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Superficial Thermal Modalities Flashcards

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1
Q

explain direct relationships in superficial thermal modalities between a thermal stimulus and

  • amount of tissue covered
  • time applied
  • temperature gradient
A

smaller amount of tissue = more intense exchange of heat

shorter duration = less absorption of heat

greater difference between temperature of soft tissue and thermal stimulus = more heat exchanged

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2
Q

explain the indirect relationship of distance between thermal stimulus and soft tissue

A

greater distance = less absorption/exchange of temperature

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3
Q

what is conduction thermal energy transfer

A

molecule vibration that causes interaction with the next molecule

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4
Q

what are examples of conduction thermal energy transfers

A

paraffin
hot packs
ice packs

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5
Q

what is convection thermal energy transfer

A

molecules being moved, not in prolonged static contact

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6
Q

examples of convection thermal energy transferred modalities

A

fluidotherapy
whirlpool with agitation

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7
Q

what is radiation thermal energy transfer

A

electromagnetic radiation that does not require molecules

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8
Q

examples of radiation thermal energy transfer

A

ultraviolet
diathermy
infrared

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9
Q

how many calories per gram of water is related to evaporation

A

0.58 cal/g of water

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10
Q

a localized addition of thermal energy of ______°F and ______°C causes physiological responses

A

91.4 / 33

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11
Q

what physiological responses are seen when localized temperature or core temperature increases

A

perspiration
erythema
metabolic rate
HR
RR
nerve conduction velocity

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12
Q

compare A-Beta and A-Delta/C fibers

A

A-B = faster traveling
- respond to nonpainful tactile stimulus like vibration and touch

A-Delta/C = slower traveling
- respond to painful stimuli

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13
Q

what is the gate control theory and how do modalities relate to it

A

idea of inhibiting painful stimuli and promoting nonpainful stimuli to the CNS

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14
Q

what are the physiological effects of superficial thermal modalities

A

increased blood flow
increased nerve conduction velocity
increase tissue metabolic activity
increase joint freedom
decrease muscle tone

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15
Q

physiologically speaking, how do superficial thermal modalities decrease muscle tone

A

cutaneous modulation of ventral horn motor neuron allows for decreased contractility sensitivity

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16
Q

how do superficial thermal modalities increase joint freedom?

A

decrease viscosity of periarticular tissue, allowing for less resisted motion at the joint

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17
Q

how deep do superficial thermal modalities reach

A

2 cm

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18
Q

temperature, timeframe, and depth of tissue associated with superficial thermal modalities

A

at 5-6°C or 41-42°F

for
6-8 min = 2 cm
10-15 min = slightly more than 2cm
>15 = marginal return
- rate of depth gained and temp lost nears breaking even

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19
Q

what are clinical uses of superficial thermal modalities

A

analgesia
decreased hyperesthesia
increased wound healing
decreased muscle spasm/guarding
decrease edema
increase A/PROM

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20
Q

how is analgesia obtained via superficial thermal modalities

A

gate control theory concept
- increased nonpainful stimuli to mask pain signal

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21
Q

what specific superficial thermal modalities can be used to decrease hyperesthesia

A

fluidotherapy
whirlpool

– will increase nerve conduction velocities

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22
Q

what stages in wound healing phases could superficial thermal modalities be indicated? why these stages vs others?

A

subacute and chronic
– not acute because of hemostasis and inflammation, would rather stimulate circulation and nerve healing later on

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23
Q

what is the idea behind the pain spasm circle? how do we combat that?

