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DPT 690 - PT Interventions II > Thermal Agents - Thermotherapy > Flashcards

Thermal Agents - Thermotherapy Flashcards

1
Q

Modes of Heat Transfer

  • Heat transfer resulting from energy exchange by direct contact between molecules of two materials at different temperatures = ?

Thermal Agents: Thermotherapy

A

Modes of Heat Transfer:

(I) Conduction (Hot Pack):

  • Heat transfer resulting from energy exchange by direct contact between molecules of two materials at different temperatures.
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2
Q

Modes of Heat Transfer:

  • Heat transfer through direct collision of a circulating medium with material of a different temperature = ?

Thermal Agents: Thermotherapy

A

Modes of Heat Transfer:

(II) Convection (Whirlpool):

  • Heat transfer through direct collision of a circulating medium with material of a different temperature.

Examples:

  • Boiling water: Heat moves from the burner into the pot, heating the water at the bottom, causing it to rise. The cooler water then moves down to replace it, creating a circular motion.
  • Convection oven: A fan circulates hot air around the food, allowing heat to transfer via convection.
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3
Q

Modes of Heat Transfer:

Heat transfer by conversion of a non-thermal form of energy (ex., mechanical, electrical or chemical) into heat = ?

Thermal Agents: Thermotherapy

A

(III) Conversion (Ultra-sound):

  • Heat transfer by conversion of a non-thermal form of energy (ex., mechanical, electrical or chemical) into heat.

Examples:

  • Diathermy
  • Ultrasound.
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4
Q

Modes of Heat Transfer:

Transfer of energy from one material to another without the need for direct contact or an intervening medium = ?

Thermal Agents: Thermotherapy

A

(IV) Radiation (Heat Lamp):

  • Transfer of energy from one material to another without the need for direct contact or an intervening medium.
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5
Q

Differentiate and provide and example:

  • Conduction = ?
  • Convection = ?
  • Conversion = ?
  • Radiation = ?

Thermal Agents: Thermotherapy

A

Modes of Heat Transfer:

(I) Conduction (Hot pack):

  • Heat transfer resulting from energy exchange by direct contact between molecules of two materials at different temperatures.

(II) Convection (Whirlpool):

  • Heat transfer through direct collision of a circulating medium with material of a different temperature.

(III) Conversion (Ultrasound):

  • Heat transfer by conversion of a non-thermal form of energy (ex., mechanical, electrical or chemical) into heat.

(IV) Radiation (Heat Lamp):

  • Transfer of energy from one material to another without the need for direct contact or an intervening medium.
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6
Q

Conduction

  • The rate of temperature rise decreases in proportion to = ?

Thermal Agents: Thermotherapy

A

Conduction:

(I) The greater the temperature difference between a heating/cooling agent and the body part it is applied to,

  • the faster the rate of heat transfer.

(II) Materials with high thermal conductivity transfer heat faster than those with lower thermal conductivity.

(III) The larger the area of contact between a thermal agent and the patient,

  • the greater the total heat transfer.

(IV) The rate of temperature rise decreases in proportion to tissue thickness.

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7
Q

Convection

True or False:

  • More heat is transferred by convection than by conduction during the same period of time = ?

Thermal Agents: Thermotherapy

A

Convection:

(I) During convection, the thermal agent is in motion.

(II) More heat is transferred by convection than by conduction during the same period of time.

(III) Blood circulating in the body also transfers heat by convection.

(IV) Vasodilation increases the rate of circulation therefore increasing the rate at which the tissue temperature returns to normal.

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8
Q

Conversion

Rate of tissue temperature increase depends on = ?

Thermal Agents: Thermotherapy

A

Conversion:

(-) Rate of tissue temperature increase depends on:

  • Size of the area being treated.
  • Size of the applicator
  • Efficiency of transmission from the applicator to the patient
  • Type of tissue being treated

Conversion Notes:

  • Not affected by the temperature of the thermal agent.
  • Rate of heat transfer depends on the power of the energy source.
  • Doesn’t require direct contact between the thermal agent and the body.
  • DOES require an intervening material to be a good transmitter of that type of energy.
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9
Q

Radiation

Rate of temperature increase depends on = ?

