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133 Cards in this Set
- Front
- Back
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What is accommodation?
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When a nerve and muscles membranes threshold for excitability increases secondary to stimulation by a pulse that has a slow phase rise time. Quicker the rise time, the less the nerve can accommodate
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What is an ampere?
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Unit of measure to describe rate of current
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What is amplitude?
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Magnitude of current, often labeled Volt or Intensity
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What is anode?
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Positively charged electrode that attracts negative ions during direct current
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What is capacitance?
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a property of an insulator that allows for the storage of energy when the opposing surfaces of the insulator have an electrical potential difference
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What is a cathode?
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Negatively charged electrode that attracts positive ions used during direct current e-stim
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What is Chronaxie?
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Testing procedure to measure amount of time required to produce a small muscle contraction at a particular intensity
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What is conductance?
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Describes ease at which a particular material will allow current flow (mho)
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What is current?
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Describes the flow of electrons from one place to another.
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What is direct current?
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constant unidirectional flow of ions. Direction of current is dependent on polarity
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What is duty cycle?
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The percentage of time the electrical current is on in relation to the entire treatment time.
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What is electrical impedance?
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Resistance of a tissue to electrical current
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What is Frequency?
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Determines number of pulses delivered through each channel per second. Labeled rate
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What is high volt current?
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Waveform greater than 150V with a short pulse duration.
Intermittent Used for deeper tissue penetration |
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What is impedance?
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Property of a substance that provides resistance to flow of current by offering an alternate current
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What is inductance?
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describes how easily a certain material will induce an electromotive force (emf) within a circuit.
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What is Interpulse Interval?
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Period of time of electrical inactivity between each pulse, expressed in microseconds
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What is an ion?
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Positively or negatively charged ion
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What is a low-volt current?
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waveform less than 150V and used for neuromuscular stimulation
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What is a negative ion?
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Has gained one or more electrons and possesses a negative charge
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What is Ohm's law?
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There is a direct proportional relationship between current and voltage and an indirect proportional relationship between current and resistance
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What is a positive ion?
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Has lost one or more electrons and possesses a positive charge
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What is a pulse?
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One individual waveform
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What is a pulse duration?
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Amount of time it takes to complete all phases of a single pulse.
Pulse duration=pulse width |
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What is a pulsed current?
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Allows for non-continuous flow of either alternating or direct current with periods of no electrical activity
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What is a ramp?
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Number of seconds it takes for amplitude to gradually increase or decrease to the max value set by amplitude control
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What is Resistance?
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Ability of a material to oppose the flow of ions through it
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What is Rheobase?
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Minimal intensity used with a long current duration that produces a small muscle contraction
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What is a Volt?
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Unit of measure of electrical power or electromotive force
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What is a waveform?
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consistent pattern of a current measured on an oscilloscope
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What is minimal assist?
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pt requires 25% assist from therapist to complete task
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what is moderate assist?
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pt requires 50% assist from therapist to complete task
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What is maximum assist?
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pt requires 75% assist from therapist to complete task
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When is a sliding board transfer used?
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pt who has some sitting balance, some upper extremity strength, and can follow directions; PT is in front of patient
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When is a stand pivot transfer used?
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for pt who can stand and bear weight through one or both Les, must possess functional balance to pivot
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When is a dependent squat pivot transfer used?
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pt can bear some weight through trunk and LEs
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What is adult standard wheelchair width?
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18 inches
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what is standard adult wheelchair seat depth?
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16 inches
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What is standard adult wheelchair seat height?
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20 inches
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What is standard adult wheelchair back height?
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16 to 16.5 inches
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What is standard adult wheelchair armrest height?
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9 inches above the chair seat
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how do you measure wheelchair Seat height/Leg length?
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Measure from user’s heel to popliteal fold and add 2inches to allow clearance of foot rest
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How do you measure wheelchair seat depth?
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Measure from user’s posterior buttock along lateral thigh to popliteal fold, then subtract 2 inches
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how do you measure wheelchair seat width?
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Measure the widest aspect of user’s buttocks, hips or thighs and add 2 inches (provides enough space for bulky clothing, orthoses, clearance of trochanters from armrest side panel.
