PT Board Exam Chiro Essentials pt 1

What three things must be working for pain to be experienced

Local site of injury, spinal cord, and brain

What is nociceptive pain

Nerve is carrying the message

What is neuropathic pain

Nerve itself

What is radiating pain

Spreads outward from central location

What is radicular pain

Follows particular nerve root

What is referred pain

Pain felt in a differnet part of the body than the true generator

What is Gate Control Theory? Names of inventors?

Melzak and Wall said nerves that carry sensation pass through the same gains that carry pain. If the gate is flooded with sensation, pain signals are diminished

Types of fibers in gate control fiber

A beta is large and fast for sensation. A delta is small and fast for sharp pain.. C fibers are small and slow for dull pain

What is conduction and examples of it

Heat transferred between two touching objects. Moist hot pack paraffin bath

What is radiation energy transfer? Example?

HEat travels through the air to reach target tissue with infraredheat

What is convection energy transfer? Example

Swirling medium provides constantly supply of heat or cold which will change temperature of tissues faster. Hydrotherapy or fluidoptherapy

What is evaporation energy transfef? Example

Liquid changing into gas causes a rapid drop in temperature. Vapocoolan spray

What is conversion energy transfer ? Example

Different type where energy converted to heat, Deep heating such as continuous ultrasound or diathermy

What does the application of heat cause

vasodilation, increased blood flow, increased tissue elasticity, and increased cellular metabolic rate

Difference of superficial and deep heat depth

Superficial is 1cm. Deep is 3to 5 cm

What happens if heat is too intense or duration too long

Rebound vasoconstriction

Contraindicastions to heat therapy

Skin lesions, bleeding, numbness, tumor, burns

What can decreased cellular metabolism with cryotherapy lead to

Reduction in suecondary trauma. Loss of surrounding healthy cells

What does cold cause to the body

Vasoconstriction, decreased inflammation, decreased pain, and reduction in cellula rmetabolic rate

Four sensations of cold exposure in order

CBPN- cold, burning, pain,numb

What is the Lewis Hunting Responose

Too much cold exposure can cause rebound vasodilation

Contraindications to cold therapy

Cold allergy (hives/joint pain) , Raynauds, numbness, frostbite

Biggest concern for cold therapy and heat therapy

cold is frost bite, heat is burns

Why is vapocoolant spray helpful with trigger pooints

Rapid drop in temperature, then stretch

What is a contrast bath? why is it good?

Back and forth between cryo and heat. Get benefits of both for athletes.

General instructions of rmoist hot packs

6 layers of towel between hot pack/skin, patient should not lie on their back, superficial heat

Examples of infrared heat

Lamps, pads, IR saunas

What type of heat for infrared

Superficial is 1cm. Deep is 3to 5 cm

Paraffin baths helpful for

Arthritides or distal extremities

What additional exercises could be prescribed for patient in hydrotherapy or fluidotherapy

Range of motion exercises.

What kind of heat for paraffin bath, hydro/fluidotherapy, infrared, and moist heat

Superficial is 1cm. Deep is 3to 5 cm

Described therapeutic ultrasound

Electrical energy vibrates a crystal in soundheat and creates ultrasound waves.

Piezoelectric effect deals with which modality

Therapeutic ultrasund

Purpose of pulsed ultrasound

Decrease inflmmation and edema but does not generate heat

Purpose of continuous ultrasound

Used to increase blood flow and decrease hypertonicity bygenerating deep heat

Duty cycle for continuous versus pulsed US

Pulsed is 10,20, or 50% (optimally 20%), and continuous is 100%

What is the intensity of Ultrasound

Amount of ultrasound waves. IN W/cm^2

Recommended intensity of US

0.5-1.5 W/CM2

What is condensation , compression, rarefraction

Condensation/compression is areas of high energy in waves. Rarefraction is low eneryg

What does the frequency o ulrasound determine

Depth of penetration

What frequency of US for superficial versus deep tissues

3 mmHZ is superficial. (higher and doesn't go deep) but 1 mmHZ is less frequent and stays for deeper tissues)

What is propagation

How well the ultrasound waves move through tissues

Describe when and how to use water immersion method

Extremely tender or difficult to treat areas like a distal extremity. Sound head placed in tub of water with body part to be treated

What is phonophoresis

Using ultrasound to deliver topical medications into subcutaneous tissue

Contrinadication for US

fractures

Why is combination therapy useful

Effect of continuous ultrasound with deep heat. And effect of e stim to help pain control/muscle relaxation

What is combination therapy great for

Muscle knots , trigger piints, anything hypertonicity

Types of diathermy

Short wave and microwave. Microwave is rare

How does diathermy work

Electromagnetic field casues movement of ions. Movement causes friction which generates heat within target tissue

