here are some review questions and summaries for our physiotherapy final-- definitely some overlap with physio lab material.
LVAC, or low voltage alternating current is good for tissue healing, edema reduction, reduction of hypertonicity, among other things. it is purported to work by depolarization of peripheral sensory and motor nerve fibers, resulting in muscle contraction and pain relief. different frequency and intensity settings can be fine tuned to the specific application: for example, a sensory intensity level with a high frequency would be used for connective tissue repair with acute pain relief, whereas nociception level with low frequency would be used for pain reduction via the opiate method.
low lever laser therapy is a technique that makes use of the therapeutic effects of low power laser light. lasers are unique as a light source in that they are monochromatic, coherent, and collimated and by an essentially unknown mechanism they provide physiological benefit by way of tissue repair, pair reduction, and superficial wound healing.
TENS: transcutaneous electrical nerve stimulation. best for pain relief, although the research is spotty and inconclusive. there are several different modes that can be used which vary the frequency, pulse frequency, intensity, and use bursts of pulses as well. the conventional mode uses a high frequency, low intensity, and long pulse duration, whereas the low freq mode uses a low frequency, motor intensity, and short pulse duration. conventional is thought to manage pain via the opiate response whereas low frequency is thought to work through the gate control system.
UV lamps come in different varieties and have been used recently as an effective treatment for certain skin conditions such as psoriasis. the light is produced by electrical excitation of mercury vapor in a quartz tube and the resulting photon emission. as opposed to infrared, UV lamps do not give therapeutic heat but can stimulate chemical change in the tissues and can also have disinfectant effects. a "hot quartz" uses mostly UVA, also known as blacklight- which has the longest wavelength out of the different types of UV. it is used about 30 inches away and the dosage is determined by the sleeve test, which is used to calibrate for the minimal erythematous dose (a dose which causes erythema that starts in 6-8 hours and disappears in 24). in contrast, cold quartz is used 1 inch from the skin, and is used mainly in wound care and disinfecting.
russian current is a modality developed by Dr. Yakov Kots in 1977 which uses a biphasic, balanced, symmetrical sinewave of a medium frequency, divided into bursts of 50 bu/s. the claim is that the combination of the medium carrier frequency with the overlying burst frequency can reach the deep nerve fibers in muscles and is therefore an effective way for increasing muscle strength and endurance (although these claims have not been substantiated outside of russia).
diathermy is a deep heating modality, up to 5cm, that uses high frequency and low amplitude radio waves. it is purported to have physiological effects based on the principle of resonance, when the patients tissues oscillate at the same frequency as the diathermy wave. this can produce thermal effects as in increased circulation and metabolism, or athermal effects on a cellular level such as increased ion binding and ATP synthesis. to achieve athermal effects, "pulsed mode" is used with lower power settings and pulse frequency. two different methods of delivery are possible depending on electrode type: capacitive method uses a capacitor which produces a strong electric field, better for areas with low water content. inductive method uses a coil which produces a strong magnetic field, better for high water content areas.
IR light is another form of phototherapy that uses electromagnetic radiation with wavelengths in the IR range- approximately 1,500-5,600. they can be luminous, which uses near infrared wavelength and is best for the epidermis and dermal layers, or non-luminous which uses far infrared and is best for the stratum corneum. IR is applied about 20 inches away with no towelling and is generally good as a superficial heat source, used to heat peripheral vascular disease, inflammatory conditions, and can also help joint pain. it is not recommended in areas of malignancy, thrombus formation, or impaired sensation, and excess use might end up in mottled skin known as erythema ab igne.
IFC utilizes two separate medium frequency carrier waves which produce an interference pattern shaped like a cloverleaf which penetrates deep into tissues and depolarizes sensory and motor nerves. it uses two pairs of electrodes which create two overlapping currents of slightly different frequency, or one pair of electrode with a pre-modulated wave (still from two different carrier frequencies in the IFC machine). the "vector scan" can be used to increase treatment area in the quadripolar application by oscillating the current amplitude in one channel while keeping the other constant, and the frequency sweep can be used to subvert sensory nerve adaption. IFC is used for pain reduction, edema reduction, muscle contraction, and is contraindicated near diathermy.
ultrasound is a modality that makes use of the reverse piezoelectric effect- electrically exciting a piezoelectric material causes oscillations which then transmit pressure waves. ultrasound waves have a longitudinal and transverse component and penetrate relatively deeply within tissues. they are better transmitted through homogenous tissues (fat or high water content) and absorbed (and produce heat) in deeper, denser layers and bones. lower frequencies produce greater depth of penetration. it is best used for tissue healing, soft tissue shortening, increasing blood flow, and contraindicated in cancer, hemorrhage, pregnancy, among other things. the mechanism is thought to be both thermal and athermal- athermal effects are thought to be attributed to microcavitation, formation and movement of microscopic air pockets, and fluid shearing/movement near the bubbles.
questions
LVAC...
1. ∂escribe the general schematic for the sequence of physiological events stimulated by LVAC.
2. what are the physiological effects of LVAC?
3. what are the contraindications for LVAC?
4. what is the "reciprocal" mode of delivery for LVAC?
5. what intensity and frequency setting is best for connective tissue healing and acute pain relief?
6. what intensity and frequency is good for chronic edema reduction via muscle twitch?
7. what intensity and frequency is good for reducing muscle hypertonicity?
8. what intensity and frequency is good for pain relief using opiate vs. gate control method?
LLLT...
9. describe the nature of light created by lasers.
10. expand the acronym for lasers.
11. what are the notable differences between lasers and SLD's?
12. of the three properties of lasers in question 9, which is thought to provide most of the therapeutic effects?
13. what are the main therapeutic effects attributed to LLLT?
TENS...
14. describe the waveform used in TENS...
15. what is the "conventional" TENS mode characterized by?
16. what is the "low frequency" TENS mode characterized by?
17. what is the "brief intense" TENS mode characterized by?
18. what is the "burst" TENS mode characterized by?
19. what is the general protocol for the conventional TENS mode? which method of pain relief does this mode make use of?
20. what is the general protocol for the low frequency TENS mode? which method of pain relief does this mode make use of?
21. what are some indications for TENS?
22. what are some contraindications for TENS?
UV lamps...
23. what has been the primary therapeutic use of UV light recently?
24. what are the different types of UV light?
