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