| Question |
Answer |
| Contraindications to all modalities? |
Hemorrhage, Infection, Malignancy |
| Contraindications to all heating modalities? |
DM, TB, Encapsulated swellings, Decreased thermal sensation, Abdomen or Low back during pregnancy |
| Contraindications to all electrical modalities? |
Brain, eyes, heart, carotid sinuses, pacemaker, pregnancy (LB and Abs), open wounds, decreased sensation (LVG only) |
| The best modality to increase circulation? |
IR |
| The deepest heating modality? |
Ultrasound |
| Used to treat superficial infections? |
UV |
| Contraindications to massage therapy? |
*Vascular problems (phlebitis, thrombosis, Varicosities, local acute inflammation, ulcerations |
| Transverse friction massage is not recommended for what conditions? |
Calcific tendonitis or Bursitis |
| What are the indications for traction therapy? |
Disc syndromes, Foraminal encroachment, hyperlordosis, chronic spasms, fibrotic adhesions |
| What are the contraindications for traction? |
Bone weakening conditions (osteoporosis, rickets, osteomalacia), pregnancy, RA, acute spasm, FX, hypertensive disorders |
| What are the traction recommendations for the cervical spine? |
Begin @ 5% BW and increase 2pds each Tx (max of 50pds). Never extend the cervical spine. |
| What are the traction recommendations for the lumbar spine? |
Begin @ 25% BW, increase 5pds each Tx (max 150pds). Patient is supine w/ legs flexed (90/90) |
| Vasoconstriction followed by Vasodilation while using cryotherapy is called? |
Hunting-Lewis Rxn |
| Contraindications for cryotherapy? |
Raynaud's/Buerger's, Chilbains, frostbite, vascular problems |
| What are the sensory reactions to cryotherapy? |
Cold - Burning - Aching - Anesthesia (numbness) |
| Fingernail test? |
Barouche |
| Cold wet towels? |
Raspt |
| Physiological effects of IR? |
increases vasodilation and lymph flowdecreases spasms, BP |
| Indications of IR? |
Arthritis, contusions, Raynaud's, Bell's palsy, MSK conditions |
| Contraindications of IR? |
Same as contraindications for heat |
| Short wave IR? |
Emitted by heated bodies, 14-18" away, sunlight = heliotherapy |
| Long wave IR? |
(Direct contact) Hydrocollator (6 towel layers), Hot water bottle, electric pads (170 F) |
| Too much radiation causing mottled, splotchy skin and redness is called what? |
Erythema Ab igne |
| For every increase of 10 degrees celcius the rate of oxidation increases 2 1/2 times? |
Van Hopf's Temperature Law |
| Best form of IR? |
Hydrocollator pack (moist heat) 150-170 F |
| Best modality for superficial vascular? |
IR high frequency |
| Transmission of heat in gas and liquids by circulation of heat? (hydrocollator, hot water bottle) |
Convection |
| Transmission of heat without intervening medium getting warm? |
Radiation (sun, UV lamp, IR lamp) |
| The conversion of electrical energy into heat or mechanical energy? |
Conversion (SWD, MWD, US) |
| The transfer of heat through a substance? |
Conduction (hydrocollator, paraffin bath) |
| What is the temp for a cold bath? hot bath? |
Cold = 55-65, Hot = 98-105 |
| What are some contraindications for baths? |
vacular disorder or sensation loss |
| What type of bath would be used to treat Raynauds and Buerger's? |
Start hot and end in cold bath |
| What bath would be used to treat hemorrhoids, dysmenorrhea, coccydynia, prostatitis? |
Sitz |
| What can be a paraffin bath be used for? |
Chronic OA or RA |
| What is a Hubbert Tank used for? |
To Tx burn patients |
| What are the actions of UV? |
thermal and photochemical |
| What causes erythema when UV is used? |
Congestion of capillaries due to the release of histamine |
| Tanning of the skin is due to what? |
movement of melanin (phototaxia) |
| What conditions are indicated for UV Tx? |
Acne, fungus, herpes zoster, taenis pedis, taenia capitis, ulcers, rickets, osteomalacia |
| What are the the superficial modalities that only penetrate 1-2mm's? |
UV, IR |
| What test is used to guage the pt tolerance to UV? |
Erythema patch test aka Sleeve test |
| What is the wavelength of Short wave? Long wave? |
short (near) = 180-270 long (far) = 270-390 |
| The first two stages of burn include? |
0: suberythemal dose (SED) = No reddening, 1: minimal erythemal dose (MED) = reddening w/out desquamation |
| The last three stages include? |
2: 1st degree burn = reddening w/ sunburn, 3: 2nd degree burn = itching, redness, burning, desquamation (peeling), blisters, 4: 3rd degree burn = swelling, edema, blister |
| The optimum effect of radiation occurs when the part treated is at a right angle to the source? |
Cosine Law aka Angulation of Rays |
| The intesity of radiation from any light source varies inversely with the square of the distance from the source? |
