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Integumentary Mid Term > Ultrasound/ Ionto > Flashcards

Ultrasound/ Ionto Flashcards

1
Q

What is ultrasound?

A

is the application of high frequency sound waves beyond human audibility

arguably most effective deep heating tissue modality

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2
Q

Why is ultrasound effective?

A

provides heat to soft tissues with minimal increase in superficial temperature

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3
Q

How is ultrasound wave produced?

A

an alternating current passes through the crystal which causes crystal to vibrate which then creates high frequency sound waves

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4
Q

What is this process called?

A

reverse piezoelectric effect, expanding and compression of crystal produces heat

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5
Q

What does ERA stand for?

A

effective radiating area, area of US head that actually produces soundwaves, smaller than US head

described in cm2

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6
Q

What is the intensity formula for US?

A

watts/ERA= x w/cm2

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7
Q

What is size of treatment area in relation to ERA?

A

2-3 times the size of ERA

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8
Q

What is the beam profile?

A

describes the idea that multiple waves emerge from the head and the spatial peak intensity is farthest away from head

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9
Q

What is BNR?

A

beam non-uniformity ratio, measures consistency and quality of the crystal

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10
Q

Is a 6:1 or 4:1 ratio better for BNR?

A

4:1 as it will produce less high intensity areas and reduce risk of burn

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11
Q

What are two types of modes of application for ultrasound?

A

continuous and pulsed

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12
Q

What is continuous ultrasound?

A

outflow is 100%, can produce thermal effects based on intensity and tx duration

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13
Q

How deep can continuous go?

A

3-6 cm maybe deeper

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14
Q

What is pulsed?

A

produces non thermal effects

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15
Q

What is duty cycle equation?

A

pulse length/ (pulse length+ pulse interval) x 100

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16
Q

What are the two output frequencies most commonly used with US?

A

1 and 3 MHz

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17
Q

Which frequency goes deeper?

A

1mHz- goes 3-6 cm deep, thermal effects last longer

3 mhZ- 1-2 cm, heats 3 times faster than 1 mhZ

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18
Q

What are biophysical effects of US?

A

non thermal- changes within tissue resulting from mechanical energy

thermal- changes in tissue direct result of US elevation of tissue

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19
Q

Why would we want non thermal effects?

A

acute injury, wound healing

times when we don’t need inflammation

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20
Q

What are two ways non thermal can be achieved?

A

1) using pulsed output, duty cycle at 20–50%

2) continuous output with very low intensity (less than0.3 w/cm2

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21
Q

What are thermal effects of US?

A

1 degree- increase metabolism

2-3- decrease pain/spasm, increase blood flow, reduces chronic inflammation

4- increase collagen elasticity and extensibility

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22
Q

How does US directly reduce pain?

A
  1. increased nerve cell sodium permeability
  2. alters nerve function
  3. increases pain thresholds
23
Q

How does US indirectly reduce pain?

A
  1. increase blood flow
  2. increase capillary permeability
  3. increase oxygen delivery
  4. decreased muscle spasm
24
Q

How does US reduce muscle spasm?

A
  1. decreased pain
  2. altered nerve conduction velocity
  3. increased temp.
  4. muscle relaxation
25
Q

How does US effect tissue elasticity?

A

by heating collagen rich tissues (tendon, fascia, scar tissue)

26
Q

How long is stretching window after US?

A

3 minutes!!

27
Q

What type of wounds can be helped by US?

A

skin ulcers- 3 mhZ, low intensity output

surgical wounds- may increase granulation

cover with hydrogel or transparent film

28
Q

How can US help fracture healing?

A

mechnaical sound energy strikes bone, microvibration of bone triggers growth (osteogenesis) and osteoblastic activty

29
Q

What type of fractures can be helped with US?

A

acute, nonunion, stress

30
Q

What is phonophoresis?

A

use of US to assist with diffusion of medicine through the skin

31
Q

How does phono work?

A

increases diameter of skin portals to allow the meds to pass through hair follicles, pores and sweat glands

32
Q

What part of skin must meds diffuse from?

A

enzymatic barrier of epidermis, stratum corneum

meds stored in subcutaneous tissues for some time before going deeper

33
Q

What helps medicine uptake?

A

hydrated skin, high density of skin portals, highly vascularized, thin skin, younger aged pts

34
Q

What speed should the sound head be moved at?

A

4 cm/sec, faster movements decrease effectiveness

35
Q

What is example of direct coupling methods and why is it used?

A

gels or creams, b/c loss of consistent skin contact can damage the crystal

36
Q

What is example of indirect coupling agent?

A

water or gel filled bladder used for small or irregular areas, should be 1/2 -1 inch from skin and still kept moving

increase dosage

37
Q

What are US indications?

A

pain control, increase collagen extensibility, tissue and bone healing

38
Q

US contraindications?

A

cancer, pregnancy (avoid area of fetus), CNS tissue, joint cement, plastic or metal, pacemaker, thrombophlebitis (blood clot), hemophilia, decreased sensation or circulation

39
Q

What are possible contraindications?

A

over spinal cord s/p laminectomy, epiphyseal plates, fx site, breast implants, acute inflammation

40
Q

What is iontophoresis?

A

electrical repulsion of ions using direct current used for pain, inflammation and many other disorders

41
Q

What is theory behind ionto?

A

charges from meds can drive meds into tissue, meds must have an electrical charge

42
Q

What is the intensity of ionto machine?

A

3-5 mA

43
Q

What is typical treatment time?

A

10-20 minutes checking every3-5 minutes for skin

44
Q

What is dosage expressed in?

A

milliampere-minutes (mA-min)

total dosage delivered= current x treatment time

45
Q

what is typical ionto drug dose?

A

40 mA-min

46
Q

Contraindications of ionto?

A

same as US plus:

uncontrolled HTN, PVD, hx of seizures, confused pt, obesity

acute inflammation stage

47
Q

What is charge of anode and cathode?

A

anode= positive

cathode = negative

remember opposites attract, same charge repulses

48
Q

What is charge of acetic acid and use?

A

negative so place meds on cathode

myositis ossificans, calcific deposits

49
Q

Calcium chloride?

A

pos.

scar tissue, keloids

50
Q

copper sulfate?

A

pos. so place on anode

fungal infections

51
Q

Dexamethasone?

A

inflammation, negative

52
Q

Lidocaine?

A

pain control, pos.

53
Q

magnesium sulfate?

A

ms spasms, ischemia

pos.

54
Q

zinc oxide?

A

skin ulcers, wounds

pos.

Integumentary Mid Term (11 decks)

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