Thermal Agents: Thermotherapy

A

Radiation:

(I) Direct transfer of energy from a higher temp. material to a lower temp. material

(II) Does not require an intervening medium

(III) Rate of temperature increase depends on:

  • Intensity of the radiation
  • Relative size of the radiation source
  • Relative size of the area being treated
  • Relative size of the distance of the source from the treatment area
  • Relative size of the angle of the radiation to the tissue
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10
Q

Effects of Heat:

  • Hemodynamic Effects = ?
  • Neuromuscular Effects = ?
  • Metabolic Effects = ?

Thermal Agents: Thermotherapy

A

Effects of Heat:

(I) Hemodynamic Effects:

  • Vasodilatation = Increase blood flow =
  • Increased cooling by convection through blood flow

(II) Neuromuscular Effects:

  • Changes in nerve conduction velocity and firing rates
  • Increased pain threshold (Gate Theory)
  • Brief changes in muscle strength.

(III) Metabolic Effects:

  • Increased metabolic rate, chemical reactions (enzymatic reactions)

(IV) Altered Tissue Extensibility:

  • Increased collagen extensibility
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11
Q

Five uses of superficial heat = ?

Thermal Agents: Thermotherapy

A

Uses of Superficial Heat:

  1. Pain Control
  2. Increased ROM
  3. Decreased Joint Stiffness
  4. Accelerated Healing
  5. Infrared Radiation for Psoriasis
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12
Q

Contraindications AND precautions for thermotherapy use include = ?

6/10

Thermal Agents: Thermotherapy

A

Thermotherapy Use:

(a) Contraindications:

  • Recent or potential hemorrhage
  • Thrombophlebitis
  • Impaired sensation
  • Impaired mental ability
  • Malignant tumor
  • Infrared irradiation of the eyes

(b) Precautions:

  • Acute injury or inflammation
  • Pregnancy
  • Impaired circulation
  • Poor thermal regulation
  • Edema
  • Cardiac insufficiency
  • Metal in the area
  • Open wound
  • Where topicals have recently been applied
  • Demyelinated nerves
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13
Q

Burns, fainting, bleeding, skin and eye damage are examples of = ?

Thermal Agents: Thermotherapy

A

Adverse Effects of Thermotherapy:

(I) Burns:

  • Excessive heat can cause protein denaturation and cell death.

(-) May occur when:

  • Heat is applied for too long
  • Heating agent is too hot
  • If heat is applied where protective vasodilatation does not occur.
  • Protein denaturation begins at 45d C or 113d F

Cell death occurs when cells maintains

  • 43 C (109 F) for 60 minutes, or
  • 46 C (115 F) for 7 minutes

(II) Fainting:

(III) Bleeding:

(IV) Skin and eye damage from Infrared irradiation:

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14
Q

Adverse Effects of Thermotherapy

Burns may occur when = ?

Thermal Agents: Thermotherapy

A

Burns:

(I) Excessive heat can cause protein denaturation and cell death.

(II) May occur when

  • Heat is applied for too long
  • Heating agent is too hot
  • If heat is applied where protective vasodilatation does not occur.
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15
Q

Research Suggest …

Does heat work = ?

Thermal Agents: Thermotherapy

A

Does Heat Work ?

(I) Effects of hot pack application before high intensity stretching on the quadriceps muscle.

  • Pain was reduced compared to stretching alone.
  • No significant difference in knee flexion AROM or stiffness.

(II) Superficial heat administration and foam rolling increase hamstring flexibility acutely; with amplifying effects.

  • Superficial heat + foam roll was most effective treatment with moderate correlation

(III) A Cochrane review of superficial heat or cold for low back pain.

  • Moderate evidence that heat wrap therapy provides short-term reduction in pain and disability.
  • Insufficient evidence on effects of cold for LBP and conflicting for heat/cold for LBP.
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16
Q

DISCUSSION

(a) Discuss and differentiate the 4 types of heat transfer…

  1. Conduction
  2. Convection
  3. Conversion
  4. Radiation

(b) Discuss the effects and use of heat…

(c) Practice asking about contraindications and precautions…

Thermal Agents: Thermotherapy

A

(a) Discuss and differentiate the 4 types of heat transfer…

  1. Conduction
  2. Convection
  3. Conversion
  4. Radiation

(b) Discuss the effects and use of heat…

(c) Practice asking about contraindications and precautions…

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17
Q

Application Instructions

Seven steps in the application process = ?