25. what are some notable general characteristics of UV light?
26. how is the UV light produced?
27. what are the hallmarks of the hot quartz UV lamp?
28. what are the hallmarks of the cold quartz UV lamp?
29. what are the hallmarks of the wood's lamp?
30. what are the major physiological effects of UV light?
more on UV...
31. what are some traditional indications for UV lamps?
32. what are the contraindications for UV lamps?
33. what are two laws that govern dosage of UV light?
34. what is the sleeve test?
35. how is the MED determined?
36. how are the dosages for cold quartz determined?
37. what are some precautions to follow for UV application?
38. what are some signs of a UV overdose?
39. what is the PUVA psoriasis treatment?
40. what is the goeckerman regimen for psoriasis?
russian current...
41. describe the waveform used in russian current.
42. what is the burst frequency?
43. physiological effect is dependent on what parameter?
44. what is unique about the medium frequency characteristics of russian current?
45. what were Dr. Kot's claims about Russian current?
46. what are the indications and contraindications for Russian?
diathermy...
47. describe the type of radiation used in diathermy.
48. how does the principle of resonance apply to diathermy?
49. when is pulsed SWD used?
50. what are the thermal effects of CSWD?
51. what are the athermal effects of PSWD?
52. what is the penetration depth of diathermy?
53. what are some effects on RBC's and WBC's?
54. what is the way to decrease thermal effects of diathermy?
55. what are some indications for diathermy?
56. what are some contraindications for diathermy?
57. what is the capacitive method of application? when is it best used?
58. what is the inductive method of application? when is it best used?
59. describe the 4 dosage levels of diathermy in terms of heat sensation.
60. how far away should the lamp be in the capacitive method?
61. how thick should the towel layer be in the inductive method?
infrared...
62. what is the wavelength range for infrared light?
63. what is the depth of penetration for infrared?
64. what are the characteristics of the luminous infrared lamps? which layer does it heat most effectively?
65. what are the characteristics of the non-luminous infrared lamps? which layer does it heat most effectively?
66. how far away should IR lamps be?
67. what are the advantages to IR lamps?
68. what are some traditional indications for IR therapy?
69. what are some contraindications for IR therapy?
70. what is a local sign of IR excess?
interferential...
71. describe the waveform used in interferential.
72. describe the penetration depth of interferential current.
73. what is IFC's effect on nerve depolarization?
74. what is the parameter that is most relevant for muscle contraction?
75. when is frequency sweep used?
76. ∂escribe the quadripolar method of electrode placement.
77. what is the "vector scan"? why is it used?
78. what are the main therapeutic uses for IFC?
79. what is a condition that IFC can treat effectively?
80. what is a contraindication for IFC?
ultrasound...
81. what is the principle by which the ultrasound head produces soundwaves?
82. which is the only tissue that conducts transverse US waves?
83. what is the relationship between frequency and beam divergence?
84. what is the BNR? what is a recommended value?
85. absorption of the US beam is proportional to...
86. what is the relationship between tissue homogeneity and US absorption?
87. what are the different outcomes of a US wave within the tissue?
88. what is the relationship between frequency and depth of penetration?
89. what are the physiological effects of US?
90. what are some indications for US?
91. what are some contraindications for US?
answers
1. biphasic pulsed or continuous current causes peripheral nerve depolarization which causes pain reduction by gate closing method and muscle contraction which leads to edema and spasm reduction.
2. tissue healing
edema reduction
hypertonicity reduction
pain relief
3. general contraindications for electrotherapy: pregnancy, malignancy, pacemaker, etc.
4. two pairs of electrodes, and current switched from one pair to the other in a periodic fashion.
5. sensory intensity level, 80-150pps.
6. motor intensity, 1-10pps.
7. motor intensity, 80-150pps.
8. opiate method: nociception intensity, 1-15pps.
gate control method: nociception intensity, 80-150pps.
9. coherent, monochromatic, collimated.
10. light amplication by stimulated emission of radiation.
11. SLD's: lower power density, not coherent, collimated.
12. monochromaticity.
13. superficial wound healing, pain reduction, tissue repair.
14. biphasic, balanced, asymmetrical or symmetrical.
15. high frequency, sensory intensity, short pulse duration.
16. low frequency, motor intensity, long pulse duration.
17. high frequency, long pulse duration, motor intensity. short duration of application.
18. bursts of 5-10 pulses, low frequency, motor intensity.
19. sensory intensity level, >85pps, 75usec pulse. uses the gate control system.
20. motor intensity, <10pps,>
Showing posts with label physiotherapy. Show all posts
Showing posts with label physiotherapy. Show all posts
Monday, March 22, 2010
Saturday, March 20, 2010
physiotherapy: notes for the lab final
here are some study questions for the physio lab final (hopefully of use to future classes...)
questions
low voltage galvanism / iontophoresis...[pg. 101]
1. two indications...X√
2. two contraindications...√
3. physiological effects...√
4. how deeply do the ions penetrate in iontophoresis?√
5. what is the relationship of the sizes of the active and dispersive electrodes?√
6. the distance between the electrodes should be...√
7. what is the recommended dosage in amps?†√
8. what is the maximum safe current density?√
9. initial treatment time...√
HVPC...[pg. 120]
10. two indications...√
11. two contraindications...√
12. physiological effects...†X
13. what is the shape of the waveform in HVPC?√
14. what are typical currents and voltages used in HVPC?√
15. how does pulse width affect the type of nerve stimulated?√
16. what is "negative polarity" used for?†√
17. what is "positive polarity" used for?†√
18. when would the 10/10 surge cycle time be appropriate?√
LVAC...[pg. 135]
19. two indications...√
20. two contraindications...√
21. physiological effects...√
22. what are the four modes of application?†
23. how many pads are used in LVAC?√
microcurrent...[pg. 167]
24. two indications...√
25. two contraindications...†
26. physiological effects...X
27. what general intensity level is used in microcurrent?√
28. ƒrequency and current settings...†
29. which polarity should be used for chronic vs. acute conditions?√
30. treatment time...√
31. pad placement for dermal wound healing?†
32. pad placement for pain relief?√
TENS... [pg. 144]
33. two indications...
34. two contraindications...
35. physiological effects...
36. describe the waveform used in TENS.
37. what are the factors that dosage is determined by?
