S1_L2: Superficial Cold and Heat Flashcards by MindMed Official

TRUE OR FALSE: Cryotherapy is used as a first-aid measure after trauma. Cooling is accomplished by removing or abstracting heat from an object, rather than by adding cold.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A. Both statements are true

Source: Michlovitz

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The following statements are true about cryotherapy, EXCEPT:

A. Used to decrease the temperature of soft tissues
B. Used to increase the temperature of soft tissues
C. Used only as an adjunctive tool in the rehabilitation of musculoskeletal dysfunctions
D. Used in the rehabilitation of neuromuscular dysfunctions
E. None of the above

B. Used to increase the temperature of soft tissues

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Match the following effects of cold.

↓ Spasticity
↓ Histamine level
↑ Pain threshold
↓ Nerve Conduction Velocity
Hunting Response

A. Hemodynamic
B. Neuromuscular
C. Metabolic

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TRUE OR FALSE: Upon application of cryotherapy, there is an initial decrease in blood flow, followed by an increase in blood flow.

True

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↓ blood flow and tissue metabolism results in (1)_____ in bleeding and (2)____ in inflammation.

A. increase; decrease
B. increase; increase
C. decrease; increase
D. decrease; decrease

D. decrease; decrease

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Cold makes blood is more viscous. A decrease in blood flow decreases production and release of vasodilators.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A. Both statements are true

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This is the alternating vasoconstriction and vasodilation happening during a long application of cold to the body. It is thought off as a safety feature of the body that happens to protect tissue from damage

Hunting Response

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Cold has the greatest effect on conduction by (1)____ fibers and the least effect on conduction by (2)_____ fibers.

A. myelinated and large ; unmyelinated and small
B. myelinated and small ; unmyelinated and large
C. unmyelinated and small ; unmyelinated and large
D. unmyelinated and small ; myelinated and large

B. myelinated and small ; unmyelinated and large

Source: Cameron

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Cryotherapy can (1)____ the pain threshold and (2)____ the sensation of pain

A. increase; decrease
B. increase; increase
C. decrease; increase
D. decrease; decrease

A. increase; decrease

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TRUE OR FALSE: strength testing should be performed before cryotherapy application.

True

This is because muscle strength can be temporarily influenced by cryotherapy.

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Prolonged cooling for ___ to ___ minutes can reduce spasticity for the following 60 to 90 minutes

10 to 30

Source: Cameron

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Application of cryotherapy by 5 minutes or more may (1)____ tone. Application of cryotherapy using quick icing or brief cooling may (2)____ tone.

A. increase; decrease
B. increase; increase
C. decrease; increase
D. decrease; decrease

C. decrease; increase

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What motor neuron is facilitated in brief application of cryotherapy?

alpha motor neuron

Source: Cameron

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What motor neuron is facilitated in long cooling application of cryotherapy?

gamma motor neuron

Source: Cameron

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Cold decreases local metabolic rate and therefore can slow inflammatory activity. Cold is not recommended when healing is delayed as it will prolong the healing process

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A. Both statements are true

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Enumerate the methods of heat LOSS.

Respiration, Radiation, Evaporation, Convection, Conduction

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Match the examples of the following methods of heat loss

Sweating
Exhalation
Placing an ice pack
Immersing foot in water
Through air

A. Respiration
B. Radiation
C. Evaporation
D. Convection
E. Conduction

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Cryotherapy may reduce the severity of delayed-onset muscle soreness (DOMS). It is used as a symptom management for multiple sclerosis

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A. Both statements are true

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Cryotherapy is not used when burns are in the acute stage. It is also contraindicated in pts c Raynaud’s disease

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

D. Only the 2nd statement is true

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_______ is the application of a cooling agent before stretching.

Cryostretch

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_______ is a technique that combines the use of cold and exercise to treat pathology or disease.

Cryokinetics

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TRUE OR FALSE: When a pt has a history of being hypertensive, a PT must take precaution in applying cryotherapy.

