US Lecture Flashcards
1
Q
how does US work?
A
electrical current is applied to quartz crystal and generates ultrasonic sound waves the leads to vibration in the tissues
2
Q
t/f: US works through reverse piezoelectric effects
A
true
3
Q
is 1 or 3 MHz US deeper?
A
1 MHz
4
Q
what should be considered in the efficacy of US?
A
calibration status
beam profile of the crystal applicator
effective radiating area of the crystal applicator
power and intensity
5
Q
t/f: 39-85% of US machines in the USA didn’t meet 2 or more US performance standards
A
true
6
Q
with the beam non-uniformity ratio (BNR) in US, does a higher or lower value give a better beam and more consistent beam?
A
a lower BNR value (5 or less)
7
Q
what is the unit for the effective radiating area (ERA) in US?
A
W/cm^2
8
Q
what coupling mediums are used in US?
A
gel, other solutions, temp, direct, and indirect techniques
9
Q
what are the direct techniques for applying coupling mechanisms in US?
A
US gel and US lotion
10
Q
what are the indirect techniques for applying coupling mechanisms in US?
A
water bath
hydrogel
mist
surgical glove/condom filled with water
11
Q
how much gel is needed in US?
A
only ~5mm of gel bw the skin and head
12
Q
the tx are is ___x the head size
A
2
13
Q
how fast should we move the US wand to avoid burns?
A
1-2cm/sec
14
Q
t/f: US required constant motion of the tool
A
true
15
Q
the US head should be applied ___deg to the tx surface
A
90
16
Q
t/f: US can be theramal or nonthermal
A
true
17
Q
is pulsed US thermal or non thermal?
A
non thermal
18
Q
is continuous US thermal or non thermal?
A
thermal
19
Q
what is the depth of penetration of 1 MHz US?
A
1-2 inches (2.5-5cm)
20
Q
the 1MHz US can reach down to what structure?
A
the periosteum
21
Q
the 3 MHz US can reach down to what structures?
A
fascia and subQ fat
22
Q
what is the depth of penetration of 3 MHz US?
A
up to 1 inch (2.5cm)
23
Q
t/f: if the pt feels a stinging/needling sensation, you aren’t moving the US head fast enough
A
true
24
Q
what are the parameters for 3MHz needed to reach mild US (1deg C) thermal effects?
A
0.5 W/cm^2 x 3min
1.0 W/cm^2 x 1.5min
25
what are the parameters for 1MHz needed to reach mild US (1deg C) thermal effects?
1.0 W/cm^2 x 4.5 min
1.5 W/cm^2 x 3min
26
what are the parameters for 3MHz needed to reach moderate US (2deg C) thermal effects?
0.5 W/cm^2 x 6min
1.0 W/cm^2 x 3min
27
what are the parameters for 1MHz needed to reach moderate US (2deg C) thermal effects?
1.0 W/cm^2 x 9 min
1.5 W/cm^2 x 6min
28
what are the parameters for 3MHz needed to reach vigorous US (4deg C) thermal effects?
0.5 W/cm^2 x 12min
1.0 W/cm^2 x 6min
29
what are the parameters for 1MHz needed to reach vigorous US (4deg C) thermal effects?
1.0 W/cm^2 x 18 min
1.5 W/cm^2 x 12min
30
what are the subthermal effects of US?
dec pain
dec ms tone/spasticity
inc circulation
facilitate and promote tissue healing
31
t.f: subthermal US can help dec scars, acute pain, hematoma, RA pain, CTS, neuroma
true
32
t/f: subthermal US can minimize hematoma and ecchymosis
true
33
t/f: subthermal US can facilitate tissue healing in tendons, ligs, wounds, and bone
true
34
t/f: subthermal US is great for bruising and edema
true
35
what are the mechanisms of action of US?
acoustic streaming
stable cavitation
micromassage
local interface heating
36
what is involved in the acoustic streaming mechanism of US?
it pushes fluid in the same direction (pebble in a pond)
37
what is involved in the stable cavitation mechanism of US?
collapse of bubbles increases cellular permeability and membrane profusion
38
what is involved in the micromanage mechanism of US?
pulsed US stimulates GTOs, stretch receptor, and mechanoreceptors=dec spasm/tone/pain
39
all actions of US tried to contribute to what effects?
break up calcific deposits
stimulate tissue metabolism
reduce edema
reduce pain
dec muscular tone
40
what is the strength of evidence of US for myofascial pain syndrome trigger points?
strong for p/ppth/ROM
41
what is the therapeutic effectiveness of US for myofascial pain syndrome trigger points?
dec pain-substantiated
inc in pressure-pain threshold-conflicting
inc in cervical ROM-unsubstantiated
42
what is the recommended tx parameters for US to treat myofascial pain syndrome trigger points?
1-3MHz
continuous
1-2 W/cm^2
10 min
3-5x/wk
2-4 wks
43
what is the strength of evidence of US for back pain?
strong for both p/f
44
what is the therapeutic effectiveness of US for back pain?
dec back pain-substantiated
improve fxn-substantiated
45
what is the recommended tx parameters for US to treat back pain?
1MHz
continuous
1-2 W/cm^2
10 min
3x/wk
4 wks
46
what is the strength of evidence of US for shoulder conditions (non-specific)?
lacking for pain, mod for f
47
what is the therapeutic effectiveness of US for shoulder conditions (non-specific)?
dec pain-lacking evidence
improving fxn-substantiated
48
what is the recommended US tx parameters for shoulder conditions (non-specific)?