Thermal Agents: Thermotherapy

A

Application Process:

  1. Evaluate the patient’s problem and set the goals of treatment.
  2. Determine whether thermotherapy is the most appropriate intervention.
  3. Determine that thermotherapy is not contraindicated for this patient or this condition.
  4. Inspect the treatment area for open wounds andrashes, andassess sensation.
  5. Check the patient’s chart for anyrecord of previous adverse responses to heat or for any disease that may predispose the patient to an adverseresponse.
  6. Explain to the patient the procedure and the reason for applyingthermotherapy.
  7. Describethe sensations that the patient can expect to feel, mild warmth.
18
Q

Application Instructions

5 steps in selecting the proper modality = ?

Thermal Agents: Thermotherapy

A

Selecting Proper Modality:

  1. The body part to be treated and thedesired response.
  2. Best fit to location and size of area treated to contour to area.
  3. Easily applied in desired position.
  4. If ROM desired, applied in a way that allows for AROM/PROM.
  5. Reasonably Priced
19
Q

Application Instructions

Removing Process = ?

Thermal Agents: Thermotherapy

A

Removing Process:

(1) Inspect the treated area and assess the outcome of treatment.

(2) Assess for any adverse response

(3) Reevaluate the patient progress based on goals -

  • Re-measure quantifiable subjective complaints and objective impairments and disabilities.

(4) Document the intervention.

20
Q

DISCUSSION

Review the application process for thermotherapy…

Thermal Agents: Thermotherapy

A

Review the application process for thermotherapy:

21
Q

Thermotherapy Modalities

Three sizes for hot packs = ?

Thermal Agents: Thermotherapy

A

Hot Packs:

(a) Three sizes =

  • Standard Size: 12 x 12 for general use
  • Double Size: 24 x 24 for low back, buttocks
  • Cervical: 6 x 18

(b) Stored in hot water kept at about 70-75d C (158d F-167d F).

  • Hot pack should be reheated for at least 30 minutes between uses and for 2 hours or more before initial use.

(c) Layers required, do not apply hot pack directly on patient.

  • DO NOT allow patient to lay on hot pack
22
Q

Hot pack application:

  • How many layers of towels should be used = ?
  • How long should they be applied = = ?

Thermal Agents: Thermotherapy

A

Hot Pack Application:

(-) 6-8 layers

  • Hot Pack sleeve = 2-3 layers

(-) 20 min.

23
Q

Hot Packs:

  • Advantages = ?
  • Disadvantages = ?

Thermal Agents: Thermotherapy

A

Hot Packs:

(I) Advantages:

  • Easy to use
  • Inexpensive
  • Short use of clinician’s time
  • Low level of skill required for application
  • Can be used to cover moderate to largeareas
  • Safe because packs start cooling onremoval from water cabinet
  • Readily available

(II) Disadvantages:

  • Must be removed to view treatmentarea during treatment
  • Patient may not tolerate weight of hotpack
  • Pack may not maintain good contactwith small or contoured areas
  • Active motion not practical duringtreatment
  • Moderately expensive heating cabinet
24
Q

Three paraffin methods = ?

Thermal Agents: Thermotherapy

A

Paraffin Methods:

(1) Dip-wrap:

  • Most commonly used
  • Distal extremity

(2) Dip-immersion

  • Distal extremities

(3) Paint

  • Applied anywhere
25
Q

What should we do during the pre-paraffin application = ?

Thermal Agents: Thermotherapy

A

Pre-Paraffin Application:

  • Remove all jewelry from the area to be treated
  • Inspect thearea for open wounds or contraindications to heat
  • Thoroughly wash and dry the area to be treated to minimize contamination of theparaffin.
26
Q

Dip-Wrap Application = ?

Thermal Agents: Thermotherapy

A

Dip-Wrap Application:

  • With fingers apart, dip the hand into the paraffin as far as possible and remove.
  • Advise the patient to avoidmoving the fingers during the treatment because movement will crack the paraffin coating.
  • Advise the patient toavoid touching the sides or the bottom of the tank because these areas may be hotter than the paraffin.
  • Wait briefly for the layer of paraffin to harden and become opaque.
  • Re-dip the hand, keeping the fingers apart.
  • Repeat dip6-10 times
  • First, Wrap the patient’s hand in a plastic bag, wax paper, or treatment-table paper (Prevents towel from sticking)
  • Then wrap in a towel ortoweling mitt, (insulation to delay cooling).
  • Elevate the extremity.
  • Leave the paraffin in place for 10 to 15 minutes or until it cools.
  • When the intervention is completed, peel the paraffin off the hand and discard it
27
Q

What should we be cautious of during Dip-Wrap = ?

