Flashcards
EPA test
Flashcards do conjunto (34)
- 1What are the precautions for superficial cold therapy? (6)Impaired circulation - (risk of tissue necrosis)
Hypertension- (Increased cardiac output)
very young and very old - (risk of skin damage)
Cardiac insufficiency
Hemiplegic patients - ( risk of MI)
Thoracic area of patients with coronopathy- (Risk of cardiac problems & coronary artery restriction)
superficial peripheral nerves - risk of transient neuropathies - 2What are the contraindications to superficial cold? (5)Lack of cold sensitivity (risk of burn)
Cold sensitivity (risk of skin reactions)
open dermal wounds (reduced healing)
Peripheral vascular disease (tissue necrosis)
Confused and unreliable patient ( risk of poor treatment compliance) - 3physiologic effects of the superficial cold?decreased cellular activity - (decreased membrane permeability )
altered blood flow (immediate vasoconstriction but after 10 minutes cold-induced vasodilation - huntings reaction)
increased collagen stiffness
stimulation of a delta fibres for endorphin release - 4What are the therapeutic effects of cold therapy?Pain relief (endorphin), reduction in swelling
swelling ( vasoconstriction, reduced membrane permeability )
increases then decrease in muscle tone ( due to an immediate increase in Alpha motor neurons)
Reduced speed of contraction (failure of electrical properties, reduced metabolism and increased fluid viscosity)
reduced secondary tissue damage - 5What are the precautions for superficial heat therapy?Open wounds - risk of tissue overheating affecting scar tissue production
metal implants (burns)
impaired circulation (tissue overheating)
cardiac insufficiency (increased cardiac output)
Patients with orthostatic hypotension ( risk of fainting) - 6Contraindications of superficial heat?devitalised skin (risk of burn)
lack of sensation
hypersensitive
Acute iflammatory conditions - aggravate inflammatory response
confused and unreliable patients ( poor treatment compliance affecting safety)
Local bleeding (increase bleeding)
area of thrombus- clot dislodging
Skin conditions (carcinoma) - the risk of increasing cellular activity increasing
tumour growth and metastasis
Abdomen, pelvic or lower back of pregnant- effect on fetal development - 7What are the physiological effects of superficial heat therapy?Increased cellular activity
blood flow vasodilation
stimulates a beta fibre - pain gait control (however as heat increases stimulates a delta and c fibres = tissue damage)
decreased tissue viscosity increases flow - 8What are the therapeutic effects of superficial heat?pain (pain gate )
a decrease in swelling (vasodilation of vessels and decreased viscosity increases extravasation of fluid from intersistial space)
decrease in muscle spasm (GTO and MS firing rate initiating relaxation)
improved joint mobility ( collagen extensibility)
improves healing (vasodilation , increased BF, more 02 available to tissue) - 9What are the precautions to ultrasound?radiotherapy (skin may not cope with heating, may stimulate malignant cells)
poor sensation (risk of burn)
metal implants (risk of burn)
epiphyseal plates in children (rapidly dividing tissue) - 10What are the contraindications of ultrasound?ischemic areas (increase ischemia)
over malignancy (risk of tumour growth)
the pelvis, abdominal and lumbar of pregnant people (cavitation in amniotic fluid)
over a haemorragic area ( risk of increased blood loss)
over thrombus (risk of thrombus detachment)
menstruation
plastic implants
electric implants
eyes
confused and unreliable
malignancy - 11What are the possible dangers to ultrasound thermal and athermal?thermal burns
periosteal burns
standing waves
cavitation
damage to the crystals in the applicator head - 12What are the physiological effects of continuous ultrasound?Increased cellular activity
decreased blood viscosity
A beta stimulation (pain gait)
improves healing
vasodilation
increased collagen extensibility
increased extensibility of tendons and scar tissue - 13What are the therapeutic effects of continuous ultrasound?pain
swelling
joint mobility
spasms - 14What are the non thermal physiological effects of ultrasound?cavitation ( at high intensities with ultrasound there us formation of gas bubbles in the tissue as a result of ultrasonic vibration)
standing waves ( when two waves are superimposed they lead to a standing wave) - can cause blood stasis and damage to vessels moving treatment head reduces this risk
acoustic streaming (Fluid movement in the ultrasound beam) - (creation of pressure on surfaces which the ulstrasound passes through or is reflected from)
micro massage (secondary to the mechanical effect of the sound pressure) - 15What are the therapeutic effects of a thermal pulsed ultrasound?Inflammatory phase - stable cavitation and acoustic streaming ( calcium ion diffusion access cell membranes - stimulates relsease of wound healing factors and mast cell degranulation - gentle agitation of fluid may also increase the rate of phagocytosis
proliferative phase
stimulates fibroblasts, endothelial cells and myofibroblasts and enhances cpllagen synthesis
Remodelling phase
initates remodelling of scar tissue and reorientated collagen fibres - 16Overall therapeutic effects of ultrasound?pain
optimizes inflammation (ultrasound is pro inflammatory)
wound, fracture and cartilage repair
reduces stiffness - 17What are the precautions of a TENS machine?Hyperalgesia (Over reaction)
allodynia (Over reaction)
dermatological conditions (skin reactions)
undiagnosed pain (you dont know!)