38. what are typical treatment times and frequencies?
interferential...[pg. 180]
39. two indications...√
40. two contraindications...X
41. physiological effects...†
42. describe the waveform used in IFC.√
43. what is the "Wedisnky inhibition" in IFC?√
44. what can be done to reduce adaptation to the beat frequency?√
45. what beat frequencies should be used for pain reduction vs. muscle contraction?
46. what beat frequency range should be used for edema reduction?√
47. what is the difference in bipolar, quadripolar, and quadripolar with vector scan pad placement?
48. what is a typical treatment time for IFC?√
ultrasound...[pg. 215]
49. two indications...√
50. two contraindications...√
51. physiological effects...√
52. what is the frequency range of ultrasound?
53. which body tissue conducts transverse waves of ultrasound?√
54. absorption of sound waves is proportional to...
55. how does frequency relate to depth of penetration?
56. what is the rationale behind choosing continuous vs. pulsed duty cycle?
57. over bony areas, which mode should be used?
58. what intensity should be used for acute vs. chronic conditions?
59. if the coupling medium is a water bath, how should the intensity be modified?
60. what are recommended treatment times for acute and chronic conditions?
diathermy...[pg. 254]
61. two indications...
62. two contraindications...
63. physiological effects...
64. describe the frequency and amplitude for diathermy.
65. diathermy uses what principle?
66. how deeply does diathermy penetrate?
67. what settings should be used to minimize thermal effects of diathermy?
68. describe the settings, patient experience, and physiological effects of dose I.
69. describe the settings, patient experience, and physiological effects of dose II.
70. describe the settings, patient experience, and physiological effects of dose III.
71. describe the settings, patient experience, and physiological effects of dose IV.
72. what are some notable differences between diathermy and ultrasound?
infrared...[pg. 287]
73. two indications...
74. two contraindications...
75. physiological effects...
76. how deeply does infrared penetrate?
77. how far away should a infrared lamp be from the patient's skin?
78. what is the "inverse square law" in the context of infrared lamps?
79. typical treatment time is...
answers
1. spains/strains, athelete's foot.
2. open skin lesions, skin with impaired innervation.
3. delivering therapeutic ions through the skin. effects vary depending on ion delivered.
4. 1mm.
5. dispersive is half the size of the active.
6. at least twice the diameter of the dispersive electrode.
7. 1-5 mA for 20 mins recommended, or a range of 40-80 mA*min.
8. 1mA per in^2 of active electrode.
9. 3-4 mins.
10. pain reduction, reduce muscle hypertonicity / spasm.
11. cancer, pregnancy.
12. dermal wound healing, reductions of edema.
13. paired monophasic peaks.
14. 0.5-2.0 mA, 500V.
15. narrow pulse width is better for stimulating sensory nerves and wider pulse width is better for motor nerves.
16. wound healing, edema reduction, muscle contraction.
17. acute stage of injury and pain relief.
18. treatment of chronic edema.
19. reduce muscle hypertonicity, strengthen atrophied muscles.
20. pacemaker, or if treatment area is infected.
21. reduced hypertonicity due to muscle fatigue, and reduced edema due to muscle pumping.
22. pulsed, tetanize, surge, reciprocal.
23. 2 or 4.
24. pain relief, healing of wound/fractures/soft tissue.
25. cancer, pregnancy.
26. wound / tissue healing
increased ATP production / protein synthesis
27. sub-sensory.
28. 3hz, 60uA.
29. acute- positive. chronic- negative.
30. 15-20 mins.
31. one pad on wound and another pad 5-15cm away.
32. on either side of the tissue so that the line between the pads transects the target tissue.
33. acute pain (as in post surgery), joint pain relief.
34. when the source of the pain is unknown, or over the anterior cervical area.
35. pain reduction and selective nerve depolarization.
36. biphasic, balanced, and either symmetrical or asymmetrical.
37. tens mode, duration of application, frequency of application.
38. 15mins-4 hours (until relief), 1-6 times a day.
39. pain relief, edema reduction.
40. through brain, or near shortwave / microwave diathermy machine.
41. depolarization of sensory and motor nerve fibers.
42. combination of two different medium frequency sinusoid waveforms.
43. a phenomenon that occurs in the medium frequency range where nerve fibers are in a constant state of depolarization without repolarization.
44. the sweep feature.
45. 5bpm for pain reduction, 150pps for muscle contraction.
46. 1-15bpm.
47. bipolar is used for both superficial and deep treatment. quadripolar is used more for deep treatment. vector scan is deep with a wider treatment area.
48. 15-20 mins.
49. tissue healing via inflammation reduction, contracture of scar tissue.
50. over plastics, malignancy.
51. elevated tissue temperature, increased blood flow, metabolism.
52. 85Khz and 3Mhz.
53. bone.
54. protein content of tissue.
55. lower frequency yields deeper penetration; 1Mhz = 3-5cm, 3Mhz = 1-2cm.
56. continuous has more of a thermal effect and pulsed is more mechanical.
57. pulsed to avoid standing wave / hotspot formation.
58. 0.5 W/cm2 acute, 1.0 W/cm2 chronic
59. add 0.5 W/cm2.
60. 3-5 mins acute, 8-10 mins chronic.
61. soft tissue injury, sprains/strains repair.
62. within 15-20 feet of an IFC, russian current, or US. over metallic objects.
63. increased metabolism and increased ATP production via increased ion binding capability.
64. high frequency, low amplitude.
65. resonance of frequencies of tissue and diathermy machine.
66. up to 5cm.
67. pulsed setting, low pulse frequency, power output less than 38W.
68. less than 38W on PSWD, no sense of warmth, but good for treating acute trauma.
69. more than 38W on PSWD, light warmth, good for subacute trauma.
70. low-medium setting on CSWD, pleasant warmth, good for basically everything.
71. medium-high setting on CSWD, maxiumum warmth, good for collagen stretching.
72. diathermy has less treatment time but longer lasting effects, and a wider treatment area.
73. non-acute inflammation of the joints, muscle spasm / hypertonicity.
74. over gonads or areas of diminished sensation.
75. superficial thermal effects, deeper effects via reflex actions.
76. 0.5 inch.
77. 18-24 inches for a luminous, 29-36 inches for non-luminous.
78. the intensity of the infrared lamp is inversely proportional to the square of the distance from the tissue.
