Physiotherapy - BOARDS PT 1
Short wave Diathermy Indications include:
(GENERAL)Deep muscle issue (thoracic cavity), bronchitis, Joints, Pelvic inflammatory disease, Prostatitis, Sinusitis, -algia, neuritis, amenorrhea and otitis media
Microwave Diathermy Indications:
(LOCAL) Deep muscle, joints, Pelvic inflammatory disease, prostatitis, otitis externa, best for hip conditions, neuritis
Thermal effects of Therapeutic Ultrasound:
- Depth is up to 5-6 cm (the sound must stay in constant motion) Absorption in muscle depends on the sound head being parallel to the tissue (If sound waves are reflected bone and metal will not absorb it)
Flexion of the Muscles of the Shoulder Joint Complex:
-Anterior Deltoid -Coracobrachialis -Pectoralis Major (Clavicular)
External Rotation of the Muscles of the Shoulder Joint Complex:
-Infraspinatus -Teres Minor -Posterior Deltoid
Extension of the Muscles of the Shoulder Joint Complex:
-Latissimus Dorsi -Teres Major -Posterior Deltoid
Abduction of the Muscles of the Shoulder Joint Complex:
-Middle Deltoid -Supraspinatus -Serratus Anterior
Thermal modality (Heat therapy) Options :
-Moist Heat Packs -Paraffin wax bath -Fluidotherapy -Warm Whirlpool - Electric Heating Pads -UV
Indications for Heat Therapy :
-Pain -Muscle spasm -Decreased ROM -Reduction of joint contractures
Adduction of the Muscles of the Shoulder Joint Complex:
-Pectoralis Major -Latissimus Dorsi
Most common conductive methods of cooling:
-Placing ice or cold packs over an affected area (conduction) -Immersing a distal extremity in cool or cold water - Applying a cuff filled w/ ice water (w/ recirculating of the water) around the affected area
Scapular Retraction of the Muscles of the Shoulder Joint Complex:
-Rhomboids
Internal Rotation of the Muscles of the Shoulder Joint Complex:
-Subscapularis -Pec Major Sternal -Latissimus Dorsi -Teres Major -Anterior Deltoid
Results of Ultraviolet Therapy:
-Vasodilation -Bacteriocidal -Phototaxis -INC Vitamin D synthesis (inc calcium) -INC Reticulocytes -Stimulates metabolism -Improves skin and msucle tone (elasticity/0
Rules of application- Heat therapy:
-test the heated object on yourself - closely monitor the pt every 3-5 mins - treatment time is 20 minutes - 6 to 8 layers of towel - PT's shouldn't lie directly on a hot pack (heat pack always goes on top of pt) Base treatment on pt tolerance
Which frequency of ultrasound will have the greatest divergence and depth of penetration? 3.0 MHz 2.0 million hertz 0.75 million hertz 1.0 MHz
0.75 million hertz
An ultrasound frequency of _______ Mhz will have the most depth of penetration and _________ beam divergence
0.75; most
Which of the following ultrasound frequencies will give the greatest beam divergence? 0.87 MHz 1.0 MHz 0.80 MHz 3.5 MHz
0.80 MHz
The Therapeutic depth of paraffin bath is approximately ______________cm. 1 3 5 6
1
In therapeutic ultrasound the sound waves can either:
1- Reflect (lose a lil effectiveness) 2- Refract (it will spread into the tension w/ a ripple like effect) 3- be absorbed (ultrasound frequency is so fast it causes the molecules themselves to vibrate) -these sound waves are moving so fast you can't even hear
Microwave Diathermy Distance Time
1-7 inches 10-20 min
Contraindications for Traction:
1. Acute cervical trauma (whiplash associated symptoms) 2. Osteoporosis/ Osteopenia 3. Use of Steroids or other medications that tend to compromise bone integrity 4. Pregnancy 5. Joint hyper mobility/ instability 6. Prior surgical stabilization or decompression 7. Spinal implants/ prosthetic discs 8. No mechanical pain 9. Rheumatic disorders affecting connective tissue (including RA and AS)
11 Contraindications of Heat therapy :
1. Acute injuries (no heat on edema or inflammation) 2. Impaired circulation 3. Peripheral vascular disease 4. Deep vein thrombosis 5. Advanced arthritis 6. Poor thermal regulation 7. Anesthetic areas (no sensation) 8. Neoplasms 9. Thrombophlebitis 10. Closed infection 11. Pregnancy
12 Contraindications to Cryotherapy:
1. Circulatory insufficiency (don't want vasoconstriction in someone w/ poor blood flow) 2. Deep Vein Thrombosis 3. Cold Hypersensitivity/ Cold Urticaria 4. Anesthetic skin (if they can't feel there don't apply anything that could potentially be harmful) 5. Advanced Diabetes 6. Chronic Wounds 7. Uncovered open wounds 8. Peripheral vascular disease 9. Raynaud's Phenomenon 10. Lupus 11. Hemoglobinemia 12. Cold induced myocardial ischemia
4 methods of therapeutic heating:
1. Conduction 2. Convection 3. Radiation 4. Conversion
Indications for Traction:
1. Disc pathology (bulge or herniation) 2. Mobilization of degenerative conditions 3. Radicular symptoms 4. Joint mobilization 5. Facet syndrome 6. Lumbar/ cervical pain 7. Stimulate proprioception 8. Stretches adhesions and fibrosis 9. Reduces muscle spasm 10. Disc imbition
2 major ways of doing diathermy:
1. Induction Field Diathermy 2. Capacitive field Diathermy
5 Contraindications of Paraffin Wax:
1. Open wound 2. Diminished sensation 3. Acute skin disorders 4. Acute arthritic conditions 5. Paraffin is flammable (Avoid open flames)
The increased disc space associated with traction results in (4 things):
1. Reduces pressure IVD 2. Reduces pressure on spinal nerves roots 3. Opens the facet joints 4. Elongates the soft tissue
5 benefits of chiropractic:
1. Reduction in pain 2. Headache relief (dec frequency and intensity 3. Improved function/ quality of life (better mobility) 4. Eliminate medication (quit opioids PT's seeing chiro are 49% less likely to fulfill opioid prescription) 5. ATHLETIC PERFORMANCE IMPROVEMENT
7 Factors influencing Response to cold therapy:
1. Temp diff between cold object and soft tissue 2. TIME OF EXPOSURE 3. Thermal conductivity of area being cooled 4. Type and size of cooling agent 5. Total body surface area cooled 6.Activity level (inc activity—> inc circulation—-> faster rewarming) 7. Ability of cooling agent to maintain its temp
3 major effects of heat therapy:
1. Tissue Healing 2. Pain Reduction 3. Decrease Muscle Spasm All roads lead to PAIN REDUCTION
Which is an approximate value for therapeutic ultrasound frequency? 1.0 MHz 27.12 MHz 4,150 MHz 13.56 MHz
1.0 MHz
Which is the therapeutic ultrasound frequency that is mostly used over thick tissue acute phase? 1.0 MHz 10,000 hertz less than 5,000 hertz 4,150
1.0 MHz
Deep heating= Superficial heating=
1.1 MHz (VG- 1.0) 3.0 MHz (VG- 3.3) -USE DEEP HEAT on thick muscles like biceps, glutes and
Clavicle Interna/ external rotation:
10
Clavicle abduction / adduction:
10
Acute injury settings for ultrasound would be: Continuous , .75 w/cm2, 6 min 50%duty cycle, .9 w/cm2, 6 min 20% duty cycle, 1.2 w/cm, 6min 10% duty cycle, .5 w/cm2, 6 min
10% duty cycle, .5 w/cm2, 6 min
