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PT Intvtn: US

Questions for Ultrasound

25 y/o pt. walks in with redness & swelling of the left ankle secondary to broken ankle in healing for over 2 weeks. Which modalities would you use; Explain dosage. Cold (ice massage) for no more than 20 min. or ultrasound for 5 min. to promote healing.
definition of ultrasound DEF: vibration by reverse piezoelectric effect (electricity causing vibration)
Thermal effects of ultrasound heat helps heal and loosens things up, goes deeper than ordinary heating methods, done by friction, smaller areas (2xERA), skips the skin
Non-thermal effects of ultrasound heals, increases fibroblastic, increases protein synthesis, increases blood flow
what is micromassage? cavitation (gas bubbles) AND mircrostreaming (increased cell wall permeability)
reasons why we move the transducer (3) 1. reflection: standing waves will make the impact summate 2. cavitation: prolongued use w/o mvmt will increase intensity, lower freq, and cause too many air bubbles. 3. BNR: variability of intensity of transducer may cause burns.
frequency: 1MHz vs. 3MHz(depth) 1 MHz: 2-5cm vs. 3MHz: up to 2cm...so when deciding which freq. to use if you can touch it, it is considered superficial and you would use 3MHz, if you can't easily palpate it than you would use 1MHz.
Frequency 1 vs. 3 (all points) 3MHz: Superficial 1-2cm, higher absorption, heats faster, less divergent 1MHz: deeper: 2-5cm, lower absorption, heat slower, more divergence.
intensity chart Acute -> .1-.5 (no heat)Subacute -> .5-1.0 (no to minimal heat)Chronic -> 1.0-2.0 (heating/warmth)
temperature to application Nonthermal: 0 (37.5 baseline)->acute injury, edema, healing Mild Thermal: 1C (38.5)-> subacute injury, healing, hematoma Mod. Thermal: 2C (39.5)-> Chronic Inflam., Pain, trigger pt's, ms spasms Vigorous: 4C (41.5) -> stretch, collagen
Parameters: pt has trigger pts along their UT for over 3 months FREQ: (supfl/deep?)deep 1MHz DC: 100% TEMP: mod. 2C (for trigger pts)INTEN: 1.5 -> 1.0-2.0(range for chronic) DUR: chart reads .3; Calc: 2C/.3 deg/min = 6.7 min
Parameters: pt comes in with lat. epicondylitis for last 2 days FREQ: (sf/d?) sf: 3MHz DC: 25% TEMP: non-thermal 0C (acute stage) INTENS: .1-.5 DUR: 5 min/ERA (standard for acute stage)
Parameters: pt sprained ankle 3 wks ago FREQ: (sf/d?) sf so 3MHz DC: 50% TEMP: mild 1C (subacute stage) INTEN: .5-1.0 (going to choose 1 cuz its faster)DUR: chart reads .6; Calc: 1C/.6 deg/min = 1.7 min
Parameters: pt with acute ankle sprain has tight soleus that has been isolated o the middle lateral portion. FREQ: (sf/d?) deep 1MHz; DC: 25% TEMP: vigorous 4C (stretch); INTEN: 1-2 (We'll pick 2 cuz its faster); DUR: chart reads .4; Calc: 4C/ .4 deg/min = 10 min.
Created by: j.padilla