cardiovascular problems (risk of over stimulation)
sensory loss (why do it) - 18What are the contraindications of TENS?epileptic patients ( risk of seizure)
malignancy ( risk of dissemination)
unreliable patients ( safety)
abdomen, lumbar, pelvic (risk of inducing labour)
transthoracic application ( avoid the heart)
testes , eyes, cranial region
cervical region
pacemakers (interferes with pacemaker) - 19What are the therapeutic effects of TENS?pain relief -
pain gait - a delta
longer lasting effect for intense (endorphin) a beta
Muscle stimulation - 20What are the precautions of MMF (modulated medium frequency and IFT interferential therapy?Sensory loss
circulatory insufficiency
epilepsy
risk of dissemination
exacerbation of symptoms
reduced sharp blunt discrimination
over broken skin - 21What are the contraindications to MMF and IFT?over carotid sinus
over transthoracic
pelvic region during pregnancy
over implanted stimulator
cranial region
malignancy
haemorrhagic
active epiphyseal regions
eyes
anticoagulant or history of pulmonary embolism
dermatological conditions - 22what are the physiological EFFECTS of MMF and IFT?pain gait theory (beta fibres)
@ higher intensities and less comfortable a delta fibres and endorphin release
skeletal alpha a motor nerve fibres stimulation (deeper than Tens)
stimulation of denervated muscle
overall there is deeper penetration compared to TENS - 23What are the recommended dosages for all the modalities?Cold- 10- 15 mins 2-3 times a day
heat 15-20 mins 2-3 times a day
wax bath - briefly immerse when wax becomes opaque reapeat 6-8 times then wrap and leave for 15 -20 mins
contrast bath- 20 mins (3-4 mins compared to 1 minute)
TENS
conventional - 3-4 hrs
intense & accupuncture -15-30mins
IFT AND MMF -15 - 20 MINS - 24What are the therapeutic effects of MMF and IFTPain control (endorphin/ pain gait)
muscle stimulation (motor nerve stimulation & denervated muscle) TO
(strengthen, re-education, stimulation to decrease wasting)
good for deeper muscles that direct low frequencies cant access (i.e to help incontinence)
swelling - probably due to the muscle pump
Note denervated muscle needs much more current because the tissue is not as excitable - 25What should recording include?DO recording so someone knows exactly what you did so they can repeat it ...
What they presented with
What treatment you used
where you did it
the parameters and time
Subjective - what they felt after
Senstation , warning , IC,
s tick tick , W, tick tick , IC, Tick Tick - 26How is heat transferred from/to the body?Evaporation - heat loss in the form of sweat
conduction- placing something that's hot or cold directly on the body
Convection - using warm/ cold air/fluid against the skin to raise or lower the temperature
Radiation - exposing the body to radiation waves, which generates heat - 27how is body temperature controlled?controlled by the thermoregulatory centre in the hypothalamus which receives input from internal (brain) and external (skin) thermoreceptors
- 28WHat is the normal temperature for the human body to sit at?Between 36 and 38 degrees
- 29What are the 4 stages of sensation after a cold pack is put on and how would you describe this in the informed consent?Cold, burning, aching & numbness
You should feel a period of gradually increasing cold, followed by a period of numbness and then the area should go numb. - 30what are the risks associtiated with ice cold therapy?ice burn
skin reaction (autonomic reaction) - 31What is the melting point of wax? but parrafin or mineral oil reduces the melting point to ?54 deg
42-50 deg - 32How long to do the inflammatory stages last bleeding? Inflammatory? proliferative? remodelling?0- 48 hrs
peaks in 1-3 days and lasts 2-3 weeks
24-48 hrs - peaks at 2-3 weeks can last up to several months
remodelling up to 12 months - 33what are the risks associated with heat?thermal burn
chemical reaction
skin irritation - 34What is the most comfortable temperature range for humans?30 degrees
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- FlashCards sobre EPA test, criado por show horses em 23-05-2019.
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