Treatment time for hot whirlpool is between: 5-10 min 10-15 min 10-20 min 20-30 min
10-20 min
What is the treament time for ice immersion therapy? 5-10 min 10-20 min 15-25 min over 25 min
10-20 min
What is the treatment time for Ice immersion therapy? 5-10 min 10-20 min 15-25 min over 25 min
10-20 min
The highest temperature that can be applied to the skin for an extended period of time without damage is: 103 deg F 103 deg c 109 deg F 113 deg F
113 deg F
Glenohumeral Abduction / Adduction :
120 / 45
Glenohumeral Flexion / Extension :
120 / 55
Hydrocollator temp is maintained at ______-______ deg Fah
160-165
The best BNR for ultrasound is: 7:1 8:1 1:1 1:2
1:1
Which beam non-uniformity ratio (BNR) is the most favorable for patients? 4:1 3:1 2:1 1:1
1:1
Shortwave diathermy distance Time
2 inches (Towel) 20-30 mins
Contrast bath protocol includes: 2 tubs placed close together position the patient standing btw 2 tubs contrast bath last 45-60 min cold is always given first
2 tubs placed close together
The max power setting of therapeutic Ultrasound is usually:
2.5 W/cm2
scapular internal/ external rotation
25
Remodeling of collagen tissue occurs primarily in phase _________________________ of inflammation? 1 2 3 4
3
The depth of penetration for diathermy is __________________cm 1-2 3-5 7-8 10-12
3-5
The ultrasound frequency of _________________MHz has the least beam divergence 0.75 3.0 1.5 1.0
3.0
Which frequency for therapeutic ultrasound is used when thin tissue penetration is the goal in the acute stage? 3.3 MHz 2MHz 3.0 MHz 1.0 MHz
3.3 MHz
clavicle elevation / depression:
5
Which of the following values is used by a medium frequency modality? 5,000 Hz 11,000 Hz 100,000Hz 50,000 Hz
5,000 Hz
Water temp for immersion in Cold Bath:
50 deg to 64.4 Fah - the lower the temp range, shorter the duration of immersion
What is the minimum percentage of a patient's body weight should traction never exceed? 10% 20% 35% 50%
50%
The wavelength frequent which penetrates the deepest would be: 390-470 nm (Violet to deep blue) 475-545 nm (blue to green) 545-600 nm (yellow to orange) 600- 650 nm (Red)
600- 650 nm (Red)
The least adequate beam non-uniformity ratio (BNR) would be: 8:1 2:1 1:1 7:1
8:1
Glenohumeral Internal Rotation / External Rotation:
90 /90
All of the following are shortwave diathermy frequencies except: 27.12 MHz 40.68 MHz 915 MHz 13.56 MHz
915 MHz
All arw source of ATP within a muscles except: creatine phosphate ADP Glycolysis Oxidative Phosphorylation
ADP
With Anterior pelvic tilt, typically it's the _____________ and ______________ which have become weakened
Abdominals; Glutes
What is Erythema ab igne?
Abnormal hyperemia It's a localized erythema due to heat exposure— you'll see this right before you get burn damage to the tissue -it heals on it's own
Static traction = Intermittent traction =
Acute Chronic
Which of the following is a contraindication to diathermy? Prostatitis Acute injury OA Sinusitis
Acute injury
Ultimate Outcome of all forms of ultrasound:
All leads to improve tissue healing and decrease pain
What is biphasic current is also known as? Galvanic Interferential High volt Alternating current
Alternating current
A figure "8" or Louisiana wrap is used for which? Clavicle Fractures Ankle inversion sprain AC joint separation drop foot
Ankle inversion sprain
CRYOTHERAPY:
Application of cold modality w/ temp range between 32 deg - 65 deg Fah (removing heat NOT adding cold)
Paraffin application procedure:
Applied directly to skin! Dip n Wrap; Dip n Re-immerse 7- 10 times (glove like appearance) Place in plastic bag then wrap in a towel/ mitt which will lock in that thermal energy 15-20 minutes Heat transferred by conduction
The depth of vascular changes with superficial heat therapy: Are greater than cold Are more than 5 cm Are confined to the skin Are time dependent
Are confined to the skin
Traction contraindication Question:
Are you claustrophobic? Claustrophobia= the perception of being enclosed in the harnesses and confined on the table may precipitate anxiety
Indications for ultraviolet radiation treatment would include: Aseptic wounds Hyperthyroidism Pellagra Diabetes
Aseptic wounds
Short wave and microwave diathermy reduces:
Blood pressure, nerve pain, muscle cramps, muscle spasms
Which type of exercise is recommended for treating scoliosis? williams Codman's DeLorne Blount's
Blount's
Which of the following types of TENS has duration of pain relief usually below one-half hour? Low TENS High TENS Brief-Intense TENS Motor TENS
Brief-Intense TENS
PT ask what they should expect to experience from Cryotherapy:
CBAN Coolness (3-5 mins) Burning (1-2 mins) Aching (1-2 mins) Numbness
Transfer of heat by direct interaction of the molecules in the warmer area with those in the cooler area:
CONDUCTION -Warmer, rapidly moving particles give up or transfer heat to nearby cooler, slower moving particles
If pt has __________________ the may find the lumbar harness of lumbar traction uncomfortable
COPD (Chronic Obstruction Pulmonary Disease) -may find the lumbar harnesses uncomfortable and may be compromised by the supine position
Anterior Pelvic Tilt is often the result of:
Certain muscles that have gradually become either under active or overactive
Angles of pull traction:
Cervical- 0 degrees for upper cervical spine Place head 25-30 degrees flexion for C5-C7 Lumbar- Prone straight pull (supine) L1- 0 deg L4 & L5- 25 TO 30 deg
Traction weights:
Cervical- 10lbs (Don't exceed 30 lbs) Lumbar- start @ 25% of BW, do not exceed 50% of body weight or 120 lbs if they are really big (never go past 120)
You can only do traction on the _______________ and ______________ spine
Cervical; lumbar -for cervical pull only 10 lbs -for lumbar pull 50% of pt body weight max
Ultrasound Indications:
Chronic inflammatory condition Pain reduction (mc) Trigger points (mc) Muscle spasm (mc) Neuroma Scar Tissue Spasticity Warts CPTMMSSW -ALL ROADS LEAD TO PAIN REDUCTION
Which of these lasers are safe for momentary viewing (directing beam into eye)? Class II laser Class IIIa laser Class IIIIb laser Class V laser
Class II laser
Which of these exercises are designed to treat scoliosis? Frenkel's exercises Jacobsen's exercises Clayton's exercises William's Flexion Exercises
Clayton's exercises
Frozen shoulder is a condition that is best treated with __________________ exercises DeLorne Blount Codman Williams
Codman
There are no thermal effects of:
Cold Laser
Examples of Convection (cooling):
Cold Whirlpool -water moves over the PT's skin via turbines that circulate the water OR by the pt moving the body part within the water
Most common form of cryotherapy:
Cold packs
Objects contact one another and heat is transferred to the object of lower temperature describes what method of therapeutic heating?