True

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Enumerate the 4 stages of sensation upon application of cryotherapy

Cold
Burning
Aching
Numbness/Analgesia

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When using cryotherapy to control inflammation on the extremities, apply for no longer than ____ minutes at least ____ hour/s apart

Source: Cameron

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TRUE OR FALSE: Superficial heating agents do not heat to the depth of most muscles. To heat deep muscles, use exercise or deep-heating modalities such as ultrasound or diathermy. A. Both statements are true B. Both statements are false C. Only the 1st statement is true D. Only the 2nd statement is true

A. Both statements are true Source: Cameron

Nerve conduction velocity increase by (1)___ m/s for every (2)____ºC rise

1. 2 2. 1

Determine the LAW being described when applying radiation. Intensity of radiation is inversely proportional to the distance squared

Inverse Square Law

Determine the LAW being described when applying radiation. Intensity and duration of the dose of radiant energy is inversely proportional

Bunsen Roscoe Law of Reciprocity

Determine the LAW being described when applying radiation. There is an optimal amount of energy absorption per unit time for beneficial results to be expected

Arndt-Schultz Principles

Determine the LAW being described when applying radiation. Waves must be absorbed to be induce chemical processes/changes

Law of Grothus Draper NOTE: This is also known as the Principle of Chemical Activation

Determine the LAW being described when applying radiation. Optimum radiation occurs when the source is perpendicular (right angle) to the center of the surface to be radiated

Lambert’s Cosine Law NOTE: This is also known as the Right Angle Law

_____ is the use of electrical current to facilitate the delivery of specific drugs and ions to reduce tissue inflammation, decrease local pain, reduce calcium deposits, and reduce scar restrictions

Iontophoresis

Categorize the following findings in the application of cold. 1. Open wound 2. Inflammation 3. Edema 4. Over a regenerating peripheral nerve 5. Over the superficial main branch of a nerve A. Indication B. Precaution C. Contraindication

1. B 2. A 3. A 4. C 5. B

TRUE OR FALSE: Applying a cold pack after a hot pack improves passive ROM (PROM) in patients with restricted knee ROM more effectively, rather than applying a hot pack alone.

True Source: Cameron

This technique involves applying a cooling agent to the point of numbness shortly after an injury to reduce the sensation of pain, enabling the patient to exercise and work toward regaining range of motion (ROM) as early as possible A. Cryokinetics B. Cryostretch

A. Cryokinetics

The purpose of this sequence of treatments is to reduce muscle spasm A. Cryokinetics B. Cryostretch

B. Cryostretch

This approach is most commonly used to rehabilitate athletes. A. Cryokinetics B. Cryostretch

A. Cryokinetics

Explain how cryokinetics is performed.

1. cold is applied for up to 20 minutes or until the patient reports numbing 2. patient performs strengthening and stretching exercises for 3 to 5 minutes until sensation returns 3. sequence is repeated for five times

______ is an uncommon disorder characterized by the aggregation of serum proteins in the distal circulation when the distal extremities are cooled.

Cryoglobulinemia

This reaction is marked by the transient appearance of smooth, slightly elevated patches, which are redder or more pale than the surrounding skin and are often attended by severe itching.

Cold Hypersensitivity/ Cold-induced Urticaria

_____ is a condition in which hemoglobin from lysed red blood cells is released into the urine in response to local or general exposure to cold.

