Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
93 Cards in this Set
- Front
- Back
|
Physical Agents |
........ |
|
|
What are the functions of the skin? |
-Largest organ in the body -Protection -Temperature regulation -Sensation -Water resistance |
|
|
How thick is the skin? |
-Thickness varies at different parts of the body -Eyelids-0.07-0.12 mm -Plantar aspect of the hand/foot-1.4-2.0 mm |
|
|
What types of therapy are used for acute inflammation? |
-Cryotherapy -Hydrotherapy -Shortwave diathermy -E-stim |
|
|
What types of therapy are used for chronic inflammation? |
-Heat -Ultrasound -Paraffin -Diathermy |
|
|
What types of therapy are used for fibroblastic repair/tissue proliferation? |
-Thermal agents -Electrotherapy -Hydroexercise -Contrast bath
|
|
|
What does the term "thermal" mean? |
Related to heat
|
|
|
What types of modalities are used for superficial penetration (1 cm of penetration)? |
-Hot packs -Whirlpool -Paraffin -Fluidotherapy -Infrared heat |
|
|
What types of modalities are used for deep penetration (3-5 cm of penetration)? |
-Ultrasound -Diathermy |
|
|
What is conduction? |
Energy exchange via collision of molecules that are of differing temperatures |
|
|
What is convection? |
Exchange via circulation of a medium around another material of differing temperature |
|
|
What is conversion? |
Changing a nonthermal form of energy into a thermal one |
|
|
What is radiation? |
Energy exchange from warmer to cooler material without direct contact |
|
|
What is evaporation? |
Material absorbs energy by changing from a liquid to a vapor |
|
|
What are the physiologic effects of heat transmission? |
-Circulatory/vascular -Metabolic -Neuromuscular -Immune -Systemic |
|
|
Superficial Thermotherapy |
Exciting!! |
|
|
What types of heat are considered superficial? |
-MOIST hot pack -Short wave diathermy -Paraffin -Fluidotherapy -Infrared heat
|
|
|
What are the goals and indications for superficial heat? |
1) Heat the area 2) Relax tissue or decrease tissue stiffness 3) Increase blood flow in preparation for movement 4) Prior to massage or manual work 5) Muscle spasms 6) In combination with other modalities 7) Prior to other modalities |
|
|
What are the precautions for superficial heat? |
-Make sure heating medium is kept at the correct temperature -Anything electric must be plugged into outlet with ground fault interrupter -Cover areas of active infection -Test sensation prior to application -Proper barrier between patient and heat source |
|
|
What are the general contraindications of superficial heat? |
-Active bleeding or presence of increased edema -Active blood clot -Poor circulation or sensation -Very old or very young -Peripheral vascular disease -Over malignancies -Pregnancy (can use distally to womb) |
|
|
How many layers must be between a hot pack and the patient's skin? |
Must have 6-8 layers between HP and pt.
(Hot pack covers are 2-3 layers each) |
|
|
What is the temperature of the hydrocollator water? |
70-75 degrees C or 158-167 degrees F |
|
|
How long does it take for a HP to reheat after use? |
30 minutes |
|
|
How long is a HP considered therapeutic? |
About 20 minutes, usual tx time= 10-15 mins |
|
|
What should you do during and after treatment with a HP? |
-Check on the pt throughout treatment to ensure they are not getting too hot -Always inspect skin after removing HP |
|
|
What are the advantages to HP use? |
-Easy to use and inexpensive -Minimal clinician contact time -Can be used to treat large areas |
|
|
What are the disadvantages to HP use? |
-Weight -Difficult to maintain contact in some positions -Cannot perform motion while in use |
|
|
What is the paraffin bath mixture? |
Paraffin wax mixed with mineral oil (6:1 or 7:1) |
|
|
What is specific heat? |
The amount of heat per unit of mass required to raise the temperature of a substance by 1 degree. |
|
|
What is the temperature of a paraffin bath? |
52-57 degrees C or 126-134 degrees F |
|
|
What are the dipping methods for paraffin bath? |
1) Dip and Wrap-dip 6 times, wrap in plastic, place in mitt or boot 2) Dip and immerse- dip 1 time to coat, wait about 15 secs then place back into bath for up to 20 minutes 3) Paint-paint on the extremity and then wrap
***Make sure pt washes hands |
|
|
What are the advantages to paraffin treatment? |
-Fits contoured areas -Inexpensive -Oil moisturizes skin -Available as a home unit
|
|
|
What are the disadvantages of paraffin treatment? |
-Messy -Cannot be used over an open wound, scar, or incision |
|
|
What is fluidotherapy? |
The use of a heated environment and cornmeal acting together as a liquid
Between 102 and 108 degrees F
Tx time 10-20 minutes |
|
|
What are the advantages to fluidotherapy? |
-Weightless -Constant temperature -Can exercise during treatment
|
|
|
What are the disadvantages to fluidotherapy? |
-Expensive -Constant heat means constant monitoring of patient -Cornmeal can spill out, getting on clothes |
|
|
What is infrared radiation? |