Conduction
Prinicipal modes of energy transfer used for therapeutic cooling:
Conduction Convection Evaporation/ Radiation
Therapeutic Ultrasound: _____________________: 100% of heat produced _____________________: 10% 20% 50%
Continuous; pulsed
Exchange of heat between a surface and a liquid or gas moving over that surface is what method of therapeutic heating:
Convection
_____________________ has Faster heat abstraction compared to Conduction
Convection
Heat abstraction when there is direct contact between the skin and moving fluid particles:
Convection If you put you hand or foot inside a cold tub of ice and MOVING water (if water is not moving then that's conduction)
The radiant energy of the sun is strongest at a 90 deg angle to the earth, This refers to the: Arndt-Schultz Principle Cosine Law Inverse Square Law Grotthuss Draper Law
Cosine Law
Vasoconstriction Decreased metabolic rate Decreased Inflammation Decreased Pain Reduction in spasticity Increased muscle tone Blood becomes thicker Analgesia Local physiologic response to:
Cryotherapy
A 25 year old female tennis player w/ chronic right lateral epicondylitis falls forward, landing on her hands and knees, reinjured her elbow yesterday. Which modality treatment plan would be best to treat this injury? -ultrasound, 3 MHz, 1.5 w/cm2, 50% duty cycle for 6 mins., R.elbow -Hot pack for 20 mins on R. Elbow -Cryotherapy for 10 mins R. Elbow
Cryotherapy for 10 mins R. Elbow
What does CPT (code) stand for?
Current Procedural Terminology
We need ultraviolet light for Vitamin _____
D - it is used to convert vitamin D
Traction allows for pressure to be taken off the:
DISC Also small arteries of the spinal column and nerve root
Ultrasound contraindications:
DON'T WANNA USE continuous Ultrasound on Acute conditions Ischemic areas Over suspected DVT Cancerous Tumors Active infection or sepsis Anesthetic areas (don't do anything that requires the use of feeling in a place where there's no feeling) Over replaced joints Over the face eyes skull carotid sinus or genitals Pregnancy (over the pelvic or lumbar areas) DON'T COOK THE BABY
In Fluidotherapy, the heat is _____ so it can be much more intense than paraffin or whirlpools
DRY -High intensities of heat and micro-massage
Primary response for cryotherapy:
Decreasing cell metabolism (decreased metabolic response)
Diathermy literally means:
Deep heat -heat is produced by high frequency alternating currents -Heat is developed by resistance - non-ionizing electromagnetic energy
Which muscle "caps" the shoulder and abductions the shoulder joint?
Deltoid
_________________ result in increase in blood hemoglobin to release Oxygen
Deoxyhemoglobin
Which deep heating modality treats conditions such as bronchitis, sinusitis and myositis? TENS Russian Stimulation Interferential Diathermy
Diathermy
Diathermy vs Ultrasound __________________ uses the entire bell housing and imparts a large signal into the tissue, so we use this if we need to treat really big areas, use ________________ for small areas (should only move the head the width of 2 ketchup packets and move very slowly
Diathermy; Ultrasound
Which type of current is used in iontophoresis? Direct Current (DC) Alternating Current (AC) Pulsed Current Biphasic
Direct Current (DC)
__________ heat can elevate surface temp to a greater degree
Dry
With Anterior pelvic tilt, typically it's the _____________ and ______________ which have become TOO TIGHT
Erector Spinae; Hip Flexors
Vapocoolant sprays use _____________ as a means of thermal energy transfer (cooling)
Evaporation -these are used for temporary pain relief before stretching muscles w/ active trigger points or muscles w/ local spasm
Convection:
Exchange of heat between a surface and a liquid or gas moving over that surface
Microwave diathermy Penetration Wavelength
Fat 2-12 cm (2450 megacycles Frequency
Short wave Diathermy heat hits _____________ first and then its absorbed by muscle
Fats (Outside -> In)
Dry whirlpool that uses cellulose particles (ground cellulose) to pre-heat and blow around air to deliver heat primarily for the extremities:
Fluidotherapy
Which of these are exercises designed as a system of slow repetitious exercises for the treatment of ataxia? Frenkel' exercises Jacobson's exercises Clayton's exercises Williams Flexion exercises
Frenkel' exercises
Which muscle or group of muscles would be weak in a positive trendelenburg test? Iliopsoas Hip adductors Hamstrings Gluteus Medius
Gluteus Medius
How to properly posteriorly pelvic tilt (for ppl with ant pelvic tilt):
Have pt lay on floor w/ knees up (you'll likely see a space between the floor and the lower back). Flatten your lower back into the ground by tilting Can also do it standing by simply contracting abdominals and squeezing the glutes to come into posterior pelvic tilt GO BACK N FORTH BETWEEN POSITION 10x
Procedure Therapeutic Ultrasound:
Head Warming: OFF- Depth (Deep) Time 3-12 mins (7 mins) Non-thermal (deep micro massage) Frequency: 1 MHz Duty Cycle: 20% Non-thermal (superficial) Frequency: 3.3 MHz Duty cycle: 20% Deep Heat: Frequency: 1 MHz Duty Cycle: 100% Shallow Heat: Frequency: 3.3 MHz Duty Cycle: 100%
___________ therapy results in increases in molecular vibration and cellular metabolic rate
Heat -it's the opp of cold
Vasodilation is an effect of ________ therapy
Heat -spinal-level reflex
Contraindications to all Modalities:
Hemorrhage (if pt is hemorrhaging they should not be in your office) Infection Malignancy PG-lb/ abd
Conversion:
High frequency electric current produces oscillations that are converted into heat
Thermal energy always moves from _______ conc to __________ conc
High; low
A 48 year old male w/low back pain for 1 month duration. He denied any injury or trauma. He denies any injury or trauma . He does have persistent muscle tightness. Which modality would be best to treat this person? Ice pack, 10 mins over low back Hot pack for 20 mins over low back Ultrasound, 1 MHz, cont 1.25 w/cm2 for 6 mins over low back Low volt galvanic, negative pad, 20 mins over low back
Hot pack for 20 mins over low back
MC form of superficial heat:
Hot packs
Erythema ab igne aka:
Hot water bottle rash -it literally translates to Redness by Fire
Conduction is used by which of the following modalities? whirlpool bath hydrocollator pack ultraviolet infrared lamp
Hydrocollator pack
For cryotherapy, a small nearby area of skin should be tested with the cold modality to determine if ___________________ is present
Hypersensitivity (wheals, hives)
According to the sliding filament model of contraction, as a muscle contracts the ________ band shortens
I
___________ is the most effective type of cold as it must undergo a phase change from solid to liquid, which causes greater heat extraction than when no phase change occurs
ICE
What is the most effective way to treat an acute injury within the first 24 hours?
ICE and Elevation for 15-20 minutes
The Gate Theory of pain has led to the discovery of: Fluidotherapy Russian Stimulation TENS IFC
IFC
RICE (REST, ICE, COMPRESSION AND ELEVATION) IS AIMED AT REDUCING
INFLAMMATION
Inflammatory stage is extremely important for healing, if you block it with NSAIDs what is the result:
Increase in proliferation of Scar Tissue -turning an acute injury into a chronic condition (scar tissue develop forever)
A physiological effect of traction on the articular facet joints is: lengthening of muscle surrounding joints activated muscle proprioceptors lengthen ligaments Increase separation between joint surfaces
Increase separation between joint surfaces
Buerger-Allen exercises are best used for: Chronic disc lesions Urinary incontinence Intermittent Claudication Postural Deviations
Intermittent Claudication
Treatment Times Traction:
Intermittent: 15- 30 mins Continuous: mins-hours
Negative polarity as used. In high volt pulsed current has which effect? It increases vascularity In increases macrophage activity It decreases collagen production It increases bacterial growth
It increases vascularity
Why do we use knee bolsters for lumbar traction:
It takes out the lordotic curve -takes pressure off the spine
Eccentric muscle contraction requires muscles to:
Lengthen against resistance
During endurance type aerobic exercise the primary ATP source is: Creatine Phosphate Glucose Glycogen Lipid
Lipid
Tendonitis differs from tenosynovitis in what way?