1 MHz
continuous
0.5-2 W/cm^2
10 min, 3-4x/wk
accompanied by stretching and exercise
49
what is the strength of evidence of US for lateral epicondylitis (inflammation)?
lacking evidence <5
50
what is the therapeutic effectiveness of US for lateral epicondylitis (inflammation)?
dec pain-conflicting
51
what is the recommended tx parameters for US to treat lateral epicondylitis (inflammation)?
1 MHz
pulsed 25%
1-2 W/cm^2
5-10 min
2-3x/wk
3-4 wks
52
what is the strength of evidence of US for CTS (inflammation)?
strong p/f, lacking NCS
53
what is the therapeutic effectiveness of US for CTS (inflammation)?
dec pain-substantiated
improve fxn-substantiated
54
what is the recommended tx parameters for US to treat CTS (inflammation)?
1 or 3MHz
continuous (may work with pulsed too)
0.5-1.5 W/cm^2
5-10 min
5x/wk
2-4 wks
55
what is the strength of evidence of US for calcific tendonitis (shoulder)?
moderate for pain/fxn
56
what is the therapeutic effectiveness of US for calcific tendonitis (shoulder)?
dec pain-substantiated
improve fxn-substantiated
57
what is the recommended tx parameters for US to treat calcific tendonitis (shoulder)?
1-3 MHz, continuous, 1-2 W/cm^2, 10 min, 3x/wk, 4-8 wks
2 studies: 20% pulsed, 1 MHz, 2-2/.5 W/cm^2, (+) results radiographs, pain, ROM
58
what is the strength of evidence of US for bursitis?
moderate
59
what is the therapeutic effectiveness of US for bursitis?
dec pain-substantiated (4)
improved fxn-substantiated (3)
60
what is the recommended tx parameters for US to treat bursitis?
1 MHz
continuous
1 W/cm^2
5-10 min
3x/wk
3-4 wks
61
what is the strength of evidence of US for arthritis (hip, knee, shoulder, hands)?
strong p/ROM, mod f
62
what is the therapeutic effectiveness of US for arthritis (hip, knee, shoulder, hands)?
dec pain-substantiated
fxn-conflicting
inc ROM-conflicting
63
what is the recommended tx parameters for US to treat arthritis (hip, knee, shoulder, hands)?
1MHz
continuous
1-2 W/cm^2
5-10 min
3x/wk
2-3 wks
Insufficient studies with pulsed US
64
what is the strength of evidence of US for improved tissue extensibility (adhesive capsulitis)?
strong
65
what is the therapeutic effectiveness of US for improved tissue extensibility (adhesive capsulitis)?
improved ROM-conflicting (insufficient power, tx area too large)
66
what is the recommended tx parameters for US to treat improved tissue extensibility (adhesive capsulitis)?
1-3 MHz
2-3 W/com^2
2-4x ERA
5-14 min
3x/wk
apply stretch during and 4-5 min after
67
have studies demonstrated effectiveness of continuous US on tissue swelling?
nope
68
does evidence show effects of US on scar tissue remodeling?
nope
69
what are common uses for pulsed US?
MTrPs
shoulder pain and dysfxn
CTS
calcific tendinitis
arthritis
ankle edema
70
t/f: there is strong evidence for US in myofascial pain
true
71
there is evidence for US in use for what conditions?
myofascial pain
CTS
dermal wounds
tissue extensibility
arthritis
CLBP
72
there is strong evidence for US for what conditions?
myofascial pain
back pain
back dysfxn
arthritis for pain
CTS pain and dysfxn
73
there is moderate evidence for US for what conditions?
nonspecific shoulder conditions
calcific tendinitis for pain and fxn
bursitis for pain and fxn
lateral epicondylitis
74
there is lacking evidence for US in what conditions?
trigger points
nonspecific shoulder conditions for pain and dysnfxn
lat epicondylitis
CTS
calcific tendinitis
arthritis
dermal wounds
ankle edema following acute sprain
75
US is most effective in treating what? how?
painful conditions by reducing pain
76
are improvements in fxn with US as robust as reduced pain?
no
77
what is a common use of pulsed US that actually has no effect?
pulsed US for inflammatory processes
78
how are chronic wounds managed (TIME)?
tissue debridement
inflammation control
moisture balance
epithelialization of wound edges
79
what is MIST US?
fine saline mist used with non-contact low frequency US to treat wounds (0.6 W/cm^2 @ 40kHz)
LOW intensity
80
what is phonophoresis?
the application of US to enhance the absorption of topical agents through the skin
81
are we going to see much change with phonophoresis?
not typically
82
what is the theory behind how phonophoresis works?
pressure drives the drug into the skin
tissue heating=vasodilation and increased drug absorption
change in permeability of the cell membranes allow the drug to diffuse into the skin
83
what drugs could be used for anti-inflammatory effects in phonophoresis?
hydrocortisone
dexamethasone
ketoprophen
84
what drug can be used for analgesic effects in phonophoresis?
lidocaine
85
what drug can be used for sclerolytic effects in phonophoresis?
iodine with methyl salicylate
86
what drug can be used to treat wounds in phonophoresis?
zinc
87
research has found that most drugs in phonophoresis don't actually get to and stay in the tissues they are intended to except for what drug?
ketoprophen
88
what is the technique for using phonophoresis?
select and apply med
select frequency based on target tissue
select sound head size
determine intensity (duty cycle)
determine tx duration based on intensity and duty cycle
89
who has to obtain a med script and the drug for phonophoresis and bring it each time?
the pt
90
can the clinic store the meds for phonophoresis?
nope, the pt has to bring it and take it back home each time they come in
91
t/f: some meds may require a special cream to be accepted by the phonophoresis mechanism
true
92
is phonophoresis with hydrocortisone and analgesics recommonded as of now? why or why not?
no bc there is conflicting evidence for it and there are many other approaches are available to treat pain and inflammatory conditions
