VCU DPT - Agents (Ultrasound PART 2)

contraindications to ultrasound (11)

malignancy

pregnancy if over area

prosthetic joint cement

over epiphysis

hemorrhagic condition

DVT

pacemaker

over radiated tissue

carotid sinus/ant neck/head/reproductive organs

impaired sensation/sensation/cognition (CONTINOUS)

inflamed or infected tissue (cont)

ultrasound precautions (4)

over spinal cord, or regenrating nn

acute inflammation

impaired sensation/cognition/circulation PULSED

over inflamed or infected tissue (pulsed)

with ultrasound, avoid what sensation over what type of prominence?

why??

ache or pain over bony prominence

could be periosteal heating

adverse effects to ultrasound

BURNS

cross contamination an infection

why do we need to santize the machine and not touch tip of US gel to patient

cross contamintion/infection

what things could lead to burns

high intensity US

poor circulation/sensation

superficial bone

what are the 4 main principles for US application

US head kept perpindicular to skin

- to avoid energy loss

applicator remain in contact with skin

- or else crystal can break at high inten.

coupling gel MUST be used

transducer MUST be continouslly moving during treatment

t/f: moving the tranducer too quick will not result in decreased heating, but moving it in too large of an area will

true

speed we need to move transucer during US treatment

4 cm/sec

1.5 in/sec

what is optimal techqniue for US transducer app

ssmall overlapping circles in a larger, big circle

- big circle max as big as 2x ERA

name some coupling mediums

gel

gel pads

ultrasound lotion

water

- is use water, hold application a little away from the tx area

for ultrasound AROUND wound (peri-wound)

- frequency

- duty cycle

- intensity

- US head size

1 MHz

100%

1-1.5 W/cm^2

1.5-2x wound size

for ultrasound application TO wound

- what is needed as barrier

- intensity

- duty cycle

- frequnecy

- duration

- frequency per week

hydrogel sheet over wound, or fine saline mist

0.5-1 W/cm^2

20%

1 MHz or 3 MHz

5 min (add a min for every square cm)

3-5 times a week

we can use __(1/3)__ MHz for both peri-wound or directly on wound US, but we can only use ___(1/3)__ MHz for application directly to wound

1

3

what is phonopoersis

ultrasound to help deliver transcutaneous drug

used mostly w/ corticosteroids, salicyates, anesthetic

US allows for stratum corneum permeability

common phonoporesis paramters

frequency

duty cycle

intensty

duration

3 MHz

20% duty cycle

0.5-0.75 W/cm^2

5-10 min

benefits to phonopoesis

higher concentration at delivery site

no gastric irritation

no frst pass by liver

no pain/trauma at injection

larger area of delivty

effects of phonoporesis

local

systmeic

local: more concentrate

systemic: via vascular circulation, less effect

is the research very positive for phonpohoresis

nope!

if you decide that US may help pomote tissue healing, what would you do

what if it would help with tissue being short?

pulsed might help

thermal/continous might help, in combo w/ stretching

does acute injury want thermal

no

1 MHz goes ___ inch deep, while 3 MHz goes ____ inch deep

2, 1

effect: mild thermal

temp increase is ________

application is for _________

1 deg C

subacute injury

effect: moderate thermal

temp increase is ________

application is for ______

2-3 deg C

pain, MTrP

effect: vigorous thermal

temp increase is ______

apllication is for _______

4 deg C

collagen elongation

anything unique about the application

no, just be comfortable

test sensation

sund head 1/4 to 1/2 treatment area size

use coupling medium

start moving before turning US on

use constnat pressure to eliminate air between skin

when units turns off, inspect skin

which comes first:

moving of US head

turning machine on

moving of US head

why do we need constant pressure with US head

to avoid air/space between, so less attenuation occurs