1
Q
Paraffin Bath is a type of _______
A
conduction
2
Q
Paraffin machine is kept at a higher temperature of ______ due to ____ specific heat
A
125-127F; lower
3
Q
What is the total duration of paraffin wax?
A
20-30 minutes
4
Q
The depth of penetration of paraffin wax is less than ___
A
1cm
5
Q
Paraffin is most commonly used for what demographics?
A
- Distal extremities
- Arthritic hands and feet
- Healed burns (scar tissue)
6
Q
If using paraffin therapeutically, when would you use it during a treatment?
A
prior to stretching
7
Q
Specific contraindications of paraffin bath includes
A
- Infection
- Open Wound
- New Skin Graft
8
Q
Specific precautions of paraffin bath include
A
- Remove all jewelry
2. No movement is allowed or burn can occur from cracked wax
9
Q
What is the main physiologic response of paraffin bath?
A
Integument: retains moisture and softens the skin
10
Q
The proper procedure for doing paraffin wax is to dip, remove and allow to harden. The first dip is always the _____
A
deepest
11
Q
How many dips of paraffin wax do you do?
A
8-10 dips
12
Q
What do you wrap around paraffin treatment for insulation?
A
a plastic wrap and towels
13
Q
Fluidotherapy is a type of _____
A
convection (dry heat)
14
Q
What is fluidotherapy?
A
fine cellulose particles through which heated air is blown
15
Q
Fluidotherapy has ___ specific heat than water, which means the treatment temp is ____ to ____
A
less; 105F to 125F
16
Q
The depth of penetration of fluidotherapy is less than
A
1cm
17
Q
What is the treatment duration of fluidotherapy?
A
20 minutes
18
Q
In fluidotherapy, the moving particles eliminate the _____
A
temperature gradient
19
Q
What are the unique things about fluidotherapy?
A
- Can exercise during rx
- Can eliminate gravity
- Only distal body parts
- Provides desensitization
20
Q
Vapocoolant spray is a type of _____ and _____
A
conduction; evaporation
21
Q
Vapocoolant spray provides a _____ effect
A
sensory
22
Q
What is vapocoolant spray made of?
A
Ethyl chloride or fluori-methane
23
Q
With vapocoolant spray, you may ____ the ROM when stretch is applied
A
increase
24
Q
What 2 things should you be cautious of with vapocoolant spray?
A
- The eyes
2. The US sound head
25
Vapocoolant spray stimulates ___ fibers involved in what theory?
A; Gate Control Theory
26
Vapocoolant spray ____ pain/spasm cycle
decreases
27
Vapocoolant spray creates cold which inhibits what?
mm spindle activation
28
What are 3 common clinical applications of using vapocoolant spray?
1. Torticollis
2. Muscle Spasms
3. Myofascial trigger points
29
How many times do you spray?
2-4 times
30
You should spray at a ____ angle to the skin and spray from ____ to ____
acute; origin to insertion
31
You should apply a slight ___ on the muscle before spraying it
stretch
32
You should avoid ____ of the skin when using spray
frosting
33
What does contrast bath cause?
alternate constriction and dilation of local blood vessels
34
What are common reasons to use contrast baths?
1. Subacute swelling
| 2. DOMS
35
Contrast baths stimulate _____ and _____
blood flow; healing
36
The warm bath should be between _____F and the cold bath should be between ____F
104-106; 50-60
37
For contrast baths, you should immerse in a warm bath/cold bath for a _:1 or a _:1 ratio
3:1 or 4:1
38
During a contrast bath, you should encourage what?
ROM
39
The dosage for contrast baths are not well researched, however, you should aim for ____ minutes or ___ cycles
20-30 min; 4-5 cycles
40
With contrast baths, you should end with warm or cold depending on what?
injury status
41
Diathermy provides heat by ____
conversion
42
Diathermy causes the heat in the body tissues to raise due to ____ of the tissue to the passage of energy
resistance
43
There are 2 types of diathermy modalities, _____ and ____
microwave and shortwave
44
Diathermy is most commonly used where?
