Review for Exam 1

Question 1

ice increases viscosity true or false

Answer 1

true

Question 2

prolonged ice increases spasticity true or false?

Answer 2

false

Question 3

Why would you use thermo therapy?

Answer 3

increase extensibility, cause vasodilatation, increase metabolic rate, increases the pain threshold.

Question 4

Would you do a manual muscle test after a hotpack?

Answer 4

no strength would be questionable

Question 5

Ultra sound reflects off of bones true or false?

Answer 5

true, that means it will heat the periosteum

Question 6

When deciding what modality to use, what three factors come into play?

Answer 6

pt. preference, quality research, and clinician experience.

Question 7

What is the temp of hydrocollator

Answer 7

158-167

Question 8

What is the temperature of paraffin

Answer 8

113-122

Question 9

What is the temp for fluidotherapy

Answer 9

100-118

Question 10

when setting up a contrast bath for someone who is hypersensitive what parameters would you use?

Answer 10

64-100 the more narrow numbers

Question 11

How does ultrasound work?

Answer 11

the pieso electric effect

Question 12

what are the parameters for ultrasound tissue healing?

Answer 12

duty cycle 20%

it will increase cell permeability

Question 13

1 mgtz goes how deep?

Answer 13

5cm

Question 14

Does metal get rapidly heated by ultrasound?

Answer 14

no

Question 15

How should you respond to adverse effects during phonophoresis treatment?

Answer 15

stop treatment
wash it off 
check the vital signs 
get the supervising PT
Documenting adverse effect

Question 16

What type of diathermy is used in the united states?

Answer 16

short wave diathermy

Question 17

Capacitive plates reflect off what tissue?

Answer 17

fat tissue

Question 18

Are metal implants a precaution for diathermy?

Answer 18

yes

Question 19

What are the indications for thermotherapy?

Answer 19

• Pain Control
• Via gait control pain theory
• Indirectly by dec muscle spasm, rec ischemia

Inc ROM

• Due to soft tissue extensibility
• Inc extensibility & viscoelasticity of periarticular structure

Accelerate healing
*Via inc circulation, enzymatic activity & availability of oxygen to

Question 20

What are the contraindications for thermotherapy?

Answer 20

Recent or potential hemorrhage

Thrombophlebitis

Impaired sensation

Impaired mentation

Malignant tumor

IR irradiation of eyes

Question 21

What are the precautions for thermotherapy?

Answer 21

Acute (First 72 Hours) injury/inflammation

Edema - (may do contrast bath for chronic)

Pregnancy

Impaired circulation

Poor thermoregulation

Cardiac insufficiency

Metal in area

Over open wound

Over area where topical counterirritant applied

Demyelinated nerves

Question 22

Thermotherapy Physiological Effects are:

Answer 22

Vasodilation
Neuromuscular Effects
Inc Pain Threshold
Dec Muscle Strength
Inc Metabolic Rate Effects
Altered Tissue Extensibility

Question 23

Cryotherapy Physiological Effects are:

Answer 23

Vasoconstriction
Inc blood Viscosity 
Delayed - Inc blood flow
Dec Nerve Conduction velocity 
Inc Pain Threshold
Altered Muscle Strength
Dec Spasticity 
Facilitate muscle contraction
Decrease Metabolic Rate Effects

Question 24

What are the application parameters for cold pack?

Answer 24

10-20min for pain, inflammation, edema
30 min for spasticity
23F
Gel ice stays cold longer

Question 25

What are the application parameters for ice massage?

Answer 25

5-10min | 23 degrees F

Question 26

What are the parameters for Controlled Cold Compression?

Answer 26

Temp of water 50-59F Cold consistent throughout Various types of units - gain ready unit

Question 27

What is Vapocoolant Spray used for?

Answer 27

Used to relieve pain from trigger points | Facilitate stretching

Question 28

What are indications for cryotherapy?