A

more pain = more spasms/guarding
– as pain increases, so does guarding and spasming

want to address either pain or spasming to decrease the other

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24
Q

hot packs are examples of ______ method of thermal modality

A

conduction

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25
what are hotpacks made of
canvas/nylon cases that are filled with hydrophilic substance
26
what is the necessary temperature of water for hotpacks to be in
160-175° F 70-80° C
27
what is the amount of towel layers needed between patient and hot pack in a prone position
8
28
how many layers of coverage does one layer of a hot pack count as
3
29
what is something to keep in mind when making a hot pack for a body area while one is in a supine position
heat will follow the path of least resistance and it will escape in the direction of the room easier than through the towels in the direction of the tissue
30
how to contain heat when a hot pack is placed on an individual in a supine position?
>8 towel layers must be on the side opposite of tissue to contain the heat
31
average duration of superficial thermal modalities
15-20 minutes
32
advantages of superficial hot packs
quick / easy inexpensive can be done as part of HEP easy to adjust heat via layers added or removed different shapes and sizes for different body contours
33
disadvantages of superficial hot packs
does not always contour well to specific areas of the bdoy temperature/heat level cannot be specifically measured body part cannot be seen during treatment
34
indications of superficial thermal hot packs
subacute/chronic pain increased muscle tension preparation of area for other treatments
35
localized contraindications of superficial hot packs / fluidotherapy
acute inflammation malignancies in the area active bleeding localized infection
36
systemic contraindications of superficial hot packs / fluidotherapy
fever cardiac insufficiency unreliable thermoregulatory systems peripheral vascular disease
37
precautions of superficial hot packs
edema diminished sensation confusion
38
how to document superficial hot pack usage
modality applied - moist heat in this case location position duration pre/post treatment assessment -- skin condition layers of padding (if different from standard)
39
what is the ratio associated with the mixture of paraffin
5 lbs of wax 1 pint of mineral oil
40
what is the temperature associated with paraffin storage
47-55°C / 115-130°F
41
what are the primary treatment methods of paraffin
dip and immerse dip and wrap / glove method
42
what needs to be done prior to paraffin treatment
wash and dry skin inspect for open wounds assessment of sensation jewelry removal prepare supplies / educate patient on process and what to expect
43
explain the dip and wrap / glove method of paraffin wax application
body part dipped into wax and removed -- allow wax to solidify while maintaining position repeat 7-10 times wrap gloved part with plastic insulation followed by towel insulation
44
how long is paraffin left in place?
10-20 min
45
how is thermal energy translated from modality to soft tissue in paraffin wax application
wax will start at 115-130°F once applied and slowly decrease from there
46
explain the dip and immerse method of paraffin application
body part is submerged and a layer of wax is solidified - then that same process is repeated but is not removed from wax for 10-20 min
47
pros and cons of dip and emersion paraffin application
pro = temperature is maintained for entire intervention con = body is left in dependent position / can be inconvenient --> edema precautions may contraindicate dependent position
48
why is paraffin an effecient source of heat
low melting point low specific heat conducts heat slowly
49
advantages of paraffin
can be done as part of an HEP due to inexpensive nature can contour to body areas
50
disadvantages of paraffin
slightly more messy more time involved open wound contraindication
51
indications of paraffin
subacute/chronic traumatic and inflammatory conditions
52
compare moist heat and paraffin contraindications
all the same, but paraffin has open wounds
53
precautions of paraffin
edema diminished sensation impaired local circulation local anesthesia
54
documentation of paraffin
body part treated method of treatment duration of treatment pre/post treatment assessment
55
what specifically needs to be documented with paraffin treatment method?
amount of layers glove vs painting vs immersion method
56
fluidotherapy is an example of a ______ thermal modality
convection
57
explain how fluidotherapy works
cellulose particles are enclosed in a vacuum in which heated air is circulated
58
what is turbulence? how does this relate to treatment?
