304lecture: diathermy

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304lecture: diathermy
2014-05-04 16:00:05
304 modalities

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  1. high frequency electromagnetic energy used to produce deep heat within the tissues is called:
  2. the FFC reserved which 3 frequencies for medical use only:

    which frequency is the most common used:
    • 13.56
    • 27.12
    • 40.68

    most common: 27.12
  3. the energy delivered to the body is high frequency alternating electrical current, but:
    the wavelength lacks the duration needed to depolarize motor nerves ( and contraction of muscles)
  4. list the thermal effects of diathermy: (7)

    (similar to those of heat in general)
    • changes in physical properties of tissues (extensibility)
    • tissue temperature increase
    • increased blood flow (vasodilation)
    • increased venous and lymphatic flow
    • increased metabolism
    • muscle relaxation
    • analgesia
  5. list the non-thermal effects of pulsed SWD used to tx soft tissue injuries and wounds: (5)
    • change ion binding to cell membrane
    • -activation of fibroblast
    • -increase macrophage activity
    • -edema reduction
    • corrects cell dysfxn
  6. list 3 other names to which pulsed SWD can be referred to by:
    • pulsed electromagnetic energy (PEME)
    • pulsed electromagnetic field (PEMF)
    • pulsed electromagnetic energy tx (PEMET)
  7. the method of SWD in which the pt. becomes a part of the electrical circuit is called:

    what is the depth of penetration for this method:
    • condenser (capacitive) unit
    • depth of penetration: 2-5 cm and can be uneven

    plates are on both side of the area being tx'ed
  8. the method of SWD that uses a coil or a drum to tx the area being placed in the electromagnetic field is called:

    what is the depth of penetration for this method:
    induction unit
  9. the capacitive method (condenser units) is not recommended for which pts:
    pts. who have a large layer of adipose tissue
  10. pulsed SWD produces the same magnitude and depth of muscle heating as which frequency in U.S:
    pulsed SWD produces the same magnitude and depth of muscle heating as: 1 MHz ultrasound

    • both give even heating at the same depth
    • both lose heat within 5-10 minutes, so strecth, ROM, ect!!!

  11. explain how the following heats the tissues listed above in the pic...

    inductive coil:
    capacitive plates:
    • inductive coil: cuts thru adipose, doesnt heat the bone
    • capactitive plates: selectively heats adipose tissue, does not heat other tissues well. Also heats bone, be cautious with metal in bone
    • ultrasound: similar to inductive coil, cuts thur adipose tissue, and doesnt heat the bone
  12. list (2) considerations for the setup of capacitive plates:
    • equal distance above the tissue
    • differential heats adipose tissue directly below plates and bone

    • keep movement to a minimum
    • tx time: 15-20 minutes
  13. list (3) considerations for the setup of induction drum:
    • position above toweling .5 to 1 inch
    • may need to let unit warm up
    • greatest heat within muscle driectly below drum

    • keep movement to a minimum
    • tx time: 15-20 minutes
  14. uneven spacing of the capacitor plates can cause uneven heating with more heat accumulation on which side of the surface:
    heat will accumulate on the side where the electrode is closer

    the sensation of heat is in direct proportion to the distance of the electrode from the skin

    parts of body low in subcutaneous fat is the best tx'ed
  15. The capacitor electrodes the electrical field is is the lines of force exerted on the charged ions that cause:

    where in the capactiro electrodes is the current density the highest:
    • cause movement from one pole to the other
    • current density is the highest: in the center, not the periphery
  16. SWD (capacitor pads) cause a great deal of rotation that prodcues:
    kinetic energy that is then released as heat within the tissues
  17. where is a high # of dipole concentration found:

    what is the energy/heating ratio for a high # of dipoles:
    • high # of dipoles found: skin and muscles
    • more energy =  less heating
  18. where is a low # of dipole concentration found:

    what is the energy/heating ratio for a low # of dipoles:
    low # dipole concentration: adipose tissue

