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Modalities > Ultrasound - Phonophoresis - Iontophoresis > Flashcards

Ultrasound - Phonophoresis - Iontophoresis Flashcards

1
Q

Ultrasound, iiontophoresis, phonophoresis

What US Beam Non-Uniformity Ratio is considered acceptable?

A

6:1

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2
Q

Ultrasound, iiontophoresis, phonophoresis

US over or near electronic implants?

A

no, contrainidicated

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3
Q

Ultrasound, iiontophoresis, phonophoresis

US over a thrombotic area?

A

no, contraindicated

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4
Q

Ultrasound, iiontophoresis, phonophoresis

Acustic impedance:

A

a property of a tissue defined as density of tissue and velocity of sound in that tissue.

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5
Q

Ultrasound, iiontophoresis, phonophoresis

The reverse of the piezoelectric effect converts ….

A

when a material capable of generating piezoelectricity is exposed to an electric field, it will undergo mechanical deformation.

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6
Q

Ultrasound, iiontophoresis, phonophoresis

US over a malignant area?

A

no, contraindicated

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7
Q

Ultrasound, iiontophoresis, phonophoresis

What is the US frequency?

A
  • Determines the depth of the tissues affectect
    • 1 MHz penetrates >2cm deep
    • 3 MHz penetrates 1-2 cm deep
  • Number of times per second that a pulse, cycle, beat will repeat itself
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8
Q

Ultrasound, iiontophoresis, phonophoresis

What do you instruct (expectations) the pt prior to US application?

A
  • Pt should feel some warmth within 2 to 3 minutes of initiating US when thermal effects are applied
  • What about using US for its nonthermal effects?
  • Pt should not feel increased discomfort at any time during the treatment
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9
Q

Ultrasound, iiontophoresis, phonophoresis

Therapeutic Ultrasound uses the mechanical energy from sound waves to create ____________ or _____________ effects

A
  • thermal
  • mechanical
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10
Q

Ultrasound, iiontophoresis, phonophoresis

US Absorption:

A
  • Absorption is the main form of attenuation. Absorption happens as sound travels through soft tissue, the particles that transmit the waves vibrate and cause friction and a loss of sound energy occurs and heat is produced. In soft tissue sound intensity decreases exponentially with depth.
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11
Q

Ultrasound, iiontophoresis, phonophoresis

US over Pelvic abdominal/ lumbar region of pregnant or menstruating women

A

no, contraindicated

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12
Q

Ultrasound, iiontophoresis, phonophoresis

delivery mode determines what?

A

continuous vs pulsed

thermal vs. mechanical effects

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13
Q

Ultrasound, iiontophoresis, phonophoresis

What is attenuation?

A
  • Measure of the decrease in sound energy as it travels (via absorption, refraction,
    reflection)
  • absorption
  • Generally tissue high in protein and collagen absorb US best.

​

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14
Q

Ultrasound, iiontophoresis, phonophoresis

Ultrasound frequency determines what?

A

depth of therapeutic effects

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15
Q

Ultrasound, iiontophoresis, phonophoresis

What is the piezoelectric effect?

A

the ability of certain materials to generate an electric charge in response to applied mechanical stress.

The word Piezoelectric is derived from the Greek piezein, which means to squeeze or press, and piezo, which is Greek for “push”.

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16
Q

Ultrasound, iiontophoresis, phonophoresis

Low-Intensity Pulsed Ultrasound is used for:

Frequencies?

Type of effects?

A
  • Medium Frequencies (1.5 MHz) & low intensities
  • Used for bone healing for fresh and slow to heal bone fractures
  • Mechanical effects
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17
Q

Ultrasound, iiontophoresis, phonophoresis

What is the strenght of research evidence for using US for post exercise muscle soreness?

A

strong

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18
Q

Ultrasound, iiontophoresis, phonophoresis

US area to be treated:

A
  • Depends on the ERA and duration of treatment
  • Impractical to treat areas less than 1.5 X ERA
  • Preferably 2-3 X ERA
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19
Q

Ultrasound, iiontophoresis, phonophoresis

There is strong evidence to show that the main, and only, target tissue for LIPUS therapy is

A

bone

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20
Q

Ultrasound, iiontophoresis, phonophoresis

US research based inidications:

A
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21
Q

Ultrasound, iiontophoresis, phonophoresis

US Reflection

A
  • When a sound wave is incident on a interface between two tissues, part of it is reflected back into the original medium. The amount of energy reflected back depends on impedance.
  • The greater the difference in impedance between the tissues forming the interface the greater the amount of energy that is reflected back.
  • Impedance is a property of a tissue defined as density of tissue and velocity of sound in that tissue.
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22
Q

Ultrasound, iiontophoresis, phonophoresis

US over an ischemic (poor vascularity) area?

