Phys agents test 1

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Phys agents test 1
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  1. _________: systematic manipulation of the body applied primarily by the use of hands, but also by mechanical modalities such as electrical or battery powered vibrators (ha), rollers, or hydrothermic turbines.
    massage
  2. True or False: massage prevents atrophy or remove adipose tissue.
    False
  3. Most famous and enduring contributions to the practice of massage were _____ and ______.
    Rohr and Ling (Ling system=swedish massage)
  4. 20th century german surgeon _____ _____ wrote the book, Technic der Massage (1890), which is still one of the basic texts on massage. Described the 5 basic strokes.
    Alvert Hoffa
  5. 4 types of strokes or manipulations: list
    gliding, percussing, compressing, vibrating
  6. ______: strokes that glide
    ______: knead, lift wring
    ______: strike, produce stimulus (percussion)
    ______: compress deeper tissue
    ______: shake, vibrate
    • effleurage
    • petrissage
    • tapotement
    • friction
    • vibration
  7. Indications of Massage: 6 things
    • promote general relaxation
    • reduce muscle spasms and resultant pain
    • aide lymphatic return
    • loosen adherent skin,scars
    • increase circulation
    • enables therapist to evaluate soft tissue
  8. Contraindications of Massage: 4 things
    • skin infections/conditions that spread through blood/lymph
    • malignant melanoma, cancerous mole/tumor
    • over area where there is bleeding
    • some circulatory disorders
  9. ______: excess interstitial fluid in the tissues. Manifestation of altered physiological function. Increased capillary pressures, increased capillary permeability, and decreased protein levels.
    Edema
  10. ____-Edema: fluid is mobile; press finger into area for 2-3 sec. Indentation remains after finger is removed. Length of time indentation lasts indicates degree of edema.
    _____-Edema: area is firm and discolored. Serum proteins accumulate and coagulate; from infection or trauma. Accumulation of fluid in serous cavities (not usually treated with massage)
    • Pitting Edema
    • Non-Pitting Edema
  11. ______ ______: various modalities which, when applied to the patient, transfer or remove heat from the patient's tissue.
    Thermal agents
  12. _______ energy emitted throughout the entire range of the electro magnetic spectrum (heat, radio, light, ultraviolet, infrared, x-ray, cosmic rays)
    Radiant energy
  13. True or False: all forms of radiant energy are self-propagating; the waves are produced by the acceleration of electrically charged molecules that ravel in a vacuum at the speed of light.
    True
  14. True or False: Radiant energy is indirectly proportional to frequency?
    False, it is directly proportional. e.g. cosmic rays are more penetrating than infrared radiation.
  15. When electromagnetic energy contacts tissues, the radiation may be: ______, ______, or _______.
    reflected, refracted, absorbed
  16. _______-_______ principle: there is an optimal level of intervention that is therapeutically beneficial. No effect occurs in the tissue if the amount of energy absorbed is insufficient to achieve the therapeutic threshold. Damage will occur if the amount of energy is excessive.
    Arndt-Schultz principle
  17. Law of _______-_______: if the energy is not absorbed in the tissues, then it is transmitted to deeper layers. The greater amount of energy that is absorbed, the less the amount of energy that is transmitted.
    Grothus-Draper
  18. _____ _____: the amount of energy required to raise the temperature of a given weight of material by a given number of degrees.
    specific heat
  19. If the specific heat is high for the physical agent being applied, it should be applied at a (higher or lower) temperature.
    lower temperature
  20. Arrange the following in (High Conductivity) or (Low Conductivity): blood, cartillage, ligament, sweat, muscle, fat
    • High: blood, muscle, sweat
    • Low: fat, ligament, cartillage
  21. _______: the transfer of heat from a material of higher temperature to a material of lower temperature by direct collision of the molecules.
    _______: the transfer of energy by means of current such as liquids or gases.
    • Conduction (moist packs, cold/ice packs)
    • Convection (fluidotherapy, whirlpool, blood flow)
  22. ________: the transfer of energy by the change or conversion of one form of energy to another form.
    ________: process by which the energy is propagated from a warmer source to a coooler source without direct contact.
    _______: transfer of energy from liquid to vapor.
    • Conversion (ultrasound, diathermy, metabolism)
    • Radiation (infrared lamp, sun)
    • Evaporation (spray and stretch, sweat)
  23. ________: application of a cooling agent for the purpose of reducing tissue temperature in order to achieve a therapeutic effect. This is done most commonly by conduction, convection, and evaporation.
    Cryotherapy
  24. The physiological effective cooling range for cryotherapy is ___ to ___ degrees celsius.
    10 to 32
