what is the application of shortwave or microwave electromagnetic energy to produce heat and other changes within tissues
diathermy
T/F: diathermy heats deeper than MHP and heats a larger area than US
true
is pulsed shortwave diathermy thermal or non-thermal?
non-thermal
when using diathermy for increasing tissue temp. is it thermal or non-thermal and what is the mode?
thermal; continuous
what are the 3 types of diathermy application?
inductive coil
capacitive plates
magnetron
which type of diathermy involves high frequency alternaing current in an antenna to deliver MWD?
magnetron
which type of diathermy is made of metal incased in plastic houseing (drum) or carbon electrodes within a sleeve?
capacitive plates
pain control
accelerated tissue healing
decreased joint stiffness
increased ROM
these are clinical indicators for what?
thermal level diathermy
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
avoiding fatty areas and making sure to keep skin dry are precautions to reduce the risk of adverse effects due to what?
diathermy
what is defined as an upward force on an object immersed in water equal to the amount of water that is displaced?
buoyancy
a force that counters the direction of movement and increases water in proportion to speed of motion
resistance
pressure exerted y water that increased with depth of immersion
hydrostatic pressure
hydrotherapy acts as a ____________ and can be used in conjunction with dissolved _____________ & _________________
debriding agent; surfactants & antimicrobials
decreased weight bearing, strengthening, effects on bone density loss, and less fat loss than other forms of exercises are musculoskeletal affects of what?
hydrotherapy
increased venous circulation, cardiac output & volume, and decreased heart rate, SBP, VO2 response to exercise are cardiovascular effects of?
hydrotherapy
decreased vital capacity and exercised induced asthma and increased work of breathing are respiratory effects of?
hydrotherapy
what are the 2 ways in which hydrotherapy can affect the kidneys?
diuresis and increased sodium and potassium excretion
how does hydrotherapy have a psychological effect?
its relaxing and invigorating... it depends on the water temp
ambulation, coordination, cardiopulm conditioning and psychological well being can be improved using what physical agent?
hydrotherapy
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
does water therapy decrease OA pain compared to land therapy?
yes
is water therapy beneficial for pt. with fibromyalgia?
yes, it can reduce their pain and swelling
T/F: water therapy can be good for CHF if closely monitored?
true
who do pregnant ladies like water therapy?
unloads WB jt.'s
controls peripheral edema
less elevation HR, BP, and body temp
why is hydrotherapy beneficial for older pt's?
increase strength
function mobility
balance
quality of life
what two pt. populations are good candidates for hydrotherapy because it is especially good for controlling their pain?
OA and fibromyalgia
what is the issue with hydrotherapy and wound care?
risk of infection
NPWT or wound vac is used for what?
removes fluid and mechanically debrides the wound
drowning, burns, fainting, bleeding, hyponatremia, infection, aggravation of edema, asthma exacerbation are all adverse effects of what?
hydrotherapy
what is the therapeutic temp range for a pool?
79-98 degrees
what is a contrast bath?
hot -> cold -> hot -> cold...
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
what are the 3 bands that UV is divided into?
UVA, UVB, UVC
which band produced flourescence in many substances?
UVA
which band produces the most skin erythema?
UVB
what the is most significant source of UV?
the sun
which bands reach the earth from the sun
UVA & UVB
which band penetrates the deepest?
UVA
what is thickening of the superficial ayer of the skin that occurs 72 hours post exposure?
epidermal hyperplasia
psoriasis, psoriatic arthritis, vitiligo, and wound healing are clinical indicators for what?
UV
burning, premature aging, carcinogenesis, eye damage, and oral psoralens are adverse effects of?
UV radiation
"laying of the hands", lowers tension and anxiety and well being are psychological effects of what?
massage
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
what kind of mechanical effects will massage thereapy have on muscles?
increase blood flow
ROM
retard mm atrophy
stretch mm, elongate fascia, STM
what kind of mechanical effects will massage have on skin?
increased temp
loosen adhesions and scar tissue and btw skin and sub-q tissue
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
what type of massage is described as gliding lightly over skin?
effleurage
what direction shoud you move your hands while doing effleurage?
begin peripheral and move towards heart
during what part of the massage do you do effleurage?
beginning and end
what type of massage is described as kneading, manipulation to press and roll the muscles under fingers and hands?
petrissage
what is the goal of petrissage?
break adhesions, loosed fibrous tissue and increase skin elasticity
what type of massage is described by series of risk contact with skin like hacking, slapping, beating, cupping, and tapping?
tapotement or percussion
what is the main goal of percussion?
increase circulation and stimulation of peripheral blood flow and clapping/cupping is used with posteral drainage
a hands on technique that involves applying gentle sustained pressure into the myofascial connective restrictions to restore motion and decrease pain?