A

no, contraindicated

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23
Q

Ultrasound, iiontophoresis, phonophoresis

US over spinal cord after laminectomy?

A

no, contraindicated

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24
Q

Ultrasound, iiontophoresis, phonophoresis

How does US controls pain?

Which type of US is best in controlling pain?

A
  • By altering the transmission or perception of pain or by modifying the underlying condition causing the pain.
  • Some studies have indicated that continuous US may be effective for reducing pain
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25
Q

Ultrasound, iiontophoresis, phonophoresis

What is the physiological change of rising tissue temperature by:

1 C?

2-3C?

4 C or more?

A
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26
Q

Ultrasound, iiontophoresis, phonophoresis

2 main types of US

A

diagnostic US

therapeutic US

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27
Q

Ultrasound, iiontophoresis, phonophoresis

US over gonads?

A

no, contraindicated

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28
Q

Ultrasound, iiontophoresis, phonophoresis

Knowing the concept of BNR, what do I need to do during my application of the sound head transducer to avoid spatial peak concentrations in tissue?

A
  • Move it
  • Apply on areas that are 3 to 4 times the size of the ERA
    • ERA = Effective Radiating Area
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29
Q

Ultrasound, iiontophoresis, phonophoresis

US over epiphysial plate?

A

no, contrainidicated

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30
Q

Ultrasound, iiontophoresis, phonophoresis

Ultrasound is sound traveling through a medium at frequencies
above the upper limit of human audibility of:

A

> 20 kilohertz

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31
Q

Ultrasound, iiontophoresis, phonophoresis

In ultrasound, the lower the number MHz the ________ it penentrates

A

deeper

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32
Q

Ultrasound, iiontophoresis, phonophoresis

Conventional Ultrasound is used for:

frequency?

A
  • soft tissue conditions
  • thermo-mechanical effects
  • (heat up the tissue or “cellular massage”)
  • 1 - 3 MHz
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33
Q

Ultrasound, iiontophoresis, phonophoresis

US Intensity:

A
  • Amount of acoustic power measured in watts per unit area of the transducer ERA (W/cm2)
  • Beam Non-Uniformity Ratio: the sound beam is greater in the center than at the edges of the ERA.
    • ERA= Effective Radiating Area
34
Q

Ultrasound, iiontophoresis, phonophoresis

Duty Cycle of US:

A
  • Duration in terms of percentage
  • Duty Cycle (%) = on/ (on + off) x 100
  • (2s/ 2+8) x 100 = 20%
  • What would be the duty cycle for a continuous mode?
35
Q

Ultrasound, iiontophoresis, phonophoresis

What can higher spatial peaks (US) create in the soft tissue?

A

burns

36
Q

Ultrasound, iiontophoresis, phonophoresis

Types of therapeutic US:

A
  1. Conventional US (most common used in clinic)
  2. Low-intensity pulsed US
  3. Noncontact Low Frequency US (MIST therapy)
37
Q

Ultrasound, iiontophoresis, phonophoresis

Recommended frequency of treatment for nonthermal US during subacute or chronic
phase of healing:

A

may be as frequent as daily

38
Q

Ultrasound, iiontophoresis, phonophoresis

US over the eyes?

A

no, contraindicated

39
Q

Ultrasound, iiontophoresis, phonophoresis

What type of US is indicated for soft tissue extensibility and increase joint ROM when applied conjunction with stretching?

Dosimetry?

A
  • continuos US (conventional)
  • Recommended that stretching be applied during heating by US and maintained for 5 to 10 minutes after US
40
Q

Ultrasound, iiontophoresis, phonophoresis

What is the strenght of research evidence for using US for perineal lesions?

A

strong

41
Q

Ultrasound, iiontophoresis, phonophoresis

Indications for US use:

A
  • Shoft tissue shortening (CUS)
  • Pain control (Nociceptive)
  • Dermal ulcer (NCLFUS)
  • Surgical skin incisions (NCLFUS)
  • Tendon and ligament injuries (CUS)
  • Resorption of calcium deposits
  • Bone fracture (LIPUS)
42
Q

Ultrasound, iiontophoresis, phonophoresis

US over an infected lesion?

