US & ESWT

Question 1

Frequency of US

Answer 1

greater than 20,000 Hz

Question 2

T/F: US has a frequency beyond human hearing

Answer 2

True

Question 3

Generation of Ultrasound

Answer 3

By reverse piezoelectric effect

Question 4

Mechanical Energy to Electrical Energy

Answer 4

Direct piezoelectric effect

Question 5

Most commonly used material due to its cheap price & efficiency

Answer 5

Plumbium (lead) zirconium titanate (PZT)

Question 6

Materials used in an US transducer

Answer 6

PZT, Quartz, Barium Titanate

Question 7

What happens when the crystals in the transducer expands?

Answer 7

Compresses the material in front of it

Question 8

T/F: When the piezoelectric material of US expands, the sound also expands

Answer 8

True

Question 9

Where is the near field located?

Answer 9

Near the transducer head

Question 10

Where is the far field located

Answer 10

Far from transducer head

Question 11

Zone wherein there is absence of divergence

Answer 11

Fresnel Zone

Question 12

Zone wherein there is more divergence

Answer 12

Fraunhofer Zone

Question 13

Critical angle of US

Answer 13

15 degrees

Question 14

Law that states that the US head should be perpendicular & in contact c body

Answer 14

Lamber’s Cosine Law/Right Angle Law

Question 15

This decreases US intensity as the waves travel through tissue

Answer 15

Attenuation

Question 16

T/F: Attenuation is greatest in tissues c low collagen content

Answer 16

False

Question 17

T/F: Absorption of US depends on collagen content

Answer 17

True

Question 18

T/F: As the US travels through different tissues, the intensity increases

Answer 18

False

Question 19

T/F: Frequency and Attenuation are directly proportional

Answer 19

True

Question 20

Frequency c more superficial penetration

Answer 20

3 MHz

Question 21

Frequency c more deeper penetration

Answer 21

1 MHz

Question 22

Frequency c more attenuation

Answer 22

3 MHz

Question 23

T/F: US is not ideal for tendons, ligaments, joint capsules, and fascia

Answer 23

False

Question 24

T/F: US generally heats larger and more deeper areas compared to superficial heating agents

Answer 24

False

Question 25

How to facilitate thermal effects in US

Answer 25

use of continuous mode (100% duty cycle)

Question 26

Thermal effects of US

Answer 26

Inc metabolic rate Pain & spasm reduc Inc NCV Inc Blood Flow Inc ST extensibility

Question 27

How to facilitate non-thermal effects in US

Answer 27

Use pulsed mode (around 20% duty cycle)(

Question 28

Non-thermal Effects of US

Answer 28

Tissue healing Inc Cell membrane permeability Inc intracellular Ca+ Promotes macrophage responsiveness Inc rate of protein synthesis by fibroblasts

Question 29

The use of ultrasound in order for the body to better absorb the percutaneous medication

Answer 29

Phonophoresis

Question 30

System that makes phonophoresis possible

Answer 30

Acoustic Streaming

Question 31

Formation, growth, and pulsation of gas-filled bubbles by ultrasound

Answer 31

Cavitation

Question 32

Cavitation is responsible for?

Answer 32

Inc in cellular permeability Movement of macrophages & fibroblasts

Question 33

During what mode does cavitation occur?

Answer 33

Pulsed mode

Question 34

Indications for continuous US

Answer 34

Before stretching shortened STs Reduction of Pain

Question 35

Indications for Pulsed US

Answer 35

accelerate tissue healing Phonophoresis

Question 36

Unit of measurement for US intensity

Answer 36

W/cm2

Question 37

duration of pulse (on time) over pulse period (on + off time)

Answer 37

Duty Cycle

Question 38

1-2 cm deep penetration

Answer 38

3MHz

Question 39

depth of penetration for 1 MHz

Answer 39

up to 5 cm

Question 40

How to estimate the point of maximum acoustical intensity?

Answer 40

Between near & far fields

Question 41

T/F: As the pt progresses from the acute to subacute to chronic stages, you should keep the duty cycle at 20%

Answer 41

False

Question 42

What should pt feel during US application

Answer 42

Nothing, only that the US gel could feel a little bit cold

Question 43

How high can the spacial peak intensity be if the BNR is 6:1 and spatial average intensity is 1.5 W/cm2?