Answer 28

``` Control inflammation Reduce pain (acute) Reduce edema Reduce spasticity (slows nerve conduction) Control symptoms of MS Facilitate movement (quick ice) ```

Question 29

What are contraindications for cryotherapy?

Answer 29

Cold Hypersensitivity (vascular skin rxn) Cold Intolerance (Severe pain, numbness, color changes) Cryoglobulinemia (Disorder results in impaired circulation w. Exposure to cold) Paroxysmal cold hemoglobinuria(RBC in urine in response to cold) Raynaud’s phenomenon (Significant blanching) Over Regenerating peripheral nerves Over area w. Compromised circulation

Question 30

What are the precautions for cryotherapy?

Answer 30

Over superficial main branch of nerve (elbow, face, hand) Ex. Median Nerve Over open wound. Contamination issue and possible disrupt new tissue growth Hypertension Esp. for large sections of the body Poor sensation or mentation Poor sensation - be very mindful (vascularly compromised?) Distress vs Benefit Very young or very old Cant regulate temperature very well

Question 31

What are ultrasound indications?

Answer 31

Phonophoresis * Enhance transdermal topical meds * anti-inflam. Meds * ex. Hydrocortisone, dexamethasone, salicylates,lidocaine Inc soft tissue extensibility Pain control via gait control, modification of underlying condition Accelerate healing *Surgical incisions Tendon Injuries * Promotes healing * Dec inflammation Ligament Injuries *Accelerate healing Bone fx *Due to piezoelectric effect of bone on low dose US

Question 32

What are contraindications to ultrasound?

Answer 32

Malignant Tumor Pregnancy (abdomen, low back, & pelvis) CNS tissue Joint cement Plastic components Pacemaker Thrombophlebitis Eyes Reproductive Organs

Question 33

What are precautions for ultrasound?

Answer 33

Acute Inflammation *Cld cause inc bleeding, pain, swelling Epiphyseal Plates *Xrays would need to determine if growth complete FX *High level US over fx is painful, may impair healing Breast Implants *Could rupture implant

Question 34

What are some adverse reactions to look for during ultrasound treatment?

Answer 34

Usually occur when US is contraindicated or not applied correctly Burns - high intensity US or stationary application Cross contamination/infection - 27% contaminated w. Pain to periosteum

Question 35

What are they thermal effects of diathermy?

Answer 35

``` Vasodilation Inc. nerve conductivity Elevation of pain threshold Alt. muscle strength Alt. enzymatic activity Inc. soft tissue extensibility ```

Question 36

What are the non thermal effects of diathermy?

Answer 36

Tissue Healing Inc healing process via inc microvascular perfusion Inc local circulation, inc tissue oxygenation, inc nutrient availability & phagocytosis Alter cell membrane function (similar to US non-thermal) Bone Healing

Question 37

What are indications for non-thermal diathermy?

Answer 37

``` Non-thermal Control pain & edema Soft tissue healing Nerve healing Bone healing OA symptoms ```

Question 38

What are contraindications to diathermy?

Answer 38

* Implantable devices - ie pacemakers * Pregnancy ``` Thermal Diathermy Metal implants (different than US) Growing Epiphyses Malignancy Eyes Testes ```

Question 39

What are the precautions for diathermy?

Answer 39

``` Obesity Copper IUD Skeletal immaturity For PT/PTA Therapist should be 1-2m away from cont. Diathermy application 30-50cm away from PSWD ```

Question 40

What are some adverse effects to look out for when performing diathermy?

Answer 40

Fat tissue likely burned with capacitive plates | Pt’s skin must be kept dry, wrap with towel to avoid burns

Question 41

What is the method for heat transfer for hydrotherapy?

Answer 41

convection

Question 42

What temperature in necessary for cold induced vasodilation?

Answer 42

tissue temp of 50 degrees.

Question 43

What is the hunting response?

Answer 43

alternating vasoconstriction and dilation after 15min of prolonged ice.

Question 44

What type of fibers are most effected by cold temperature?

Answer 44

A- delta fibers because they are myelinated and small in diameter.