Paroxysmal cold hemoglobinuria

_____ is a paroxysmal digital cyanosis resulting from some regional or systemic disorder.

Raynaud disease

TRUE OR FALSE: Too much exposure to radiation causes heat. Less exposure to radiation promote heat loss. A. Both statements are true B. Both statements are false C. Only the 1st statement is true D. Only the 2nd statement is true

A. Both statements are true

The following are indications for cryotherapy, EXCEPT: A. Inflammation Control B. Edema Control C. Pain Control D. Modification of Spasticity E. None of the above

E. None of the above

The following are indications for cryotherapy, EXCEPT: A. Facilitation of Tone B. Inhibition of Tone C. D. E. None of the above

The following are indications for cryotherapy, EXCEPT: A. Desensitization B. Conjunction with deep friction massage C. Conjunction with joint mobilization D. Conjunction with strenuous workouts E. None of the above

E. None of the above

Why is cryotherapy contraindicated to be applied directly over a regenerating peripheral nerve?

results to local vasoconstriction or altered nerve conduction that results to a delay in nerve regeneration

TRUE OR FALSE: Poor sensation or mentation becomes a contraindication in applying cryotherapy.

False a PT must only take precautionary measures

TRUE OR FALSE: Extreme ages of patients is a precaution in applying cryotherapy.

True

Determine the time of application for the following cryotherapy modalities. 1. whirlpool 2. iced towel 3. quick icing A. 3 times B. 3-5 mins C. 10-15 mins D. 10-20 mins E. 5-15 mins

1. E 2. C 3. A

Determine the time of application for the following cryotherapy modalities. 1. chemical cold packs 2. ice massage 3. ice packs A. 3-5 seconds, 3x B. 3-5 mins C. 10-15 mins D. 10-20 mins E. 5-15 mins

1. C 2. B 3. D

1. Convenient for emergency use 2. Used primarily in patients with CNS disorder A. cold packs B. ice packs C. ice massage D. quick icing E. chemical cold packs

1. E 2. D

1. Usually done over a small area before deep pressure massage 2. Technique developed by Rood A. cold packs B. ice packs C. ice massage D. quick icing E. chemical cold packs

1. C 2. D

1. Usually effective on flaccid/hypotonic muscles only 2. Rapid application of ice as a stimulus to elicit desired motor patterns A. cold packs B. ice packs C. ice massage D. quick icing E. chemical cold packs

1. D 2. D

1. Indicated for conditions in which exercise of the injured part during cold treatment is desired 2. Most practical if cooling of the distal extremities is desired A. cold baths B. cold whirlpool C. vapocoolant spray

1. B 2. A

1. Most intense application of cold 2. Used for trigger points A. cold baths B. cold whirlpool C. vapocoolant spray

1. B 2. C

1. used to increase ROM 2. Ensures circumferential cooling of the extremities A. cold baths B. cold whirlpool C. vapocoolant spray

1. C 2. A

Enumerate the methods of heat GAIN.

1. Conduction 2. Convection 3. Radiation

How many layers of towel must a hot moist pack be wrapped with?

6-8 layers

The following are ADVANTAGES of ICE OR COLD PACKS, EXCEPT: A. Low level of skill required for application B. Covers small areas C. Can be used for POLICE principle D. Can be applied to elevated limb E. None

B. Covers small areas It may cover moderate to large areas, which is its advantage.

The following are ADVANTAGES of ICE MASSAGE, EXCEPT: A. For small, irregular areas B. Treatment area can be observed during application C. Clinician has an active participation throughout application D. Can be applied to an elevated limb E. None

C. Clinician has an active participation throughout application

The following are ADVANTAGES of a COLD COMPRESSION UNIT, EXCEPT: A. Temperature and compression force are easily and accurately controlled B. Can be applied on large joints C. Can be applied on trunk and digits D. Allows simultaneous application of cold and compression E. None

C. Can be applied on trunk and digits

The following are ADVANTAGES of FLUIDOTHERAPY, EXCEPT: A. Easy application B. Free limb movement C. Circumferential heating D. Constant heating pattern E. None

A. Easy application

TRUE OR FALSE: HMPs have a circumferential heat distribution. During application, no limb movement is allowed. A. Both statements are true B. Both statements are false C. Only the 1st statement is true D. Only the 2nd statement is true

D. Only the 2nd statement is true It has a radial heat distribution

TRUE OR FALSE: Fluidotherapy is limited to the extremities only. Both HMP and PWB required toweling upon application. A. Both statements are true B. Both statements are false C. Only the 1st statement is true D. Only the 2nd statement is true