How is diatheramy similiar and different to US

Similiar in pulsed/continutous. Different in both pulsed and continuous diathermy generate heat

When is diathermy better than US

Deep heats larger areas more

What is contraindication to diathermy

Metal jewelry or metal implants

Four types of electrical current

Direct, Alternation , Pulsed , Biphasic

What is direct current? Examples

Uniteruppted, unidirectional flow. Example is low volt stimulation

What is alternation current

Uninterupred , bidirectional (alternates). Example is IFC and pre-modulated

What is pulsed current

Unidirection flow of electrons intersperes with periods of no flow. Example is High volt stimulation

What is biphasic current

Bidirectional flow of electrons intersperes with periods of no flow. Example is russian stimulation

Indiciations for electrical therapy

Pain, hypertonicity, edema, neuromuscular reeeducation, atrophy

What is contraindications for electrical therapy

Skin lesions, numbness, tumor, seizures, implanted electrical device

What causes more stimulation: small or larger electrodes

Smaller due to high current density

What is the beat frequency of FC

Difference between 2 channels

How to connect pads for IFC

4 pads criss crossed around area of complaint qusdripolar

What frequency to use for IFC with aucte pain

High frequency. Not sitting around much 80-150HZ

Whatfrequency to use for IFC with chronic pain

Low frequency. sit around for 3-5 Hz.

What is sweep mode for IFC

Help avoid patient accomodation

how is premodulated current different than IFC

Similiar to IFC but for smallertreatment areas so use machine creating interference internally then sending out to 1 channel

How to set up premod curent

2 pads around the area of complaint , proper frequency (80 to 150 hz for acute0 and low frequency (3-5 for chronic)

When to use high voltage pulsed stimulation

Edema, spasm,muscle re-ed, nerve sitmulation and pain control

What direction for high voltage stimulation

Push edema proximally

Difference between negative polarity and positive

Negative is from active pads to dispersive pad, positive polarity is from dispersive to active pads

What is low voltage direct current based on

Iontphoresis; using electrica current to deliver ionized medictions throught he skin

When to use russian stimulation

Atrophy and neuromuscular reeducation

Normal russian stim

1 channel, 2 pads on 1 muscle

Reciprodcal russian stim set up

2 channels, 2 pads on agonist and 2 on antagonist

Co-contraction of russian stim

2 channels, 4 pads on large muscle like quads

Meaning of cycle time for russian stim 10/30

10 secons on, 30 seconds off

Meaning of ramp for russian stim 1seocond

Each time a cycle will take 1 second to reach full strength

When to use microcurrent, goal?

Wound healing and pain control, goal is cellular stimulation not the nerve

What is TENS

Transcutaenous electrical nerve sitmulation. Usually small portable units

What theory does TENS unit rely upon

Gate Theory.

General indications for cervical and lumbar traction

Hypombobility, foraminal encroachment , nerve root impingement, facet syndrome, disc herniations

General containdications for cervical and lumbar traction

Hypermobility or instability, acute sprain/strain, boint or joint weakening diseases

What is absolute contraindication to cervical distraction

Vertebral artery disorders

Recomennded traction force for lumbar/cervical distraction

Minimal to obtain desired effects

Difference between continuous and sustained traction

Continuous is for hours/days at low force. Sustained is less than an hour

How could you know cervical traction would be good for a patient

Using manual distraction causes relief.

Contraindiction for massage

Acute inflammation, skin conditions, bleeding, clots

What is effleurage

Long strokes in the same direction as muscle fibers

What is petrissage

Kneading between thumb and forefingers

What is tapotment

Percussion massage with rhythmic tapping or pounding

What kind of massage stroke coud be used for bronchial congestion

Tapotment

What is cross friction massage

Applied perpendicular to direction of muscle fibers or tendon to help with fiber bundle alignement

What is the process of IASTM

Physically break up fascial adhesions and scar tissue through controlled microtrauma. Reactivating the healing process.

How does IASTM work with colagen

remodeling of unorganized colagen fiber matrix

How are trigger points maintained

Positive feedback loop until this loop is interrupted.

Difference of latent versus active trigger point

latent is not spontaneously painful. Active is spontaneously painful.

What to look for with trigger point

Perpetuating factors in patient biomechanics and activites of daily living

Types of braces

PICS : protective, immobiliatio,, corrective, supportive

Phyisological effects of bracing

Relieve weight bearing, limit motion

When is bracing a contraindication?

Whenever immobilization promotes muscular atrophy., weakness , or adhesions. Whenever may produce congestion, stasis or dependence