physical agents exam 3

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KatyRichman
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300726
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physical agents exam 3
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2015-04-15 23:00:47
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diathermy compression massage hydrotherapy UV russian biofeedback
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physical agents exam 3
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  1. what is the application of shortwave or microwave electromagnetic energy to produce heat and other changes within tissues
    diathermy
  2. T/F: diathermy heats deeper than MHP and heats a larger area than US
    true
  3. is pulsed shortwave diathermy thermal or non-thermal?
    non-thermal
  4. when using diathermy for increasing tissue temp. is it thermal or non-thermal and what is the mode?
    thermal; continuous
  5. what are the 3 types of diathermy application?
    • inductive coil
    • capacitive plates
    • magnetron
  6. which type of diathermy involves high frequency alternaing current in an antenna to deliver MWD?
    magnetron
  7. which type of diathermy is made of metal incased in plastic houseing (drum) or carbon electrodes within a sleeve?
    capacitive plates
  8. pain control
    accelerated tissue healing
    decreased joint stiffness
    increased ROM

    these are clinical indicators for what?
    thermal level diathermy
  9. control edema
    pain control
    soft tissue healing
    nerve healing
    bone healing
    OA symptoms

    these are clinical indicators for what?
    non-thermal short pulsed wave diathermy
  10. avoiding fatty areas and making sure to keep skin dry are precautions to reduce the risk of adverse effects due to what?
    diathermy
  11. what is defined as an upward force on an object immersed in water equal to the amount of water that is displaced?
    buoyancy
  12. a force that counters the direction of movement and increases water in proportion to speed of motion
    resistance
  13. pressure exerted y water that increased with depth of immersion
    hydrostatic pressure
  14. hydrotherapy acts as a ____________ and can be used in conjunction with dissolved _____________ & _________________
    debriding agent; surfactants & antimicrobials
  15. decreased weight bearing, strengthening, effects on bone density loss, and less fat loss than other forms of exercises are musculoskeletal affects of what?
    hydrotherapy
  16. increased venous circulation, cardiac output & volume, and decreased heart rate, SBP, VO2 response to exercise are cardiovascular effects of?
    hydrotherapy
  17. decreased vital capacity and exercised induced asthma and increased work of breathing are respiratory effects of?
    hydrotherapy
  18. what are the 2 ways in which hydrotherapy can affect the kidneys?
    diuresis and increased sodium and potassium excretion
  19. how does hydrotherapy have a psychological effect?
    its relaxing and invigorating... it depends on the water temp
  20. what does water exercise increase?
    • circulation
    • muscle strength
    • jt. viscoelasticity
    • flexibility/ROM
  21. hydrotherapy exercise decrease _____________, ______________ & ________________.
    pain, muscle spasm, stiffness
  22. ambulation, coordination, cardiopulm conditioning and psychological well being can be improved using what physical agent?
    hydrotherapy
  23. pt.'s with muscskele and neuro problems, decreased cardiac fitness, who are pregnant, have exercise induced asthma or age related deficits would benefit from what type of physical agent?
    hydrotherapy
  24. does water therapy decrease OA pain compared to land therapy?
    yes
  25. is water therapy beneficial for pt. with fibromyalgia?
    yes, it can reduce their pain and swelling
  26. T/F: water therapy can be good for CHF if closely monitored?
    true
  27. who do pregnant ladies like water therapy?
    • unloads WB jt.'s
    • controls peripheral edema
    • less elevation HR, BP, and body temp
  28. why is hydrotherapy beneficial for older pt's?
    • increase strength
    • function mobility
    • balance
    • quality of life
  29. what two pt. populations are good candidates for hydrotherapy because it is especially good for controlling their pain?
    OA and fibromyalgia
  30. what is the issue with hydrotherapy and wound care?
    risk of infection
  31. NPWT or wound vac is used for what?
    removes fluid and mechanically debrides the wound
  32. drowning, burns, fainting, bleeding, hyponatremia, infection, aggravation of edema, asthma exacerbation are all adverse effects of what?
    hydrotherapy
  33. what is the therapeutic temp range for a pool?
    79-98 degrees
  34. what is a contrast bath?
    hot -> cold -> hot -> cold...
  35. psoriasis, scleroderma, eczema, atopic dermatitis, cutaneous T-cell lymphoma, vitiligo, and palmoplantar pustulosis are conditions that are treated in PT using what type of modality?
    UV radiation
  36. what are the 3 bands that UV is divided into?
    UVA, UVB, UVC
  37. which band produced flourescence in many substances?
    UVA
  38. which band produces the most skin erythema?
    UVB
  39. what the is most significant source of UV?
    the sun
  40. which bands reach the earth from the sun
    UVA & UVB
  41. which band penetrates the deepest?
    UVA
  42. what is thickening of the superficial ayer of the skin that occurs 72 hours post exposure?
    epidermal hyperplasia
  43. psoriasis, psoriatic arthritis, vitiligo, and wound healing are clinical indicators for what?
    UV
  44. burning, premature aging, carcinogenesis, eye damage, and oral psoralens are adverse effects of?
    UV radiation
  45. "laying of the hands", lowers tension and anxiety and well being are psychological effects of what?
    massage
  46. effects skin and superficial connective tissues
    mobilizes and stimulates sensory receptors
    possible ans response
    causes sedation, relieves tension, and increases blood flow
    pain gate theory
    increased circulation via dilation of lymphatics and capillaries
    effleurage, slow, gently, rhythmic