Location: tendon vs tendon sheath
Tendonitis differs from tenosynovitis in which way? Location: tendon vs tendon sheath Pain scale cause: overuse vs trauma
Location: tendon vs tendon sheath
______________ TENS has an onset of pain relief approximately of 30 minutes Low Brief-Intense High Noxious
Low
Which type of TENS uses the burst mode in operation? High TENS Low TENS Sensory TENS Noxious TENS
Low TENS
When working on early rehabilitation of grade 2 anterior shoulder sprain, emphasis should be on: maintenance of strength increasing endurance increasing proprioception and flexibility Maintaining proprioception and decreasing chance of Adhesions
Maintaining proprioception and decreasing chance of Adhesions
Which of the following exercises should be administered to increase a lumbar lordosis? McKenzie Williams Codmans Isometric
McKenzie
Which of the following modalities has the lowest frequency? IFC Russian Microcurrent Shortwave Diathermy
Microcurrent
Which type of brace is used for Scoliosis? Somi Orthosis Milwaukee brace Philadelphia collar williams brace
Milwaukee brace
Laser Photons activate: muscle spindles to decrease muscle spasm golgi tendon organs to inc muscle tension DNA protein production Mitochondrial ATP production
Mitochondrial ATP production
Laser photons activate: Muscle spindles to decrease muscle spasm Golgi tendon organs to increase muscle tension DNA Protein production Mitochondrial ATP production
Mitochondrial ATP production
Paraffin bath is a form of:
Moist superficial Heat
Short wave diathermy penetration wavelength
Muscle-fat interface 11 meters (27.12 megacycles)
Microwave Diathermy heats ____________ first and is then absorbed by ____________
Muscle; fats
Radiation:
Objects between which the transfer of heat energy occur are separated by a medium that does not become warmer
Conduction:
Objects contact one another and heat is transferred to the object of lower temp
For cervical traction patient lays in the same or opposite position as lumbar?
Opposite -also make sure you raise the foot of the table up @ an angle
Interferential contraindications include: Edema Pain Pacemaker Muscle Spasm
Pacemaker
White wax-like substance with a very low melting point, that is made of paraffin and mineral oil:
Paraffin -it's very good for small areas like the hands
MC reason for Physiotherapy malpractice suit:
Patients being burned from therapeutic Heat
Contraindications for Diathermy include which of these? Joint inflammation Subacute Inflammation Peripheral Vascular Disease Osteoarthritis
Peripheral Vascular Disease
Which phase of inflammation is characterized as the fibroblastic repair phase? Phase 1 Phase 2 Phase 3 Phase 4
Phase 2
_________________ effect is when Zicornate (which sits inside the head itself) titanate produce a positive and negative charge they contract and expand. ______________ effect is the reverse of the charge to produce ultrasound
Piezoelectric; Electropiezo - when the crystal contracts and expands that causes the sound waves. The reverse of the charge produces the ultrasound itself. ]
Contraindications of Short Wave diathermy:
Pregnancy, casts, metal, hearing aide, casts, contacts, wet skin, ulcers, pacemakers, advanced osteoporosis
An 18 year old male who was in a car accident one week ago and now complains of neck pain with muscle spasm of left levator scapulae. Which modality treatment would be the best to treat this injury? -ultrasound 3Mhz, 1.0 w/cm2, 20% duty cycle for 10 mins on L. Levator -Premodulated interferential, high, sweep, 20 mins on the L. levator -Contrast therapy (hot for 10 mins followed by cold for 5 mins then hot for 10 mins on the L.Levator
Premodulated interferential, high, sweep, 20 mins on the L. levator
All of the following are indications for shortwave and microwave diathermy except: bronchitis OA Fibrositis Pyrexia
Pyrexia
For every 18 deg Fah increase in skin temp, the cell's metabolic rate increases speed up 2-3 times. What is the name of this phenomenon?
Q10 Effect
Objects between which the transfer of heat occurs but they are separated by a medium that does not become warmer describes which therapeutic method of heating?
Radiation/ Evaporation
Ice massage is contraindicated in the treatment of: Thermal Injuries Osteoarthritis Raynaud Syndrome Tenosynovitis
Raynaud Syndrome
Which of the following is a contraindication to using cryotherapy? Raynaud's Disease Acute Soft tissue injury Burns To decrease edema
Raynaud's Disease
Which muscle a primary torso stabilizer, responsible for maintaining posterior pelvic tilt? Quadratus lumborum Quadriceps Rectus Abdominus Gluteals
Rectus Abdominus
What predominant color is the HeNe Laser? Blue Purple Red Green
Red
Transcutaneous neuromuscular nerve stimulation (TENS) can: -Treat acute pain by activating C nerve fibers -Release opioid Beta endorphins by stimulating A delta and C nerve fibers -Relieve pain associated with cancer -Alter (selectively depolarize) efferent nerve function
Release opioid Beta endorphins by stimulating A delta and C nerve fibers
The final healing stage could take (months to years):
Remodeling
Indications for traction include all except: apophyseal joint impingement disc protrusion Rheumatoid Arthritis Foraminal Encroachment
Rheumatoid Arthritis
Which muscle is the prime mover in adduction and elevation of the scapula? Latissimus dorsi Rhomboid Major Trapezius 1 Levator Scapulae
Rhomboid Major
All of the following are considered low frequency modalities except: low-volt galvanic TENS Faradic Russian Stimulation
Russian Stimulation
Which of the following is not a high frequency modality ? infrared Russian Stimulation Ultrasound Diathermy
Russian Stimulation
Short wave Diathermy contraindications:
SAME as for all/ any heat modality (don't cook the baby, don't do it on metals, don't do it on active infections, don't do it on DVT, Don't do it on metastasis)
All of the following conditions are treated with Codman's exercise except: Shoulder Tendonitis Adhesive capsulitis of the shoulder Frozen Shoulder Scoliosis
Scoliosis
Which of the following is not an indication for shortwave diathermy? myositis OA Tednonitis Sensory Loss
Sensory Loss
_____________________ Diathermy increases temperature pulse, respiration, BMR, lymph flow, elimination, nutrition, vasodilation, glandular secretions and endocrine changes
Short Wave and Microwave
All of the following are low frequency modalities except: TENs Sine wave high voltage galvanic Short wave diathermy
Short wave diathermy
Raynaud's, circulatory disturbances and joint inflammation are indications for which modality? Short wave diathermy cold pack ice massage infrared
Short wave diathermy
Which of the following is a good conductor of electricity? distilled water glass wood Silver
Silver
Microwave Diathermy contraindications:
Sinusitis, metal scars, wet skin, open epiphysis and otitis media (Same as SWD)
ICE massage is usually performed over a _____________ area (muscle belly, tendon, bursa) or over________ points before deep pressure release
Small; trigger
Ultrasound produces _____________ waves diathermy produces _______________
Sound; radio
The principle of variation in resistance training is:
Specific variables must be constantly manipulated to adapt
Evaporation Examples:
Spray and Stretch and instant ice -as the liquid leaves the pressurized canister, it begins to evaporate -the stream cools and extracts heat upon contact w/ skin
Best Solution based exercises for ANT pelvic Tilt:
Strengthen Glutes and ABs : Hip thrust (targets glutes)(don't arch lower back that takes the glutes out the equation) Glute bridges (targets glutes) Ab exercises that minimize action of the hip flexors like RKC planks Stretch: hip flexors (lunge stretch); Rectus femoris
Solution for anterior pelvic tilt:
Stretch the overactive muscles primarily the HIP FLEXORS Strengthen the weakened muscles primarily the abdominals and Glutes)
What is the preferred position of the patient for cervical traction? Prone Supine Sitting standing
Supine
_____________ is usually used for pain control only ultrasound TENS infrared sine wave
TENS
A 62 year old male with moderate chronic pain which he categorizes as a constant 6/10 on the right side of his neck. What treatment plan would be the most useful for this patient's condition? -Cryotherapy, 10 mins, on the neck 3 x daily for 1 week -Hot packs, 20 mins on the neck 2x daily for1 week -TENS, 30 mins 2x daily for. R side of the neck, 5 pps, burst, 125 microsec
TENS, 30 mins 2x daily for. R side of the neck, 5 pps, burst, 125 microsec
_______________ is a _____________ frequency modality mainly for pain control TENS; low Microcurrent; low diathermy; medium Russian stimulation; high
TENS; low
Which of the following statements is false pertaining to ultrasound? a. The largest transducer will have the most beam divergence b. The smallest transducer will have the most beam divergence c. The lowest frequency will have the most depth of penetration d. The lowest frequency will have the most divergence
The largest transducer will have the most beam divergence
for therapeutic ultrasound Des the head really have to remain in motion???
