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Contraindications to ALL modalities (3)
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Contraindications to ALL HEATING modalities (5)
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ChiroBoards PT's!!
ChiroBoards Physical Therapy (nearly complete, except for simple muscle stuff)
| Question | Answer |
|---|---|
| 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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