Busy. Please wait.
or

show password
Forgot Password?

Don't have an account?  Sign up 
or

Username is available taken
show password

why


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
We do not share your email address with others. It is only used to allow you to reset your password. For details read our Privacy Policy and Terms of Service.


Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.

Remove Ads
Don't know
Know
remaining cards
Save
0:01
To flip the current card, click it or press the Spacebar key.  To move the current card to one of the three colored boxes, click on the box.  You may also press the UP ARROW key to move the card to the "Know" box, the DOWN ARROW key to move the card to the "Don't know" box, or the RIGHT ARROW key to move the card to the Remaining box.  You may also click on the card displayed in any of the three boxes to bring that card back to the center.

Pass complete!

"Know" box contains:
Time elapsed:
Retries:
restart all cards




share
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

PTA Thermal Energies

Theramal Energies

QuestionAnswer
temperature means of measuring heat using the relative terms heat and cold
specific heat amount of energy required to raise the temp of a given weight of material one degree
materials of high specific heat (SH) hold more energy at the same temp than materials of lower SH
the higher the SH the hotter the substance feels
SH of water 1 which is higher than paraffin and fluidotherapy
methods of heat transference an object heated to a higher temp that its surroundings will give off heat in one of three methods-conduction, convection, radiation
conduction transfer of heat by molecular collision when two bodies are in contact and not the same temp
convection transfer of heat by the movement of a mass, gas or liquid
radiation transfer of heat between two bodies separated by a medium which does not become heated
conversion non-thermal energy(mechanical, electrical, chemical) is changed to thermal energy
evaporation vaporization of a liquid. molecules with energy escape from a liquid surface and change into gas
thermoregulation heat or cold
systemic (general) heat dissipation 70% skin, 27% evaporation, 2% warm inspired, 1% excretion
70% Skin radiation, convection
excessive systemic heating overheating-heat prostration, heat stroke
local heat dissipation when area is being heated, when heat is removed
when area being heated convection, conduction
when heat is removed radiation, convection
TTR tissue temp rise, heat is applied faster that the body can dissipate
heat magnitude of physiological effects depends on temp differential btw skin and modality, rate at which heat is added, volume of tissue heated, circulation in area, length of application, thermal conductivity of tissue
physical effect heat receptor site, thermal
physiological heat hemodynamic, neuromuscular, metabolic altered tissue properties
increased physiological effects from thermal heat energy vasodialation, shunts blood flow fr other structures, mild inflame reaction, local hyperemia-erythema, dec viscosity of blood,rise in tissue temp superficial + deep,inc NCV-edema-cellular metabolism- and removal of metabolites,inc pain threshold
decreased physiological effects from thermal heat energy dec gamma motor neuron activity, dec in strength and endurance
changes in tissue from thermal energy inc tissue extensibility of connective tissue and muscle
analgesia elevation of pain threshold due to thermal heat
physiological effects of thermal heat energy edema inc hydrostatic, inc permeability
systemic effects thermal heat energy inc HR, inc RR, inc excretion, dec BP, general vasodilation, general relaxation
local effects thermal heat energy promote soft tissue healing, pain reduction, relaxation, and decreased joint stiffness
vasodilation local cutaneous blood vessels (skin blood flow), axon reflex(local), reflex heating mechanism (central)
heat application temperature raise heat in tissues 40-45 degrees C (104-113 degrees F)
heat application superficial vs deep, moist vs dry, constant heat sources, local vs general
superficial heat direct increase in surface temp with slight indirect heating of deeper structures= type of physiological effect is heat
types of heating hot packs, paraffin, fluidotherapy, infrared
skin responses even hyperemia and erythema, skin warm to touch, mottling is a danger sign, blanching is a danger sign