The sound head should be moved approx. 4 cm per sec 1MHz= 10-12 mins 3MHz= 3-4 mins
During a muscle contraction: The larger the load the shorter the latent period The larger the load the longer twitch duration The latent period does not change w/ the type of load (light v heavy) The twitch is inversely proportional to the type of load (lights heavy)
The twitch is inversely proportional to the type of load (lights heavy)
Combination therapy:
The use of ultrasound in combination with an electrical modality
The Arndt-Shultz principle states: -There is an optimal amount of energy absorption per unit of time -The US transducer converts electrical energy into sound waves -Tissue penetration is inversely proportional to wavelength -The more homogenous the tissue the less energy absorbed during an ultrasound treatment
There is an optimal amount of energy absorption per unit of time
4 major actions of ultrasound:
Thermal, mechanical, chemical or neural
When using ultrasound, tissue extensibility occurs when: Tissue temperature is elevated 1 dg cel Tissue temperature is elevated 3 deg Fahrenheit Tissue temperature is elevated 4 deg cel Tissue temperature is decreased 2 deg Fahrenheit
Tissue temperature is elevated 4 deg cel
Traction comes from the Latin word:
Tractico
___________ helps to rehydrate the IVD
Traction - the pulling really helps w disc protrusions and desiccation
Scapular Elevation of the Muscles of the Shoulder Joint Complex:
Trapezius -Upper Trapezius -Middle Trapezius -Lower Trapezius -Levator Scapula
Scapular Stabilization of the Muscles of the Shoulder Joint Complex:
Trapezius -Upper Trapezius -Middle Trapezius -Lower Trapezius -Serratus Anterior -Rhomboids
______________________ are located in muscle, fascia, tendon, and ligaments that are hypersensitive to stimulation Acupuncture points Trigger Points Motor points Sensory points
Trigger Points
Therapeutic Ultrasound coupling media (good friends):
Ultrasound gel -Water glycerine and mineral oil Function: Conductance to the tissues Lubrication And prevents an air gap
Mechanical action of heat therapy: __________________ Electrical or magnetic currents: __________________
Ultrasound; Diathermy
Which high frequency modality generally treats skin conditions such as acne and Psoriasis? Ultrasound Russian Stimulation Ultraviolet HeNe Laser
Ultraviolet
Light Therapy Includes:
Ultraviolet light (UV) Supra-luminous Light-Emiting Diode (SLED) LASER
All of the following are indications for traction except: chronic muscle spasm IVF Encroachment Unstable ligaments Disc syndromes
Unstable ligaments
Cryokinetics involves the use of: Ice therapy after an injury Use of ice and motion to treat an injury use of ice and massage to treat an injury use of ice prior to stretching
Use of ice and motion to treat an injury
Which cryotherapy treatment does not use conduction? VaPocoolant spray Hot Pack Ice pack Ice Massage
VaPocoolant spray
Which of the following is the first event to occur after a superficial, soft tissue injury? Vasodilation Vasoconstriction Margination Granulation
Vasoconstriction
Reflex effects of Cold: (same effects of hypothermia)
Vasoconstriction of internal organ Decreased Perspiration & glandular activity Anesthesia of the PNS Mild sedation of CNS
_________________ is the relaxing of arterioles smooth muscle, triggering good the release of neurotransmitters and peptides
Vasodilation
Which should be strengthened primarily to prevent outward rolling of the patella? Vastus medialis hamstrings abdominal soleus
Vastus medialis
Traction inc spaces between the:
Vertebrae Pulls on the VB making the space where the disc is located inc and the disc is attached to the sup and Inf end plates creating a suction inside the disc and drawing more fluid inside the disc itself
In a nut shell diathermy is __________________ heating
Vigorous
ICE Massage procedure:
Water is frozen is paper or Styrofoam cups to make it easier for the practitioner to handle the ice. The ice is continually moved over the skin, which decreases the risk of tissue damage or frostbite - simple and safe for home use
In Raynaud's phenomenon the hands/ finger nails first go _____________ _______________ and ______________. Then suddenly the vessels dilate and fill the area with hot fresh blood which leads to a _______________ sensation
White; cold; numb; Burning
Which of the following exercises is most appropriate to decrease a lumbar hyperlordosis? McKenzie Codman's Williams Eccentric Contraction
Williams
Hot packs are indicated in An acute ankle injury an acute tenosynovitis of the hand an open wound infection a chronic knee
a chronic knee
A single motor unit is defined as:
a single motor neuron and the muscle fibers it controls
A single motor unit is defined as: -a single motor neuron and the muscle fibers it controls - a group of motor neurons and the muscle fibers they control -a single motor neuron -a single muscle fiber
a single motor neuron and the muscle fibers it controls
Cryostretch involves the use of: an ice cup ice pack for 10 minutes followed by 5 minutes of stretching a vapocoolant 10 mins of ice pack followed by active range of motion
a vapocoolant
Magnesium is generally used in ionotrophoresis for the treatment of? a. arthritis b.edema c. scars d. bursitis
a. arthritis
The lateral shift of the trunk stance phase during walking gait is due to which hip muscle weakness? adductors flexors abductors extensors
abductors
What are the 4 major types of skin injuries? abrasions, incisions, lacerations and avulsions abrasions, incisions, lacerations and dislocations rash, incisions, lacerations and avulsions rash, incisions, lacerations and dislocations
abrasions, incisions, lacerations and avulsions
COLD IS the ______________ of heat
absence
The neurotransmitter found in the neuromuscular junction is: norepinephrine acetylcholine GABA Serotonin
acetylcholine
Which physical sensation comes directly before the numbness stage of therapeutic ice? stinging stabbing warming aching
aching
Which of the following is not part of the electromagnetic spectrum? acoustic wave cosmic ray x-ray electric power
acoustic wave
Which type of condition is most appropriate for pulsed ultrasound? acute subacute chronic fracture
acute
Contrast baths are used for which? acute injuries when patient suffers from cold allergy over superficial nerves irregular shaped areas
acute injuries
Which of the following is a contraindication for hydrotherapy? acute injury burns open wounds arthritis
acute injury
Contraindications for cold packs include: Chronic pain postsurgical pain and edema subacute injury advanced diabetes
advanced diabetes
The loss in the ability to comprehend written words is known as which of the following? anomia dysarthria apraxia alexia
alexia
Impedance occurs in _______________ current; it is measured in ________________ alternating, volts alternating, ohm's direct, miliamps pulsed, miliamps
alternating, ohm's
The rate at which current flow is which of the following? watt ampere impedance ion
ampere
Raynaud phenomenon is characterized by: an inability to feel cold an inability to feel heat an allergic reaction to cold an allergic reaction to heat
an allergic reaction to cold
A sprain is defined as: an injury to a tendon an injury to a muscle an injury to a ligament an injury to a joint capsule and synovium
an injury to a ligament
Oxidation of anions will occur at the ______________, which will yield an ______________ reaction. cathode, acidic anode, acidic cathode, alkaline anode, alkaline
anode, acidic
Precautions for high volt pulsed current include: edema pressure sores anterior cervical area using underwater technique
anterior cervical area
The depth of Vascular changes with superficial heat therapy: are greater than cold are more than 5 cm are confined to the skin are time dependent
are confined to the skin
Which of the following is not a contraindication to all modalities? tumors cancer endocrine disease aseptic wounds
aseptic wounds
Neuromuscular Electrical Stimulation (NMES) -is designed for pain relief -is safe over a pacemaker -is used exclusively for muscle spasm relief -assists in patient proprioception and kinesthetic awareness of muscle movement
assists in patient proprioception and kinesthetic awareness of muscle movement
Cathodes used in iontophoresis would have all of the following effects except: pain is elevated has a heating effect hyperemia attracts oxygen
attracts oxygen
Treatment parametes for cold laser LLLT include:
avg output, time of light exposure and treatment (area) size
The most common form of cryotherapy is: a. vasocoolant spray b. ice pack c. cold whirlpool d. fluidotherapy