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How do you measure wheelchair back height?
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measure from seat of chair to floor of axilla with user’s shoulder flexed to 90 degrees and then subtract 4 inches. This allows final back height to be below the inferior angle of the scapula.
-Person should be measured while on seat cushion or the thickness of the cushion must be added back in |
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how do you measure wheelchair armrest height?
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Measure from seat of the chair to olecranon process with user’s elbow flexed to 90 degrees and then add approximately 1 inch.
-Person should be measured while on seat cushion or the thickness of the cushion must be added back in |
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how are axillary crutches measured?
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o Crutches 6 inches in front and 2 inches lateral to patient
o No greater than 3 finger width under axilla o Hand grip height should allow 20-25 degrees elbow flexion while grasping o Platform attachment can be used |
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how are loftstrand crutches measured?
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o Allows 20-25 degrees elbow flexion while holding handgrip
o Crutches should be 6 inches in front and 2 inches lateral o Arm cuff should be 1-1.5 inches below olecranon process |
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what is the purpose of an arterial line?
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measures BP or obtains blood samples
More accurate than traditional method of BP measuring |
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What is an external catheter?
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applied over shaft of penis and held in place by padded strap/adhesive tape
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What is a foley catheter?
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indwelling urinary tract catheter that has a balloon attachment at one end
Balloon must be deflated before removing catheter |
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What is the purpose of an IV line?
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Catheter inserted into vein, to infuse fluids, electrolytes, nutrients, and medication.
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Where is an IV line trypically inserted?
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into superficial veins such as basilic, cephalic, or antecubital
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What is max oxygen a patient can receieve through nasal cannula?
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6 liters per minute
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What is the purpose of a NG tube?
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Used for liquid feeding, medication administration, or removing gas from stomach
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What is a suprapubic catheter?
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Indwelling urinary catheter surgically inserted directly into bladder. Performed under general anesthesia
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What is the purpose of a Swan-Ganz catheter?
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Inserted through vein into pulmonary artery
Continuous measurements of pulmonary artery pressure Pts can exercise with it in place |
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Describe the inflammatory phase of tissue healing
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Lasts 1-6 days
Required for healing to occur Presents with calor (heat), rubor (redness), tumor (swelling), dolor (pain) Clot formation and phagocytosis occur |
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Describe the proliferation phase of tissue healing
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Day 3-20
Involves connective tissue and epithelial cells Epithelialization, collagen production, wound contracture, and neurovascularization occur |
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Describe the maturation phase of tissue healing
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Day 9 to ongoing
Can last over one year Progression towards restoration of prior function of injured tissues Collagen synthesis and lysis balance Collagen fiber orientation |
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What is a keloid scar?
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when collagen production exceeds collagen lysis, extends beyond original boundaries of injury and damages healthy tissue
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What is a hypertrophic scar?
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raised but stays within boundaries of original injury
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What are indications for Cryotherapy?
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acute or chronic pain, myofascial pain syndrome, muscle spasm, Bursitis, Tendonitis, reduction of spasticity, acute/subacute inflammation, musculoskeletal trauma
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what are contraindications for Cryotherapy?
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o Area of compromised circulation
o Peripheral Vasular disease (PVD) o Ischemic tissue o Cold hypersensitivity, Raynaud’s o Cold urticaria (rash) o HTN o Infection o Cryoglobulinemia |
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Describe the stages of perceieved sensation of cryotherapy?
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1. Intense cold within 3 minutes
2. Aching/burning 4-7 minutes 3. Anesthesia to analgesia 8-15 minutes 4. Numbness from 15-30 minutes |
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Which type of cryotherapy has most magnitude?
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ice massage
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What are the parameters for a cold pack?
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Parameters: 23 degrees F, apply for 15 minutes (30 min to reduce spasticity)
-Requires observation every 10 minutes -Applied every 1-2 hours for reduction of inflammation and pain control -Apply with moist towel |
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what are the parameters for a cold bath?
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55-64 degrees F, body part immersed for 5-15 minutes
Water with crushed ice can be used |
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'What are the parameters for Vapocoolant spray?
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Identify trigger point and make 2-5 sweeps with spray in direction of muscle fibers.
