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PTI II > Thermal Physiology and Modalities > Flashcards

Thermal Physiology and Modalities Flashcards

(97 cards)

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1
Q

Decision making process

A

asses the pt

look at your toolbox of multiple modalities

determine the most appropriate modality

be sure to check the precautions and contraindications for the modality you are considering

check the parameters

is the modality cost effective?

will the modality allow for safety?

does the pt understand what the goals of the modality are?

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2
Q

indications for thermotherapy

A

sub-acute/chronic conditions

pain

decreased ROM

resolution of edema (post inflammatory phase)

myofascial trigger points

muscular conditions

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3
Q

could you use heat during the inflammatory phase

A

NO

most of the time use cold

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4
Q

contraindications of thermotherapy

A

acute musculoskeletal conditions (if the injury just occurred)

impaired circulation

vascular disease (PVD)

skin anesthesia (they can’t feel the heat)

open wounds or skin conditions

acute DVT

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5
Q

why don’t you want to use heat on an acute DVT

A

you don’t want to dislodge a clot and move it

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6
Q

physiological effects of local superficial heating on tissues

A

dilation –> increased circulation (blood flows throughout the body more efficiently)

reduction of sympathetic impulses –> increase blood flow to venous plexuses

increased metabolic rate

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7
Q

consensual heat vasodilation

A

remote vasodilation in response to heating

is a good response

joint/musculoskeletal tissue loosens, more effective when we use interventions

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8
Q

2 types of penetration

A

deep

superficial

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9
Q

what would we use to penetrate heat to deeper tissues

A

diathermy or ultra sound

increase tissue temp w/ increased blood flow

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10
Q

what would we use to penetrate heat to superficial tissues

A

hot pack

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11
Q

effects of heat

A

increase local temp

increased local metabolism

vasodilation

increase BF

increased release of leukocytes and phagocytes

increased capillary permeability

increased lymph and venous drainage

increased removal of metabolic waste

analgesia

decrease mm tone

decrease spasm

increased tissue elasticty

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12
Q

methods to apply therapeutic heat

A

hot pack (conduction)

paraffin bath (conduction)

fluidotherapy (convection)

infared (radiation)

hydrotherapy (convection)