b. ice pack
The principle of _________________ is involved in the Milwaukee brace fluid compression distraction sleeve principle balanced horizontal force
balanced horizontal force
The type of stretching which is most prone to cause injury is: ballistic stretching PNF stretching Dynamic stretching Static stretching
ballistic stretching
The differences between two original interferential sine wave frequencies creates a new: amplitude modulation sweep scan beat frequency
beat frequency
Which of the following exercises should not be recommended to a patient with a heart condition? walking running bicycling biceps curl
biceps curl
Which should be avoided for a patient with Achilles tendonitis? bicycling hamstring stretch foot inserts flexible shoe soles
bicycling
The various effective US coupling agents include all the following excepts: ultrasound gel gel pad biofreeze water (as in inderwater technique)
biofreeze
Absorption of ultrasound is least in which of the following? tendon bone blood cartilage
blood
All of the following are contraindications for shortwave diathermy except: pyrexia cardiac pacemaker phlebitis bronchitis
bronchitis
Lidocaine anode in iontophoresis is used to treat ________________. excessive sweating bursitis athlete's foot ischemic
bursitis
Which of the following is not true regarding microcurrent? a. it elevates the making of cellular ATP b. Protein synthesis is increased c. It operates at a medium frequency d. It helps healing to occur at a faster rate
c. It operates at a medium frequency
Which of the following is a negatively charged ion used in ionotrophoresis for the treatment of scars? a. niacin b. xylocaine c. chlorine d. acetate
c. chlorine
In order for a muscle contraction to occur: calcium must bind with troponin magnesium binds with troponin a cross bridge must be deactivated acetylcholine binds with actin
calcium must bind with troponin
How does cold laser (low level laser therapy -LLLT) differ from ultrasound? works from the outside in emits a multiphasic frequency can be used over bony prominences cannot be used on chronic conditions
can be used over bony prominences
All of the following are indications for interferential except: pain modulation fracture healing cancer enhance range of motion
cancer
All of the following are indications for shortwave diathermy except: chronic RA cancer bursitis radiculitis
cancer
Reduction of cations will occur at the __________________, which will yield an _________________ reaction. anode, alkaline cathode, acidic cathode, alkaline anode, acidic
cathode, alkaline
Ultrasound's non thermal effects are d/t: cavitation within the tissues inc circulation Arndt-shultz law Intracellular fluid
cavitation within the tissues
Which is not an indication of cold therapy? boils chilblains fever herpes blisters
chilblains
Which of the following is an indication to paraffin? chronic arthritis sensory loss open wound acute injury
chronic arthritis
Contraindications for hot pack use include all the following except: infection acute inflammation chronic inflammation active hemorrhage
chronic inflammation
What is the fourth stage of Overuse injury? Pain after activity only chronic unremitting pain pain during activity, does not restrict performance pain during activity, restricts performance
chronic unremitting pain
Shortwave Diathermy has all of the following indications except: to diminish muscle spasm myostitis bronchitis circulatory conditions
circulatory conditions
All of the following are indications for cryotherapy except: pain acute injury circulatory insufficiency muscle spasm
circulatory insufficiency
A ________________ water bladder for applying ultrasound would not block the transmission of sound waves red black white clear
clear
What color should be used for the water bladder, which is used when applying ultrasound? clear (no color) black white red
clear (no color)
Which of the following does not help to regulate the swelling in the acute phase of an injury? leucotaxin histamine collagen necrosin
collagen
Which is true of a infared heating lamp? comes in 2 types (luminous and non-luminous) indicated for subacute conditions indicated in acute conditions produces chemical reaction within the subcutaneous tissues only
comes in 2 types (luminous and non-luminous)
A leg curl is an example of a (n) _______________ type of contraction a isotonic concentric isometric eccentric
concentric
A biceps curl would represent a(n) _____________ type of contraction; and performing leg extension is a type of ______________ contraction
concentric; eccentric
Transfer of energy which occurs from direct contact is: convection conduction evaporation conversion
conduction
With Paraffin Wax Heat is transferred d/t _____________________
conduction
Which of the following is not recommended in the Acute stage after an injury? compression elevation continuous ultrasound ice
continuous ultrasound
Ultrasound utilizes _______________________; in this way acoustic waves are created convection radiation conversion low voltage
conversion
Which of the following has the highest frequency in the electromagnetic spectrum? X-ray microwave cosmic ray acoustic wave
cosmic ray
The sequence of events during a muscle contraction are:
cross bridge attachment -> activation of myosin head -> power stroke-> cross bridge detachment
A 57 yr old female with frozen shoulder for the past 6 weeks. Which treatment plan would be the most effective in treating this type of injury? -cryokinetics on affected shoulder with Codman exercises daily for 2 weeks -ultraviolet radiation, 20 mins followed by codman exercises on the affected shoulder, daily for 1 week -interferential, high sweep, 20 mins intensity to tolerance, 3x week for 2 weeks - cold laser (LLT) on affected shoulder, dosage=1 joule perpoint, minimum of 5 points 3 x week
cryokinetics on affected shoulder with Codman exercises daily for 2 weeks
Which of the following is least ideal in the maturation-remodeling phase of acute injury ? cryotherapy microwave diathermy ultrasound shortwave diathermy
cryotherapy
Which of the following should be used 10 hours after an initial injury? Ultraviolet hydrocollator pack cryotherapy shortwave diathermy
cryotherapy
1. Acute Injury of inflammation 2. Acute, chronic or post surgical pain 3. Prevent edema formation 4 Prior to or in conjunction w/ rehab exercises 5. Spasticity accompanying CNS disorders 6. Acute or chronic muscle spasm 7. Neuralgia 7 Indications for:
cryotherapy (ICE)
Average power amount of therapeutic ultrasound energy is produced at the surface of the:
crystal Power is measured per unit W/cm2_
All of the following are indications for traction except: a. herniated disc b. subacute pain c. IVF narrowing d. bone infection
d. bone infection
All of the following are types of friction massage except: a. cross fiber b. storm technique c. circular d. cupping
d. cupping
Which of the following is an indication for traction? a. Osteoporosis b. acute inflammation c. fracture d. degenerative joint disease
d. degenerative joint disease
Low power lasers are not used for: a. wound healing b. treatment of tendon injury c. arthritis and treatment of burns d. surgical incision procedures
d. surgical incision procedures
Which of the following is not an effect of applied heat? decrease in Phagocytosis rise in arteriole dilation analgesia rise in metabolism
decrease in Phagocytosis
Electrically stimulating currents that cause muscle contractions have all of the following effects except : retardation of atrophy muscle strengthening increased range of motion decreased range of motion
decreased range of motion
Indications for paraffin bath include: Open wounds decreased range of motion (ROM) Sensory loss Peripheral Artery Disease
decreased range of motion (ROM)
A wobble board for ankle rehabilitation is designed to: reduce edema decrease proprioceptive input develop stability and proprioception reduce range of motion
develop stability and proprioception
All of the following are indications for ultraviolet except: diabetes sinusitis osteomalacia herpes zoster
diabetes
All of the following are indications for ultraviolet treatment except: acne hyperthyroidism diabetes psoriasis
diabetes
All of the following are superficial heating modalities except: hydrotherapy infrared fluidotherapy diathermy
diathermy
Superficial heat include all the following except: hot packs paraffin bath infared lamp diathermy
diathermy