deep direct increase in temp in deep structures without heating of superficial structures=physiological effects are mixed
types of deep heating ultrasound, short wave diathermy
hot pack hydrophilic silica gel in canvas w/property to hold water, tank water temp 158-179 deg, water level should cover packs, new pack req 24 hrs to heat, 20-30' pack to re-heat, rapid loss of heat to atmosphere(HP should be made just prior to application)
hot pack protocol 6-8 layers, 20',comfortable warmth
Hot pack factors to consider age, will pt be laying on pack, towel or hot pack cover, how busy is machine, area treating
paraffin paraffin wax and mineral oil, 126 degree tank temp, feet and hands
paraffin feet and hands feet will feel warmer, harder to dissipate heat
paraffin wax and mineral oil 6-7:1 ratio, lower specific heat than water (SH=.65), mineral oil lowers the specific heat and facilitates easy removal
glove paraffin protocol remove jewelry, bandage any open cuts, glove, wrap c baggie or towel, elevate, 20',
two paraffin techniques glove and immersion
immersion paraffin protocol remove jewelry, bandage any open cuts, 1-2 layers, remain in tank, 5-10', constant heat
treatment procedure wash part, support part, instruct pt to relax part and to avoid moving once treatment starts, explain that first dip is the warmest, make sure first layer covers the treatment area and is the highest layer
fluidotherapy air and cellulose (corn cob), stimulates thermoreceptors and mechanoreceptors, can move during treatment, can wear splints and use exercise equipment, wash part and remove jewelry
fluidotherapy protocol set temp setting, set air speed, instruct in exercise prior to starting treatment if actively exercising, 20'
summary of hot pack conduction, moist heat, inexpensive, covers large area, treat most areas of the body, easy to apply at home, uneven heating of irregular surfaces
summary of paraffin conduction, moist heat, good with irregular surfaces, uniform heating, skin softening, limited to hands and feet, messy, immersion is constant heating, greater risk of mottling especially immersion method
fluidotherapy convection, dry heat, uniform heating, can exercise during treatment, limited to distal limbs, messy removal, constant heating
indications heat subacute and chronic inflammatory conditions, pain, spasm, contractures, spasticity, prelim
precautions heat diminished sensation, elderly, children, scars, RA, pregnancy, poor thermoregulation
contraindications heat acute conditions, edema, fever, skin rashes, lesions,infection,hemorrhage, malignancy, infants, cardiac insufficiency, PVD, thrombophlebitis, impaired mentation
dangers heat burn, fainting, bleeding
systemic general heat retention non-shivering thermogenesis, muscle tensing, shivering, pyeloerection, counter-current exchange
problem of excessive cooling frostbite
counter-current exchange exchange of heat from arteries to veins to prevent blood too cooled from going back to the core, results in cooler blood going to the periphery
what does the exchange of heat from arteries to veins to prevent blood too cooled from going back to the core do prevents dec in body temp
what does cooler blood going to the periphery do dec the differential btw the cold environment and the skin, reduces heat transfer through radiation
local heat retention when area is being cooled, when cold is removed
when area is being cooled conduction
when cold is removed radiation, convection, conduction
TTD tissue temp drop, rate of heat is removed faster than body can rewarm
cold magnitude of physiological effects depend on temp differential btw skin and modality, rate at which heat is removed, volume of tissue cooled, length of application, thermal insulation of tissue
physical effect cold receptor, thermal
physiological cold hemodynamic, neuromuscular, metabolic, altered tissue properties
physiological effects cold vasoconstriction, opening of A-V shunts, shunting of blood from other structures, local erythema, inc viscosity of blood, dec in NCV, elevation of pain threshold,dec cellular metabolism, inc stiffness of tissue, systemic effects
local erythema blanching, cyanosis
dec in NCV small more that large, myelinated more that unmyelinated
anesthesia elevates pain threshold
