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ChiroBoards PT's!!

ChiroBoards Physical Therapy (nearly complete, except for simple muscle stuff)

Contraindications to ALL modalities (3) Hemorrhage, Infection w/ suppuration (not inflammation)(exception with superficial UV therapy), Malignancy
Contraindications to ALL HEATING modalities (5) decreased thermal sensations; active TB; low back and abdomen during pregnancy; encapsulated swelling (i.e herpes simplex); Late stage diabetes
Contraindications to ALL ELECTRICAL modalities (7) pacemaker; low back and abdomen during pregnancy; decreased sensation (LVG); Brain=transcerebral; Eyes; Heart=transthoracic; carotid sinuses
High freq. modalities (100,000Hz or greater) = (5) UV, IR, SWD, MWD, US
Medium freq. modalities (2,000-10,000) = (2) IF and Russian Stim
Low freq. modalities (1-2,00 Hz) = (6) LVG; HV; SW; Faradic; Tens; IF
Ultra low freq. modalities (below 1Hz) = microcurrent
What does micro-current do? increase ATP, increase AA, Decrease Pain
what system does massage effect the greatest? vascular system
Physiologic effects of massage: increases what? blood and lymph flow; HR; BP; breaks adhesions; removes lactic acid
Physiologic effects of massage: decreases what? edema; congestion; nerve activity (sedation)
Indications for massage = strains; sprains; bruises; tendonitis; bursitis
Contraindications for massage (5) = Key is vascular problems = -phlebiliths -thrombosis -variscosities - ulcerations -local acute conditions
Types of massage = stroking (begin and end every stroke towards the heart -centripital force = ? Effleurage
Types of massage = deep kneading for muscle tissue = Petrissage
Types of massage = percussion (hacking, cupping) = Tapotment
cupping massage is good for what dx? cystic fibrosis
Types of massage = deep rubbing with powder = Friction massage
Types of massage = shaking of extremities, gentle rub, thumper = Vibration massage
Types of massage = deep pressure massage = Nimmo acupressure
When is TFM not recommended for tendonitis and bursitis? when it has calcified
Physiological Effects of Traction = Decrease intradiscal pressure; increase IVF space; Breaks adhesions (intermittent); Breaks muscle spasms (intermittent) and straightens curves (continuous); gliding of facet joints.
Traction indications = (5) disc syndromes; foraminal encroachment; hyperlordosis; chronic muscle spasms; fibrotic adhesions
Traction contraindications bone weakening conditions (osteoporosis, rickets, osteomalacia); preganancy; RA = transverse ligament (or down's) unless flex/ext. views are taken; acute muscle spasms; fractures (healed compression fx); hypertensive disorders
Cervical traction dosage: start and progression = Begin at 5% of body weight and increase 2 pounds max each treatment to a max of 50 pounds. Never exceed this, or pt. tolerance
It takes how many pounds to overcome the weight of the skull = 10 pounds
Cervical traction position = flexion= 25-28 degrees C2-C7; neutral or 0 degrees for occuput-C1 upper cervical
Lumbar traction dosage: start and progression = Begin at 25% of body weight, and increase 5 pounds max with each treatment to a maximum of 150 pounds. (50%)
Lumbar traction position = supine with legs flexed and knees flexed
2 names for lumbar traction position = (1) 90 90 traction (2) Goucher's position (relaxes mm. and flattens lumbar curve)
Cryotherapy: physiologic effects = LOCAL effects (5) vasoconstriction (followed by vasodilation =hunting-lewis rxn) ; decreased capillary pressure; edema reduction; decreased nerve metabolism; anesthetic to nervous system.
Cryotherapy: physiologic effects = SYSTEMIC effects (2) -increased BP and -Decreased blood flow
Cryotherapy contradictions = Circulatory compromise (raynauds and buergers) , pt. hypersensitivity to cold, frostbite, chilblains, HIGH BLOOD PRESSURE
Ice pack time 1 towel layer for 20 min
Blue ice time 1 towel layer for 20 min
ice immersion time 10-15 min
ice massage time 5 min and keep moving
Vapocoolant sprays fluromethne = time flexible, keep 14-18 INCHES away from pt.