A

no, contraindicated

43
Q

Ultrasound, iiontophoresis, phonophoresis

Recommended frequency of treatment for thermal US during subacute or chronic
phase of healing:

A

3 X/week recommended

44
Q

Ultrasound, iiontophoresis, phonophoresis

US over plastic and cemented implants?

A

no, contrainidicated

45
Q

Ultrasound, iiontophoresis, phonophoresis

Noncontact Low-Frequency Ultrasound (MIST Therapy System) is used for what?

Type of effects?

Frequecy?

A
  • Low frequency (40 kHz) & low intensities
  • Used for dermal wound healing
  • Mechanical effects
46
Q

Ultrasound, iiontophoresis, phonophoresis

US over a hemorrhagic area?

A

no, contraindicated

47
Q

Ultrasound, iiontophoresis, phonophoresis

Would I want to use an US device with a lower or higher BNR?

A

lower 6:1 ratio

48
Q

Ultrasound, iiontophoresis, phonophoresis

What are spatial peak and spatial average intensities?

A
  • Spatial Peak= highest peak intensity (approx. central 1/3 of sound head)
  • Spatial Avg*= average intensity projected
    • Also known as Spatial average temporal average intensity used for pulsed US: ISATA= ISATP (total energy) x duty cycle
49
Q

Ultrasound, iiontophoresis, phonophoresis

How is Beam Non-Uniformity Ratio calculated?

A
  • Calculated by ratio of:
  • Spatial Peak intensity and Spatial Average intensity
50
Q

Ultrasound, iiontophoresis, phonophoresis

Ultrasound (in general) targets which type of tissue?

A

protein rich type of tissue (tendon, ligaments, capsule, muscles)

51
Q

Ultrasound, iiontophoresis, phonophoresis

What is the strenght of research evidence for using US for ankle sprains?

A

strong

52
Q

Ultrasound, iiontophoresis, phonophoresis

By how many degrees C must the tissue temperature be increased in order to reduce pain and muscle spasm and increase blod flow?

A

2 - 3 C

53
Q

Ultrasound, iiontophoresis, phonophoresis

By how many degrees C must the tissue temperature be increased in order to increase collagen extensibility?

A

4 C

54
Q

Ultrasound, iiontophoresis, phonophoresis

By how many degrees C must the tissue temperature be increased in order to increase metabolic rate?

A

1 C

55
Q

Ultrasound, iiontophoresis, phonophoresis

the lower the impedance the ________ transmission and the ________ the absorption

A

higher transmition - lower absortion

56
Q

Ultrasound, iiontophoresis, phonophoresis

Use of US to drive whole molecules (drug) across the skin into the tissue to deliver the drug for local or systemic effects

A

phonophoresis

57
Q

Ultrasound, iiontophoresis, phonophoresis

in phonophoresis, active transport of the topical drug occurs as a result
of what type of mechanisms?

A

thermal and nonthermal mechanisms

58
Q

Ultrasound, iiontophoresis, phonophoresis

Medications commonly applied using phonophoresis?

A
  • Anti-inflammatories: hydrocortisone
  • Analgesics: lidocaine
59
Q

Ultrasound, iiontophoresis, phonophoresis

the method of delivering medicated ions through the skin to a localized area via direct electrical current:

A

Iontophoresis

60
Q

Ultrasound, iiontophoresis, phonophoresis

Indications for use of iontophoresis

A
  • Localized inflammatory soft tissue conditions (uses Dexamethasone [-] as an anti-inflammatory)
  • Localized pain stemming from soft tissue injury (uses lidocaine [+] as a local anesthetic)
  • Calcific tendonitis, myositis ossificans (uses Acetic Acid [-] to increase solubility of calcium deposits)
  • Skin ulcers (uses Zinc Oxide [+] acts like a general antiseptic)
  • Hyperhidrosis (uses tap water [+/-] to decrease sweating of palms, feet, axillae)
61
Q
A

Anodal inotophoresis

62
Q

Ultrasound, iiontophoresis, phonophoresis

Types of iontophoresis

A
  • Anodal iontophoresis = phoresis of positively charged drug under active electrode
  • Cathodal iontophoresis = phoresis of negatively charge drug under active electrode
    • (NO-BLACK-CAT)
63
Q

Ultrasound, iiontophoresis, phonophoresis

What type of medication and Iontophoresis is used for localized inflammatory soft tissue conditions?

