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  1. What happens once LLLT enter the tissue?
    • - once it has entered the tissue, laser is scattered by divergence
    • - reflected  and refraction, and it is attenuated by absorption
    • - once absorbed, increases kinetic energy
  2. What are the penetration depths of LLLT?
    • 1-2mm for red visible light
    • 2-4mm for short infrared
  3. How is LLLT absorbed in the tissues?
    • - by photosensitive molecules called chromophores in cell wall or mito
    • - cytochromes within the cell mitochondria
  4. Is laser thermal of chemical?
    - Chemical
  5. What electrode is visible red wave lengths and what is it absorbed by?
    • - HeNe
    • - 400-700nm
    • - absorbed by melanin, Hb and myoglobin
    • - very pigment specific 
  6. What does the diode gallium arsenide give off?
    • - non visible wavelength
    • - 600-1200 nm
    • - less pigment specific
    • - water and mm and other organic chromophores in cell membrane
  7. What does the permeability of tissue effet of LLLT?
    • - the effectiveness of absorption and stimulation 
    • - calcium ions are transported across the cell membrane setting the cell function- healing effects
  8. LLLT has two main functions
    • - potobiostimulation v photobioinhibition
    • - Arndt- Schultz
    • - low LLLT- photostimu
    • - High LLLT- photoinhib 
  9. What are the direct and indirect effects of LLLT?
    • direct- response in tissue to absorption
    • - indirect effect-normal metabolic process in the deeper tissue is sped up from the energy absorption in the superficial structures 
  10. Therapeutic uses of LLLT?
    Image Upload 1
  11. Tissue healing of LLLT?
    - wave length- young et al 660, 820 and 870 wavelengths encourage macrophages to release factors that stimulated fibroblasts. 880nm was inhibitory

    - pulse frequency - 700Hz - more organised fibroblasts
  12. LLLT effective for what sort of pain relief
    • - mmskeletal disorders
    • - neurogenic conditions- trigeminal, post traumatic
    • - trigger/ acupuncture points
    • - nerve conduction rate 
  13. What is the effectiveness of LLLT?
    - ongoing discussion about the effectiveness
  14. What are the principle of application?
    • - most applied directly to skin by hand held applicator- light pressure can increase the penetration depth and squeeze blod out of the capillaries
    • - thers held in a rigid stand 30 cm away- covers large area
    • - cluster probes-  emit at diff wavelengths
    • EYEWEAR needs to be worn 
  15. Application of LLLT
    • - - applicator at right angles- maximum penetration
    • - if contact not wanted- glad wrap or hold off
    • - if area is large reprosition applicator and start again
    • 1cm2 is one application 
  16. What is visible red laser used for?
    • - superficial conditions such as wounds, ulcers and other skin conditions
  17. What are infrared to treatment
    • - they are used for deeper mmskeletal structures
  18. Energy density of LLLT
    • treatment given in J/cm2
    • - other names for this are energy density or radiant exposure
    • - mean power output in mW is usually fixed. When divided by the fixed area of the beam, it gives the power desity or irradiance in mW/cm2
    • - when this is x by time for it is applied it is given in j/cm2
    • - usual range is 1-10J/cm2
    • - higher dosages are usually recommended for subcutaneous tissues
    • - dosages described are those applied to the skin surface. The dosage depth is unknow
  19. What is the pulse output?
    • - pulse duration is adj such that low pulse rates have long pulse lengths
    • - low frequencies and long durations are used for acute condition and higher pulse rate and shorter pulse duration for chronic conditions 
  20. Area of treatment?
    • - discrete lesions should be treated directly over the afected part
    • - if treating wounds and larger areas, the part is divided into 1cm2 by a grid
    • - painful areas are usually treated at the point of max pain- subcutaneous
  21. Treatment parameters
    Image Upload 2
  22. What are the dangers and contraindications?
    • - beam application to the eye
    • -neoplastic tissue- increase acitivty
    • - uterus of preg woman (unclosed fontanelle)
    • - haemorrhaging or infected tissue 
  23. What is the warning for LLLT?
    • During laser treatment you should feel nothing other than the pressure of the applicator against your skin. If you feel any discomfort, you must inform me immediately and the treatment will be terminated. Side effects from laser therapy include dizziness, nausea or an initial increase in pain. They are short term only and usually only occur if the treatment dose is too high. Please do not move or touch any of the equipment during treatment. If you become uncomfortable tell me immediately.
    • Do you understand what I have said? Do you have any questions? Are you happy for me to proceed?
  24. Laser
    • - output 10, 20, 30 or 40mW
    • - Ga Al as diode
    • - 830nm wavelength
    • - continuous output mode
    • - 60 sec time 
  25. Power output-therapower
    Image Upload 3
    • mW- milli watts Power density= mean power/ area of beam = mW/ cm2 Power density x n# seconds = number of jules/ cm2- energy density EXAM!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
    • Mean power = 10mW
    • Beam area= 0.125
    • Power density = 10/0.125 = 80 mW/cm2
    • Time 50 sec= PDx time= enery density = 80 x 50 = 4000mJ/cm2 = 4J/cm2
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