Adjunct 2 quiz 3 study

What duty cycle causes non thermal effects?

~20%

What duty cycle produces thermal effects?

100%

What are beneficial effects on non thermal ultrasound?

Free flowing ions released

Destruction of fibrin clots

Increased blood flow

What are downstream effects of ion release?

Causes increased cell membrane permeability

Increases phagocytosis

Calcium enters cell

Decreased sodium permeability

What is a downstream effect of calcium entering the cell?

Increased collagen production

What is a downstream effect of decreased sodium permeability?

Increased pain threshold

cavitations and microstreaming stimulate the release of what?

Histamines

What is the term for Formation of microscopic gas bubbles that expand and compress as a result of ultrasonic induced pressure changes wich causes fluid movement?

Cavitations

What is the term for Unidirectional flow of fluids along boundaries of cell membranes from pressure wave caused by ultrasound?

Microstreaming

What are the (13) contraindications for ultrasound?

Acute conditions (for continuous (100%) duty cycle)

Ischemic areas

Areas of impaired circulation

Deep vein thrombosis or thrombophlebitis

Areas of poor sensation

Over cancer

Over active infection

Over exposed metal that penetrates the skin

Over Fracture

Over joint replacements using plastic or cement

Over pacemaker

Areas around the eyes, heart, carotid sinus, genitals

Over pelvis or lumbar area during pregnancy

What are the (2) precautions of ultrasound?

Over epiphyseal areas in young people

Over nerve plexuses, or over spinal cord after laminectomy

How often can ultrasound be used in the acute stage?

1-2x per day for the first few days (4-6 min)

How often should ultrasound be used in the chronic stage?

Less frequently, but for longer periods of time (8-10min)

What is the maximum number of applications that should be done for ultrasound?

14

When should you stop ultrasound useage if no improvements are seen?

After 3 treatments

What is the maximum time for 1 ultrasound session?

10 minutes

What is the term for water-soluble gels used to decrease acoustical impedance at the air/skin interface?

Coupling medium

What are the 3 types of ultrasound application?

Direct contact

Immersion

Bladder

How fast should the ultrasound head be moved during treatment?

4 cm/s

How large should the treatment area of ultrasound be?

2-3x the ERA (the size of the sound head)

What are the parameters of 1 MHz ultrasound application in the acute phase?

4-6 minutes

0.5-1.5 w/cm2

10-20%

What are the parameters of 1 MHz ultrasound application in the subacute phase?

6-8 minutes

0.75-1.25 w/cm2

20-50%

What are the parameters of 1 MHz ultrasound application in the chronic phase?

8-10 minutes

1.0-2.0 w/cm2

100%

What are the parameters of 3 MHz ultrasound application in the acute phase?

4-6 minutes

0.5 w/cm2

50%

What are the parameters of 3 MHz ultrasound application in the subacute phase?

6-8 minutes

0.75-1.0 w/cm2

50%

What are the parameters of 3 MHz ultrasound application in the chronic phase?

8-10 minutes

0.5-1.0 w/cm2

100%

What frequency is always used in immersion or bladder ultrasound?

1 MHz

What is the only difference in settings in bladder or immersion ultrasound?

increase intensity by 0.5 w/cm2

When is immersion US used?

Treatment area has an irregular surface

over bony prominences

3 MHz not available for superficial treatment

How far away should the ultrasound head be held from the skin in immersion ultrasound?

1 inch

What is the term for using ultrasound with a balloon filled with water, with conduction medium between head-balloon-skin?

Bladder

What is the term for the use of US to drive in topical medium into tissues?

Phonophoresis

What types of mediums can be used with phonophoresis?

lidocaine

salicylates

cortisol

dexamethasone (cortisone)

T or F: An open circuit is active, and electrons are moving

False (open circuit = nothing is happening)

What is the direction of flow of ions?

From high concentration to low concentration

What is the term for movement of ions?

Current

What is the term for the number of electrons flowing across a point per second?

Ampere

What is 1 ampere?

1 coulomb/second

What is the term for electromotive force which is produced when there is a difference in electron population between two points?

Volt (v)

What are the best conductors in the body, from best to weakest?

Blood vessels (best conductors)

nerves

muscles

What are the best insulators in the body?

Skin

Fat

Which law states that Current in an electrical circuit is directly proportional to voltage and inversely proportional to resistance?

Ohm's law

What is the equation of ohm's law?

I = V/R

What is the unit for the measure of the ability to perform work (power)?

Watt

What is the equation for power (watts)?

Voltage x amps (P = IV)

What are the 3 types of current?

Direct

Alternating

Pulsatile

What is the AKA of direct current?

Galvanic

Which form of current has a continuous unidirectional flow of electrons?

Direct

What effects are direct current best for?

