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Each ______ (degree) change in body temperature results in __ (%) change in the tissues metabolic rate
1c/1.8F & 13%
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Law of Grotthus Draper:
states that the more energy absorbed by superficial layer, the less that there is to be absorbed by deeper layers.
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Conversion
Energy is changed from one form to another. Ultrasound, diathermy, electrical energy into heat.
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Radiation
- emmited from surfaces above absolute 0
- transfer of energy without the use of a medium
- Body, Sun, Infared Lamp, LASER, UV
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Cold Modalities
- Range from 32-65
- In order to be beneficial, skin temp must lower to 57
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Cryo Indications
- Acute Injury or imflammation
- Pain
- Muscle spasms
- Restoration of ROM
- small, superficial 1st degree burns
- Post surgical pain & edema
- Neuralgia
- Post-Exercise
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Cryo contraindications
- Cardiac or respiratory involvement
- open wounds
- cold allergy
- circulation insufficiency
- advanced diabetes
- analgesic skin
- Reynauds
- Lupus
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Effects of cryo
- lowers tissue temperature
- vasoconstriction
- Prevents or limits swelling
- decreased metabolism
- decreases need for oxygen (reduces # of cells killed due to lack of o2)
- decreases pain by increasing pain threshold
- decreases cellular waste
- decreases muscle spasms
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Cold decreases inflammation by:
- decreases the release of inflammatory mediators (histamine & prostaglandin)
- decreases prostaglandin synthesis
- decreases capilary permeability
- decreases creatine-kinease activity
- decreases leukocyte-endothelial interaction
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Cold decreases pain by
- decreasing edema
- decreasing muscle spasms
- decreases conduction velocity
- interrupts pain transmission
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Mottling
blotchy discoloration of the skin
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Transfer of heat occurs via
conduction
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Local thermo effects
- increases metabolism
- vasodilation
- increased capillary permeability
- increased nerve conduction
- decreased pain
- decreased spasm
- edema formation
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Systemic thermos effects
- increases pulse rate
- increases body temp
- increases respiratory rate
- decreases blood pressure
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indications for thermo
- subacute & chronic pain
- increase ROM
- increase lymph drainage
- increase blood flow
- increase metabolism
- increase pulse
- increase respiratory rate
- decrease pain
- decrease muscle spasm
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thermo contraindications
- acute injury
- open wounds
- heat stress or illness
- loss of sensation
- impaired circulation
- clots
- cancer
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Primary limiting factor for heat
adipose tissue
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Questions to ask before using heat
- Does the body area feel warm to the touch?
- Is the injured area still sensitive to light to moderate touch?
- Does the amount of swelling continue to over time?
- Does swelling during activity (joint motion)?
- Does pain limit the joint’s ROM?
- Would you consider the acute inflammation process to still be active?
- Does the patient continue to display improvement with the use of cold modalities?
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Indications for whirlpool
- stage 3 & 4 pressure ulcers
- infected wounds
- wounds with think eschar
- burns
- subacute or chronic inflammation
- conditions that produce weakness
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indications for contrast bath
- post athletic exertion as it increases the departure of lactic acid
- subavute or chronic inflammatory issues
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contraindications for contrast
- ankle sprains
- pts with type 2 diabetes (cannot vaso constrict or dilate)
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Precautions for contrast bath
- age (under 4 or old as there is inability for thermoregulation)
- raynauds
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indications for compression
- post surgery (edema/decreases dvt liklihood)
- lymphadema
- amputations
- venous ulcers
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contraindications for compression
- edema w/o diagnosis
- DVT
- renal edema
- arterial wounds
- cardiac edema
- acute infections (cellulitis)
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precautions for compression
- diabetes
- cancer
- altered mental status
- paralysis
- cellulitis
- sensitivity to compression
- inability to comply with home instruction
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Benefits of US
- Increase in blood flow
- Increase in metabolism
- Increased nerve conduction velocity
- Increased CT extensibility
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Indications for US
- Soft Tissue Shortening
- Calcific Tendonitis
- Osteoarthritis
- Later epicondylitis
- Carpal Tunnel Syndrome
- Tendon Healing
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Precautions for US
- Concentration can cause burns
- Epiphysis of growing bones
- Avoid too high of intensity
- Acute inflammatory pathologies
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Contraindications for US
- Over anesthetic areas, cervical ganglia & pacemaker
- Impaired arterial circulation
- Hemorrhage
- Cancer
- Thrombophlebitis
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Indications for phonophoresis
- LAteral epicondylitis
- Shin Splints
- Knee osteoarthritis
- TMJ Dysfunction
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What is TENS used for
Controlling acute & chronic pain
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What is ESTR used for
- Reducing Edema
- Tissue Repair
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What is NMES used for
- Reducing muscle spasms
- Strengthening muscle
- minimizing atrophy
- Facilitating fracture healing
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The driving force of the electrical current is?
The voltage
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What is an amper
the measurement of the current
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Cathode
Negative pole of high electron concentration
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Anode
Positive pole and area of low electron concentration
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Semiconductor
conducts 1 direction better than the other
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Rate
how fast the energy travels
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Voltage
- Force or potential difference between the 2 poles
- Low <100-150
- High>100-150
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Resistance
- The opposition to the flow of current ... eg:
- length
- Material
- temperature
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Ohm's law
- THE RELATIONSHIP BETWEEN CURRENT, VOLTAGE AND RESISTANCE
- Current is directly proportional to voltage
- Current is inversely proportional to resistance
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Critereon for depolarization
- amplitude
- rise time
- duration
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frequency
- the amount of pulses/time
- MENS<IFC<TENS
- 1K-100K Hz
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Contraindications for AC/DC
- Heart Issues
- PAcemaker
- Pregnancy
- Menstration
- Cancer
- Site of Infection
- Metal implants
- Nerve Sensitivity
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Precautions
- Peripheral neuropathy
- Decreased sensation
- Skin conditions
- Cognition
- Obesity
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