Which of the following most closely relates to Ohm's Law? more voltage means more current intensity heat made is proportional to intensity, resistance and current time different wavelengths have consequences of different effects 90 degrees to a source of energy give the greatest absorption effect
different wavelengths have consequences of different effects
Which of the following types of electrical current typically contribute to the production of a chemical reaction? alternating current pulsed current direct current interrupted direct current
direct current
Electrodes are placed right over a painful spot and are parallel to the midline of the body in __________________________ for TENS contiguous placement direct placement indirect placement multiple modulation
direct placement
Contraindication to lumbar traction include all of the following except: infection fracture disc herniation spondylolisthesis
disc herniation
The term Valgus means:
distal segment of the body moves away from midline
Which is a contraindication for a heating modality? drop in thermal sensation pain muscle spasm edema
drop in thermal sensation
Fluidotherapy is most closely described as using which of the following treatments? ice massage ice pack dry heat paraffin
dry heat
The inability to articulate words correctly is called: dysarthria alexia anomia apraxia
dysarthria
Codman's exercises were developed for: early shoulder rehabilitation elbow rehabilitation late shoulder rehabilitation knee rehabilitation
early shoulder rehabilitation
A muscle lengthening contraction is specifically of which type? eccentric concentric isokinetic isometric
eccentric
A triceps extension weightlifting exercise is an example of a(n) _____________________type of contraction iometric eccentric concentric isotonic
eccentric
Examples of isotonic contraction are ________ and _______
eccentric and concentric
Centripetal stroking refers to which method of massage? tapotement petrissage kneading effleurage
effleurage
Deep and superficial stroking are characterized by which form of massage? tapotement petrissage effleurage tapping
effleurage
Massage session should begin and end with: effleurage friction pertissage tapotment
effleurage
Superficial stroking would be described as a type of ________________ tapotement effleurage petrissage beating
effleurage
Which type of massage exhibits a deep and superficial stroke? tapotement friction effleurage petrissage
effleurage
Generally, massage should start with _________________, using a _______________ effleurage, superficial stroking petrissage, kneading technique effleurage, kneading technique tapotment, tapping technique
effleurage, superficial stroking
The organization of a muscle from inside to outside is: Endoderm, periderm, epiderm periderm, endoderm, epiderm endomysium, perimysium, epimysium epimysium, permysium, endomysium
endomysium, perimysium, epimysium
Which of the following is a contraindication to interferential? fracture healing muscle reeducation epilepsy pain
epilepsy
Hemoglobinemia:
excess of hemoglobin in blood plasma
Which type of motion is primarily involved in McKenzie exercises? flexion extension lateral flexion rotation
extension
Individual muscle fiber (myocytes) are bundled into: perimysium fascia fascicles endomysium
fascicles
Which of the following types of muscle fiber are considered to be most fatigable? fast glycolytic fast oxidative slow oxidative type 1 fibers
fast glycolytic
Fast twitch oxidative fibers: fatigue quickly are used to maintain posture use ATP slowly are used in nonexertional movement such as walking
fatigue quickly
Codman's exercises would be most closely described as which of the following? finger wall walking back extension back flexion neck distraction
finger wall walking
The patient assessment for rehabilitation exercise includes all, except: range of motion neurological activity joint stability flexibility
flexibility
Ultraviolet radiation is used: when diabetes is suspected for septic wounds for Hepatitis C Over the eyes and genitals
for septic wounds
All of the following are contraindications to high voltage electrical modalities except: pregnancy thrombophlebitis cancer fracture healing
fracture healing
The number of Oscillations per second is referred to as the: frequency wavelength acoustic eave pulse duration
frequency
Percussion movements encompass all of the following massage techniques except: clapping slapping friction beating
friction
Cataphoresis and anaphoresis are used in which type of current? high frequency faradic galvanic sinusoidal
galvanic
Iontophoresis is commonly associated with: microcurrent galvanic current ultrasound lasers
galvanic current
Which of the following is false pertaining to the effects of cathodes used in iontophoresis? it increases bleeding it is not attracted to acids vasodilation is produced has a cold effect
has a cold effect
Anodes used in iontophoresis would have all of the following effects except: has a heating effect dehydrates tissue attracts oxygen vasoconstriction
has a heating effect
Faradic electric stimulation: is extremely comfortable used for denervated muscles was replaced by Russian Stimulation has a nonsymmetrical wave length w/ a long duration small positive and short duration large negative spike
has a nonsymmetrical wave length w/ a long duration small positive and short duration large negative spike
Oxidative muscle fibers have the following characteristic: lack myoglobin have large numerous mitochondria have small sized mitochondria are white in color
have large numerous mitochondria
Ultraviolet, infrared and microwave diathermy are _______________________ frequency modalities very low low medium high
high
Advantages of IFC include all except: pain relief- acute and chronic reeducation of muscle spasm higher skin resistance cover a large area than TENS
higher skin resistance
Most common use for a cane is an ankle sprain a knee tendonitis hip osteoarthritis post surgical ankle or knee
hip osteoarthritis
Most common use for a cane is:
hip osteoarthritis
Which of the following is used for superficial heating? hydrocollator packs therapeutic ultrasound shortwave diathermy microwave diathermy
hydrocollator packs
Which is not a sign of inflammation? tumor calor rubor hypermobility
hypermobility
Which of the following is not treated by the HeNe Laser? migraines ulcer burn hyperthyroidism
hyperthyroidism
Lumbar rehabilitation is designed to accumulate endurance strength flexibility hypertrophy
hypertrophy
Peripheral nerve palsy can occur when: heat is applied directly over a nerve ice is applied directly over the nerve laser is applied directly over a nerve ultrasound is applied directly over a nerve
ice is applied directly over the nerve
Precautions for NMES include which of these: increased Range of motion Old scar tissue impaired sensation Residual muscle spasm
impaired sensation
Precautions for NMES include which of these? increased range of motion old scar tissue impaired sensation residual muscle spasm
impaired sensation
Interferential current (IFC) -is less comfortable than tens -is a form of high frequency electrical stimulation -imposes 2 separate medium frequency currents on one another -works only on chronic pain syndromes
imposes 2 separate medium frequency currents on one another
Interferential current (IFC) imposes 2 separate medium frequency currents on one another is less comfortable than TENS is a form of high frequency electrical stimulation works only on chronic pain syndromes
imposes 2 separate medium frequency currents on one another
Interferrential current (IFC): imposes 2 separate medium frequency currents on one another is less comfortable than TENS is a form of high frequency electrical stimulation works only on chronic pain syndrome
imposes 2 separate medium frequency currents on one another
All of the follwoing are physiological effects of cryotherapy except: vasoconstriction increase in metabolism decrease heart rate decrease inflammation
increase in metabolism
The physiological effects of traction on ligaments include: increase in elastic deformation increase in ligament density exchange of synovial fluid increase in plastic deformation
increase in plastic deformation
Which of the following is not an indication for William's exercises? decrease lumbar lordosis spondylolisthesis facet syndrome increase lumbar lordosis
increase lumbar lordosis
Ultrasound (US) non-thermal effects include which of these? inc blood flow increased collagen extensibility increased cell permeability decrease in muscle spasm
increased cell permeability
Disk herniation, subacute pain, and Spondylolisthesis are specific ________________ for ____________________. indications, traction contraindications, traction indications, intermittent compression indications, TENS