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13
Q

what is conduction

A

heating up locally

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14
Q

what is convection

A

moving particles around

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15
Q

hot pack unit temp

A

166-175 F

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16
Q

how long does the heat pack stay on

A

15-20 minutes

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17
Q

how many layers of toweling for hot packs

A

6-12

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18
Q

what do we want to avoid with hot packs

A

the pt lying on the hot pack directly

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19
Q

what temp should the paraffin unit be at

A

126 F

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20
Q

how much more heat does paraffin provide than water

A

6x

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21
Q

what is the equipment used for paraffin

A

unit

towels

plastic bags

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22
Q

what’re the methods for applying paraffin

A

dipping

painting

submersion

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23
Q

how many layers do we apply of paraffin

A

6-10

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24
Q

how long do we use paraffin

A

20 minutes

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25
how do we prepare the pt for paraffin treatment
ensure the body part is cleansed and dried (could use gel hand sanitizer) inspect for any cuts, irritation, sensitivity or redness
26
can we reuse paraffin
yes cleaner to just throw out and replace
27
what is the standard formula for infrared lamps
20 in for 20 minutes
28
equipment for IR
lamp dry toweling moist toweling
29
fluidotherapy machine
through convection heats up a joint
30
physiologic effects of cold
decreased local temp decreased metabolic rate local vasoconstriction decreased nerve conduction velocity depressed excitability of free nerve endings and peripheral nerve fibers control of pain control of edema
31
in what stages of healing can we use cold
all 3 stages
32
how do we determine the extent of cooling to use
type of cooling method duration of treatment thickness of the surface its on body part
33
cold physiology
initial response to cold is vasoconstriction hunting's response hypothalamus induces shivering arterial vasoconstriction result in increased blood pressure and heart rate
34
hunting's response to cold
prevents local tissue damage secondary to vasoconstriction
35
indications to use cold
acute pain edema myofascial trigger points muscle guarding and spasm acute muscle strain bursitis tendinotis DOMS spasticity
36
contraindications of cold
impaired circulation vascular disease (PVD) hypersensitivity to cold skin anesthesia open wounds or skin conditions infection
37
purpose of cutaneous circulation
nutrition temp regulation
38
cutaneous blood vessel types
subcutaneous venous plexus arteriovenous anastomoses
39
subcutaneous venous plexus
conduct heat to the skin surface
40
arteriovenous anastomoses
maximal constriction at 59 F below 59F, dilation caused by local effects of cold of the vessels this produces paralysis of the contractile mechanism of the vessel wall or blockage of nerve impulses into internal vessels ***always check on our pateints***
41
where are col, warm and pain receptors found
subendothelially
42
what happens to pain receptors at extreme temps
transmit in response to possible tissue damage
43
how do warm and cold receptors react
they readily adapt
44
what happens when larger surface areas are treated
vasomotor centers and the hypothalamus are activated
45
summary of the effects of cold
decreased local temp decreased metabolism vasoconstriction decreased blood flow decreased nerve conduction velocity decreased mm extensibility extreme anesthesia effects
46
what are contrast baths used for
used for sub-acute swelling and pain
47
what are contrast baths
having a hot and cold bath going back and forth
48
what does a contrast bath do
desensitizes and creates vasodilation/vasoconstriction response
49
equipment for contrast baths
2 large containers thermometer towels ice chips
50
what is the hot contrast bath set to
80-104 F
51
how long do you stay in the hot bath
at first 3-4 minutes, then 2-3 minutes every time, last time should be 5 minutes (end with it)
52
what is the cold contrast bath set to
55-67F
53
how long do you stay in the cold bath
2-3 minutes
54
what do we do upon completion
check girth of skin has the swelling gone down?
55
do we always start with a larger degree change
no it should be gradual
56
ice massage
apply continuously until numb watch for dripping water position carefully
57
how do we apply ice massage
in a circular pattern each stroke should cover 50% of the previous stroke
58
physiologic response to ice massage
cold stinging pain numbness
59
cold hydrocollator pack freezer temp
10-25 degrees
60
how should we position the pt while using a cold hydrocollator pack
w/ protective toweling body part in elevated position in the acute and subacute phase
61
how long should treatment with a cold hydrocollator pack be
20 minutes the pt has to be still
62
what happens if a cold hydrocollator pack is left on for prolonged periods
decrease mm tone
63
ice packs use
used for acute injuries to prevent additional swelling following exercise wouldn't be put directly on pts skin
64
treatment with an ice pack
position pt secure pack cover w/ towel to prevent heat loss up to 20 min
65
what is hydrotherapy
"Water healing" application of water for physical or psychological dysfunction
66
types of hydrotherapy
whirlpool hubbard tank contrast baths pool non immersion irrigation devices
67
indications for hydrotherapy
wound treatment enhanced environments for therex pain control/reduction edema health maitenance
68
properties of water
high specific heat thermal conductivity buoyancy resistance hydrostatic pressure
69
specific heat of water
4x that of air water hold 4x as much thermal energy things will heat up quicker in water
70
thermal conductivity
25x greater than air
71
modes of heat transfer
conduction convection radiation
72
buoyancy
upward thrust on the body opposite to the force of gravity
73
Archimedes principle
a body immersed or partially immersed in a fluid at rest experienced an upward thrust = to the weight of the fluid it displaces different bodily tissue shave different specific gravity values
74
resistance
increases in water occurs against the direction of motion in proportion to the speed of the body's motion and frontal area of the body in contact w/ the water variable
75
hydrostatic pressure
pressure exerted by a fluid on a body immersed in fluid pascal's law
76
pascal's law
fluid exerts equal pressure on all body surfaces at rest at a given depth and this pressure increased in proportion to the depth of immersion as you get deeper in water, pressure increases equal pressure on the body on all surfaces at rest
77
uses of hydrotherapy
superficial heating/cooling wound care pain control edema control
78
contraindications for hydrotherapy
superficial heat and cold anesthesia maceration around wound bleeding
79
precautions for hydrotherapy
impaired thermal sensation infection in area to be immersed impaired cognition/confusion areas of recent skin grafts
80
full body immersion precautions
confusion/disorientation alcohol ingestion medications urinary incontinence fear respiratory problems (COPD, asthma)
81
what happens to those with respiratory problems w/ full body immersion
extra pressure will be put onto the chest wall in water
82
full body immersion contraindications
cardiac instability possible spread of infection bowel incontinence severe epilepsy suicidal
83
whirlpool equipment
tank agitator stainless steal many body part sizes
84
how does cold whirlpool transfer hear
convection
85
how will you know to use cold whirlpool
it will be indicated when exercise during icing is desired
86
how long does one immerge in a cold whirlpool
5-15 minutes
87
what is the temp of the cold whirlpool
65-80 degrees
88
what should we be cautious about with cold whirlpool
gravity dependent positions can increase swelling a wet compressive wrap should be put on the part prior to treatment cover toes for comfort stay with patient
89
what is the most intense application of cold
cold whirlpool
90
whirlpool temp ranges
cold whirlpool tepid neutral warmth mild warmth hot very hot
91
cold whirlpool
32-79F acute condition won't usually go below 65F
92
tepid
79-92 cannot tolerate colder
93
neutral warmth
92-96F open wound
94
mild warmth
96-98F burns relax pt
95
hot
99-104F pain increases extensibility
96
very hot
104-110F chronic condition double check pt can tolerate
97
documentation
type of modality used pt position temp of water of dips, towels, distance, etc. duration outcome of response to treatment BE SPECIFIC ADD ANY CAHNGES DURING TREATMENT

PTI II (6 decks)

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