  25. _______ ______: the application of a heating agent for the purpose of increasing tissue temperature in order to achieve a therapeutic effect.
    thermal therapy
  26. Biophysical effects of heating:
    (increases or decreases) blood flow.
    (increases or decreases) pain threshold.
    (increases or decreases) metabolic rate.
    (increases or decreases) collagen extensibility.
    (increases or decreases) inflammatory response and rate of healing.
    increases for all of the above
  27. Biophysiological effects of cooling:
    (increases or decreases) blood flow.
    (increases or decreases) inflammatory response.
    (increases or decreases) nerve conduction (results in pain relief)
    (increases or decreases) spacticity by affecting gamma motor neurons and afferent spindle discharge.
    (increases or decreases) joint stiffness.
    (increases or decreases) metabolic rate.
    • decreases blood flow
    • decreases inflammation
    • decreases nerve conduction
    • decreases spasticity
    • increases joint stiffness
    • decreases metabolic rate
  28. Physiological effective heating range: ___ to ___ degrees celsius.
    40 to 44 celsius
  29. Depth of penetration
    _______: penetrates the skin and subcutaneous tissue within .5 cm of the skin surface (6-8 mins) and muscle up to a depth of one cm (15-30mins).
    _______: penetrates skin and deeper tissues up to 3-5 cm below the skin surface, without excessive heating the superficial tissues.
    • Superficial
    • Deep
  30. Analgesic effects of Cold:
    _____ _____ fibers affected first, then _____ _____ fibers, followed by _______ fibers.
    Cooling below __ degrees reduces Ach production.
    Cold (increases or decreases) refractory period.
    Cold reduces need for pain pills.
    • small myelinated fibers, large myelinated fibers, unmyelinated fibers.
    • 68 degrees
    • increases refractory period
  31. ______ ______: severe drop in blood flow, a cyclical increase in blood flow is seen. This is thought to be a response to protect the tissue.
    Hunting Reaction
  32. Nerve conduction slows ______ to the drop in temperature.
    proportionally
  33. Cold decreases _______ by taking an effect on intrafusal fibers and sensory wrappings of the muscle spindle. It does so by decreasing gamma motor neuron activity first and second by decreasing afferent spindle and GTO activity.
    spasticity
  34. Cold Urticaria:
    _____ reaction: paitents develops wheals. This is due to mast-cell degranulation resulting in the release of histamines which caused inceased capillary permeability, redness, swelling, and wheal formation.
    ______ reaction: flushing of the face, sharp drop in BP, and increased heart rate, and syncope (fainting or passing out).
    ______ ______ ______: condition resulting from exposure to cold in which hemoblobin from lysed RBC's is found in the urine.
    • Local reaction
    • Systemic Reaction
    • Paroxysmal Cold Hemoglobinurias
  35. _________: rare disorder involving an abnormal blood protein that forms a gel when exposed to low temperatures. The gel can lead to ischemia and gangrene and is often associated with multiple myeloma, chronic liver disease etc...
    ______ _____: present with severe pain, numbness and redness resulting from cold application. Most often found in patients iwth rheumatic diseases or severe trauma to fingers and toes.
    ______ _____: sudden loss of color in the digits of coooled extremities followed by cyanosis and then redness of the skin, often associated with Thoracic Outlet Syndrome, carpal tunnel, or trauma. Occurs most often with young women.
    • Cryoglobinemia
    • Cold intolerance
    • Raynauds Phenomenon
  36. Precautions for cold therapy: 6 things
    • over a superficial main branch of a nerve
    • over an open wound
    • hypertension
    • poor sensation or mentation
    • very young or old patients
    • prolonged exposure
  37. Temperature for Contrast Baths:
    warm: ___ to ___ degrees C
    cold: ___ to ___ C
    Ratio: Warm/cold is __ min/__ min or __ min/__ min with a limit of __x application.
    • warm: 38 to 44 degrees C
    • cold: 10 to 18 degrees C
    • ration: 3 to 1 or 4 to 1
    • limit: 4x application
  38. _____ _____ dystrophy: multi-systemic progressive condition which is associated with pain, swelling, heat, and disuse of extremity leading to muscle atrophy. When in a chronic stage, contrast baths are not tolerated by pt's.
    Reflex sympathetic dystrophy
  39. Application time for Cryo/Cuff:
    __ to __ minutes every __ to __ hours
    ___ to __ degrees F
    • 15 to 20 minutes every 1 to 2 hours
    • 50 to 60 degrees F
  40. Cryotherapy is effective when the underlying cause is an infection, malnutrition, inactivity, or organ failure. True or False.
    False: in these situations, edema is addressed by combo of compression, elevation, heat, exercise, and massage
  41. Become semisolid between _-_ degrees, which
    is optimal for use.
    Apply pack for _-_ minutes reduce/control
    pain and swelling. In the case that the pack must travel through several layers
    (towels, clothes, braces, etc.) , the time of application should be extended