cryokinetics = time ice massage for 5 min. and ROm on movements
Cryotherapy Sensort rxns = CBAN acronym stands for = Cold, burning, aching, numbnss
Transmission of heat by a liquid or a gas by curculation of the heated particles. Ex. whirlpool, sauna, = Convection
Transfer of heat by a solid substance = Conduction (hydrocollator pack, paraffin)
The transfer of electrical energy into heat (ex. shortwave, microwave, ultrasound) = Conversion
Transmission of heat without the intervening medium getting heated (IR and UV) "from sun"= Radiation
Physiological effects of IR = increases vasodilation, circulation, lymph flow
Physiological effects of IR = decreases muscle spasms, BP
IR indications arthritic conditions, RA conditions; stiff joints; chronic backache; contusions, BEURGERS AND RAYNAUD'S, Bell's Palsy, inflanmmatory conditions, muscle spasm
IR long wave = emitted by heated bodies
IR short wave= Incandescent
Long wave IR intensity = 170 degrees F
Short wave IR = distance 14 - *18* inch
Long wave IR = distance direct contact with towel layers
Shortwave vs. Longwave: wave length SW = high (700-1500) ; LW = low (2)
Hydrocolator packs = temp 150-170 degrees
Hydrocolator packs made of : canvas filled with silica gel
Hydrocolator packs : use ___ towels 6
Cold bath temp = 55-65 F
Hot bath temp = 98-105 F
whirl pool time and dosage = 20-30 min / dosage 2x a day (hot bath)
Contrast- start with : hot/cold? hot
Effects of whirlpool (2) vasodilation; sedate
Contrast hot/cold ratio 3:1
Paraffin bath temp = 125-130 F
in paraffin bath, what oil used at max temp? mineral oil
Effects of paraffin bath relief of pain, especially for Chronic RA or OA
UV actions : Thermal and Photochemical
UV physiological effects: Erythema, Tanning of the skin( photo-taxia), Metabolic effects (antibacterial)
Indications for UV: Skin conditions (acne, herpes zoster, fungal, chronic ulcers, healing wounds) Bone conditions (rickets and osteomalacia)
UV Contraindicaions All modalities = HIM acronym
Penetration of UV = Superficial 1-2 mm
UV treatment progression = increase duration by 15 seconds/session, until you reach 3 minutes max.
UV freq = high/low? high
shortwave wavelength number = 180-270mm
longwave wavelength number = 270-390mm
M/c UV device = cold quartz; neon and mercury
Optimum effect of radiation occurs when the part to be treated is at right angles to the source) (angulation of rays) = Cosine law
5 stages of Burns (UV) = 0+ SED, suberythermal dose - no red
5 stages of Burns (UV) = 1+ MED, min. erythermal dose
5 stages of Burns (UV) = 2+ 1st degree = sunburn
5 stages of Burns (UV) = 3+ 2nd degree = blistering
5 stages of Burns (UV) = 4+ 3rd degree = swelling
action of microwave diathermy action
Diathermy physiological effects = Increases Temp, pulse, resp, bmr, lymph flow, elimination, nutrition, vasodilation, glandular secretions
Diathermy physiological effects = Decreases BP, nerve pain, muscle cramps, muscle spasms
Shortwave indications: arthritis, sprain, bursitis, tenosynovitis, radiculitis, neuroitis, *Bronchitis, *Sinusitis, *PID
Diathermy contraindications: TO HEAT + = Metalic implants, epiphydeal centers, moist dressings, phlbitis, varicosities, advanced osteoporosis edema,
Extra contraindications for microwave diathermy = (2) Sinusitis and Otitis media
SWD vs. LWD = distance direct vs. 1-5 inches
SWD vs. LWD = duration 20-30 min ; 10-20 min
SWD vs. LWD = mode outside-in vs. inside-out
Butterfly electrodes are used with SWD for this condition = sinusitis
patient must where wire mesh goggles for this modality = microwave diathermy
Ultrasound's actions = Thermal (increases heat); Mechanical (micromassage); chemical (increases oxidation); Neural (mild anesthesia)
Ultrasound physiological effects: thermal hyperemia, increase alkalosis, increase leukocytes, increase gland activity, reduce muscle spasm and deep heating
Ultrasound physiological effects: mechanical dispersion of fluids, removes exudate, increse membrane permeability
Ultrasound physiological effects: Chemical Increase gas exchange and increase chemical oxidation aids in healing
Ultrasound physiological effects: Neural mild anesthesia
US indications joint and musculoskeletal inflammation - subacute sprains, contusions, tendonitis, bursitis
US contraindications Same as those for heat = spinal cord, plexus, ganglia, over epiphyseal plate, bony promnence unless using water, and FX
US max penetration amount 4-8cm
US frequency setting high 0.7-1.1 MHz
US therapeutic intensity range 0.5-2.5 watts/sq cm
US duration for injury phases: acute = 4 min (flexbile); subacute = 6 min (flexible); chronic = 10 minute max
Ultrasound pulsed vs. continous = when to use either? pulsed for acute and edema ; continuous for chronic and subacute
Piezoelectric effect: electrical to mechanical; mechanical to electrical; effects peak at bone muscle interface.
