Adjunct 2 test 3 Tutor Notes All Content

How are histamines released through ultrasound?

cavitations and microstreaming

What are the contraindications for preforming ultrasound?

Acute conditions (continuous 100% duty cycle)

Ischemic areas

Areas of impaired circulation

Deep vein thrombosis or thrombophlebitis

Areas of poor sensation

Over cancer

Cancer for males - prostate

Cancer for females - breast

Over an active infection

Exposed metal that penetrates skin (piercings)

Over fractures

Over joint replacement using plastic or cement

Over pacemaker

Areas around the eyes, heart, carotid sinus, genitals

Over pelvis and lumbar areas during pregnancy

What are the precautions for ultrasound?

Over nerve plexuses or spinal cord after laminectomy

Over epiphyseal areas in young patients

What are characteristics of ultrasound in the acute stage?

Pulsed with low intensity

What are the two reasons for use of a coupling medium with ultrasounds?

Increased conduction and decreased acoustical impedance

Which of the following is not a method of ultrasound delivery?

Indirect

What amount of motion should be kept with ultrasound

4 cm/s

What are the settings for direct application 1MHz acute on ultrasound?

Time: 4-6 min

Intensity: 0.5-1.5 w/cm^2

Duty cycle: 10-20%

What are the settings for direct application 1MHz subacute on ultrasound?

Time: 6-8 min

Intensity: 0.75-1.25 w/cm^2

Duty cycle: 20-50%

What are the settings for direct application 1MHz chronic on ultrasound?

Time: 8-10 min

Intensity: 1-2 w/cm^2

Duty cycle: 100%

What setting is required to use the immersion or bladder method for ultrasound?

1MHz

What are the settings for direct application 3MHz acute on ultrasound?

Time: 4-6 min

Intensity: 0.5 w/cm^2

Duty cycle: 50%

What are the settings for direct application 3MHz subacute on ultrasound?

Time: 6-8 min

Intensity: 0.75-1 w/cm^2

Duty cycle: 50%

What are the settings for direct application 3MHz chronic on ultrasound?

Time: 8-10 min

Intensity: 0.5-1 w/cm^2

Duty cycle: 100%

When should the bladder method be used?

When 3MHz is not available and the treatment area has an irregular surface or boney prominence

What is Phonophoresis?

Using ultrasound to drive a topical medium (lidocane, cortisol, cortisone, ect) into tissues

What are the settings for immersion or bladder for an acute case on ultrasound?

Time: 4-6 min

Intensity: 1-2 w/cm^2

Duty cycle: 10-20%

What are the settings for immersion or bladder for a subacute acute case on ultrasound?

Time: 6-8 min

Intensity: 1.25-1.75 w/cm^2

Duty cycle: 20-50%

What are the settings for immersion or bladder for a chronic case on ultrasound?

Time: 8-10 min

Intensity: 1.5-2.5 w/cm^2

Duty cycle: 100%

What is current?

Ions moving from areas of high concentration to low concentration

How is current measured?

Amperes

What is a volt?

Electromotive force which is produced when there is a difference in electron population between two points

What is a conductor?

materials which facilitate electron movement

What are examples of good metal conductors?

Copper

Gold

Aluminum

What are examples of good tissue conductors?

Vessels

Nerves

Muscles

What is the best conductor in the human body?

Blood vessels

What is an insulator?

materials that resist electron transport

What are examples of environmental conductors?

Rubber

Plastic

Dry wood

What and examples of insulators in the body?

Fat

Skin

Bone

What is the best insulator in the body?

Fat

What is Ohms law?

Current in an electrical circuit is directly proportional to voltage and inversely proportional to resistance

What fraction represents ohms law?

I = V/R

Current = volts/resistance

What do watts measure?

the ability of a current to preform work

How are Watts calculated?

voltage x amps

What are the 3 types of current?

direct, alternating, pulsatile

What is the aka for direct current?

Galvanic

Is a direct current unidirectional or bidirectional?

unidirectional

What type of current is best for chemical effects?

Direct

Is a alternating current unidirectional or bidirectional?

bidirectional

Is a pulsatile current unidirectional or bidirectional?

Both

Which type of current can be described as monophasic and biphasic?

Pulsatile

What is a waveform?

A graphical representation of shape direction amplitude and duration of current produced

What are the three types of waveforms?

Sinusoidal, rectangular, triangular

What is pulse duration

amount of time needed to complete a full cycle

What is phase duration?

time needed for portion of the phase that rises above or below baseline

What is the sensory phase duration?

10-100 microseconds

What is the motor phase duration?

200-400 microseconds

What is the pain phase duration?

1 millisecond

What is the intErpulse interval?

No current flowing between pulses

What is the intrApulse interval?

No current flowing within pulses

What is the pulse period?

The period of time from the start oner one pulse to the beginning of the next

What is spatial summation?

Pulse, duration and intensity increase recruitment of motor neurons

What is temporal summation

Pulse frequency increases the rate of contractions per second

What is amplitude?

The intensity of the current

What is amplitude measured in?

mA, uA, mV

What is modulation?

Any change in amplitude, duration, frequency or current

Is there a change in waveform with modulation?

No

What is the positive pole called

Anode

What is the negative pole called?

Cathode

What are Anions

Negative ions attracted to the positive pole

What are Cations?

Positive ions attracted to the negative pole

What is a series circuit?

A circuit that has only one path to flow from one terminal to the other.

What is an example of a series circuit?

Electrical pads of the skin

What is a parallel circuit?

A circuit that has more than one path to flow

What does Coulombs law state?

Unlike charges attract whereas like charges repel

What is Kirckoff's principle?

Current in a circuit will seek the path of least resistance

What are the physiological effects of electrical currents?

Create muscle contraction through nerve or muscle stimulation

Stimulate sensory nerves to reduce pain (pain gate)

Produce an electrical field to stimulate healing

What is Iontophoresis?

Using an electrical field to drive ions into tissues

What type of current works can preform Iontophoresis

What reactions are seen at the positive pole?

Tissue hardening

What reactions are seen at the negative pole?

Tissue softening

What are the effects of electrical currents at the cellular level?

Excite nerve cells

Change cell membrane permiability

Protein synthesis

Stimulate fibroblasts, osteoblasts

Microstimulation

What are the effects of electrical currents at the tissue level?

Skeletal muscle contraction

Smooth muscle contraction

Tissue regeneration

What are the effects of electrical currents at the segmental level?

Change joint mobility

Muscle pumping edema

Increase movement of charged proteins increasing lymph

Excitation of motor nerves indirectly stimulating the ANS

What are the effects of electrical currents at the systemic level?

Analgesic effects such as endorphins are released

Analgesic effects from the stimulation of certain neurotransmitters

What is the absolute refractory period?

When the membrane becomes incapable of depolarization for 2 milliseconds. Pumps are actively trying to re-establish the resting membrane potential

What if the relative refractory period?

Stimulus can depolarize the cell during this time but the stimulus must be stronger

What is Wedensky inhibition?

Membrane becomes partially insensitive due to repeated stimulation before there is full restoration of membrane resting potential

What is Rheobase?

The minimal current of infinite duration that causes action potential

What is chronaxie?

Length of time required for a current of twice the intensity of the rheobase current to produce tissue excitation