Ultrasound

Question 1

When acoustical energy is absorbed by tissue what is created?

Answer 1

Thermal energy is created

Question 2

Are tendons and ligaments dense tissues?

Answer 2

Yes

Question 3

Compression happens in what type of tissue?

Answer 3

Dense tissue

Question 4

Rarefraction happens in what type of tissue?

Answer 4

Less dense tissue

Question 5

What are the principles of acoustic energy?

Answer 5

• Propagation of US waves
• Production of compression and rarefractions
• effect on US on various tissue densities

Question 6

Is ultrasound more effective at heating dense tissues or less dense tissues?

Answer 6

Dense tissues

Question 7

What does alternating current cause the crystal in US sound head to do?

Answer 7

Causes the crystal to expand and compress at a fast rate

Question 8

What is the following a definition of?

Drawing in & drawing out of the shape of crystal

Answer 8

Piezoelectric effect

Question 9

What is the ERA?

ERA = effective radiating area

Answer 9

Smaller than the actual size of the sound head

Question 10

What are the frequencies that the ultrasound head can be placed at?

Answer 10

1 MHz, 3 MHz, 3.3 MHz

Question 11

Frequency and depth of penetration are ____ ____

Answer 11

inversely proportional

Question 12

Does tissue absorb heat faster at 1 MHz or 3 MHz?

Answer 12

3 MHz

Question 13

A frequency of 1 MHz will penetrate how deeply?

Answer 13

6 cm deep

Question 14

A frequency of 3 MHz will penetrate how deeply?

Answer 14

2.5 cm deep

Question 15

What are the guidelines for intensity?

Answer 15

No guidelines - follow how to pt feels and is responding to treatment

Question 16

What is the unit of measurement of dosage?

Answer 16

Joules (J)

Question 17

What mode is this?

US delivered at constant energy level throughout the treatment

Answer 17

Continous

Question 18

What mode is this?

energy flow cycles on/off

Answer 18

Pulsed

Question 19

What part of the Pulsed Mode of US is this?

Time energy is flowing?

Answer 19

Pulse duration

Question 20

What part of the Pulsed Mode of US is this?

‘on’ time (flow) + ‘off’ time (no flow)

Answer 20

Pulse Period

Question 21

What part of the Pulsed Mode of US is this?

‘on’ time / ‘on’ time + ‘off’ time

Answer 21

Duty cycle

Question 22

What is the following a definition of?

nonuniformity of acoustical energy at different parts of the collimated beam

Answer 22

Beam Nonuniformity Area (BNR)

Question 23

A low BNR (3 or less) will do what?

Answer 23

Minimize the pt’s discomfort

Question 24

What is this purpose for?

Distribute ‘hot spots’ around the treatment area and avoid burns (discomfort) by continually moving the ultrasound head

Answer 24

Beam Nonuniformity Area (BNR)

Question 25

How big should the treatment area for US be?

Answer 25

No larger than 2-4x the treatment area (ERA)

Question 26

What heats faster with ultrasound, muscle or achilles tendon?

Answer 26

Achilles tendon

Question 27

What angle should the incident angle be at to avoid reflection of the US waves

Answer 27

90 degrees

Question 28

How fast should the sound head be moving during treatment?

Answer 28

2 cm/sec to 6 cm/sec

Question 29

# What research design is the following? RCT's with an active interventin, appropriate control groups, and subjects randomly assigned to each group

Answer 29

Class I

Question 30

# What research design is the following? Active intervention and control group without randomization to groups

Answer 30

Class II

Question 31

# What research design is the following? Active intervention but without control groups; these are often single group designs

Answer 31

Class III

Question 32

# What research design is the following? Single-subject 'experimental' designs and observational studies that involve case control, cohort, and case studies

Answer 32

Class IV

Question 33

# What type of theraputive effectiveness is this? number of studies reporting improvement is greater or equal to 60%

Answer 33

Substantiated

Question 34

# What type of theraputive effectiveness is this? number of studies reporting improvement is less than 60% but greater than or equal to 40%

Answer 34

Conflicting

Question 35

# What type of theraputive effectiveness is this? number of studies reporting improvement is less than 40%

Answer 35

Unsubstantiated

Question 36

# What type of theraputive effectiveness is this? < 5 studie of any type

Answer 36

Lack of evidence

Question 37

# What type of Strength of evidence is this? 50% or more of the studies are in class I

Answer 37

Strong evidence

Question 38

# What type of Strength of evidence is this? > 50% of the stuides are in class I, II, and III

Answer 38

Moderate evidence

Question 39

# What type of Strength of evidence is this? > 50% of the studies are in class IV

Answer 39

Weak evidence

Question 40

# What type of Strength of evidence is this? fewer than 5 studies reporting on the outcomes under investigation

Answer 40

Lack of evidence

Question 41

# Which part of the body does this evidence support? - benefit for pain - conflicting evidence for increased pain threshold - unsubstantiated effect on cervical ROM

Answer 41

Myofascial pain

Question 42

# Which part of the body does this evidence support? - conflicting evidence - no definitive conclusions

Answer 42

Back pain

Question 43

# Which part of the body does this evidence support? - Insufficient evidence for thermal US - no evidence of pulsed information US

Answer 43

Shoulder pain

Question 44

# Which part of the body does this evidence support? - little evidence to support use of theraml or nonthermal US

Answer 44

Lateral epicondylitis

Question 45

# Which part of the body does this evidence support? - strong substantial evidence for thermal US - Reduction of pain and improved functional outcomes

Answer 45

Carpal tunnel syndrome

Question 46

# Which part of the body does this evidence support? - Parameters widely varied - Evidence for thermal US for pain & dysfunction

Answer 46

Calcific tnedonitis

Question 47

# Are the following contraindicatios or precautions? continous or pulsed? - Pregnancy - Active bone growth at epiphysis - cancer - tuberculosis infection - hemorrhagic conditions - impaired circulation - myositis ossificans - deep vein thrombosis - acute injury - recently irradiate tissue - impaired sensation or cognition and communication - skin disease - pacemaker - reproductive organs - anterior neck - metal implants over chest, heart or head

Answer 47

Contraindications of continous US

Question 48

# Are the following contraindicatios or precautions? continous or pulsed? - Plastic or cemented implants - spinal cord and superfical or regenerating nerves

Answer 48

Precautions of continous US

Question 49

# Are the following contraindicatios or precautions? continous or pulsed? - pregnancy - cancer - hemmorhagic conditions - myositis ossifcans - deep vein thrombosis - recently irrated tissue - pacemaker - reproductive organs - eyes - anterior neck - metal implants over heart, head, or chest

Answer 49

Contraindications of Pulsed US

Question 50

# Are the following contraindicatios or precautions? continous or pulsed? - Active bone growth at epiphysis - areas of infections - acute injury - impaired sensation - impaired cognition or communication - impaired circulation - skin disease - plastic or cemented implants - spinal cord and superficial or regnerating nerves

Answer 50

Precautios of Pulsed US

Question 51

# What is the following a definition of? - Use of US to enhance delievery of topical agents through the skin - 'pushing' molecules and increased permeability - poor evidence for either mechanism

Answer 51

Phonophoresis