increase stiffness of tissue however dec stretch reflex, dec gamma, dec 1a and 1b firing, short duration cold inc AMN firing
systemic effects of cold dec HR, dec RR,Inc BP, general vasoconstriction
vasoconstriction dec in skin blood from, reflex local vasoconstriction, CIVD
dec in skin blood flow protection other are at from cooled blood, improves heat retention
CIVD cold induced vasodilation, hunting response
A-V Shunts found in tips of fingers, toes, lips, and ears. protect cutaneous tissue against extremes in temperature. normally closed bu open with low temps.do not function in conditions of prolonged cold
secondary hypoxic injury death of uninjured tissue from lack of oxygen. cold puts tissues into hibernation by decreasing cellular metabolism=decreased cellular metabolism retards the healing process by suppressing the inflammatory response
what happens with decreasing cellular metabolism less need for oxygen, reduces damaged area, less debris, less edema, less hematoma, less to repair
superficial skin tissue response to cold immediate and rapid drop of temp, plateaus several degrees above temp or modality, immediate rewarming when cold removed
subcutaneous tissue response to cold same as superficial but less drop in temp
deep structures tissue response to cold delayed drop in temp, less cooling, TTD cont after removal of cold
colds effects is deeper than heat greater temp difference between modality and skin, less convection methods so stays colder longer, adipose tissue resists re-warming, tissues continue to drop in temp post treatment
cold application acute stage want dec metabolism, apply within 24 hours to prevent secondary hypoxia, negative effects=dec circulation, retardation of healing
cold application subacute stage want dec pain through anesthesia, cryokinetics=cold with movement, negative effects=dec metabolism, dec circulation
RICE protocol acute stage, REST, ICE, COMPRESSION, ELEVATION
RICE REST controversial
RICE ICE 30' every 2 hours
RICE Compression combat and interstitial pressure
RICE Elevation dec capillary hydrostatic pressure, combat effects of gravity
cold cycle cold, burning, aching, numbness=anesthesia, CBAN
cold pack silica gel in vinyl, tank temp 10-15 degrees F, 24 hour cooling with new pack, 30' cooling for pack between uses
cold pack protocol one thin layer, 20', explain cold cycle
ice massage protocol ice applied directly to skin, circular or longitudinal stroke, drape and do not wipe, pressure to tolerance, treat until anesthesia
ice immersion protocol water bath with ice, monitor skin color, 5-6' with musculo-skeletal sprains, 1' to dec spasticity
vapocoolant spray protocol cold in a bottle, spray and stretch, 30 degree angle, 18" from part, move 4"/sec from origin of muscle to area of pain
summary cold pack conduction, treat most areas of body, treat large area, easy to apply, erythema response
summary of ice massage conduction, limited to small areas, messy, greater TTD, blanching may occur during massage, but skin should have an erythema when ice removed
summary of ice immersion conduction, body or limb, greets TTD, greatest danger, strong erythema=can see slight cyanosis in distal digits
indications for cold acute and subacute conditions of the musculo-skeletal system, muscle spasms due to pain, post-surgical pain and edema, spasticity, fevers, emergency burn care, facilitation and inhibition techniques
precautions for cold diminished sensation, very young and very old, long duration application, run-down condition
contraindications for cold raynaud's disease, cold hypersensitivity, Hx of frostbite, cardiac disorders, unstable hypertension, compromised circulation, open wounds, over regenerating peripheral nn, cryoglobulinemia, scleroderma,lupus
danger of using cold urticaria, cyanosis, frostbite,nerve damage
3 factors when to use Heat or Cold patient preference, stage of condition, goal of treatment
when to use heat 48-72 hour waiting period, subacute and chronic, analgesia,mm lengthening, facilitates better speed of contraction, affects more superficial structures, facilitates healing,general relaxation, may have rebound effect,dec pain/spasm, works on gate theory
when to use cold can use immediately, acute and subacute, anesthesia,better for dec spasticity,facilitates tetanic contraction, affects deeper structures, inhibits healing, no rebound effect, good for dec pain and spasm, works on gate theory
Created by: mloft