A. Both statements are true

Which of the following the direct hemodynamic effect of cold? A. smooth muscle contractions B. reflex activation of sympathetic adrenergic neurons C. Both D. Neither

A. smooth muscle contractions NOTE: Option B is the INDIRECT effect

TRUE OR FALSE: Cold-Induced Vasodilation (CIVD) happens after prolonged application of cold temperature

True

_____ fibers, which are small-diameter, myelinated, pain transmitting fibers, undergo the greatest decrease in conduction velocity in response to cooling.

a-delta

Which nerve fiber is responsible for chronic pain?

c fibers

Which nerve fiber is responsible for acute pain?

a-delta

This concept is based on counterirritation via the gate control mechanism and reduction of muscle spasm, slowing of sensory nerve conduction velocity, or reduction of postinjury edema

Gate Control Theory

Application of cold for less than or equal to 5 minutes result in _____ strength

increase

Application of cold for more than or 5 minutes result in _____ strength

decrease

Application of cold Inhibits activity of (1)_____ enzymes for OA pts and reduces level of (2)____ in the blood for RA pts

1. cartilage-degrading 2. histamine

What Mnemonic is used as a principle in applying cold? Name all.

MNEMONIC: PRICES Protection Rest Ice Compression Elevation Stabilization NOTE: use POLICE to add optimal loading

When applying a vapocoolant spray, the bottle must be (1)____ and held at an (2)____ angle approximately (3)____ cm from the skin at a rate of (4)_____ cm/sec

1. upright 2. acute (or >30) 3. 30-45 4. 10 (or 4 inches/sec)

Determine which is documented correctly. A. Cryotherapy using cold-gel packs on (R) posterior buttocks in supine x 10 mins to decrease inflammation B. Cryotherapy using C. Cryotherapy using D. All E. None

CORRECT FORMAT: Cryotherapy using on in x to

Cryotherapy yields more on what kind of pain?

acute

Cryotherapy (1)_____ gamma motor activity and (2)_____ afferent spindle & GTO activity. A. increase; decrease B. increase; increase C. decrease; increase D. decrease; decrease

D. decrease; decrease

This method of energy transfer happens when 2 surfaces of different temperatures come into contact w/ one another, then heat is lost to balance temperature.

Conduction

The following conditions makes cryotherapy contraindicated, EXCEPT: A. Cold-induced Urticaria B. Cold Intolerance C. Cold Hypersensitivity D. Cryoglobulinemia E. None

E. None

The following conditions makes cryotherapy contraindicated, EXCEPT: A. Paroxysmal Cold Hemoglobinuria B. Peripheral Vascular Disorder (PVD) C. Koebner's Phenomenon D. Raynaud’s Phenomenon E. None

C. Koebner's Phenomenon

A tissue must not be cooled to (1)_____ degrees Celsius to prevent tissue death from ischemia

TRUE OR FALSE: Spasm is being reduced by cold temperature. Quick cryotherapy facilitates gamma motor neurons A. Both statements are true B. Both statements are false C. Only the 1st statement is true D. Only the 2nd statement is true

C. Only the 1st statement is true It facilitates alpha motor neurons for flaccid muscles

Delayed-Onset Muscle Soreness (DOMS) occurs (1)______ after exercise due to (2)______

1. 24-48 hours 2. lactic acid accumulation

TRUE OR FALSE: Cryotherapy reduces effects of DOMS

True

TRUE OR FALSE: Cryotherapy is not indicated when edema is caused by poor circulation.

True

TRUE OR FALSE: Raynaud phenomenon may be associated with thoracic outlet syndrome, carpal tunnel syndrome, or trauma.

True

Lowering skin-surface temperature to _____ is sufficient to produce local analgesia

13.6°C (56.5°F) Source: Michlovitz

This is a disorder c cyanotic changes on distal extremities and usually affects small arteries. it arises from cold exposure or too much stress.