79. 20-30 mins.
questions
low voltage galvanism / iontophoresis...[pg. 101]
1. two indications...X√
2. two contraindications...√
3. physiological effects...√
4. how deeply do the ions penetrate in iontophoresis?√
5. what is the relationship of the sizes of the active and dispersive electrodes?√
6. the distance between the electrodes should be...√
7. what is the recommended dosage in amps?†√
8. what is the maximum safe current density?√
9. initial treatment time...√
HVPC...[pg. 120]
10. two indications...√
11. two contraindications...√
12. physiological effects...†X
13. what is the shape of the waveform in HVPC?√
14. what are typical currents and voltages used in HVPC?√
15. how does pulse width affect the type of nerve stimulated?√
16. what is "negative polarity" used for?†√
17. what is "positive polarity" used for?†√
18. when would the 10/10 surge cycle time be appropriate?√
LVAC...[pg. 135]
19. two indications...√
20. two contraindications...√
21. physiological effects...√
22. what are the four modes of application?†
23. how many pads are used in LVAC?√
microcurrent...[pg. 167]
24. two indications...√
25. two contraindications...†
26. physiological effects...X
27. what general intensity level is used in microcurrent?√
28. ƒrequency and current settings...†
29. which polarity should be used for chronic vs. acute conditions?√
30. treatment time...√
31. pad placement for dermal wound healing?†
32. pad placement for pain relief?√
TENS... [pg. 144]
33. two indications...
34. two contraindications...
35. physiological effects...
36. describe the waveform used in TENS.
37. what are the factors that dosage is determined by?
38. what are typical treatment times and frequencies?
interferential...[pg. 180]
39. two indications...√
40. two contraindications...X
41. physiological effects...†
42. describe the waveform used in IFC.√
43. what is the "Wedisnky inhibition" in IFC?√
44. what can be done to reduce adaptation to the beat frequency?√
45. what beat frequencies should be used for pain reduction vs. muscle contraction?
46. what beat frequency range should be used for edema reduction?√
47. what is the difference in bipolar, quadripolar, and quadripolar with vector scan pad placement?
48. what is a typical treatment time for IFC?√
ultrasound...[pg. 215]
49. two indications...√
50. two contraindications...√
51. physiological effects...√
52. what is the frequency range of ultrasound?
53. which body tissue conducts transverse waves of ultrasound?√
54. absorption of sound waves is proportional to...
55. how does frequency relate to depth of penetration?
56. what is the rationale behind choosing continuous vs. pulsed duty cycle?
57. over bony areas, which mode should be used?
58. what intensity should be used for acute vs. chronic conditions?
59. if the coupling medium is a water bath, how should the intensity be modified?
60. what are recommended treatment times for acute and chronic conditions?
diathermy...[pg. 254]
61. two indications...
62. two contraindications...
63. physiological effects...
64. describe the frequency and amplitude for diathermy.
65. diathermy uses what principle?
66. how deeply does diathermy penetrate?
67. what settings should be used to minimize thermal effects of diathermy?
68. describe the settings, patient experience, and physiological effects of dose I.
69. describe the settings, patient experience, and physiological effects of dose II.
70. describe the settings, patient experience, and physiological effects of dose III.
71. describe the settings, patient experience, and physiological effects of dose IV.
72. what are some notable differences between diathermy and ultrasound?
infrared...[pg. 287]
73. two indications...
74. two contraindications...
75. physiological effects...
76. how deeply does infrared penetrate?
77. how far away should a infrared lamp be from the patient's skin?
78. what is the "inverse square law" in the context of infrared lamps?
79. typical treatment time is...
answers
1. spains/strains, athelete's foot.
2. open skin lesions, skin with impaired innervation.
3. delivering therapeutic ions through the skin. effects vary depending on ion delivered.
4. 1mm.
5. dispersive is half the size of the active.
6. at least twice the diameter of the dispersive electrode.
7. 1-5 mA for 20 mins recommended, or a range of 40-80 mA*min.
8. 1mA per in^2 of active electrode.
9. 3-4 mins.
10. pain reduction, reduce muscle hypertonicity / spasm.
11. cancer, pregnancy.
12. dermal wound healing, reductions of edema.
13. paired monophasic peaks.
14. 0.5-2.0 mA, 500V.
15. narrow pulse width is better for stimulating sensory nerves and wider pulse width is better for motor nerves.
16. wound healing, edema reduction, muscle contraction.
17. acute stage of injury and pain relief.
18. treatment of chronic edema.
19. reduce muscle hypertonicity, strengthen atrophied muscles.
20. pacemaker, or if treatment area is infected.
21. reduced hypertonicity due to muscle fatigue, and reduced edema due to muscle pumping.
22. pulsed, tetanize, surge, reciprocal.
23. 2 or 4.
24. pain relief, healing of wound/fractures/soft tissue.
25. cancer, pregnancy.
26. wound / tissue healing
increased ATP production / protein synthesis
27. sub-sensory.
28. 3hz, 60uA.
29. acute- positive. chronic- negative.
30. 15-20 mins.
31. one pad on wound and another pad 5-15cm away.
32. on either side of the tissue so that the line between the pads transects the target tissue.
33. acute pain (as in post surgery), joint pain relief.
34. when the source of the pain is unknown, or over the anterior cervical area.
35. pain reduction and selective nerve depolarization.
36. biphasic, balanced, and either symmetrical or asymmetrical.
37. tens mode, duration of application, frequency of application.
38. 15mins-4 hours (until relief), 1-6 times a day.
39. pain relief, edema reduction.
40. through brain, or near shortwave / microwave diathermy machine.
41. depolarization of sensory and motor nerve fibers.
42. combination of two different medium frequency sinusoid waveforms.
43. a phenomenon that occurs in the medium frequency range where nerve fibers are in a constant state of depolarization without repolarization.
44. the sweep feature.
45. 5bpm for pain reduction, 150pps for muscle contraction.
46. 1-15bpm.
47. bipolar is used for both superficial and deep treatment. quadripolar is used more for deep treatment. vector scan is deep with a wider treatment area.
48. 15-20 mins.
49. tissue healing via inflammation reduction, contracture of scar tissue.
50. over plastics, malignancy.
51. elevated tissue temperature, increased blood flow, metabolism.
52. 85Khz and 3Mhz.
53. bone.
54. protein content of tissue.
55. lower frequency yields deeper penetration; 1Mhz = 3-5cm, 3Mhz = 1-2cm.