Skilled Nursing Facilities
45
When using SWD, the frequency is usually around ___MHz and wavelength at ___m
27; 11
46
The delivery types of heating mechanisms of SWD can be ______(CSWD), _____(PSWD) and ____ period
continuous current
pulsed current
off period/ on period
47
Off period ____ on period to prevent accrual of heat
> or equal to
48
The production of heat in SWD uses either ____ field or ____ field
condenser; induction
49
A condenser field is ____ while an induction field is ____
electric; magnetic
50
Condenser / Electric Field uses the patient's body tissues as the _____ b/w the 2 conduction surfaces
dielectric
51
The tissues are influenced in SWD by an _____ electric field
oscillating
52
Heat is produced by _____ and _____ of molecules of tissues in SWD
vibration; distortion
53
Heat is the strongest where the density of the field is ____, aka, near the electrodes
greatest
54
The ___ spaced plates use a condenser field
air
55
The condenser method always uses ___ drums
2
56
The induction/magnetic field method places the patient in the em field of electrodes so the current is induced in the ____ tissues
conductive
57
In induction/magnetic field method, the heating is primarily in the ____ mm's
superficial
58
Deeper mm's are heated by conduction of heat for ____ tissues in induction/magnetic field method
overlying
59
The inductive method uses __ drum(s)
1
60
Oscillating magnetic field in the applicator induces oscillating ____ currents
"eddy"
61
Inductor/magnetic method is better for targeting ____ areas
smaller
62
The greatest density of eddy current activity occurs in ___ impedance tissues (also containing the ___ electrolyte content, such as skeletal muscle and blood)
low; highest
63
The condenser field places the patient in the actual _____
electrical circuit
64
The induction field places the patient in the ____ produced by the equipment
electromagnetic field
65
CSWD provides thermal heat into the _____ and the effects of this are similar to other forms of therapeutic heat
tissues
66
Why should you use CSWD in a patient? (6)
1. increased extensibility of deep collagen tissues
2. decreases joint stiffness
3. relieves deep pain/mm spasms
4. increases blood flow
5. heats deep tissues
6. heats large areas
67
What are the advantages of using SWD?
1. Heats deeper tissues
| 2. Heats larger areas
68
What are the disadvantages of using SWD?
1. Costly
2. Unable to measure the actual amount of EM energy transferred to the patient's tissues
3. Decreased selective heating
69
SWD indications include subacute and chronic traumatic or inflammatory conditions of ________ and mm's, as well as before ____
superficial joints; stretching
70
What are the contraindications for SWD?
1. Metal implants
2. pacemakers
3. very old/young
4. Epiphyseal growth plates not yet closed
5. Hemorrhaging/active bleeding menustration
6. Acute inflammation
7. Space occupying lesions (nucleus pulposis)
8. Cancer
9. Anesthetic skin
10. Ischemic tissue
11. Cardiac insufficiency
12. Fever/infection
13. Pregnancy
14. Joints/organs containing increased fluid level
71
What are the SWD precautions?
1. Ischemic areas
2. Open wounds or moist dressing
3. Uneven spacing or pressure of electrodes
4. Perspiration
5. Electronic or magnetic equipment in area
6. Impaired sensation
7. Obesity (subcutaneous fat)
72
Whirlpools can be ____ or ____
thermotherapy; cryotherapy
73
Whirlpools are stainless steel so that they can be better cleaned and prevent ____
infection
74
The method of heat transfer in whirlpools are either _____ or ____
conduction; convection (once turbine is on)
75
Whirlpools are advantageous for allowing the patient to ____ during treatment
exercise
76
Whirlpools are disadvantageous because the segment is ____, it is a _____ intervention and there is no ____ to support its use
1. dependent
2. costly
3. research
77
A Burn Tank is ____ and requires a lift to transfer the patient
larger
78
A Hubbard Tank is ___ shaped and designed for ___ body immersion with __ turbines
butterfly
full
two
79
Hubbard Tanks have almost too _____ dosing which can contribute to issues with large ____ effects
generalized; systemic
80
The turbine is the electrical motor pump which creates the agitation. Agitation is regulated by adjusting the ___ of ejected water and the amount of _____ of the water
force; aeration
81
APTA Choosing Wisely campain #5 says
do not use whirlpools for wound management
82
Whirlpools can damage the fragile _____ tissues from agitating water
healing
83
There is a risk of ____ with extremity in a dependent position in a whirlpool
edema
84
The farther to the right on the EM spectrum, the ____ the wavelengths
shorter
85
What are the 3 main bands of the UV spectrum?
UV-A, UV-B and UV-C
86
Which type of UV causes skin damage?