-Delivers electromagnetic radiation to the treatment site -Amount of heat/energy reaching the body part depends on distance between pt and lamp -Burning can be more common |
|
|
What is Whirlpool/Hydrotherapy? |
-A tank of water and a turbine to move the water around the area being treated
-10-30 min treatment time
-Used for pain control and improving soft tissue extensibility; higher end for OA, RA, and chronic conditions |
|
|
What are the three types of WPs and their temperatures? |
-Cold whirlpool-0-26 deg C or 32-79 deg F
-Purely for exercise-26-33 deg C or 79-92 deg F
-Hot whirlpool-37-43 deg C or 99-110 deg F
-Neutral whirlpool-92-96 deg F |
|
|
What are the advantages to WPs? |
-Multipurpose -Can exercise during treatment
|
|
|
What are the disadvantages to WPs? |
-Size of tank limits motion -Requires lots of water -Risk of infection -Cleaning costs and tim |
|
|
What is a contrast bath? |
-Immersing the extremity in cold bath followed by a warm bath to get effects of heating without increasing edema
-3-4 min warm water, 1 min cold water for 25 to 30 min |
|
|
What are the temperatures for the cold and hot baths? |
Cold bath- 10-18 deg C (50-64 deg F)
Warm bath- 38-44 deg C (100-111 deg F) |
|
|
What are the disadvantages and advantages to contrast baths? |
Advantage -Can exercise during treatment
Disadvantage -Annoying to hold extremity in cold water |
|
|
Deep Thermal Agents |
Are you still awake? |
|
|
What are the different types of deep thermal agents? |
-Therapeutic US-thermal or non-thermal -Diathermy -Phonophoresis
|
|
|
What are the physiological effects of deep thermal agents? |
-Increased extensibility of collagen in joint capsules and tendons -Decreased joint stiffness -Decreased muscle spasm -Modulation of pain -Increased blood flow -May reduce chronic inflammation |
|
|
What is ultrasound? |
-Acoustic energy beyond the audible range -Frequency > 20,000 Hz -Sound waves produce sinusoidal wave to vibrate tissue |
|
|
What size sound heads are available for the US machine? |
2, 5, and 10 cm2
|
|
|
What is the Effective Radiating Area (ERA)? |
The area of the sound head from which the wave travels |
|
|
A larger head produces what kind of wave compared to a smaller head? |
Large head=collimated=more focused
Small head=divergent=scattered |
|
|
What is frequency? |
The number of wave cycles completed per second (mHz) |
|
|
What are the two frequencies used? |
1mHz -Penetrates more deeply -Spread out beam
3 or 3.3 mHz -Penetrates more superficially -Focused beam
|
|
|
What is intensity? |
Power per unit area (w/cm2) |
|
|
What is attenuation? |
Intensity decreases as it travels through a material |
|
|
What is acoustical impedance? |
Resistance to flow of sound wave due to tissue composition |
|
|
What is spatial peak intensity? |
Peak intensity of US output over time; typically at the center of the beam |
|
|
What is spatial average intensity? |
Total power output of the US averaged over the area of the transducer; the therapeutic intensity |
|
|
What is Beam Nonuniformity Ration (BNT)? |
The amount of variability within the US beam (5:1 or 6:1-lower the ration, the more uniform) |
|
|
What is transmission? |
The transfer of sound wave from the crystal to the treated area; must have a medium to go through
*works best through solids of high density |
|
|
What is the Reverse Piezo-Electric Effect? |
Alternating current moves through the crystal producing compression or expansion or vibration thus generating US |
|
|
What are the two types of US? |
Continuous/Thermal Pulsed/Non-thermal |
|
|
What is: Temporal peak intensity? Temporal average intensity? Duty cycle? |
-Max intensity when the sound head is on -Power averaged for both on and off times (total treatment time) -Percentage of time that the US is being generated over one pulse period |
|
|
What is cavitation? |
The formation of gas-filled bubbles that expand and compress because of ultrasonically induced pressure changes in tissue fluid (what causes pain if the sound head does not move constantly) |
|
|
What is microstreaming? |
Pressure of the wave creates movement of fluids at the cellular level (the therapeutic aspect of US) |
|
|
Therapeutic Concepts/Effects of US |
-Absorption-highest in bony tissues -Scattering -Reflection-amount of wave that does not penetrate because of tissue impedance -Refraction-reflection of energy from a straight path **keep sound head in full contact -Penetration-depth of sound wave and treatment -Move the sound head at a speed of 4cm per sec
|
|
|
What are the indications for US? |
-Contractures -Chronic arthritis -Periarticular conditions -Muscular conditions -Neuromas -Plantar warts -Wounds -Hematomas |
|
|
What are precautions for US? |
-Check sensation -Sensitivity to pressure -Insure appropriate speed of movement -Choose appropriate intensity, frequency, and size of sound head |
|
|
What are contraindications for US? |
-Cardiac pacemaker -Pregnancy -Tumors -Thrombophlebitis -Spinal cord laminectomy -Growth plates -Eyes/reproductive organs -Cement on prosthesis |