1 megahertz is ____________(more deep/superficial) than 3 megahertz for ultrasound deeper
A substance may be introduced into the tissues by incorporating cream, lotion, or gel as a coupling medium - phonophoresis
which cream is typically used as a coupling medium with US = mineral ice
direct currents ALL have polarity = T/F? True
Type of direct currents (3) Low volt galvanic, high volt, tens
LVG def = unidirectonal/monophasic/continuous wave; Has strong polarity
High Volt def = Unidirectional/monophasic/twin peaked/pulsed wave= for pain control
Alternating currents ALL have polarity = T/F False (Do NOT have polarity)
Types of Alternating current = (3) Sine wave; Faradic; Interferential
Sinewave def= Bidirectional/biphasic/asymmetrical wave = for muscle contraction
Faradic def= Bidirectional/biphasic/asymmetrical wave = for muscle contrction
Interferential def = 2 medium freq. crossing sine waves; Deepest penetrating, least resistant= For pain control, edema reduction; and muscle contraction
soluble ionic salts are introduced into the body tissues by an electrical means = Iontophoresis (seen in galvanic therapy)
In iontophoresis, bases, metal and alkaloids are all = electropositive
In iontophoresis, aids, radicals, are all - electronegative
Anode (+) attracts = negative ions
Cathode (-) attracts= positive ions
power measured in = watts
current number of electrons measured in= amps
resistance measured in = ohms
EMF-Force measured in = volts
laser power measured in = joules
Minimum stim. to cause contraction - Rheobase
Minimum amunt of time to cause a contraction at 2x rheobase = Chronaxie
LVG positive pole is just like = ice
LVG negative pole is just like = heat
LVG positive pole physiological effects = *vasoconstriction, acute pain relief, hardens tissue attract O2, repels hydrogens, attracts acids
LVG negative pole physiological effects = *vasodilation, chronic pain relief, softens tissues, attracts hydrogen and repels O2. attracts bases
LVG indications= Contusions, sprains, myositis, fibrositis
LVG contraindications = decreased sensation*
LVG = penetration is _______; freq. is ___________ deep; low
LVG intensity = 0.5-1.0 milliamp
LVG duration = 5-20 minutes a day
Galvanic pad size difference = small for area of to be treated; large is used to cause diluting effect (no stimulating effect b/c pad is too big)
High Volt = action and mechanism -Electrokinetic -Pain control via the opiate system
High Volt = enkephilin production vs. endorphin production = Enk = high and fast (over 70 pulses/sec)<--acute) ; Endo = low and slow (1-10 pulses/sec) <-- chronic)
High Volt physiological effects -pain control = endorphins =chronic, 0-20 freq ; enkephilin = acute, 80-150 freq -reduction of edema -muscle spasm redution -muscle exercise
High Volt Indications musculoskeletal pain muscle spasms acute and subacute edema conditions muscle atrophy rehabilitate weakened muscle
High Volt contraindications ALL those for electrical = over heart, pacemakers, low back/abdomen during pregnancy -Note = Decreased sensation is NOT a contrindication*
TENS, action = -gate pain control -opiate pain control
Tens indications = all types of pain except visceral
TENS contraindications = All electrical modalities, AND not to be used during pregnancy, but ok at delivery
TENS: penetration and dosage = penetration is superficial; dosage is minutes to hours (skin irritation with long usage)
TENS pad placement areas= painful site dermatomal peripheral nerve trigger point motor point acupunture point contralateral for phantom limb pain
Interferential, action - (2) -Electrokinetic -pain control (everything same as High Volt, except penetration)
IF physiological Effects = (3) -muscle contraction -edema reduction -pain control
IF Indications = (4) -acute injuries -swelling -muscle spasm -muscle atrophy
IF contraindications = same as ALL electrical modalities