Raynaud’s Disease

Cold packs are filled with a gel covered with (1)____. Gel becomes (2)_____ at 0-5ºC, thus making it have a better conformity to body, resulting in equal distribution

1. vinyl 2. semi-solid

What ratio of water and rubbing alcohol may be used as an alternative to cold packs

4: 1 (water : rubbing alcohol)

TRUE OR FALSE: In performing ice massage, skin temperature will not drop below 25ºC because you are continuously moving the modality.

False it drops until 15 degrees

What is the recommended temperature range when using a controlled cold compression unit?

10-25 ºC

_____ and _____ technique is used to treat trigger points by spraying a vapocoolant spray in parallel strokes along the skin overlying the muscle with the trigger points and then immediately stretching the muscle

Spray and stretch

TRUE OR FALSE: Ethyl chloride is the recommended chemical formula used in vapocoolant sprays

False Ethyl chloride is no longer recommended (flammable)

To increase ROM using a vapocoolant spray, the entire length of the muscle should be covered (1)____x at a rate of (2)_____ cm/sec.

1. 2-3 2. 10

Identify the two kinds of technique using quick icing and its parameters.

1. A-icing: 3 swipes; wipe water after every swipe 2. C-icing: hold ice for 3-5 seconds, 3x; wipe water after

Chemical cold packs should remain in tank at least (1)____ hours before the first use and at least (2)____ minutes for subsequent uses

1. 24 2. 30

________ are frequently used clinically when the treatment goal is to achieve the benefits of heat, including decreased pain and increased flexibility, while avoiding increased edema.

Contrast baths

1. Small and gradual rise in temperature 2. 3x108 m/s velocity 3. 1400-3000 nm wavelength 4. Long/ Far 5. 1-3 mm penetration A. Luminous IRR B. Non-Luminous IRR C. Both D. Neither

1. B 2. C 3. B 4. B 5. A

1. More perspiration 2. Extends until the Epidermis and dermis 3. Short MIRE 4. IRA 5. Extends until the Stratum corneum A. Luminous IRR B. Non-Luminous IRR

1. A 2. A 3. A 4. A 5. B NOTE: MIRE stands for Monochromatic Infrared Energy

Match the effects of HEAT. 1. NCV 2. Pain threshold 3. Muscle strength 4. Firing Rate 5. Metabolic Rate A. Increase B. Decrease

1. A 2. A 3. B 4. B 5. A Heat decreases strength. However, it normalizes strength >30 minutes, as pain threshold has already increased

Heat increases local metabolic rate and therefore can exacerbate ______.

inflammation

TRUE OR FALSE: Heat increases tissue extensibility. This is achieved when tissue heating is maintained at 40ºC-45ºC for 5-10 mins A. Both statements are true B. Both statements are false C. Only the 1st statement is true D. Only the 2nd statement is true

True

Hot moist packs are usually made of (1)_____ (hydrophilic silicate gel) covered with (2)_____

1. bentonite 2. canvas

HMPs are stored in (1)_____ tanks at 70ºC to 75ºC. Initial heating must be done for (2)____ hrs, while reheating must be done for (3)_____ mins

1. hydrocollator 2. 2 3. 30

What is the expected intensity and recommended duration of HMPs?

Mild comfortable moist warmth c 15-20 minutes

Using a new terry cloth with be equivalent to how many layers of towel?

Using an old terry cloth with be equivalent to how many layers of towel?

The following is a CONTRAINDICATION in using superficial heating modalities, EXCEPT: A. Recent hemorrhage B. Thrombophlebitis C. Metal in the area D. Erythema ab igne E. None

D. Erythema ab igne This is only specific to IRR

The following is a PRECAUTION in using superficial heating modalities, EXCEPT: A. Acute injury or inflammation B. Pregnancy C. Impaired circulation D. Edema E. None

E. None

Which of the following is a CONTRAINDICATION in using IRR: A. Malignant tumor B. Cardiac insufficiency C. Acute dermal conditions D. Superficial metals in the area E. None

B, C, D NOTE: A is for superficial modalities

Enumerate the 3 possible adverse effect of heat.