Inverse Square Law (36" distance reduced by 1/2 increased the intensity 4x's) |
| Kromayer - water cooled device? |
Hot Quartz |
| MC neon and mercury? |
Cold Quartz |
| Goggles for both patient and operator, sore throats? |
Orificial |
| UV filtered through nickel oxide glass used for fluorescence? |
Wood's Light Lamp or Filter |
| What physiologic effects does short wave and microwave diathermy decrease? |
BP, nerve pain, cramps, spasms |
| What are indications for diathermy? |
Hip and chronic joint conditions, muscle, tendon, nerve inflammation, bone conditions, bronchitis, sinusitis |
| What are 2 specific conditions contraindicated for microwave diathermy? |
sinusitis and otitis media |
| Why do you have to wear goggles to operate MWD? |
To avoid cataracts |
| What are Butterfly electrodes used for? |
SWD - for Tx sinusitis |
| What is diapulse used for? |
Tx adrenals |
| What is the mode of action for MWD? SWD? |
MWD = inside out, SWD = outside in |
| Generally what conditions are Tx w/ SWD? MWD? |
SWD = bronchitis, sinusitis, PID, MWD = muscle strain |
| How deep does diathermy penetrate? |
Deep = 2" |
| What is the Tx distance with SWD? MWD? |
SWD = w/ towel directly on skin, MWD = 1-5" away w/ no towels (never direct contact) |
| What are the 3 best Tx's for pain? |
IFC, Tens, High Volt |
| What are the modes of action for US? |
Thermal = hyperemia, alkalosis, deep heat, Mechanical = removes exudates, Chemical = inc. gas exchange / chemical oxid., Neural = anesthesia (mild) |
| Contraindications for US? |
vascular, TB, epiphyses, bony prominence (unless under water), spinal cord, ganglia, plexuses |
| Penetration for US? |
Deep = 4-8cm (deepest heat modality) |
| US intensity w/ coupling agent: acute? chronic? |
acute = 0.5-1.5 watts / cm2, chronic = 1.0-2.0 watts / cm2 |
| US intensity w/ under water: acute? chronic? |
acute = 1.0-2.0 w/cm2, chronic = 1.5-2.5 w/cm2 |
| Pulsed US eliminates what? |
Thermal effect (used for massage effect) |
| Continuous US does what? |
Maximizes thermal effect |
| What do the piezoelectric crystals in the sound head of the US machine do? |
Convert electrical energy to mechanical vibrations |
| What is phonophoresis? |
chemical driven into skin (vit. A and E creams used as coupling medium) |
| What are the direct currents aka monophasic or unidirectional? |
LVG, HV, Tens (all have polarity) |
| This law recognizes that an increase in current increases temp? |
Joule's Law |
| This modality uses soluble ionic salts to drive a charge into the body's tissue? |
Iontophoresis (anode = + cathode = -) |
| Negative Pole / cathode is used for? |
adhesions, bursitis, bruises, scars, sprain/strain |
| Positive Pole/ anode is used for? |
edema (Mg+), fibrositis, fungus (Cu+), neuritis |
| What is the mode of action for Galvanic? |
electrokinetic/electrochemical |
| What are the physiologic effects of the positive pole? |
attracts acid, oxygen, vasoconstricts, acute pain relief, contracts/hardens tissue |
| What is electrodiagnosis used for? |
Tests for reaction of degeneration (RD), LMNL(injury that separates muscle from ant. horn cell)*NCV and EMG modalities used |
| What are the treatments for a partial RD? total RD? Absolute RD? |
partial = slight faradic, increased galvanic, 2 weeks, Total = no faradic, athetoid (vermicular) galvanic, 3 wks to 1 year, Absolute = No response to anything, no recovery |
| What size is the active electrode, and where is it placed? Dispersal pad? |
Active = small, on Tx site, Dispersal pad = large, proximal limb away from Tx site |
| High Volt has what mode of action? |
electrokinetic |
| What are the physiologic effects of High Volt? |
Pain control = endorphines and enkephalinesSpasm and Edema reducedExercises mucle (contraction) |
| Contraindications to High Volt? |
heart, pacemakers, pregnancy**Decreased sensation is NOT contraindicated |
| What is the application of the + polarity? - polarity? |
(+) = acute pain(-) = trigger point |
| What are the following high volt settings used for: 15-20? >20? 1-10? 70-100? |
15-20 = exercise, > 20 = tetanized, 1-10 = edema and endorphin production, 70-100 = enkephalin production |
| What are the following high volt rate modes used for: continuous mode? switch rate mode? interrupted mode? |
continuous = inflammation and pain, switch = spasmsinterrupted - re-educate, strengthen |
| What is monopolar dispersal pad placement used for? |
deep penetration and large area |
| What is bipolar dispersal pad placement used for? |
(same size active and dispersal) small area/individual mm groups |
| What is the mode of action for TENS? |
Gate theory and Opiate theory |
| What theory did Melzack and Wall develop? |
Gate Pain theory |
| When is TENS indicated and what is the penetration level? |