56. continuous has more of a thermal effect and pulsed is more mechanical.
57. pulsed to avoid standing wave / hotspot formation.
58. 0.5 W/cm2 acute, 1.0 W/cm2 chronic
59. add 0.5 W/cm2.
60. 3-5 mins acute, 8-10 mins chronic.
61. soft tissue injury, sprains/strains repair.
62. within 15-20 feet of an IFC, russian current, or US. over metallic objects.
63. increased metabolism and increased ATP production via increased ion binding capability.
64. high frequency, low amplitude.
65. resonance of frequencies of tissue and diathermy machine.
66. up to 5cm.
67. pulsed setting, low pulse frequency, power output less than 38W.
68. less than 38W on PSWD, no sense of warmth, but good for treating acute trauma.
69. more than 38W on PSWD, light warmth, good for subacute trauma.
70. low-medium setting on CSWD, pleasant warmth, good for basically everything.
71. medium-high setting on CSWD, maxiumum warmth, good for collagen stretching.
72. diathermy has less treatment time but longer lasting effects, and a wider treatment area.
73. non-acute inflammation of the joints, muscle spasm / hypertonicity.
74. over gonads or areas of diminished sensation.
75. superficial thermal effects, deeper effects via reflex actions.
76. 0.5 inch.
77. 18-24 inches for a luminous, 29-36 inches for non-luminous.
78. the intensity of the infrared lamp is inversely proportional to the square of the distance from the tissue.
79. 20-30 mins.
Sunday, February 7, 2010
physiotherapy: midterm review part II
here is the rest of the midterm review for physiotherapy, covering the electrotherapies we've covered so far: low volt galvanism and high voltage pulse current.
questions
electrotherapy...
1. summarize coulomb's law.
2. summarize ohm's law.
3. summarize joule's law.
4. what are the biophysical effects of electrotherapy?
5. order the major tissues in the body according to their ability to conduct electricity.
6. what are some examples of "excitable" tissue in the body?
7. what occurs on a cellular level in response to electrotherapy?
8. what occurs on a tissue level in response to electrotherapy?
9. what occurs on a "segmental" level in response to electrotherapy?
10. what are some systemic reactions to electrotherapy?
11. what are four levels of intensity of application of electrotherapy?
12. what is the optimal pulse duration for motor nerves? how does this compare to sensory nerves?
13. how does nerve size relate to reaction time?
14. what is the difference between the monopolar and bipolar electrotherapy technique?
15. what are some indications for electrotherapy?
16. what are some contraindications for electrotherapy?
17. what are some indications for iontophoresis?
18. what are some contraindications for iontophoresis?
19. what are some precautions for iontophoresis?
20. dosage in iontophoresis is proportional to...
21. what is the maximum safe current density for iontophoresis?
22. what is the recommended dose for iontophoresis?
23. initial treatment time for iontophoresis should be no longer than...
24. what is high voltage pulsed current therapy?
25. what is the average amperage of the waveform in HVPC?
26. describe the shape of the waveform in HVPC.
27. what is the pulse duration of HVPC?
28. what are the advantages to a narrow and wide pulse duration in HVPC?
29. what are the physiological effects of HVPC treatment?
30. what are the contraindications for HVPC treatment?
31. which "polarity" of HPVC application is better suited for acute vs. chronic pain relief?
what is the clinical effect of HPVC application of...
32. "sensory" intensity level and 1-15 pps frequency?
33. "sensory" intensity level and 80-150 pps frequency?
34. "motor" intensity level and 3-5 pps frequency?
35. "motor" intensity level and 1-10 pps frequency?
36. "motor" intensity level and 40-60 pps frequency?
37. "motor" intensity level and 80-150 pps frequency?
38. "nociception" intensity level and 1-15 pps frequency?
39. "nociception" intensity level and 80-150 pps frequency?
answers
1. like charges repel and unlike charges attract.
2. V=IR.
3. heat is produced by current flowing through a resistor.
4. thermal effect (joule's law), electromagnetic effect (biot-savart law), chemical effect (movement of ions by direct current therapies), kinetic effect (contraction of muscle fibers).
5. muscle, brain, tendons/fascia, fat, skin, bone.
6. nerve cells and axons, muscle cells, glandular cells.
7. changes in membrane permeability, nerve excitation, modification of fibroblasts, osteoblasts, mitochondria, microcirculation, alteration of protein and serum concentration, alteration of enzymatic activity.
8. smooth and skeletal muscle contraction / relaxation. tissue regeneration and remodeling.
9. improved joint mobility, circulation from muscle pumping, lymph drainage.
10. analgesic effects, circulatory effects, internal organ modulation.
11. non-sensory (patient doesn't feel), sensory (patient barely feels), motor (contraction of muscles), nociception level (pain).
12. 300-500 microseconds, sensory respond to shorter pulse durations.
13. larger diameter nerves have decreased capacitance and respond faster than smaller nerves.
14. monopolar's active pad is half the size of the passive pad whereas bipolar's pads are the same size.
15. reduction of pain, edema, hypertonicity. increase tissue healing, joint range of motion, fracture healing. reeducate muscles. [reduce, increase, educate]
16. pacemakers, over anterior cervicals, sensitive organs, malignancy, infection, hemorrhage, thrombophlebitis.
17. anti-inflammation, pain reduction, reducing hypertonicity, softening adhesions and scars, calcium deposits, anti-microbial effects.
18. open lesions, allergy, impaired sensation, metal or electric implants.
19. might get transient skin irritation, electrochemical burn. need adequate distance between electrodes (at least size of largest electrode). don't change intensity while moving electrodes. polarity of therapeutic ion must mach polarity of active electrode.
20. current and time of application.
21. 1.0 mA/inch squared.
22. 40-80 mA*min.
23. 3-4 minutes.
24. an electrotherapy that uses high voltage but low amperage pulsed electricity.
25. 0.5-2.0 ma.
26. double peaked, rapid rise.
27. 100-200 usec.
28. narrow stimulates sensory nerves and wide stimulates motor nerves.
29. dermal wound healing, edema reduction, spasm reduction, pain relief, muscle re-education, increased muscle blood flow.
30. see question 16.
31. positive- acute pain. negative- chronic pain.
32. connective tissue repair.
33. connective tissue repair, acute edema reduction, acute pain relief.