    If ice/cold packs are used to address
    spasticity, they should be applied for _ minutes, (checking every 10-15
    minutes for contraindications).
    • 32-41 degrees
    • 10-20 minutes
    • 30 minutes
  42. _____ ______ _____ – a condition
    that affects the muscle fascia and can include a muscle or muscle group.
    Myofascial Pain Syndrome (MPS)
  43. Heat is most often used in the _________ or __________ stage.
    subacute or chronic
  44. __________ and __________ are good heat insulators.
    Cutaneous skin and fat layers
  45. ___________, ______________ and _____________ are good conductors of heat.
    Local vascular vessels, bone, superficial muscle
  46. Mild heating occurs at ______ degrees Fahrenheit and treats _______ & _________ injuries. Examples of mild heating modalities are _________ & __________.
    • <104 degrees
    • acute and subacute
    • heat packs & hydrotherapy
  47. Vigorous heating is used between ______ & _______ degrees Fahrenheit and treats ________ injuries. Examples of vigorous heating are __________, _________ and _________.
    • 104-113 degrees
    • chronic
    • paraffin wax, fluidotherapy, infrared
  48. At what temperature does tissue damage occur with superficial heating? Treatment should be kept below this temperature.
    113 degrees Fahrenheit
  49. Superficial heat can (increase/decrease) pain, (increase/decrease) muscle spasms, and (increase/decrease) edema.
    decrease, decrease, decrease
  50. Superficial heating can also cause

    vaso (dilation/constriction)
    (increase/decrease) metabolic rate
    (increase/decrease) circulation
    (increase/decrease) mobility of joints
    (increase/decrease) extensibility of tissues
    • dilation
    • increase
    • increase
    • increase
    • increase
  51. List the 7 contraindications of superficial heating.
    acute inflammatory conditions, pre-existing fever, malignant tumor, active bleeding, older/younger people, peripheral vascular disease, hemorrhage.
  52. Paraffin wax baths should be between _____ - ______ degrees Fahrenheit.
    125-127
  53. The three paraffin wax techniques are:
    immersion, dip immersion, dip-wrap
  54. Dosiometry of paraffin:

    Duration: ___ minutes
    Frequency: ___ for subacute; less frequent for chronic conditions
    20 minutes, daily
  55. Fluidotherapy is best used for: (5 things)
    rheumatoid arthritis, bursitis, tendonitis, sprains/strains and hematomas
  56. Paraffin wax is most often used on ____ extremities and conditions such as _______ and ________.
    distal; osteoarthritis & injured muscles.
  57. Dosiometry of Fluidotherapy:

    Intensity: _____-_____ degrees Fahrenheit

    Duration: ___ minutes for subacute and ____-____ minutes for chronic

    Frequency: ____ for subacute and less frequently for chronic.
    • 100-113 degrees
    • 20; 20-30
    • daily
  58. Hot packs should be stored in a water cabinet that is kept between _____ and _____ degrees Fahrenheit. They need to be preheated for __ hours and reheated for only ____ minutes when used.
    • 158-167 degrees
    • 2 hours
    • 30 minutes
  59. Dosiometry for Hot Packs:

    Intensity: depends on patient response

    Duration: typically ____-____ minutes

    Frequency: usually used ____ or more for subacute.
    • 15-30 minutes
    • daily
  60. Commercial covers for hot packs are usually equivalent to ____ to ____ layers of toweling. Add additional towels to have ____ to ____ layers of toweling total between the pack and the patient.
    • 4-6
    • 6-8
  61. Nonluminous infared lamps produce _______wavelengths and penetrate ___-___ mm; require warm up time.
    far; 1-2
  62. Luminous lamps produce ____ wavelengths and penetrate up to ____ mm; no warm up time required.
    short; 10
  63. ________________: the intensity of radiation from the lamp is greatest when the surface to be treated is at an exact right angle to the line running from the lamp to that surface.
    Cosine Law
  64. ______________: the intensity of radiation varies inversely with the square of the distance away from the source.
    Inverse Square Law
  65. Dosiometry of Infared:

    Intensity: depends on patient tolerance; distance from the lamp determines the _____ of the heat using the ______ and _______ laws.

    Time: ___-___ minutes

    Frequency: _____ or ____ daily for subacute; less often for chronic.
    • strength
    • cosine & inverse square laws
    • 15-20
    • once or twice
  66. The theory of pain control and modulation states pain is modulated at peripheral, spinal, and cortical levels by endogenous nt's that have the same effects as ______. It was discovered by researchers studying analgesia in _____-_____. Odiopeptins have been found in ____ nerve endings, _____, and raphne nucleus. Odiopeptins indirectly inhibit pain transmission by inhibiting _______ as well as inhibition of inward calcium and potassium flux.
    • opiods
    • 1973-1975
    • peripheral nerve endings, PAGM
    • GABA
  67. ______ analog and ______ scales: allows you to ask paitents to indicate present level of pain on a line or to rate pain numerically on a scale.
    _____ pain questionnaire: scale descriptors of sensory, affective, and evaluative aspects of the paitent's pain, and groups words into various categories within aspects including temporal, spatial, pressure and thermal to describe sensory aspects of pain, anxiety, and tension.
    • Visual analog and numeric scales
    • McGill pain questionnaire
  68. ______: this questionnaire is low back pain disability index. It contains six statements in ten sections. The sections concern impairments like pain, and abilities like personal care, lifting, reading, driving, and recreational section.
    ______ inorganic signs: indicate psychological components to chronic back pain. It is used to detect malingering in paitents with back pain.
    • Owestry
    • Waddell Inorganic signs
  69. List the important information to include in the thorogh documentation of a patient's:
    pain's location, quality, severity, timing, as well as the things that make it better or worse.
  70. ______: inhibit pain by blocking the conversion of arachiadonic acid to prostaglandins by cycloxygenase; side effects: gi irritation and bleeding.
    _______: used to treat many conditions such as headache, muscle aches, arthritis, backache, toothaches, colds and fevers. Its mechanism of action is the inhibition of cycloxygenase. It is highly selective for COX-2.
    _______: provide analgesia by mimicking the effects of endorphins by binding to opiod specific receptors in the CNS; may also inhibit the nociceptive pathways.
    • NSAID's
    • Acetaminophen
    • Opiods
  71. _______: psychiatric mediaction used to alleviate mood disorders such as major depresion, dysthymia, and anxiety disorders.
    _____ _____: block nociceptive transmission when administered spinally and at high doses it can block sensory and adn motor movements.
    • Antidepressants
    • spinal analgesia
  72. List the three advantages of the use of physical agents in pain relief:
    • 1. relieve pain directly by moderating release3 of inflammatory mediators, nerve conduction, and endorphin levels.
    • 2. indirectly reduce pain by decreasing sensitivity of muscle spindle system and vascular blood flow.
    • 3. reduce pain by helping resolve underlying cause of painful sensation.

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