|
|
What are the therapeutic indications for pulsed US? |
-Soft tissue repair -Tissue regeneration -Increased blood flow to ischemic tissue -Bone healing and repair of non-union fracture -Transdermal delivery of medication |
|
|
What are the proper preparations, procedures, and techniques? |
1) Clean skin and treatment areas 2) Set up parameters on US machine 3) Apply coupling medium 4) Clean sound head after each treatment |
|
|
General Treatment Parameters |
-Frequency -Acute injury-1-2x/day -Chronic-every other day -Speed-4 cm/sec -Treatment area-no greater than 2x sound head -Time-think about parameters |
|
|
What is phonophoresis? |
-Use of US waves to deliver medicaation -10% hcn solution typically used -Have Rx from Md -Typical course of treatment=6 -Usually done with lower frequency |
|
|
What is diathermy? |
-Application of high frequency electromagnetic energy to generate heat in the body's tissues -Frequency is similar to radio frequency
|
|
|
What are the parts of a diathermy unit? |
-Generator-power supply -Electrodes -Capacitor-stronger electrical field than a magnetic field (surrounds area) -Induction-stronger magnetic field than electrical field (does not go through area) |
|
|
What are the two types of diathermy? |
Shortwave diathermy-pulsed or continuous
and
Microwave which is not found in the U.S. |
|
|
What are the physiologic effects of diathermy? |
-Increased temperature and blood flow -Fibroblastic activity for cell regeneration -Reduced muscle spasm |
|
|
What are indication for diathermy? |
-Subacute and chronic inflammation -Joint impairments and muscle spasms -Arterial insufficiency -Sinus problems -Larger treatment areas
|
|
|
What are the precautions for diathermy? |
-Remove metal -Acute inflammation or bleeding -Reduced blood supply or sensitivity -Over fluid filled areas or organs -Over wound dressings -During menstruation -Heart problems in pt or PT/PTA |
|
|
What are contraindications for diathermy? |
-Pacemakers -Metal implants -Pregnancy -Cancer -Ischemic areas -PVC -Sensory loss -Sensitive areas (abdomen, infection, reproductive organs) |
|
|
Cryotherapy |
..... |
|
|
How does cryotherapy work? |
Energy is transmitted mainly by conduction. Molecular motion is slowed by cold which limits heat from forming in the treatment area. |
|
|
What are the types of cryotherapy? |
-Cold packs -Ice massage -Crushed ice or ice towel -Ice bath or cold whirlpool (convection) -Contrast bath (convection) -Vasopneumatic device -Spray and stretch (evaporation) -Instant ice pack
|
|
|
What are the physiological effects of cryotherapy? |
Circulatory -Hunting Reflex-body's mechanism to protect itself from tissue damage; occurs between 46-50 deg F Metabolism -Decreased removal of metabolic by-product -Decreased need for oxygen=decreased cell death
|
|
|
Physiological effects continued.... |
Immune -Decrease in edema, decreased activity of leukocytes and phagocytes Neuromotor -Analgesic effect at 58 deg F or less -Increased threshold for nerve firing Joints -Skin temp has to be no more than 36 deg F to decrease intra-articular termperature |
|
|
What are indications for cryotherapy? |
-Decrease edema and bleeding -Decrease muscle spasm -Decrease pain -Acute burns -With transverse friction massage -Neurologic sensitivity |
|
|
What are contraindications for cryotherapy? |
-Raynaud's disease -Compromised circulation -Cold sensitivity -Uncovered and opened wounds (can cover wound and use if needed) -Compromised cardiorespiratory capacity -Advanced Diabetes -Precautions-very young and very old |
|
|
What are the general treatment parameters for Ice/Ice Packs/Ice Towels? |
-15-30 min treatment time -Goal is to get the treated area numb -Wait at least 2 hours between treatments -Barrier between skin and ice source -Use a strap to maintain compression if needed
|
|
|
What are the general treatment parameters for ice massage? |
-Used for small, focal treatment -Tendons -Localized hematoma -Muscle contusion -5-15 min treatment time -Must apply adequate pressure -May produce discomfort and skin color changes |
|
|
What are the general treatment parameters for ice bath/cold whirlpool? |
-Water should be 50-60 deg F -10-20 min treatment time -Good for large areas -Can perform cryokinetics (exercise while body part is submerged) |
|
|
What are the general treatment parameters for vasopneumatic devices? |
-Often given post-op -Small cooler w/ water and ice that circulates into cuff around treated area -Constant or intermittent flow -10-20 min for constant -Use a barrier and insure wrap is not too tight -Minimal weight |
|
|
What are the general treatment parameters for cryostretch/spray and stretch? |
-Vapocoolant delivered from an aerosol can -Made of ethyl chloride -Causes reflexive relaxation for immediate stretching |
|
|
What are the precautions with cryostretch/spray and stretch? |
-Frostbite -Flammable -Be mindful of skin allergies -Over open wounds or eyes -Local anesthetic but can become general if inhaled |