Thermal Agents: Thermotherapy

A

Caution during Dip-Wrap:

  • Caution the patient not to move the hand duringdipping orduring the rest period
  • Movement may crack the coating of paraffin, allowing air topenetrate andthe paraffin to cool more rapidly.
28
Q

Fluidotherapy:

  • Transfers heat via = ?

Thermal Agents: Thermotherapy

A

Fluidotherapy:

  • Dry heating agent
  • Transfers heat via convection
  • Cabinet contains finely ground cellulose particles made from corn cobs.
  • Heated air is circulated through particles suspending and moving them so they act like liquid.
  • Temperature and amount of particle agitation can be controlled.
29
Q

Fluidotherapy:

  • Advantages = ?
  • Disadvantages = ?

Thermal Agents: Thermotherapy

A

Fluidotherapy:

Advantages:

  • Patient can move during application towork on ROM
  • Minimal pressure applied to treatmentarea
  • Temperature well controlled andconstant throughout treatment
  • Easy to administer

Disadvantages:

  • Expensive equipment
  • Limb must be in dependent positionduring treatment
  • Constant heat may cause overheating
  • Corn cob particles spilled onto smoothfloor make floor dangerously slippery
  • Can’t apply to patients with cornallergies
30
Q

Infrared Lamps

Three bulletpoints for ‘process’ = ?

Thermal Agents: Thermotherapy

A

Infrared ( IR ) Lamps:

(a) Emit electromagnetic radiation within the frequency range that gives rise to heat when absorbed by matter.

  • Wavelengths of 770 nm to 106 nm
  • Clinically used IR lamps emit IR-A bands, 780-1500 nm with peak intensity around 1000 nm

(b) Safety First

  • Remove all clothing and jewelry in area
  • Both Wear opaque goggles

(c) Process

  • Positioned 20cm from heat source
  • Protective toweling to area outside of target area
  • Optimal absorption at perpendicular angle
  • Darker tissue absorbs more than lighter tissue – less treatment time needed
31
Q

Infrared Lamps

Tissue temperature increase is directly proportional to = ?

Thermal Agents: Thermotherapy

A

Infrared Lamps:

Tissue temperature increase is directly proportional to amount of radiation that penetrates the tissue

32
Q

Infrared Lamps:

Five variables = ?

Thermal Agents: Thermotherapy

A

Infrared Lamps - Variables:

  • Power
  • Wavelength
  • Distance from source
  • Angle of incidence
  • Absorption coefficient of the tissue
33
Q

Infrared Lamps

  • Advantages = ?
  • Disadvantages = ?

Thermal Agents: Thermotherapy

A

Infrared Lamps

Advantages:

  • No contact of medium with patientrequired
    • Decreased risk of infection
    • Decreased patient discomfort from weight ofapplication
    • No effect when treating contoured areas
  • Area being treated can be observedthroughout treatment

Disadvantages:

  • Not easily localized
  • Difficult to ensure consistent heating inall treatment areas.
34
Q

DISCUSSION

  • Differentiate between the different types of modalities…
  • Describe the paraffin and practice explaining it to a patient…

Thermal Agents: Thermotherapy

A

Discussion:

(a) Differentiate between the different types of modalities…

(a) Describe the paraffin and practice explaining it to a patient…

35
Q

Billing / Coding

Hot / Cold Pack = ?

Thermal Agents: Thermotherapy

A
  • Hot/Cold Pack = 97010

Billing / Coding

36
Q

Billing / Coding

Paraffin = ?

Thermal Agents: Thermotherapy

A

Paraffin = 97018

Billing / Coding

37
Q

Billing / Coding

Contrast Bath = ?

Thermal Agents: Thermotherapy

A

Contrast Bath = 97034

Billing / Coding

38
Q

Billing / Coding

Whirlpool Therapy = ?

Thermal Agents: Thermotherapy

A

Whirlpool Therapy = 97022

Billing / Coding

39
Q

Billing / Coding

Infrared Therapy = ?

Thermal Agents: Thermotherapy

A

Infrared Therapy = 97026

Billing / Coding

40
Q

Billing / Coding

What needs to be included in your documentation = ?

Thermal Agents: Thermotherapy

A

Documentation:

  • Area of body treated
  • Type of agent used
  • Treatment duration
  • Patient positioning
  • Patient response to intervention

Billing / Coding

DPT 690 - PT Interventions II (14 decks)

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