Answer 43

9 W/cm2

Question 44

How long is US applied for shortened STs?

Answer 44

5-10 minutes

Question 45

How long is US applied for painful areas?

Answer 45

3-10 mins

Question 46

Parameters for wound healing

Answer 46

0.5-1.0 W/cm2, 3MHz, 20% duty cycle x 3-10 min

Question 47

Give the 3 methods of application for US

Answer 47

Direct Method Glove or Balloon Technique Underwater Tx

Question 48

Contraindications of US

Answer 48

Malignant tumor Pregnancy CNS tissue Join cement or plastic components of arthroplasty Pacemaker Thrombophlebitis Over the eyes Near reproductive organs

Question 49

Precautions for US

Answer 49

Acute inflammation Epiphyseal plates (in growing children) Fx Breast implants

Question 50

Documentation for US?

Answer 50

Pulsed/Cont US x [frequency] x [intensity] x [tx duration] on [body part (including specific position of body part e.g. 90 deg abduction)] in [position] using [method of application] to [rationale]

Question 51

Meaning of ESWT

Answer 51

Extracorporeal Shockwave Therapy

Question 52

ESWT is the introduction of ___________ sound waves

Answer 52

high-energy

Question 53

T/F: ESWT uses single-impulse, focused acoustic sound waves c rapid rise in pressure

Answer 53

True

Question 54

How are shockwaves generated?

Answer 54

Reverse piezoelectric Electromagnetic Electrohydraulic

Question 55

T/F: ESWT has both thermal & non-thermal effects?

Answer 55

False, only non-thermal

Question 56

Physiological effects of ESWT

Answer 56

disintegration of Ca deposits Hyperstimulation analgesia Neovascularization Changes in cell permeability

Question 57

T/F: ESWT is noninvasive but powerful treatment

Answer 57

True

Question 58

Usual depth of penetration for ESWT

Answer 58

50mm of human tissue

Question 59

T/F: US Therapy reaches deeper than ESWT

Answer 59

false

Question 60

Indications for ESWT

Answer 60

Chronic Plantar Fascitis Ca tendonitis of the rotcuff Lateral Epicondylitis Achilles Tendinopathy

Question 61

unit of measurement for ESWT

Answer 61

mJ/mm2 milliJoules per millimeter squared

Question 62

< 0.1 mJ/mm2 energy per square area

Answer 62

Low intensity

Question 63

Energy per square area of High intensity ESWT?

Answer 63

> 0.2 mJ/mm2

Question 64

intensity for 0.1-0.2 mJ/mm2 energy per square area

Answer 64

Moderate

Question 65

T/F: Transient pain is expected to be felt after ESWT

Answer 65

True

Question 66

Side effects of ESWT

Answer 66

Hematoma Reddening Petechiae Local ST swelling Transient Pain

Question 67

Contraindications for ESWT

Answer 67

bleeding conditions pacemakers medications that prolong clotting children pregnancy acute injuries

Question 68

T/F: ESWT can be used in acute injuries?

Answer 68

False

Question 69

Documentation for ESWT?

Answer 69

[Modality] on [Body part] in [pt position] x [parameters] to [rationale]

Question 70

ESWT on (R) anterior shoulder x low intensity to decrease pain What is wrong in this documentation?

Answer 70

No patient position wrong parameters

Question 71

Practice documentation: - small head - (L) achilles tendon - 3,000 shocks - 0.2 mJ/mm2 - dec pain - prone

Answer 71

ESWT using small head on (L) Achilles tendon in prone c 3,000 shocks using 0.2 mJ/mm@ to dec pain

Question 72

Practice documentation (give pt position) - Big head - anterior R shoulder - 2,000 impulses - 0.28 mJ/mm2 - disintegrate ca deposits & dec pain

Answer 72

ESWT using big head on anterior aspect of R shoulder in [supine] c 2,000 impulses at 0.28 mJ/mm2 to disintegrate calcific deposits & dec pain

Question 73

T/F: You can document the duration of the therapy

Answer 73

True

Question 74

T/F: Frequency is also usually included when available

Answer 74

True

Question 75

T/F: Duration is usually not documented d/t the machine using shocks/impulses

Answer 75

True