34. chronic pain relief.
35. tissue healing, chronic edema reduction.
36. chronic edema reduction, muscle reeducation and strengthening.
37. reduce hypertonicity, spasm, spasticity.
38. acute / chronic pain via opiate method.
39. acute / chronic pain via gate control method.
questions
electrotherapy...
1. summarize coulomb's law.
2. summarize ohm's law.
3. summarize joule's law.
4. what are the biophysical effects of electrotherapy?
5. order the major tissues in the body according to their ability to conduct electricity.
6. what are some examples of "excitable" tissue in the body?
7. what occurs on a cellular level in response to electrotherapy?
8. what occurs on a tissue level in response to electrotherapy?
9. what occurs on a "segmental" level in response to electrotherapy?
10. what are some systemic reactions to electrotherapy?
11. what are four levels of intensity of application of electrotherapy?
12. what is the optimal pulse duration for motor nerves? how does this compare to sensory nerves?
13. how does nerve size relate to reaction time?
14. what is the difference between the monopolar and bipolar electrotherapy technique?
15. what are some indications for electrotherapy?
16. what are some contraindications for electrotherapy?
17. what are some indications for iontophoresis?
18. what are some contraindications for iontophoresis?
19. what are some precautions for iontophoresis?
20. dosage in iontophoresis is proportional to...
21. what is the maximum safe current density for iontophoresis?
22. what is the recommended dose for iontophoresis?
23. initial treatment time for iontophoresis should be no longer than...
24. what is high voltage pulsed current therapy?
25. what is the average amperage of the waveform in HVPC?
26. describe the shape of the waveform in HVPC.
27. what is the pulse duration of HVPC?
28. what are the advantages to a narrow and wide pulse duration in HVPC?
29. what are the physiological effects of HVPC treatment?
30. what are the contraindications for HVPC treatment?
31. which "polarity" of HPVC application is better suited for acute vs. chronic pain relief?
what is the clinical effect of HPVC application of...
32. "sensory" intensity level and 1-15 pps frequency?
33. "sensory" intensity level and 80-150 pps frequency?
34. "motor" intensity level and 3-5 pps frequency?
35. "motor" intensity level and 1-10 pps frequency?
36. "motor" intensity level and 40-60 pps frequency?
37. "motor" intensity level and 80-150 pps frequency?
38. "nociception" intensity level and 1-15 pps frequency?
39. "nociception" intensity level and 80-150 pps frequency?
answers
1. like charges repel and unlike charges attract.
2. V=IR.
3. heat is produced by current flowing through a resistor.
4. thermal effect (joule's law), electromagnetic effect (biot-savart law), chemical effect (movement of ions by direct current therapies), kinetic effect (contraction of muscle fibers).
5. muscle, brain, tendons/fascia, fat, skin, bone.
6. nerve cells and axons, muscle cells, glandular cells.
7. changes in membrane permeability, nerve excitation, modification of fibroblasts, osteoblasts, mitochondria, microcirculation, alteration of protein and serum concentration, alteration of enzymatic activity.
8. smooth and skeletal muscle contraction / relaxation. tissue regeneration and remodeling.
9. improved joint mobility, circulation from muscle pumping, lymph drainage.
10. analgesic effects, circulatory effects, internal organ modulation.
11. non-sensory (patient doesn't feel), sensory (patient barely feels), motor (contraction of muscles), nociception level (pain).
12. 300-500 microseconds, sensory respond to shorter pulse durations.
13. larger diameter nerves have decreased capacitance and respond faster than smaller nerves.
14. monopolar's active pad is half the size of the passive pad whereas bipolar's pads are the same size.
15. reduction of pain, edema, hypertonicity. increase tissue healing, joint range of motion, fracture healing. reeducate muscles. [reduce, increase, educate]
16. pacemakers, over anterior cervicals, sensitive organs, malignancy, infection, hemorrhage, thrombophlebitis.
17. anti-inflammation, pain reduction, reducing hypertonicity, softening adhesions and scars, calcium deposits, anti-microbial effects.
18. open lesions, allergy, impaired sensation, metal or electric implants.
19. might get transient skin irritation, electrochemical burn. need adequate distance between electrodes (at least size of largest electrode). don't change intensity while moving electrodes. polarity of therapeutic ion must mach polarity of active electrode.
20. current and time of application.
21. 1.0 mA/inch squared.
22. 40-80 mA*min.
23. 3-4 minutes.
24. an electrotherapy that uses high voltage but low amperage pulsed electricity.
25. 0.5-2.0 ma.
26. double peaked, rapid rise.
27. 100-200 usec.
28. narrow stimulates sensory nerves and wide stimulates motor nerves.
29. dermal wound healing, edema reduction, spasm reduction, pain relief, muscle re-education, increased muscle blood flow.
30. see question 16.
31. positive- acute pain. negative- chronic pain.
32. connective tissue repair.
33. connective tissue repair, acute edema reduction, acute pain relief.
34. chronic pain relief.
35. tissue healing, chronic edema reduction.
36. chronic edema reduction, muscle reeducation and strengthening.
37. reduce hypertonicity, spasm, spasticity.
38. acute / chronic pain via opiate method.
39. acute / chronic pain via gate control method.
Saturday, February 6, 2010
physiotherapy: midterm review part I
here are questions and answers from the first 60 pages of material from the physiotherapy textbook, covering introduction to tissue repair, thermotherapy, and cryotherapy.
questions
tissue injury and repair part I (p. 4)...
1. what are the three phases of tissue injury and repair?
2. how long does the acute inflammatory phase usually last?
3. what are the hallmarks of the acute inflammatory phase?
4. what is the end of the first phase of tissue injury and repair signaled by and what does it do?
5. what are the clinical objectives of the first phase?
phase 2, repair phase (p.7)...
6. how long after injury does the repair phase start and how long does it typically last?
7. what are the hallmarks of this phase?
8. describe the quality and orientation of the collagen that is deposited in this phase.
9. what is fibroplasia?
10. what are the clinical objectives while treating a patient in this phase?
11. how long after injury does contraction of the scar start and how long may it take?
phase 3, remodeling phase (p. 9)...
12. what is the timeframe of this phase?
13. what are the hallmarks of this phase?
14. what are the clinical objectives of this phase?
ligament injury (p.13)...
15. what is a "first degree" ligament injury?
