Modalities Quiz 2: Superficial Heat & Ultrasound – Flashcards
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types of superficial heat? (4)
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1. paraffin bath 2. hot moist heat pack 3. fluidotherapy 4. infra-red
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mechanisms of heat transfer? (3) describe them?
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1. conduction - direct contact with the source (moist heat pack) 2. convection - movement of fluid particles or air across the body surface (fluidotherapy) 3. Radiation - transfer of energy through electromagnetic waves from the source to the body. (infra-red radiation)
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biophysical effects of superficial heat are dependent on these factors? (4)
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1. extent of tissue rise 2. rate of the tissue temperature rise (TTR) 3. the volume of the tissue exposed (LxWxD) 4. thermal conductivity of the tissue
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metabolic reactions to superficial heat? (7)
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1. increased metabilic rate 2. increase O2 uptake by tissues 3. increased O2 tissue demand due to increased metabilism 4. increased production of CO2 and metabilic by-products dueto increased matabolism 5. increasd leukocytic and phagocytic activity 6. produces mild inflammation rxn 7. prmotes the release of histamine, prostaglandins and bradykinin.
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at what temperature does protein begin to denature and burn occurs?
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45-50 degrees C
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what is bradykinin?
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a strong vasodilaor released from the sweat glands
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vascular rxns to superficial heat? (5)
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1. vasodilation 2. decreased viscosity of blood 3. increased venous and lymphatic drainage 4. increased blood flow 5. landis-gibbons reflex
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what is landis-gibbons reflex?
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the application of heat to one are of the body that results in an increase of blood flow and other reactions to another part of the body. ex: heat up L arm and the R arm experiences heat also
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Neural rxns to superficial heat? (3)
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1. increased pain threshold - analgesi effect (gate theory) 2. decreased muscle spasm via decreased gamma efferent activity 3. increase in nerve conduction velocity
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connective tissue effects? (3)
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1. decreased viscoelastic properties in the jt 2. eleveate skin temp and tissues within 0.5cm from the surface 3. temperature will reach max at 6-8 minutes
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Overall clinical results of superficial heat? (5)
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1. decrease pain 2. decrease muscle spasm 3. increase blood flow to area 4. reddens the skin 5. increases EDEMA if allied too soon post-injury
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Indications for superficial heat? (10)
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1. sub-acute or chronic injury 2. strains 3. sprains 4. muscle spasm 5. tedonitis 6. tenosynovitis 7. bursitis 8. pain management 9. adhesive capsulitis 10. pt relaxation
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precautions of superficial heat? (2)
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1. presence of DVT 2. moderate to severe cases of PVD
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what is a moist heat pack made of?
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its a cancas covered pack filled with a hydrophilic silicate
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moist heat packs are stored in this? what temperature are they stored at?
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hydrocollator at 150-170 degrees F
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how many layer do you need if the pt is laying on the heat pack? if pt is not laying on heat pack?
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10 layers if pt is laying on heat pack 6-8 layers if pt is not laying on heat pack
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why do you need additional layers if the pt is laying on the heat pack? (2)
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1. capillaries are compressed so they have a decreased ability to dissipate heat (poiseuille's law) 2. water is squeezed from the MHP due to pressure which results in an increased conduction.
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what is the treatment time for MHP's?
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15-20 minutes
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after use, how long should the heat pack be placed in hydrocollator for before used again?
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at least 30 minutes
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what are the contraindicatins to superficial heat? (5)
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1. presence of skin cancer 2. presence of lymphatic cancer 3. severe CV or respiratory problems 4. hemophilia 5. long-term steroid therapy
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Paraffin bath
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...
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what is the temperature of paraffin bath?
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126-134 degrees
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three methods of paraffin bath application? explain them?
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1. gloved method - dip hand, take out to allow paraffin to form a glove. re-dip 10 times, then wrap hand in plastic wrap. 2. immersion bath method - immerse hand in bath and hold it in position. 3. dip-immersion method - dip hand, take out to allow paraffin to harden, repeat 1-2 times, then immerse hand rest of way.
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how long is paraffin bath for the gloved method?
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15-20 minutes
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how long is the paraffin bath for the immersion method?
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20 minutes
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how long is the paraffin bath for the dip-immersion method?
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15-20 minutes
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when should you use fluidotherapy? (2)
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1. for desensitization 2. tolerable agitation
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how long before the treatment should you preheat fluidotherapy?
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30-45 minutes
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what is the appropriate temperature of fluidotherapy for: 1. CRPS/desensitization? 2. foot and ankle? 3. hand, wrist and elbow?
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CRPS/desensitization: 102-106 degrees foot and ankle: 106-112 degrees hand, wrist and elbow: 112-118 degrees
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how long is treatment for fluidotherapy?
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15-20 minutes
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what is the temperatures for warm immersion bath? what is the temperature for hot immersionbath?
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96-99 for warm 100-104 for hot
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what should you add to a warm/hot immersion bath if the pt has an open wound?
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disenfectant (betadine)
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Ultrasound
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...
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what is the optimal frequencies used for physical therapy purposes?
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1-3.3 MHz
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how are ultrasound waves produced?
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by running an alternating current across a piezoelectric crystal (ultrasound head/transducer)
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why does a PT need to keep the ultrasound head moving?
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the sound waves produce hot spots. to keep from burning th pt
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components of a ultrasound machine? (4)
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1. generator - power supply 2. coaxial cable - carries the current to the transducer/crystal head 3. transducer - ultrasound head (crystal) 4. type of crystal
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soundwaves are capable of what? (4)
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1. reflection 2. refraction 3. penetration 4. absorption
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where is soundwave absorption greatest in the body?
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at tissue interfaces
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how far can soundwaves penetrate the tissue?
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5 cm below the surface
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mechanical (non thermal) effects of ultrasound? (6)
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1. increases cell permeability to calcium and sodium ions 2. increases extensibility of connective tissue 3. stimulation of soft tissue regeneration 4. promtes bone and tissue repair 5. stimulate the release of histamine 6. decrease inflammatory phase
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Indications for ultrasound? (6)
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1. jt contracture 2. subacute/chronic soft tissue inflammation (thermal) 3. muscle spasm 4. trigger point areas 5. bone healing 6. tissue repair
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contradindications for ultrasound? (8)
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1. presence of cancer 2. pregnancy 3. myositis ossificans 4. over sites of insulin injection 5. over unhealed fx sites 6. epiphyseal growth plates 7. over spinal cord 8. cemented prosthesis
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factors that influence the effect of ultrasound on target tissue? (2)
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1. absorption of the ultrasound beam 2. BNR/ERA
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what factors effect the absorption of the ultrasound? (3)
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1. the protein content of the tissue (more pro = more absorption) 2. frequency of the beam (higher frequency = more absorption) 3. presence of fat in tissue (more fat = little absorption)
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what is BNR?
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beam non-uniformity ratio: is the ratio at the highest intensity found in the near field to the average intensity
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what is ERA?
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effective radiating area: always smaller than the transducer area. the higher the ERA in relation to the transducer area, the more efficient the US can be delivered to the tissue
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depth penetration of US on the tissue is determined by what?
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the ultrasound frequency
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3 MHz has a penetration depth of ? treatment time?
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up to 2.5 cm 3-5 min
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1 MHz has a penetration depth of ? treatment time?
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up to 5 cm 7-10 min
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with BNR 2 how fast should you move the transducer
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1cm per second
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with BNR of 6, how fast should you move the transducer?
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4 cm per second
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advantages of ultrasound?
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1. preferential form of deep heat 2. target tissue specific