UV-B
87
UV-A is near the ____ spectrum
visible light
88
UV-B is the middle and ____ spectrum and used for treating ____ conditions
sunburn; skin
89
UV-C is ___ wave or far UV and is considered ______
short; bactericidal
90
UV-C cannot come from what?
sunlight
91
Clinically, UV light can be _____, _____ or ____
reflected; absorbed; transmitted
92
UV is only absorbed in the _____ and does not go any deeper, hence why it does not ____
epidermis; refract
93
UV does NOT produce any ____ benefits, only chemical changes in the epidermal cells
thermal
94
Short term effects of UV therapy include
inflammation
erythema
pigmentation
hyperplasia
95
Long term effects of UV therapy include
premature aging
| skin cancer
96
What can occur with UV and the eyes?
photokeratitis
97
UV energy is absorbed by the proteins in the ____ cell layer of the epidermis
prickle
98
_____ reactions lead to damage
photochemical
99
____ and other substances release and cause vaso___ which increases the capillary _____ and begins several hours after UV exposure (inflammation)
histamine; dilation; permeability
100
Despite not being immediately evident, this is a common sign of inflammation after using UV
erythema
101
Excessive dosage of UV can lead to ____ and ___ damage
blistering; tissue
102
Before giving a UV treatment, you need to quantify their photosensitivity first by testing their ______ (MED)
minimal erythemal dosage
103
One MED = the ____ dose/time of exposure that produces ____ erythema appearing within ___ hours following exposure and disappearing within ____ hours
shortest
minimal
1-6
24
104
1st degree erythema exhibits a faint ____ and occurs after a latent period of __+ hrs.
reddening; 2
105
1st degree erythema persists ___ hrs and is caused by being exposed ___x as long as MED skin
48; 2.5
106
2nd degree erythema exhibits a mild ____-like reaction and is visible __ hours after exposure
sunburn
| 2
107
2nd degree erythema may be a little painful and can persist from ___ to ___ hours, since it is exposed ___x as long as MED skin
48-72
| 5x
108
3rd degree erythema resembles an intense reaction similar to a ______
sunburn
109
3rd degree erythema takes greater than ___ hours to subside and shows intense reddening after ___ hr to exposure
72; 1
110
3rd degree erythema is considered ____ because the skin ___ and pigmentation ____
destructive; peels; remains
111
Repeated irradiation at certain levels causes _____ish coloration of the skin due to the deposition of ____ granules
brownish; melanin
112
Melanin granules migrate from ____ layers to ____ layers of the skin
deep to superficial
113
The role of pigmentation for therapeutic purposes is ____, since melanin is a biologic filter of UV
protective
114
With pigmentation and tanning, repeated overdoses cause cause hyper____ and hyper____
hyperkeratosis; hyperpigmentation
115
With UV therapy, there is a potential for degeneration and possible pre-___ changes
cancerous
116
UV-C light in the ___nm-___nm range such as cold quartz is 90% effective in killing or controlling certain bacterias such as pseudomonas, however, does NOT effectively destroy the ___forms of bacterial organisms. Just the active forms (repeated Rx is needed)
254-265; spores
117
Indications of using UV therapy include (3)
1. Psoriasis
2. Eczema
3. Pressure Sores
118
Factors that influence UV light sensitivity includes ___ texture, ____ and ___ color
skin; age; skin
119
Skin texture ____ decreases UV sensitivity
thickness
120
Very young and very old individuals are more ____ to UV light therapy
sensitive
121
Fair skin is more ____ to UV light therapy
sensitive
122
Additional factors that influence UV sensitivity include the _____ being treated, ____ being used, and _____ agents
body part
drugs
antibacterial; microbial
123
_____ ointment and ____ are used therapeutically for the treatment of psoriasis
coal tar; psoralens
124
Applying UV to skin for ____ healing, ___ conditions and _____ effects is one of the oldest medical modalities, however, is used infrequently now
wound
skin
photochemical
125
UV dosage
1 MED = shortest dose/time of exposure that produces the most minimal erythema appearing within 1-6 hours following exposure and disappearing within 24 hours
126
When doing a MED Sleeve Test, what do you need to keep in mind?
position and test surface
eye protection
sleeve preparation
127
when doing a sleeve test procedure, position the lamp over the area to be exposed and do 1" for ___ quartz and 30" for ___ quarts
cold; hot
128
What are contraindications for using UV light therapy?
Acute:
generalized dermatitis
eczema
psoriasis
```
Lupus erythematosus
Herpes simplex
Hyperthyroidism/diabetes
Severe itching
Freckles/moles
Photosensitizing drugs
Fever
X-ray therapy
Pellagra
Xeroderma
```
129
Pellagra is a deficiency of ____ and ____ in the diet characterized by skin eruptions
niacin; protein
130
Xeroderma is excessive or abnormal ____ of the skin
dryness
131
What are the precautions of using UV light therapy?
```
Eyes
Skin overdose
Delicate skin areas
Photosensitizing agents/meds
Hx of skin cancer
General Therapist Protection
Home Rx NOT reccomended
```
132
How long does one MED usually take?
30 seconds