amount of movement of cellulose particles in fluidotherapy chamber -- more turbulence = more thermal and mechanoreceptor stimulation
59
what is the temperature associated with fluidotherapy
room temperature to 130-140°F
60
treatment time associated with fluidotherapy
10-20 min
61
what is different about fluidotherapy compared to heat/paraffin?
fluido = active treatment option can do A/PROM or mobilizations during treatment
62
indications of fluidotherapy
subacute / chronic traumatic and inflammatory conditions hyperesthesia
63
precautions associated with fluidotherapy
open wounds need to be protected impaired local circulation peripheral vascular disease
64
how to document fluidotherapy
body part treated temperature agitation/airflow duration if A/PROM was completed pre/post treatment assessments
65
how does infrared work?
short and visible infrared waves generate heating response in tissues when absorbed
66
relationship of distance between infrared and soft tissue and heat generation
closer = more warm further = less warm
67
what is the angle in which infrared must be in comparison to the skin? what is the associated time frame of infrared intervention?
perpendicular 15-30 min
68
indications of infrared
subacute and chronic traumatic and inflammatory conditions wound care
69
contraindications of infrared
acute inflammatory conditions fever malignancies active bleeding cardiac insufficiency unreliable thermoregulatory systems peripheral vascular disease
70
precautions of infrared
existing edema sensory loss / sensory impairments confusion on treatment
71
documentation of infrared intervention
modality / method body part treated duration pre/post treatment assessment
72
how does cryotherapy work?
removal of thermal energy
73
cryotherapy benefits
decreased: metabolic rate blood flow nerve conduction velocity
74
how does cryotherapy affect edema
reduces it via - arteriole vasoconstriction - decreased metabolic activity leading to less inflammation
75
relationship between fatty tissue and thermal penetration
higher areas of fatty tissue = lower rate of thermal penetration
76
how does cryotherapy affect nerve conduction velo
increased stimulus necessary for nerve depolarization that can decrease muscle excitability causing decreased pain and spasm
77
how does timing of cryotherapy application affect muscle force
short term = increased long term = decreased for 10 or so minutes, then increased
78
timing associated with increased/decreased muscle force via cryotherapy application
short term = 1-2 = increased long term = 30 minutes = decreased then increased
79
depth of penetration associated with cryotherapy
1-4 cm
80
staging of sensation related to cryotherapy
cold --> stinging --> analgesia --> anesthesia
81
cryotherapy relationship to pain threshold
increases pain threshold
82
relationship between cryotherapy and tissue elasticity/viscosity
decreased elasticity increased viscosity
83
Hunting Response
initial vasoconstriction causing a drop in temperature until smooth muscle relaxes vasodilation occurs and then a slight increase in temperature occurs
84
what does the hunting response create in the tissue being iced
indirect muscle pump due to vasoconstriction/dilation
85
indications of cryotherapy
trigger/myofascial points decrease hyperesthesia edema spasm/cramps ligament sprain acute/chronic pain inflammation neuro-facilitation
86
timing of cryotherapy in relation to acute inflammation
0-48/72 hrs
87
maximum treatment area and time associated with ice massage
150 cm² 5-10 min
88
what makes cold pack application optimal? - time wise - adjunct treatment
5-20 min in combination with elevation/compression
89
contraindications of cryotherapy
raynaud's cold urticaria cold precipitating antibodies decreased sensation/blood flow major tissue disruption severe hypertension frostbite gout Cardio-Pulm involvement regenerating peripheral nerves
90
what is cold uritcaria
breaking out into hives when cold is applied
91
what is cryoglobulinemia
antibodies in the blood that coagulate when cold is applied
92
temperatures associated with contrast bath
warm water = 38-44°C / 100-110°F cool water = 10-18°C / 50-60°F
93
explain treatment protocol of contrast bath
ratio of 3:1 or 4:1 -- hot to cold for 20-30 min end with warm water
94
goal of contrast bath
facilitate blood flow via indirect pumping mechanism vasoconstriction/dilation
95
indications for contrast bath
impaired venous circulation subacute/chronic traumatic and inflammatory conditions edema sinus/congestive HA
96
contraindications for contrast bath
malignancies hemorrhage / active bleeding cold hypersensitivity PAD cardiac/respiratory instability fever reduced thermoregulatory systems small vessel disease -- diabetes, buerger's disease, arteriosclerotic endarteritis

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