Interferential penetration = Deep (intra-articular)
IF Types/Freq. -Medium Freq. = Old (4.000-10,000) and New (2,000-10,000) -Russian Stim. (premodulated) = 10 seconds on, 50 seconds off
Microcurrent action = (2) Healing effect pain control
constant changing of the treatment freq. equals decreased accommodation modulation
Microcurrent physiological effect = (3) -Increase ATP -Increase AA -Decrease pain
Microcurrent indications = (1) musculoskeletal injuries
Microcurrent contraindications same as all electrical modalities
Microcurrent = intensity level below patient perception
Microcurrent = tissue healing in amps = 200-800 micro amps
Cold laser, action= decrease inflammation and decrease pain, and increase ATP
Massage, contraindications = vascular problems
Type of massage used to break adhesions Friction massage
Trigger point indications = myofascial pain
Trigger point therapy = performed no longer than ___________ 10 seconds
Traction contraindications bone weak/inhibitedning conditions, ligamentous instablity; acute injury
Cryotherapy contraindications circulatory compromise; hypersensitivity to cold, frostbite, and raynaud's
IR contraindications acute conditions, inflammation, abnormal thermal sensation
IR indications Chronic muscleskeletal conditions, arthritic conditions; stiff joints
UV indications skin and bone conditions
UV contraindications HIM
US acute vs. chronic settings: Mode Pulsed=acute ; continuous=chronic
US acute vs. chronic settings: Thin tissue 0.5-1.0 = acute ; 1.0-1.5 chronic
US acute vs. chronic settings: Thick tissue 1.0-1.5 = acute ; 1.5-2.0 chronic
US settings change when performed under water Add 0.5 w/cm2 i
Faradic/Sine Wave used for : muscle contraction, to stretch fibrotic tissue; and to increase lymph flow
Trochanteric belt, aka sacroiliac girdle
SI girdle is used for SI hypermodbility (sit/stand test)
Buerger-Allen exercises for = peripheral vascular disease
WIilliams exercises were designed to reduce a hyperlordosis (hamstring stretches, pelvic tilts, abdomina crunches)
McKenzie's exercises were designed to increase lordosis and rehab a disc. (low back extension exercises)
Codman's exercises were designed to restore normal shoulder movements (finger tip wall walking and pendular exercises)
Kegel's are used to = tighten/facilitate the perineum post partum and with incontinence.
Jacobson's exercises are what? BIofeedback
DeLorme's exercises are used to rehab the knee
Crawling exercises to mobilize the spine; and exercise muscles in scoliosis (cross-crawl) Clayton's exercises
Frenkel's exercises used to = increase coordination and uses a wobble board (also helps ataxic motion)
Milwaukee brace = worn how many hrs a day? 23 hrs/day
Milwaukee brace = for what degree of scoliosis = 20-40 degrees
Extremity braces: figure 8 aka = Louisiana Strap
Extremity braces: figure 8 is for = inverse ankle sprain
Extremity braces: Lennox-Hill aka = Derotational brace
Extremity braces: Lennox-Hill is for knee
Extremity braces: Cockup slint is for wrist = carpal tunnel syndrome
Canes = Placement for OA = place cane in opposite hand
Canes = place of single crutch = place crutch in opposite hand
Fitting crutches = number acronym 2-10-30 (measure 2 inch from axilla; tip of crutch 10 inch from malleolus; crutches should be at 30 degrees.
Used for patient with cerebral palsy, "patterning" Bobarth exercises
Ballistic exercises is an example of ballistic exercises
Upper cross syndrome = weak mm. deep neck flexors, lower traps, serratus anterior
Upper cross syndrome = tight/facilitated muscles pectoralis, upper traps, levator scapula
Lower Cross syndrome = weak mm. abdominals, glute max, hamstrings
Lower Cross syndrome = tight/facilitated muscles iliopsoas, quadriceps, erector spinae
Created by: bglasman
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