-Keep spray 12-18 inches from skin and apply at 30 degree angle -Stretching should begin while applying spray and continue with steady tension and stretch -Repeated applications during sessions are safe if skin is rewarmed in between |
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What are contraindications to superficial heating agents?
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o Circulatory impairment
o Area of malignancy o Acute musculoskeletal trauma o Bleeding or hemorrhage o Sensory impairment o Thrombophlebitis o Arterial disease |
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what are the parameters of fluidotherapy?
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Body part put in first, then turned on
Temperature 111-125 degrees F Treatment time 20 min Protective covering over any open areas |
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What are parameters for hot pack?
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Hot water 158-167 degrees F
6-8 towel layers around hot pack If pt lies on top of hot pack, additional layers are required Skin checks required after 5 minutes Pt must have call device to notify PT of discomfort Treatment time 20 minutes |
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how far does an Infrared lamp penetrate?
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Less than 1-3 millimeters
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what are the parameters for infrared lamp?
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Pt positioned 20 inches from source
Moist towel placed over treatment area and skin monitored intermittently throughout Treatment time 20 min |
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what are the parameters for Paraffin?
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Temperature between 113-126 degrees F
Dip-wrap method: re-dip 6-10 times, then wrap in plastic bag with towel around limb to insulate it. Keep in bag for 15-20 min Dip-reimmersion method: after 6-10 dips, place it back in paraffin for 20 min Paint method: used for body parts that can’t be immersed in bath |
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name the general superficial heating agents
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Hot pack
Fluidotherapy Paraffin Infrared lamp |
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Name deep heating agents
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US
Diathermy |
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What are the benefits of a capacitive plate method for diathermy?
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-Field radiation is strong electrical field, weaker magnetic field
-Energy absorbed most within skin and less into deeper structures -Heating pattern superficial -Application over areas of low-fat content |
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What are the benefits of an inductive plate method for diathermy?
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-Field radiation is strong magnetic field and weaker electrical field
-Energy absorbed in deeper structures, muscle and synovial fluid -Heating pattern deeper -Application over areas of high water content |
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What are contraindications of diathermy?
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Low back, abdomen, pelvis of pregnant woman
Internal and external metal objects Eyes Malignant area Intrauterine device Cardiac pacemaker Pain and temperature sensory deficits Moist wound dressing Over hemorrhagic region Testes Acute Inflammation Ischemic tissue |
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What are indications for diathermy?
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decreased collagen extensibility, pain, tissue healing, chronic inflammatory pelvic disease, muscle guarding, DJD, joint stiffness, bursitis, peripheral nerve regeneration, chronic inflammation
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what are parameters for diathermy treatment?
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-Select the right technique based on patient exam
-Pt must remove all metal and jewelry in area surrounding tx site -If using coils, towel must be wrapped around extremity first -When using drum, place it right over treatment area -If using capacitive applicator, place 2 plates over both sides of tx area, equidistant -Pt should be checked after first few min, should have call bell -Treatment time 15-30 minutes |
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what is depth of penetration of 3MHz frequency ultrasound?
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1-2 centimeters
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what is depth of penetration for 1MHz frequency ultrasound?
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up to 5 centimeters
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what are contraindications for ultrasound?
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Over eyes, pregnant uterus, heart, testes, malignancy, cemented prosthetic joint, epiphyseal areas in children
Impaired circulation, pain or temperature sensory deficits Infection Thrombophlebitis |
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what are treatment parameters for ultrasound?
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-An area 2-3 times transducer duration of 5 min treatment time
-Thermal effects: 100% duty cycle, intensity between .5 to 2W/cm squared -Non Thermal effects: 20% duty cycle, intensity between .5 to .75W/cm squared |
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What is beam nonuniformity ratio?
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Ratio of highest peak to the average intensity of all peaks
-Want BNR LOW |
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what is Phonophoresis?
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Use of Ultrasound to administer anti-inflammatory and analgesic medications, can be effective with pulsed or continuous
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Name the 6 properties of Water.
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Total Drag Force
Specific Heat Specific Gravity Buoyancy Resistance Hydrostatic Pressure |
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What is hydrostatic pressure?
