Unit 2: Week 2 Content - Heat/Cold

Question 1

How does heat move from one place to the next

Answer 1

-conduction
-convection
-radiation

Question 2

Conduction

Answer 2

-interaction between molecules energized at different rates
-energy passed directly from one molecule to another
-molecules don’t change their location, they “jiggle and collide

Question 3

Radiation

Answer 3

-energy passes through straight lines

Question 4

How bodies regulate temperature

Answer 4

-vasomotor
-metabolic
-sweating
-voluntary control

Question 5

Convection

Answer 5

-circulation brings heat from some molecules to another area of the body

Question 6

What considerations are needed between applications of heat

Answer 6

-heat may conduct differently in different people (adiposity)
-aging may alter skin integrity and bodies ability to regulate heat

Question 7

Biophysical basis of heating

Answer 7

-sensory
-circulatory
-muscle tone
-tissue extensibility
-metabolism

Question 8

How does heat contribute to edema

Answer 8

-blood vessels vasodilate due to smooth muscle relaxation and local axon reflex
-this increases blood flow
-leads to skin redness and edema

Question 9

Effect of heating on muscle tone

Answer 9

-golgi tendon organ are stimulated which causes muscles to relax
-muscle spindles are stimulated when muscles are stretched causing muscles to relax

Question 10

Effect of heating on ligaments and tendons

Answer 10

-tissues contain fluid and heat decreases fluid viscosity
-tendons and ligaments contain collagen and heat increases collagenous tissue
-increases extensibility of ligaments
-less force needed to mobilize a joint

Question 11

Effect of heating on tissue metabolism

Answer 11

-heating tissues increases its metabolism
-increased need for oxygen by tissues
-increased metabolic waste products produced by tissues

Question 12

Can a hot pack heat deep tissues

Answer 12

-no

Question 13

Why would you use heat

Answer 13

-decrease pain through pain modulation
-increase tissue repair through increases in metabolic rate and O2 availability
-increased joint range due to tissue extensibility, increased synovial slide, and decreased muscle spasm

Question 14

Why cant heat be used for infections

Answer 14

-cause enhanced growth of bacteria

Question 15

General indications for heating agents

Answer 15

-pain
-muscle spasm
-chronic inflammation
-contracture

Question 16

Biophysical basis of cooling

Answer 16

-sensory
-circulatory
-muscle tone
-extensibility
-metabolic

Question 17

Circulatory effects of cooling

Answer 17

-immediate capillary vasoconstriction
-arteriolar constriction follows more slowly
-decreased formation of edema

Question 18

Does ice reduce swelling

Answer 18

-no it reduces the formation of new swelling

Question 19

What is the lewis hunting reaction

Answer 19

-capillary vasocontriction alternates with vasodilation in order to conserve heat loss from the body while simultaneously protecting skin from ischemia
-skin appears mottled

Question 20

Cooling and muscle tone

Answer 20

-decreased muscle tone
-prologed cooling causes paralysis

Question 21

Cooling and muscle performance

Answer 21

-impaired contractility of muscle
-decreased twitch amplitude
-decreased twitch duration
-decreased rate of force development
-increased number of motor units recruited

Question 22

Cooling and extensibility

Answer 22

-decreased ligament extensibility due to decreased collagen extensibility
-increased muscle and joint stiffness due to increased fluid viscosity

Question 23

Would you cool before exercising or stretching

Answer 23

-no

Question 24

Metabolic effects of cooling

Answer 24

-decreased cellular metabolism
-with tissue inflammation, there is increased metabolic activity due to the presence of inflammatory cells

Question 25

Physiological effects of cooling

Answer 25

-vasoconstriction -reduced conduction in sensory, pain and motor pathways -reduced release of inflammatory agents -reduced metabolic rate -increased fluid viscosity -reduced extensibility

Question 26

General indications for cooling agents

Answer 26

-pain -muscle spasm -acute injury (decrease development of swelling)

Question 27

How long should we apply ice to decrease pain and not cause deep cooling

Answer 27

-10 min

Question 28

Should we heat before stretching

Answer 28

-heating for minimum 5 min can increase ROM and decrease muscle stiffness

Question 29

Potential benefits of icing after acute surgery

Answer 29

-decreases need for medication

Question 30

Contraindications for heat and cooling

Answer 30

-cognitive deficit -morbid obesity -open wounds -loss of sensory discrimination -cold allergy -tissue ischemia -dermatitis -hypersensitivity/reynauds -cryoglobinemia

Question 31

Contraindications for heat

Answer 31

-do not use in acute injury -do not use just prior to balance or strengthening exercise

Question 32

Indications for heat

Answer 32

-pain -muscle spasm -subacute soft tissue injury -late tissue healing -fibrosis and scar tissue -joint stiffness

Question 33

Contraindications for cold

Answer 33

-do not use in sub-acute or late tissue repair unless to decrease pain and improve exercise tolerance -do not use in fibrosis and scar -do not use in joint stiffness -do not use just before balance training or strengthening exercises

Question 34

Indications for cold

Answer 34

-acute injury -pain -muscle spasm

Question 35

What is the main consideration about EPAs

Answer 35

-used as an adjunct to treatment and rarely used in isolation

Question 36

Patient prep for EPAs

Answer 36

-explain procedure -explain benefits/risks -obtain consent -screen for contraindications or take precautions -attend to limb and body support/patient comfort -instruct patient when are how to get attention -check on patient during procedure