16. what is a "second degree" ligament injury?
17. what is a "third degree" ligament injury?
18. what are the times for recovery for first, second, third degree muscle strains?
19. tendonitis grade I.
20. tendonitis grade II.
21. tendonitis grade III.
22. tendonitis grade IV.
23. tendonitis grade V.
thermotherapy (p.16)...
24. what is the therapeutic temperature range?
24b. what is normal skin temperature range?
25. what are the mechanisms for heat transmission in thermotherapy?
26. what are examples of radiation and conversion?
27. what is the distinction between superficial and deep heat?
28. which methods of heat transmission are better suited to heating tissue deeply?
29. what are thermotherapy's effects on metabolism?
30. what are thermotherapy's effects hemodynamically?
31. what is erythema ab igne?
32. what is the effect of thermotherapy on the muscles?
33. how much does the heart rate rise in response to every 1 degree rise in body temperature?
34. what is the temperature law of van't-hoff?
35. what are some systemic conditions for which thermotherapy would be appropriate for?
36. what are some contraindications for thermotherapy?
37. what is the temperature range for hot packs?
38. what is the temperature range for home heat wraps?
39. what is the temperature range for paraffin baths?
40. what are some conditions which are particularly indicated for paraffin baths?
cryotherapy (p. 38)...
41. what are the two mechanisms of cryotherapy?
42. what are cryotherapy's effects on hemodynamics?
43. what are the vascular effects of cryotherapy?
44. what are the metabolic effects of cryotherapy?
45. what are the muscular effects of cryotherapy?
46. what is the hunting response?
47. what are some contraindications for cryotherapy?
48. what is the duration and frequency of cold application in cryotherapy?
49. how soon after injury should cryotherapy ideally be applied?
50. what is the temperature range of an ice pack?
51. what are the four stages of reaction from ice massage?
52. what is the "cryokinetics" technique?
53. what is a potential argument against the merits of contrast hot/cold cryotherapy?
54. what are some indications for passive contrast hot/cold therapy?
55. what are some indications for active contrast hot/cold therapy?
56. what is the generally accepted ratio for time of application of hot / cold in contrast hot/cold therapy?
answers
1. acute inflammatory, repair, remodeling.
2. anywhere from 2-72 hours.
3. changes in vascular flow, permeability, edema, cellular changes.
4. fibrinolysin signals the end, opens the lymph channels to begin wound healing.
5. pain relief
vasoconstriction
increase circulation
maintain muscle tone and range of motion
[pain, circulation, movement]
[constrain the pain of bloody muscles]
6. 24 hours after, lasts 2 days to 6 weeks.
7. collagen deposition, removal of cell debris, fibroplasia.
8. not fully oriented in direction of tensile strength, inferior to original in terms of integrity.
9. the contracting of a wound by the action of myofibroblasts.
10. prevent adhesions
orient repair tissue
pain relief
muscle tone and movement.
[orient collagen, prevent adhesions]
11. 4 days, 6 months.
12. 3 weeks to a year.
13. reorientation of collagen for more effective resistance of tensile forces.
14. proper alignment
elasticity
break down adhesions
relieve spasms
increase strength and ROM
15. an injury that has little noticeable signs, minimal functional loss, recovery within 2 weeks.
16. an injury that results with significant structural weakening, tends to recur, may need immobilization, and may take 2-3 months to recover fully.
17. a severe injury that causes a loss of structural integrity, needs prolonged protection or surgery, and will only recover to 50-80% in 1-6 months.
18. 2-20, 20-90, 50-180.
19. pain only with activity, does not interfere.
20. same, but localized instead of generalized tenderness.
21. interferes with activity, but disappears after.
22. same, but doesn't disappear and more severe.
23. interferes with ADL's, chronic/recurrent, altered tissue/muscle.
24. 104-113F.
24b. 82-90F.
25. conduction, convection, radiation, conversion.
26. radiation: infrared light. conversion: ultrasound, diathermy.
27. less than or greater than 1cm into the tissues.
28. diathermy or ultrasound.
29. increased enzymatic activity, O2 consumption, phagocytosis, metabolite clearing.
30. increased capillary pressure and permeability increases fluid, nutrient exchange.
31. mottled pigmentation of skin that may result from excess application of superficial heat- might be from destroyed RBC's or permanently dilated arterioles.
32. no change in muscular blood flow, but marked relaxation via inhibition of muscle spindles.
33. 10bpm.
34. for every 18F increase in body temperature, metabolism increases 2-3 times.
35. polio, GBS, polyneuropathy, collagen vascular disease.
36. malignancies, thrombophlebitis, hemorrhage, over gonads.
37. 165-170F.
38. 104-154F.
39. 124-129F.
40. non-acute RA, osteoarthritis, raynaud's, dupuytren's.
41. conduction, evaporation.
42. decreased temperature, increased viscosity leads to decreased blood flow, decreased histamine release.
43. a sympathetic mediated reflex vasoconstriction leading to decreased capillary pressure and edema.
44. decreased metabolic rate: decreased oxygen requirement, tissue damage, edema.
45. decreased spasm, viscosity, tensile strength, increased connective tissue strength and isometric muscle strength.
46. bursts of alternating vasoconstriction and vasodilation after 10-15 minutes of extreme cooling of tissues.
47. cold hives, raynaud's, cryoblobulinemia, paroxysmal cold hemoglobinuria.
48. 20 minutes on, 2 hours off.
49. within 5 minutes.
50. 23-32F.
51. CBAN: intense Cold, Burning pain, Aching, Numbness.
52. repeated cold application to the point of numbness followed by voluntary activity/stretching in order to enhance rehabilitation and shorten recovery time.
53. some studies suggest that contrast hydrotherapy is only effective in superficial tissues.
54. chronic inflammatory conditions, sinus/congestive headaches.
55. arthritis, sprains, strains, venous congestion.
56. 4:2 hot:cold.
questions
tissue injury and repair part I (p. 4)...
1. what are the three phases of tissue injury and repair?
2. how long does the acute inflammatory phase usually last?
3. what are the hallmarks of the acute inflammatory phase?
4. what is the end of the first phase of tissue injury and repair signaled by and what does it do?
5. what are the clinical objectives of the first phase?
phase 2, repair phase (p.7)...
6. how long after injury does the repair phase start and how long does it typically last?
7. what are the hallmarks of this phase?