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Water exerts pressure that is perpendicular to the body and increases in proportion with depth of immersion
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what are contraindications for Hydrotherapy?
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PVD
Gangrene Bowel/bladder incontinence Advanced cardiopulm disease Buerger’s disease with contrast bath Impaired circulation Renal infection Bleeding surface area Diminished sensation |
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Describe the treatment temperature guidelines for Hydrotherapy
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Degrees F Purpose
32-79 Acute inflammation of distal extremities 79-92 Exercise 92-96 Wound care, spasticity 96-98 Cardiopulm compromise, treatment of burns 99-104 Pain management 104-110 Chronic Rheumatoid Arthritis or Osteoarthritis, increased ROM |
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What are the parameters for a contrast bath?
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-Start with extremity in hot whirlpool 100-110 degrees for 3-4 minutes, then place extremity in cold water 55-67 degrees for one minute.
-Repeat sequence for 20-30 min -Pt should end treatment in hot whirlpool -Used primarily with arthritis of smaller joints, musculoskeletal sprains and strains, RSD, and to desensitize residual limb post amputation |
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what are contraindications to mechanical traction?
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When motion is contraindicated
Joint instability Tumor Pregnancy Acute Inflammatory response Acute sprain Osteoporosis Fracture |
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what are the treatment parameters for cervical traction?
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pt should be supine with head in 25-35 flexion or in sitting position
start with force of 10-15 lbs and progress to 7% pts body weight as tolerated for separation of vertebrae. |
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What are the parameters for lumbar spine traction?
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supine or prone, treatment time 5-20 minutes
Initially, start with less than half pt’s body weight, 25-50lbs Force of up to 50% is required for actual separation of vertebrae |
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What are contraindications for compression?
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Malignancy of treated area
DVT Unstable or acute fracture Heart failure Infection of treated area Pulmonary edema Circulatory obstruction |
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What are treatment parameters for compression?
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3:1 ratio used for on/off time with 40-100 seconds inflation, 10-35 seconds deflation
Inflation pressure ranges from 30-80mmHg and should not exceed pt’s diastolic BP Treatment of UE usually 30-60mmHg Treatment of LE usually 40-80mmHg Treatment time: 2-4hrs per day, 3X per day to 3X per week When treatment over, PT should reassess extremity, girth measurements and BP |
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what is the purpose of UV therapy?
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Treat skin disorders: chronic wound/ulcer, acne, psoriasis, osteomalacia, Vit D deficiency
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how far into skin does UV therapy go?
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1-2 millimeters
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what are contraindications to UV therapy?
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Photosensitive medication
Lupus Erythmatosus Tuberculosis Herpes Simplex Renal or hepatic pathology Diabetes Melitus Pellagra (vitamin deficiency B3) |
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What are treatment parameters for UV therapy?
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Prior to tx must obtain minimal erythemal dose (MED)
MED=time of exposure needed to produce an area of mild redness between 8-24 hrs after treatment Visual inspection after 8 hr period will determine MED Lamp at 90 degree angle to area of treatment and distance of 24-40 inches from forearm Squares exposed for 15,30,45,60, and 75 seconds Treatment time should increase with each treatment since skin adapts to UV exposure |
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What are the contraindications to massage?
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Infection
Arterioslerosis Thrombus Cellulitis Acute injury Embolus Cancer |
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What are parameters for massage?
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Start and end with effleurage
Intensity should progressively increase then decrease Lubricant indicated with all strokes except friction massage Treatment time: Back 15 minutes, smaller area 8-10 minutes |
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When is friction massage used?
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Chronic inflammation or overuse injuries
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what are the goals of Petrissage massage?
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Loosen adhesions
improve lymphatic return facilitate removal of metabolic waste from treatment area |
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What is the purpose of tapotement massage?
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Enhance circulation and stimulate peripheral nerve endings
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What is the purpose of using vibration massage?
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relaxation
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What are contraindications to Electrotherapy?
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o Cardiac pacemaker
o Patient with bladder stimulator o Use of carotid sinus o Seizure disorders o Phlebitis o Malignancy o Over pregnant uterus o Cardiac arrhythmia o Osteomyelitis |
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When is an alternating current used in electrotherapy?