indicated for pain (not vascular)penetrates superficial |
| What is the size and function of A-beta fibers? |
largest, fastest, proprioception |
| What is the size and function of A-delta fibers? |
smaller, slower, temperature, touch, pain |
| What is the size and function of C-fibers? |
smallest, slowest, carry only pain |
| What is the mode of action for sinusoidal/faradic? |
AC, low voltage, low frequency, electrokinetic |
| What is the difference between sinusoidal AC and faradic AC? |
sinusoidal = each cycle is neutral/equal, faradic = high intensity pulse more effective |
| What modality has the deepest (intra-articular) penetration? |
IFC |
| What is the mode of action for IFC? |
electrokinetic, pain control |
| Russina stimulation (premodulated) increases what? |
mucle size and strength |
| Modulation constantly changes what? |
frequency (decreasing accomodation) |
| What is the difference between vectoring on and vectoring off? |
on = large Tx areaoff = small Tx area |
| What is Wedensky inhibition? |
Inhibition of muscle response resulting from application of a series of rapidly repeated stimuli to the motor nerve where slower frequency of stimulation results in muscle response |
| What are the rotator cuff muscles and actions? |
Supraspinatus = abduction, Infraspinatus = ext. rotation, Teres Minor = ext. rotation, Subscapularis = internal rotation |
| What condition can be Tx through VMO (quad) rehabilitation? |
chondromalacia patella (lateral tracking) |
| What is the action of the teres major? |
adducts and medially rotates shoulder |
| What are the actions of the hamstrings? |
Leg flexion, rotation of tibia |
| What is the action of the gasctrocnemius? |
plantar flex, flex the leg at knee |
| What is the action of the soleus? |
plantar flexion |
| What is the action of the tibialis anterior? |
dorsiflexion and inversion |
| What is the action of the iliopsoas? |
flexion of the thigh |
| When should passive exercised be utilized? |
during joint inflammation (prevents contractures) |
| What is an isometric contraction? |
no change in muscle length, no joint movement |
| What is an isotonic contraction? |
muscle length is changed, joint moved |
| What is concentric contraction? |
shortening |
| What is eccentric contraction? |
lengthening |
| A Cybex machine changes muscle length while constantly changing pressure at a constant speed through a full ROM. What type of contraction does it utilize? |
Isokinetic |
| Exercises used for peripheral vascular disease. Pt. sitting, legs elevated until blanching of extremity? |
Buerger-Allen |
| Group of exercises to reduce low back pain. Pt. is in a sit-up position, iliopsoas not used, flexion exercises? |
Williams's |
| Extension exercises for acute low back pain, disc problems? |
McKenzie's |
| Exercise that strengthens shoulder girdle, but eliminates use of supraspinatus, frozen shoulder? |
Codman's |
| A systematic approach to muscle strength gain by increaseing resistance? (wt. training) |
DeLorme's |
| Exercise used to improve pelvic floor muscles, urinary incontinence? |
Keagles |
| Stress exercises to aid in relaxation? |
Jacobson's |
| Used to mobilize the spine, exercise muscles in scoliotic condition, cross-crawl? |
Clayton's |
| Ataxic motion, wobble board, develops proprioception? |
Frenkel's |
| This type of exercise shortens the muscle very quickly? |
Ballistic |
| What is an example of an open chain exercise? |
knee extension |
| What is an example of a closed chain exercise? |
squats |
| What are Kayoki exercises used for? |
Hip |
| What support would be indicated if George's line is disrupted, the patient can rotate head? |
Firm Cervical Collar (moderate cervical laxity) |
| What support is indicated for severe laxity of the cervical spine? |
Philadelphia Collar (no ROM) |
| If no cervical laxity is found what support should be used? |
Soft foam collar |
| What brace is recommended for a Cobb's angle of 20-40 degrees? (scoliosis) |
Milwaukee brace |
| This brace is indicated for SI hypermobility aka trochanteric belt? |
Sacroiliac girdle |
| This brace is used for inversion ankle sprains? |
Figure 8 aka Lousiana strap |
| This brace is used on the knee aka the De-rotational brace? |
Lennox-Hill |
| This brace is used to keep the wrist out of flexion and for carpal tunnel syndrome? |
Cockup Splint (worn at night) |
| What is the best modality for acute injury? |
Pulsed US |
| What is the most indicated modality for fracture? |
microcurrent |
| What are Bobath exercises used for? |
Cerebral Palsy or UMNL |
| Force/Time = minutes of time to create a contraction, 2x's rheobase? |
Chronaxie |
| Amount of time of muscle stimulation to create a contraction? |
Rheobase |
mr. charles11