MFR
what are the different types of MFR?
cross-hand arm pull
arm/leg pull
scar release
sub-occipital release
rebounding
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
what is compression used for?
reduce swelling
improve circulation
modify scar tissue formation
compression is accomplished by increasing the ____________ in the _____________.
hydrostatic pressure; interstitial space
what is steady application of pressure called?
static compression
what do you call it when pressure is alternately applied and released?
intermittent compression
what is the primary reason you would use compression?
control peripheral edema due to vascular or lymphatic dysfunction
how does compression help with scar modification?
enzyme activity to break down collagen = possible theory to control scar formation
normal fluid equilibrium in the tissues is maintained by the balances between?
hydrostatic pressure and osmotic pressure
blood pressure + gravity =
hydrostatic pressure
concentration of proteins inside and outside the blood vessels
osmotic pressure
what fluid is rich in protein, water and macrophages?
lymphatic
what are the factors that effect edema?
healthy diet
vascular system
muscular contraction
venous insufficiency and dysfunction of the lymphatic system and the most common reasons for what?
pt.'s develop edema
exercise, trauma, surgery, burns, infection, preggo, and dependent positions are other issues that ____________ may also present with
edema
CHF, liver failure, acute renal disease, diabteic golmerulonephritis, malnutrition and radiation injury are pathologic examples of what?
edema
what is the most common cause of edema due to venous insufficiency?
phlebitis; inflammation of the veins
lack of physical activity, dysfunction on the venous valves due to degeneration and mechanical obstruction are other causes for what?
edema
what is swelling caused by excessive lymphatic fluid in interstitial space?
lymphedema
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
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
decreased levels of plasma protein and plasma albumin, mechanical obstruction of the system, abnormal distribution of vessels and nodes are reasons for what?
lymphadema
Hx of CA and radiation therapy, node disruption, onset of swelling at birth or puberty, chronic inflammation are risk factors for what?
lymphedema
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
almost all cases of lymphedema are?
secondary
secondary lymphedema is caused by what?
inflammation, preggo, neoplasm, trauma or surgery
what is the only primary cause for lymphedema?
congenital
what is manual lymphatic drainage contraindicated for?
CHF or pulmonary edema
restrictions of ROM, limitations on function, pain, chronic edema and advanced chronic edema are all adverse consequences of?
edema
compression is effective in controlling edema due to?
venous insufficiency
lymphatic dysfunction
compression is less effective in controling edema due to?
infection
malnutrition
inadequate physical activity
organ dysfunction
what is defined as blood clots in the deep veins?
deep vein thrombosis
DVT is most common in?
immobilized pt.'s or extremities
after surgery
recovering from cardiac failure or stroke
what is defined as areas of tissue breakdown and necrosis that occur as the result of impaired venous cirulation?
venous stasis ulcers
impaired venous circulation may be a result of?
lack of muscle contraction
venous insfficiency
mechanical obstruction
what can impaired venous circulation result in?
poor tissue oxygenation
poor tissue nutrition
reduced local immunological responses
accumulation of waste products
what can be used for residual limb reduction and shaping after amputation?
compression
is static or intermittent compression faster for amputation healing?
intermittent
what is the most common method used for hypertrophic scarring?
compression
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
while controlling a hypertrophic scar, how long would you want to use compression?
8-12 months or until mature
how much pressure is recommended for controlling hypertrophic scar formatin?
20-30 mmHg of pressure
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
SICUS
S: stroke or significant vascular insufficiency
I: impaired sensation/mentation
C: cancer
U: uncontrolled HTN
S: superficial peripheral nerves
aggravation of condition causing edema, impaired circulation, and it may act if a tourniqut if too much are adverse effects for what/
compression
what are the 2 different techniques for applying an compression bandage?
figure 8
spiral
16-18 mmHg is used for ?
prevention of DVT
20-30 mmHg is used for?
control scar tissue formation
30-40 mmHg is used for?
control edema in ambulatory pt.'s
what type of pressure is exerted when elastic is put on stretch?
resting
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
what type of pressure is active mm pushing against inelastic bandage?
working pressure
what is a semi-rigid bandage formed of zinc oxide impregnated gauze to exert working pressure?
unna boot
what is unna boot used for?
venous stasis ulcers
how long is a unna boot typically left on for?
1-2 weeks
what is a TED hose?
anti-embolism stocking
how much pressure is received from anti embolism stockings to prevent DVT?
16-18 mmHg
how long are TED hose worn?
up to 24 hr's a day
custom fit and off the shelf compression garements meant for scar formation are applied with a pressure of what?
20-30 mmHg
what is the pressure range for compression stockings for an ambulatory patient?
30-40 mmHg
what are IPC's?
intermittent pneumatic compression pumps
what is the on/inflation time for stasis ulcers when using an IPC?
80-100 seconds
what is the off/deflation time for stasis ulcers when using an IPC?
25-50 seconds
what is the on/inflation time for residual limb redution when using IPC?
40-60 seconds
what is the off/deflation time for residual limb reduction when using IPC?
10-15 seconds
T/F: it is okay for the inflation pressure to exceed that of diastolic blood pressure
false!
what is the treatment time for compression?
1-4 hr's a day 3X-4X a week
improved venous and lymphatic circulation, limits the shape and size of tissue and increased tissue temp are all effects of what?
external compression
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?