    these are what type of effects massage can produce?
    reflexive
  47. what kind of mechanical effects will massage thereapy have on muscles?
    • increase blood flow
    • ROM
    • retard mm atrophy
    • stretch mm, elongate fascia, STM
  48. what kind of mechanical effects will massage have on skin?
    • increased temp
    • loosen adhesions and scar tissue and btw skin and sub-q tissue
  49. reduce pain, increase ROM, decrease edema, break adhesions, myositis, migraine or HA relief, trigger point, mm spasm or cramping, scar tissue, bursitis, tendonitis intermittent claudication, and raynauds are indications for what?
    massage
  50. what type of massage is described as gliding lightly over skin?
    effleurage
  51. what direction shoud you move your hands while doing effleurage?
    begin peripheral and move towards heart
  52. during what part of the massage do you do effleurage?
    beginning and end
  53. what type of massage is described as kneading, manipulation to press and roll the muscles under fingers and hands?
    petrissage
  54. what is the goal of petrissage?
    break adhesions, loosed fibrous tissue and increase skin elasticity
  55. what type of massage is described by series of risk contact with skin like hacking, slapping, beating, cupping, and tapping?
    tapotement or percussion
  56. what is the main goal of percussion?
    increase circulation and stimulation of peripheral blood flow and clapping/cupping is used with posteral drainage
  57. what is the progression of massage therapy?
    superifical stroking > deep stroking > kneeding > friction > deept stroking > superficial stroking
  58. what is the general time frame for massage?
    10-15 minutes
  59. a hands on technique that involves applying gentle sustained pressure into the myofascial connective restrictions to restore motion and decrease pain?
    MFR
  60. what are the different types of MFR?
    • cross-hand arm pull
    • arm/leg pull
    • scar release
    • sub-occipital release
    • rebounding
  61. application of mechanical force that increases external pressure on the body or a body part. it is used to improve fluid balance and cirulation and modify scar tissue formation 
    compression 
  62. what is compression used for?
    • reduce swelling
    • improve circulation
    • modify scar tissue formation 
  63. compression is accomplished by increasing the ____________ in the _____________.
    hydrostatic pressure; interstitial space 
  64. what is steady application of pressure called?
    static compression 
  65. what do you call it when pressure is alternately applied and released?
    intermittent compression 
  66. what is the primary reason you would use compression?
    control peripheral edema due to vascular or lymphatic dysfunction 
  67. how does compression help with scar modification?
    enzyme activity to break down collagen = possible theory to control scar formation 
  68. normal fluid equilibrium in the tissues is maintained by the balances between?
    hydrostatic pressure and osmotic pressure 
  69. blood pressure + gravity =
    hydrostatic pressure
  70. concentration of proteins inside and outside the blood vessels
    osmotic pressure 
  71. what fluid is rich in protein, water and macrophages?
    lymphatic 
  72. what are the factors that effect edema?
    • healthy diet
    • vascular system
    • muscular contraction 
  73. venous insufficiency and dysfunction of the lymphatic system and the most common reasons for what?
    pt.'s develop edema 
  74. exercise, trauma, surgery, burns, infection, preggo, and dependent positions are other issues that ____________ may also present with
    edema 
  75. CHF, liver failure, acute renal disease, diabteic golmerulonephritis, malnutrition and radiation injury are pathologic examples of what?
    edema 
  76. what is the most common cause of edema due to venous insufficiency?
    phlebitis; inflammation of the veins 
  77. lack of physical activity, dysfunction on the venous valves due to degeneration and mechanical obstruction are other causes for what?
    edema 
  78. what is swelling caused by excessive lymphatic fluid in interstitial space?
    lymphedema
  79. system of vessels and nodes designed to carry excess fluid from the interstitial spae to the venous system and to filter the fluid, removing bacteria and other foreign particles 
    lymphedema 
  80. fluid generally flows into the lymphatic system because of the greater concentration  of __________ in the lymphatic vessels is __________ than in the interstitial space
    proteins; greater 
  81. decreased levels of plasma protein and plasma albumin, mechanical obstruction of the system, abnormal distribution of vessels and nodes are reasons for what?
    lymphadema
  82. Hx of CA and radiation therapy, node disruption, onset of swelling at birth or puberty, chronic inflammation are risk factors for what?
    lymphedema 
  83. edema that is not relieved by elevation or is pitting edema early on and non-pitting later with fibrotic much later are characteristics of what?
    lymhedema 
  84. almost all cases of lymphedema are?
    secondary
  85. secondary lymphedema is caused by what?
    inflammation, preggo, neoplasm, trauma or surgery 
  86. what is the only primary cause for lymphedema?
    congenital
  87. what is manual lymphatic drainage contraindicated for?
    CHF or pulmonary edema 
  88. restrictions of ROM, limitations on function, pain, chronic edema and advanced chronic edema are all adverse consequences of?
    edema 
  89. compression is effective in controlling edema due to?
    • venous insufficiency
    • lymphatic dysfunction
  90. compression is less effective in controling edema due to?
    • infection
    • malnutrition
    • inadequate physical activity
    • organ dysfunction 
  91. what is defined as blood clots in the deep veins?
    deep vein thrombosis 
  92. DVT is most common in?
    • immobilized pt.'s or extremities 
    • after surgery
    • recovering from cardiac failure or stroke 
  93. what is defined as areas of tissue breakdown and necrosis that occur as the result of impaired venous cirulation?
    venous stasis ulcers 
  94. impaired venous circulation may be a result of?
    • lack of muscle contraction
    • venous insfficiency 
    • mechanical obstruction 
  95. what can impaired venous circulation result in?
    • poor tissue oxygenation
    • poor tissue nutrition
    • reduced local immunological responses
    • accumulation of waste products
  96. what can be used for residual limb reduction and shaping after amputation?
    compression 
  97. is static or intermittent compression faster for amputation healing?
    intermittent 
  98. what is the most common method used for hypertrophic scarring?
    compression
  99. what are the different ways compression can help facilitate scar formation?
    • may directly shape the scar
    • believed to help facilitate collagenase activity
    • may control scar formation by inducing local tissue hypoxia 
  100. while controlling a hypertrophic scar, how long would you want to use compression?
    8-12 months or until mature 
  101. how much pressure is recommended for controlling hypertrophic scar formatin?
    20-30 mmHg of pressure 
  102. ROSA ASH
    • R: recent/acute DVT, thrombophlebitis, or PE
    • O: obstructed lymphatic or venous return
    • S: severe PAD or ulcers due to arterial insufficiency
    • A: acute local skin infection