8. describe the quality and orientation of the collagen that is deposited in this phase.
9. what is fibroplasia?
10. what are the clinical objectives while treating a patient in this phase?
11. how long after injury does contraction of the scar start and how long may it take?
phase 3, remodeling phase (p. 9)...
12. what is the timeframe of this phase?
13. what are the hallmarks of this phase?
14. what are the clinical objectives of this phase?
ligament injury (p.13)...
15. what is a "first degree" ligament injury?
16. what is a "second degree" ligament injury?
17. what is a "third degree" ligament injury?
18. what are the times for recovery for first, second, third degree muscle strains?
19. tendonitis grade I.
20. tendonitis grade II.
21. tendonitis grade III.
22. tendonitis grade IV.
23. tendonitis grade V.
thermotherapy (p.16)...
24. what is the therapeutic temperature range?
24b. what is normal skin temperature range?
25. what are the mechanisms for heat transmission in thermotherapy?
26. what are examples of radiation and conversion?
27. what is the distinction between superficial and deep heat?
28. which methods of heat transmission are better suited to heating tissue deeply?
29. what are thermotherapy's effects on metabolism?
30. what are thermotherapy's effects hemodynamically?
31. what is erythema ab igne?
32. what is the effect of thermotherapy on the muscles?
33. how much does the heart rate rise in response to every 1 degree rise in body temperature?
34. what is the temperature law of van't-hoff?
35. what are some systemic conditions for which thermotherapy would be appropriate for?
36. what are some contraindications for thermotherapy?
37. what is the temperature range for hot packs?
38. what is the temperature range for home heat wraps?
39. what is the temperature range for paraffin baths?
40. what are some conditions which are particularly indicated for paraffin baths?
cryotherapy (p. 38)...
41. what are the two mechanisms of cryotherapy?
42. what are cryotherapy's effects on hemodynamics?
43. what are the vascular effects of cryotherapy?
44. what are the metabolic effects of cryotherapy?
45. what are the muscular effects of cryotherapy?
46. what is the hunting response?
47. what are some contraindications for cryotherapy?
48. what is the duration and frequency of cold application in cryotherapy?
49. how soon after injury should cryotherapy ideally be applied?
50. what is the temperature range of an ice pack?
51. what are the four stages of reaction from ice massage?
52. what is the "cryokinetics" technique?
53. what is a potential argument against the merits of contrast hot/cold cryotherapy?
54. what are some indications for passive contrast hot/cold therapy?
55. what are some indications for active contrast hot/cold therapy?
56. what is the generally accepted ratio for time of application of hot / cold in contrast hot/cold therapy?
answers
1. acute inflammatory, repair, remodeling.
2. anywhere from 2-72 hours.
3. changes in vascular flow, permeability, edema, cellular changes.
4. fibrinolysin signals the end, opens the lymph channels to begin wound healing.
5. pain relief
vasoconstriction
increase circulation
maintain muscle tone and range of motion
[pain, circulation, movement]
[constrain the pain of bloody muscles]
6. 24 hours after, lasts 2 days to 6 weeks.
7. collagen deposition, removal of cell debris, fibroplasia.
8. not fully oriented in direction of tensile strength, inferior to original in terms of integrity.
9. the contracting of a wound by the action of myofibroblasts.
10. prevent adhesions
orient repair tissue
pain relief
muscle tone and movement.
[orient collagen, prevent adhesions]
11. 4 days, 6 months.
12. 3 weeks to a year.
13. reorientation of collagen for more effective resistance of tensile forces.
14. proper alignment
elasticity
break down adhesions
relieve spasms
increase strength and ROM
15. an injury that has little noticeable signs, minimal functional loss, recovery within 2 weeks.
16. an injury that results with significant structural weakening, tends to recur, may need immobilization, and may take 2-3 months to recover fully.
17. a severe injury that causes a loss of structural integrity, needs prolonged protection or surgery, and will only recover to 50-80% in 1-6 months.
18. 2-20, 20-90, 50-180.
19. pain only with activity, does not interfere.
20. same, but localized instead of generalized tenderness.
21. interferes with activity, but disappears after.
22. same, but doesn't disappear and more severe.
23. interferes with ADL's, chronic/recurrent, altered tissue/muscle.
24. 104-113F.
24b. 82-90F.
25. conduction, convection, radiation, conversion.
26. radiation: infrared light. conversion: ultrasound, diathermy.
27. less than or greater than 1cm into the tissues.
28. diathermy or ultrasound.
29. increased enzymatic activity, O2 consumption, phagocytosis, metabolite clearing.
30. increased capillary pressure and permeability increases fluid, nutrient exchange.
31. mottled pigmentation of skin that may result from excess application of superficial heat- might be from destroyed RBC's or permanently dilated arterioles.
32. no change in muscular blood flow, but marked relaxation via inhibition of muscle spindles.
33. 10bpm.
34. for every 18F increase in body temperature, metabolism increases 2-3 times.
35. polio, GBS, polyneuropathy, collagen vascular disease.
36. malignancies, thrombophlebitis, hemorrhage, over gonads.
37. 165-170F.
38. 104-154F.
39. 124-129F.
40. non-acute RA, osteoarthritis, raynaud's, dupuytren's.
41. conduction, evaporation.
42. decreased temperature, increased viscosity leads to decreased blood flow, decreased histamine release.
43. a sympathetic mediated reflex vasoconstriction leading to decreased capillary pressure and edema.
44. decreased metabolic rate: decreased oxygen requirement, tissue damage, edema.
45. decreased spasm, viscosity, tensile strength, increased connective tissue strength and isometric muscle strength.
46. bursts of alternating vasoconstriction and vasodilation after 10-15 minutes of extreme cooling of tissues.
47. cold hives, raynaud's, cryoblobulinemia, paroxysmal cold hemoglobinuria.
48. 20 minutes on, 2 hours off.
49. within 5 minutes.
50. 23-32F.
51. CBAN: intense Cold, Burning pain, Aching, Numbness.
52. repeated cold application to the point of numbness followed by voluntary activity/stretching in order to enhance rehabilitation and shorten recovery time.
53. some studies suggest that contrast hydrotherapy is only effective in superficial tissues.
54. chronic inflammatory conditions, sinus/congestive headaches.
55. arthritis, sprains, strains, venous congestion.
56. 4:2 hot:cold.
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