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muscle retraining, spasticity, and stimulation of denervated muscle.
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What is Interferential Current?
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Combines two high frequency alternating waveforms that are biphasic, uses shorter pulse widths. Attempts to reach deeper tissues with high frequency
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What are treatment parameters for IFC for pain management?
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Frequency 50-120 pulses per second
Pulsewidth 50-150 microseconds |
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What are treatment parameters for IFC for muscle contraction?
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Frequency: 20-50 pulses per second
Pulse Width: 100-200 microseconds |
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What are contraindications for IFC? (5)
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Malignancy
All types of electronic implants During first trimester of pregnancy Over lower abdomen/uterus during pregnancy Over anterior transcervical area |
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How does Russian current work?
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strengthens the muscle groups of otherwise healthy individuals and athletes by
Depolarizing both sensory and motor nerve fibers resulting in tetanic contractions that are painless and stronger than voluntary contractions |
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What are contraindications for russian current?
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Over abdominal/pelvis area of pregnant woman
Over area of hemorrhage Malignancy Over anterior cervical area Over electronic implants |
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What are parameters of russian current?
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10 contractions of 10 seconds each and 50 second rest period in between each of the 10 contractions
Average peak current amplitude of 100mA, 50 bursts per second, with an on/off time ratio of 10/50 |
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What are contraindications of TENS unit?
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Cardiac pacemakers (relative contraindication)
Epilepsy During first trimester of pregnancy Over lower abdomen/uterus during pregnancy Over anterior neck |
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What are treatment parameters for TENS unit?
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Frequency 50-150 Hz
Duration: 20-100 microseconds Amplitude: 10-30mA Patient should feel tingling |
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What is an acidic reaction to Iontophoresis?
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skin hardens over time
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What is an alkalinic reaction to Iontophoresis?
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skin softens over time
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What is a redox reaction?
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decomposition of water when an electrical current is passed through it. Water will be reduced to net accumulation of hydrogen ions under the anode, and hydroxyl ions under the cathode.
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What are parameters for Iontophoresis?
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Pt should never lie on top of electrodes
Use continuous direct current Polarity must be set to the same polarity of the ion solution Negative cathode should be twice the size of the positive anode Active electrode placed over the target area and the disperse pad as far from target area as possible. Slowly increase intensity towards maximum of 5 milliamperes. Treatment 15-20 minutes, additional time required for treatment at less than 5 milliamps Must monitor pt during tx to ensure no burns under electrode |
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What are the positive ions used for Iontophoresis?
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Lidocaine
Lithium Hydrocortisone Histamine Magnesium Zinc |
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What are the negative charges used for Iontophoresis?
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Acetate
Dexamethasone Salicylate Iodine Chlorine Tap water (+ and -) |
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What are parameters for HPVC?
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Phase duration: 5-20 microseconds
Pulse width: 100-200 microseconds Voltage 150V-500V 1 large dispersive pad along with one, two, or four electrodes Electrodes can be positive or negative in polarity |
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What are parameters for HPVC for wounds?
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One electrode over wound (using warm sterile gauze and sponge) and the other over healthy skin a minimum of 5 cm away.
Polarity in reversal mode so 50% with negative polarity and 50% with positive polarity Frequency: 30-200 pulse per second Amplitude: 1-500V Duration of treatment: 10-60 min per session. Dermal wounds treated 5-7 days per week for best result |
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What are contraindications for HPVC?
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o Cardiac pacemakers (relative contraindication)
o Over heavy scarring tissue o Malignancy o Over abdomen/uterus during pregnancy o Over anterior neck o Over osteomyelitis |
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When do you use indwelling electrodes for EMG?
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for smaller or deep muscles or when need to record a single motor unit potential.
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What do fibrillation potentials on an EMG indicate?
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LMN syndrome
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What do positive sharp waves seen on EMG indicate?
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denervated muscle disorders at rest, primary muscle disease like MD
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What do fasciculations seen on EMG indicate?
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irritation/degeneration of anterior horn cells, nerve root compression, or muscle spasms
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What do repetitive discharges seen on EMG indicate?
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: lesions of anterior horn cell and peripheral nerves; myopathies
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