A
  • cathodal
  • uses Dexamethasone [-] as an anti-inflammatory
64
Q

Ultrasound, iiontophoresis, phonophoresis

What type of medication and iontophoresis is used for localized pain stemming from soft tissue injury?

A
  • uses lidocaine [+] as a local anesthetic
  • anodal
65
Q

Ultrasound, iiontophoresis, phonophoresis

What type of medication and iontophoresis is used for Calcific tendonitis, myositis ossificans ?

A
  • uses Acetic Acid [-] to increase solubility of calcium deposits
  • cathodal
66
Q

Ultrasound, iiontophoresis, phonophoresis

What type of medication and iontophoresis is used for Skin ulcers?

A
  • uses Zinc Oxide [+] acts like a general antisepti
  • anodal
67
Q

Ultrasound, iiontophoresis, phonophoresis

What type of medication and iontophoresis is used for Hyperhidrosis?

A
  • uses tap water [+/-] to decrease sweating of palms, feet, axillae
  • anodal or cathodal
68
Q

Ultrasound, iiontophoresis, phonophoresis

Which iontoporesis electrode conductive surface area should be larger?

A

cathode area should be larger regardless of whether the cathode is used as the active or dispersive electrode

69
Q

Ultrasound, iiontophoresis, phonophoresis

iontoporesis electrododes incorporates 2 layers:

A
  • 1st layer acts as a buffer
  • 2nd layer is a drug reservoir
70
Q

Ultrasound, iiontophoresis, phonophoresis

Max recommended iontoporesis CD for the active electrode is:

A

0.5 mA/cm2

71
Q

Ultrasound, iiontophoresis, phonophoresis

iontoporesis current density formula

A

max recommended safe CD for the active electrode is 0.5 Ma/Cm^2

CD = current amplitude / electrode conductive surface area

72
Q

Ultrasound, iiontophoresis, phonophoresis

When the conductive surface area = 6cm^2 what is the maximun safe current amplitude?

A

CD = current amplitude / surface area

current amplitude = CD X surface area

= 0.5 mA/cm^2 X 6

= 3 mA

73
Q

Ultrasound, iiontophoresis, phonophoresis

iontoporesis dosage formula

A
  • The dose (mA.min) = Amplitude (mA) X Time (min)
  • Typical dose: 40 mA.min
  • Time = 40mA / amplitude
74
Q

Ultrasound, iiontophoresis, phonophoresis

what is the tx duration when the dose is 40mA.min and the current amplitude is 4 mA?

A

The dose (mA.min) = Amplitude (mA) X Time (min)

time = 40 mA.min / 4 mA

= 10 minutes

75
Q

Ultrasound, iiontophoresis, phonophoresis

frequency and number of treatments for use of iontoporesis?

A
  • depends on the condition
  • usually no more frequent than every 2 days to allow for the skin to recover from the effects of the DC
  • 2-5 treatments
  • Continued iontophoresis treatments without evidence of effectiveness cannot be justified
  • Occurrence of adverse effects would preclude continuation of treatment
  • medicated electrode can be left in place for 12 to 24h to enhance initial treatment
76
Q

Ultrasound, iiontophoresis, phonophoresis

Normal responses to iontoporesis

A
  • should only feel a strong tingling under the electrodes
  • if unconfortable decrease amplitude, but increase time
  • must monitor pt response throughout
  • skin may be slightly pink or white post application
77
Q

Ultrasound, iiontophoresis, phonophoresis

Advantages and disadvantages of iontoporesis:

A
  • Advantages: non-invasive, safer than neddle injection,not systemic effects (as with oral meds), somwhat painless
78
Q

Ultrasound, iiontophoresis, phonophoresis

Iontoporesis over damaged skin and open skin lesions?

A
79
Q

Ultrasound, iiontophoresis, phonophoresis

Iontoporesis over known sensitivity areas or allergic to the therapeutic ions areas?

A

No, contrainidicated

80
Q

Ultrasound, iiontophoresis, phonophoresis

Iontoporesis over metal implants?

A

No, contrainidicated

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