    • A: acute Fx or other trauma
    • S: significant hyperproteinemia
    • H: heart failure or pulmonary edema 
  103. SICUS 
    • S: stroke or significant vascular insufficiency
    • I: impaired sensation/mentation
    • C: cancer
    • U: uncontrolled HTN
    • S: superficial peripheral nerves 
  104. aggravation of condition causing edema, impaired circulation, and it may act if a tourniqut if too much are adverse effects for what/
    compression
  105. what are the 2 different techniques for applying an compression bandage?
    • figure 8
    • spiral
  106. 16-18 mmHg is used for ?
    prevention of DVT
  107. 20-30 mmHg is used for?
    control scar tissue formation
  108. 30-40 mmHg is used for?
    control edema in ambulatory pt.'s 
  109. what type of pressure is exerted when elastic is put on stretch?
    resting
  110. what type of pressure is applied approx. 60-70 mmHg and is most effective for immobile patients and an ace bandage is the most commonly used bandage?
    long stretch bandage/high stretch
  111. what type of pressure is active mm pushing against inelastic bandage?
    working pressure 
  112. what is a semi-rigid bandage formed of zinc oxide impregnated gauze to exert working pressure?
    unna boot 
  113. what is unna boot used for?
    venous stasis ulcers 
  114. how long is a unna boot typically left on for?
    1-2 weeks 
  115. what is a TED hose?
    anti-embolism stocking
  116. how much pressure is received from anti embolism stockings to prevent DVT?
    16-18 mmHg
  117. how long are TED hose worn?
    up to 24 hr's a day
  118. custom fit and off the shelf compression garements meant for scar formation are applied with a pressure of what?
    20-30 mmHg
  119. what is the pressure range for compression stockings for an ambulatory patient?
    30-40 mmHg
  120. what are IPC's?
    intermittent pneumatic compression pumps 
  121. what is the on/inflation time for stasis ulcers when using an IPC?
    80-100 seconds
  122. what is the off/deflation time for stasis ulcers when using an IPC?
    25-50 seconds
  123. what is the on/inflation time for residual limb redution when using IPC?
    40-60 seconds
  124. what is the off/deflation time for residual limb reduction when using IPC?
    10-15 seconds
  125. T/F: it is okay for the inflation pressure to exceed that of diastolic blood pressure
    false!
  126. what is the treatment time for compression?
    1-4 hr's a day 3X-4X a week 
  127. improved venous and lymphatic circulation, limits the shape and size of tissue and increased tissue temp are all effects of what?
    external compression
  128. if you have a pt. with edema, DVT, venous stasis ulcers, residual limb shaping or you need to control a hypertrophic scar what might you use?
    external compression 

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