    less energy= rapid over heating

    heat will build up here, not dissapate
  19. what is the advantages of the conductor pads:
    • allows for larger tx area
    • the further apart they are from each other, the deeper the penetration
    • (closer together is a smaller tx area)
  20. list 2 ways to provide uniform heating for the pad electrods:
    • even contact pressure
    • uniform distance from the skin
  21. increasing the space between the electrod pads will increase the depth of penetration, but what will it do to the density current:
    decrease the current density
  22. list 4 situations in which diathermy should be used:
    • if the skin or some underlying soft tissue is tender and will not tolerate pressure
    • in areas where subcutaneous fat is thick and deep heating is required (hot pack will not cut thru)
    • when the tx goal is to increase tissue temps in a large area (2x the area with a sound head, much larger area than U.S.)
    • SWD energy is not reflected by bone- so no periosteal heating
  23. list (7) indications for the use of diathermy:
    • pain
    • edema
    • tissue healing
    • nerve healing
    • bone healing
    • OA symptoms
    • ROM
  24. list (7) contraindications for the use of diathermy:
    • peripheral vascular disease (not good BF, cant cool area)
    • pregnancy
    • fever
    • malignancy
    • pacemakers
    • growth plates (epiphyseal)
    • shunts
  25. list (6) precautions to consider in the environment of diathermy tx:
    • beds
    • chairs
    • stools
    • splints
    • medical instruments
    • electrical modalities
  26. list (7) precautions to consider that are near the patient during a diathermy tx:
    • jewlery
    • piercings
    • watches
    • change in pockets
    • belt buckles
    • metal in underwire bras
    • hearing aids
  27. list (7) precautions to consider that may be "in the patient" during a diathermy tx:
    • braces
    • dental fillings
    • ORIF devices
    • metal heart valves
    • IUD's
    • pacemakers
    • shunts
  28. the intensity of the energy striking the tissues is proportional to the square of the distance between the source of the energy and the tissues is called:
    the inverse square law

    most SWD tx last for 20-30 minutes
  29. heating with continuous SWD that will provide "vigorous heating within pain threshold" is a TTR of:
    • Dose IV (or 3-4o)
    • Heavy
  30. heating with continuous SWD that will provide "no sensation of heat" is a tx of:
    • Dose I
    • Lowest
  31. heating with continuous SWD that will provide "mild heating sensation" is a tx of:
    • Dose II
    • Low
  32. heating with continuous SWD that will provide "moderate or pleasant heating sensation" is a tx of:
    • Dose III
    • Medium
  33. during SWD applications, high frequency electromagnetic energy is changed to heat by the process of:

    A. convection
    B. conversion
    C. collection
    D. conduction
    B. conversion
    (this multiple choice question has been scrambled)
  34. which of the following types of SWD application places the athletes tissues within the generators physical circuit.

    a. capacitive method
    b. inductive method
    a. capacitive method
  35. when using a SWD induction drum, the drum should be positioned ____ in. from the pts. skin

    A. 1
    B. 2
    C. 4
    D. 8
    (this multiple choice question has been scrambled)
  36. which form of SWD should not be used over large areas of adipose tissue?

    a. capacitive plate
    b. inductive method
    a. capacitive plate
  37. what 5 factors determine a medications (phonophorsis) ability to diffuse thru the tissues:
    • hydration
    • age
    • composition
    • vascularity
    • thickness
  38. compare the following features between ultrasound and SWD:

    type of energy:
    tissues heated:
    volume of tissues heated:
    temperature increase:
    heat retention:
    • ultrasound
    • type of energy: acoustical
    • tissues heated: collagen-rich
    • volume of tissues heated: small (20 cm2)

    • temperature increase:
    • 1MHz: more than 6.3oF (3.5oC)
    • 3MHz: more than 14.9oF (8.3oC)

    heat retention: short appox 3 minutes

    • SWD
    • type of energy: electromagnetic
    • tissue heated: (capacitive): adipose tissue, skin, (inductive): muscle, blood vessles
    • volume of tissue heated: large (200 cm2)

    • temperature increase:
    • capacitor: more than 7oF (3.9oC) (adipose tissue)
    • inductive: more than 18oF (10oC) (intramuscular tissue)

    heat retention: long (approx. 9 minutes)
  39. when setting the diathermy for non thermal (relative) effects, what is the default intensity:
    200 watts
  40. the most vigorous dose (temp) of heating for diathermy and used for tissue extensibility is:
    dose IV or 4-6 degree TTR
  41. the diathermy application that selectively heats adipose tissues is called:
  42. the therapy that uses a magnetic field to produce "eddy" currents are called:
    shortwave diathermy