Chemical effects

Which type of current has a continuous flow of electrons that is bidirectional, reversing polarity?

Alternating

Which form of current can be unidirectional or bidirectional, which can be interrupted by discrete periods of noncurrent flow?

Pulsatile

What are the two types of pulsatile current?

Monophasic

Biphasic

What are the 3 types of waveforms?

Sinusoidal - arch-like

Rectangular

Triangular

Which waveform can penetrate deeper?

Sine waves

What is the term for the amount of time needed to complete a full cycle?

Pulse duration

What is the time needed for a portion of the phase that rises above or below baseline?

Phase duration

What is the phase duration for sensory signals?

10-100 microseconds

What is the phase duration for motor signals?

200-400 microseconds

What is the phase duration for pain?

1 millisecond

T or F: Pulse duration and phase duration are the same for a monphasic wave and different for a biphasic wave

True

What is spatial summation derived from?

pulse duration and intensity

What is temporal summation derived from?

A calculation of pulse frequency

What is the term a period of time when no current is flowing?

Interpulse (between pulses) / intrapulse (within a pulse) interval

T or F: Pulsatile currents can have interpulse or intrapulse intervals

True

What is the term for the time period of one whole pulse?

Pulse duration

What is the term for the period of time when no current is flowing between pulses?

Interpulse interval

What is the term for the time it takes to complete one phase within a pulse?

Phase duration

What is the term for the period of time between phases within a pulse then no current is flowing?

Intrapulse interval

What is the term for a pulse duration plus an interpulse interval?

Pulse period

What is the term for the period of time from the start of one pulse to the beginning of the next?

Pulse period

What is the term for the intensity of current, found on the vertical axis of the pulse chart?

Amplitude

What is the term for any change in the amplitude, duration, or frequency of the current?

Modulation

What is the term for Peripheral nervous system adaptation to continuous stimuli?

Accommodation

What is the term for Central nervous system adaptation to continuous stimuli?

Habituation

What is the purpose of modulation?

prevent accommodation and habituation

What is the term for the positive pole of an electrical circuit?

anode

What is the term for the negative pole of an electrical circuit?

cathode

Which pole attracts anions (negative ions)?

Anode

What type of circuit is produced with electrical pads on the patient?

Series circuit, with the capacity for a parallel circuit

Which law states that unlike charges attract whereas like charges repel?

Coulomb's law

What principle states that current in a circuit will seek out the path of least resistance?

Kirchoff's principle

What are the physiological effects of current?

Create muscle contraction through nerve or muscle stimulation

Stimulate sensory nerve to reduce pain

Produce electric field to stimulate healing

What reaction occurs at the positive pole of monophasic/direct current?

Tissue hardening

Blood clotting

Attraction of leukocytes and macrophages

What causes the effects at the positive pole of a monophasic current?

Attraction of chloride and the production of sodium chloride (an acidic substance)

What reaction occurs at the negative pole of monophasic/direct current?

Tissue softening

clot removal

could increase collagen formation

What causes the effects at the negative pole of a monophasic current?

Attraction of sodium, creating a basic reaction

What is the term for introduction of ions into superficial tissues by means of a monophasic current?

Iontophoresis

What is the difference between monophasic and direct current?

Direct current is continuous

What are the effects of current at the cellular level

Excite the nerve cells

Change cell membrane permeability

Protein synthesis

Stimulate fibroblasts, osteoblasts

Microcirculation

What are the effects of current at the tissue level?

Skeletal muscle contraction

Smooth muscle contraction

Tissue regeneration

What are the effects of current at the segmental level?

Change of joint mobility

Muscle pumping edema

Increased movement of charged proteins increasing lymph

Excitation of motor nerve indirectly stim autonomic system

What are the effects of current at the systemic level?

Analgesic effects as endorphins are released

Analgesic effects from stimulation of certain neurotransmitters

What is the requirement for a stimulus for ions to be pushed through a membrane and cause depolarization?

Strong enough for long enough

What is the term for a membrane being incapable of depolarization?

Absolute refractory period

How long is the absolute refractory period?

2 ms

What is the term for when a membrane capable of depolarization but stimulus needs to be stronger?

Relative refractory period

What is the term for when a membrane becomes partially insensitive due to repeated stimulation before there is full restoration of membrane resting potential?

Wedensky inhibition

What is the term for the minimal current of infinite duration that will product and action potential or muscle contraction?

Rheobase

What is the term for the Length of time required for a current twice the intensity of rheobase current to produce tissue excitation?

Chronaxie

Ultrasound for chronic injury using a 3mHz head has all the following settings EXCEPT?

a. Duty cycle at 100%

b. intensity at 1-2 w/cm^2

c. make sure the head is moving approximately 4 cm/S

d. time 8 to 10 minutes

b. intensity at 1-2 w/cm^2

3 multiple choice options