solution mixtures
126
What substances are used under the positive pole (anode) in LVG?
```
"Repels Metals"
*Magnesium - edema, IVD, DJD, arthritis, neuritis, PNE
*Calcium - adhesions, capsulitis
*Copper - fungus
*Zinc - ulcers, gyn., derm
Histamine - PVD, spasm
Hyaluronidase - post trauma swelling
Potassium - sprains
Xylocaine - painful ROM
Hydrocortisone - DJD, PNE
```
127
What substances are used under the negative pole (cathode) in LVG?
```
"Repels non-metals"
*Salicylate - pain, inflammation, arthritis
*Iodine - scars, adhesions
Chloride - adhesions & scars
*Acetate - calcium deposits, bursitis
Niacin - PVD, arthritis
PABA - Scleroderma
Novocaine/alcohol - strains
Hesperidin - ecchymosis
```
128
What intensity is used for LVG?
1-5mA
129
What are indications for HVG?
Acute & subacute injuries to reduce edema
Analgesia & spasms reduce muscle atrophy
Cast, disuse atrophy
130
What settings do you use in EMS for edema? muscle exercise? fatigue? endorphin production? enkephalin production?
```
Edema - 3-5pps
Muscle exercise - 15-25pps
Fatigue - ~50pps
Endorphin production - 1-20pps
Enkephalin production - 80-150pps
```
131
What are the 3 modes of HVG?
Continuous Mode - beneficial for edema, pain, & neuritis
Reciprocal Mode - permits alternating contracture of agonist & antagonist, limits accommodation
Surge on/off - used when re-education & exercise is desired
132
What is the primary effect of MENS?
tissue healing
133
Immediately after trauma, noxious stimulation lowers nerve thresholds
Primary Hyperalgesia
134
W/i hours of trauma, chemicals diffuse to surrounding tissues causing hypersensitivity
Secondary Hyperalgesia
135
Nerve pain fiber that is well localized, often first pain (protopathic), stings or burns
A-delta
136
Nerve pain fiber that causes diffuse, second pain, & visceral pain (epicritic), achy or throbbing
C-fiber
137
Type of nerve fiber that is large, myelinated mechanoreceptors. Responds to light touch & can interrupt nociception in dorsal horn
A-beta
138
Small regions of metabolic distress, caused by the combination of increased energy demand & impairment of oxygen & energy supply. This is probably d/t a local restriction of circulation.
Trigger points
139
What is biofeedback used for?
Used to modulate autonomic functions
140
What are indications for biofeedback?
```
Hypertension
Migraines
Stress
ADD
Incontinence
```
141
Cervical brace used for emergency transport?
Philadelphia collar (hard collar)
142
Brace used for scoliosis
Milwaukee/Risser Jacket (Boston brace used on juveniles)
143
Brace used for a spondylolisthesis, L/S disc
Lumbosacral corset (Boston brace)
144
Brace used for SI dysfunctions
Sacroiliac girdle (Williams)
145
Brace used for hip lesions?
Intertrochanteric belt/girdle
146
How many effleurage strokes per min?
12
147
What is the purpose of the effleurage stroke?
To sedate
148
What is the purpose of the Petrissage stroke?
For spasm
149
What is the purpose of the Tapotement stroke?
For congestion
150
What is the purpose of the Friction stroke?
Break adhesions
151
What is the purpose of the Vibration stroke?
For congestion
152
What is the purpose of the Deep Pressure stroke?
Adhesions, trigger points
153
What is low velocity vibratory therapy used for?
Congestion
154
What is the minimal & maximum amount of weight used in cervical traction?
```
Min = 10lbs
Max = 30-50lbs
```
155
What position do you use for traction of C3-C6?
Flexion at 20-28degs
156
What is the starting tx dose for cervical traction?
Begin at 5% of body weight, increase 2lbs max each tx
157
What is the starting tx dose for lumbar traction?
Begin at 25% of body weight & increase 5lbs max w/ each tx
158
What is the minimum & maximum amount of weight used for lumbar traction?
```
Min = 25% of body weight
Max = 50% of body weight or 120lbs
```
159
What are the different types of traction?
Continuous
Intermittent - imbibition
Inversion - Lumbars (contra - high BP)
Positional - Decrease pressure best
Over the door - Csp, face door w/ 28degs of Csp flex.
Axial - don't use w/ osteoporosis, Paget's, Mets (weak bone)
Rotational - don't use w/ facet trophism
Hydrotherapy traction - water belts, wings & buoys
160
What are 3 reliable LBP questionnaires?
Oswestry
Roland-Morris
Quebec
161
What area examples of ADL charts?
Copenhagen - neck
Croft - shoulder
Harris - hip
162
Breathing exercises & posture used for COPD's, aging, & AS
Breugger's
163
Administered to pt's w/ peripheral vascular disease
Buerger - Allen's
164
The Harvard step test is used to test for what?
Endurance
165
Flexion exercises for the low back. Pt is instructed to do sit-ups w/ knees flexed, hands in front of the chest, while the head & shoulders are lifted off of the table. The position is held for 5mins. Purpose is to help decrease lordosis by strengthening the abdominal muscles. Benefits spondylolisthesis, facet syndrome, increased lumbosacral angle, hyperlordosis
William's exercises
166
Modified McKenzie exercises are used for what?
Benefits acute discs & spinal stenosis. Flexion exercises
167
Extension exercises for low back. Purpose is to help increase lordosis by strengthening the paraspinals. Benefits chronic disc & acute lumbar antalgia to "centralize" pain & get pt to neutral position
McKenzie's
168
LBP (core) exercises. Includes side bridge, bird dog, & abdominals
McGill's
169
Exercises for the pelvic floor musculature. Benefits incontinence
Kegel's
170
Strengthens the shoulder girdle while eliminating the use of the supraspinatus muscle
Codman's/Pendular
171
Use fingers to crawl up the wall for shoulder ROM
Wall walking
172
This type of exercise is focused on position & breathing mechanics. Benefits spinal stability & balance.
Yoga
173
What is the terrible triad composed of?
Medial meniscus
ACL
MCL
174
What sign is assoc. w/ a PCL tear?
Sag sign