1. burn injuries 2. blister formation 3. blanching skin

Which of the following is a PRECAUTION in using superficial heating modalities: A. Metal close to the target area B. Demyelinated nerves C. Over areas with recently applied topical counterirritants D. Poor thermal regulation E. Impaired sensation

All

What is the parameters used for contrast bath?

1. Hot (3-4 mins) → Cold (1 min) 2. Repeat the cycle for 5-6 times 3. total duration: 25-30 mins 4. End with warm water

Choose the temperature used for Contrast Bath for warm water. A. 30-36ºC B. 34-37.5ºC C. 38-44ºC D. 40-44ºC

C. 38-44ºC

Choose the temperature used for Contrast Bath for cold water. A. 10-18ºC B. 12-21ºC C.10-28ºC D.14-24ºC

A. 10-18ºC

Heat has a (1)_____ effect d/t release of (2)_____ and (3)_____

1. vasodilatory 2. histamine 3. prostaglandins

What is the direct effect of heat when cutaneous receptors become activated?

relax smooth muscles of blood vessels this happens through the release of nitrous oxide w/ help of bradykinin

What is the indirect effect of heat when cutaneous receptors become activated?

activation of spinal cord reflexes this decreases sympathetic adrenergic activity, resulting in vasodilation

What is the direct effect of heat on an individual's pain threshold?

Gating effect and activation of a-beta fibers

What is the indirect effect of heat on an individual's pain threshold?

↓ ischemia and muscle spasm, breaking pain-spasm-pain cycle

Upon using head, firing rate of type II muscle spindle efferents & gamma efferents _____, while firing rate of type Ib (GTO) _____. A. increase; decrease B. increase; increase C. decrease; increase D. decrease; decrease

C. decrease; increase

What is the Paraffin wax to mineral oil ratio?

6:1 or 7:1

TRUE OR FALSE: PWB has low specific heat and low thermal conductivity of the wax

True

What is the parameters for using dip and wrap method when applying PWB?

6-10 dips

What is the parameters for using dip immersion method when applying PWB?

20 mins

What is the total duration of using PWB?

20-30 mins

What method of heat transfer is used in fluidotherapy?

convection

IR lamps emit electromagnetic radiation with a wavelength of 770 to 106 nm lying between the (1)____ and (2)____

1. visible light 2. microwaves

Angle of rays during application of IRR must be?

perpendicular

TRUE OR FALSE: Luminous IRR must be warmed up for 5-10 minutes

False. This is used immediately while non-luminous IRR are preheated.

What are the 3 main indications in using IRR?

1. Psoriasis 2. Pressure sores 3. ↓ skin impedance(adjunct to ES)

TRUE OR FALSE: The warmth of the sun’s rays is a well-known example of heat transfer via ultraviolet energy.

True Source: Michlovitz

TRUE OR FALSE: superficial heating modalities are indicated to be applied on stiff structures. it is also indicated to accelerate tissue healing A. Both statements are true B. Both statements are false C. Only the 1st statement is true D. Only the 2nd statement is true

A. Both statements are true

TRUE OR FALSE: superficial heating modalities are indicated for acute and subacute conditions. it is also indicated to treat pain and muscle spasm A. Both statements are true B. Both statements are false C. Only the 1st statement is true D. Only the 2nd statement is true

D. Only the 2nd statement is true

The following are indications for superficial heating modalities, EXCEPT: A. Stiff structures B. Muscle spasm C. Pain D. Subacute and chronic conditions E. None

E. None

TRUE OR FALSE: IRR is used as an adjunct to electrical stimulation to prevent electricity from flowing through inside the individual.

True

S1_L2: Superficial Cold and Heat Flashcards

(139 cards)