indications, traction
________________ is a contraindication to microcurrent fracture neuropathy infection acute pain
infection
All of the following has a heating depth of 3-5 cm except: infrared microwave diathermy shortwave diathermy ultrasound
infrared
Which of the following uses radiation as a mechanism of heat transfer? infrared lamp ultrasound hot pack ice massage
infrared lamp
All of the following are high frequency modalities except: ultrasound microwave diathermy interferential ultraviolet
interferential
Which of the following modalities consist of a crossing between two medium frequencies that result in a low frequency? infrared microwave diathermy interferential microcurrent
interferential
Which of the following modalities is characteristic of polyphasic current? diathermy ultrasound cryotherapy interferential
interferential
What is galvanic (direct) current is most often used for? iontophoresis Muscle contraction muscle reeducation reduction of edema
iontophoresis
Which of the following modalities has the lowest frequency? russian stimulation diathermy iontophoresis infrared
iontophoresis
Raynaud disease (Syndrome) involves the hands onky is a cold sensitivity is heat intolerance is d/t osteoarthritis
is a cold sensitivity
Cold Laser (LLLT) tissue penetration: is greater in darker skinned individuals is not affected by obesity is not affected by wave length is affected by wave length and power
is affected by wave length and power
TENS treatment time never exceeds 30 min never exceeds 2 times per day is extremely variable
is extremely variable
Hot whirl pool: treatment should last 30-60 min should never have a temp above 98 deg F is indicated when range of motion (ROM) is decreased is contraindicated in chronic injuries
is indicated when range of motion (ROM) is decreased
What is the depth of penetration when using US? -is proportional to the frequency of sound wave (1<3) -is inversely proportional to the frequency of the sound wave (1>3) -is not dependent upon the frequency of the sound wave -is proportional to the intensity (W/cm2)
is inversely proportional to the frequency of the sound wave (1>3)
Single leg traction requires one person is a form of mechanical traction can be performed standing or lyind gown is performed by 2 persons or one person and a torso strap
is performed by 2 persons or one person and a torso strap
Zinc anode in iontophoresis is used to treat ______________________________ ischemic ulcer plantar warts athlete's foot bursitis
ischemic ulcer
Holding a five pound thumb bell straight in front without moving it is considered a (n) _________________ type of contraction eccentric concentric isometric isotonic
isometric
There is muscle tension with no muscle lengthening or shortening; this is a _______________ type of contraction isometric isotonic eccentric concentric
isometric
When a joint is casted or braced, the best type of exercise to maintain strength would be: isometric isotonic isokinetic pylometric
isometric
Which type of contraction involves a lack of change in muscle length? isokinetic isotonic eccentric isometric
isometric
Negative polarity as used in high volt pulsed current has which effect? it increases vascularity it increases macrophage activity it decreases collagen production it increases bacterial growth
it increases vascularity
Which of the following is false regarding direct current (DC)? It can bring on a chemical reaction it is Biphasic It flows in a positive or negative direction it flows in the same direction
it is Biphasic
Which of the following is not true pertaining to effleurage? it relieves tension it tones muscles aids in circulation of blood it is a deep kneading
it is a deep kneading
All of the following are true regarding diathermy except: non-ionizing electromagnetic radiation causes higher pain thresholds causes relaxation of muscle it is a medium frequency modality
it is a medium frequency modality
Which is true of long wave diathermy? it is no longer used it is considered more effective than short wave diathermy it forms a magnetic field around the treatment site
it is no longer used
Which of the following is false regarding paraffin bath? it is used for the feet and hands it decreases pain it is used for arthritis it is used on the neck for hyperextension injury
it is used on the neck for hyperextension injury
Which of the following is not a form of tapotement? beating clapping kneading hacking
kneading
Diathermy is best utilized for: Small areas involving acute conditions large areas with severe acute inflammation small areas involving chronic conditions large areas involving chronic conditions
large areas involving chronic conditions
Monochromatic, coherence and collimation are all principles of: ultrasound infrared russian stimulation laser
laser
The sagittal plane divides the body into:
left and right segments
Microcurrent uses a frequency of ________________________. 1 MHz 2000 MHz less than 1 Hz 25 Hz
less than 1 Hz
Which positive ion is used in iontophoresis to treat neuritis? lidocaine (+) anode copper (+) anode calcium (+) anode hyoluronidase (+) anode
lidocaine (+) anode
Contraindications for moist heat packs include which of these? chronic inflammation chronic muscle spasm local infection impaired circulation in area to be treated
local infection
Electric heating pads fall under which category of modality? long wave infrared short wave diathermy microwave diathermy short wave diathermy
long wave infrared
The Pizoelectric effect transfers ______________ energy into electrical energy chemical sound mechanical ultraviolet
mechanical
The of diathermy include all the following except: shortwave diathermy microwave diathermy long wave diathermy medium frequency diathermy
medium frequency diathermy
Which of the following is a contraindication to shortwave diathermy? metal implants tendonitis sinusitis bursitis
metal implants
_____________ is a type of _________________ modality that is used for pain relief; it is closest to the current of the human body microcurrent, electrical Infrared, heating Faradic, Electrical Ultraviolet, Heating
microcurrent, electrical
Which of the following is a high frequency modality? iontophoresis microwave diathermy microcurrent russian stimulation
microwave diathermy
The rate at which current flows is usually measured by modalities in: milliamps watts volts amperes
milliamps
Laser only emits the energy of one wavelength; this is a characteristic of: collimation spatial coherence temporal coherence monochromatic
monochromatic
Direct current (DC) has a waveform that is referred to as : monophasic bi-directional biphasic polyphasic
monophasic
When using high volt galvanic to stimulate wound healing, treatments should occur: more than once per day every other day for one week 3 times per week for 2 weeks once per week
more than once per day
Which is not a contraindication to every modality? malignancy endocrine disease tumor muscle atrophy
muscle atrophy
Massage is indicated in the following condition: acute inflammation skin conditions muscle spasm localized infection
muscle spasm
Thick filament is: Actin myosin myofibril ytropomyosin
myosin
The majority of strength gained the first 4-8 weeks occurs d/t: neuromuscular adaptation hypertrophy of muscle fibrils expansion of the capillary bed within the muscle increase in the cross sectional size of the muscle
neuromuscular adaptation
Which type of leukocyte is primarily involved in the acute phase of inflammation? neutrophil monocyte lymphocyte eosinophil
neutrophil
______________ is a type of infrared that will feel warmer to the skin because it penetrates the skin _______________
non luminous; less
The resistance to electric current that ions encounter is measured in: watts amps ohm's volts
ohm's
Contraindications for cold laser (LLLT) include all except: direct eye irradiation open wound pregnant uterus irradiation organ transplant patients
open wound
Intereferential contraindications include: Edema pain pacemaker muscle spasm
pacemaker
All of the following are contraindications to all modalities except: infection patients with pacemakers pain endocrine conditions
pain
Which of the following is the primary indication of TENS? acne sinusitis pain control pyrexia
pain control
All of the following are contraindications to laser treatment except: pregnancy pain from muscle spasm over any fontanel malignancy
pain from muscle spasm
Neuralgia:
pain in a nerve
Dipping and wrapping are procedures associated with: paraffin hydrotherapy ice pack massage
paraffin
Which of the following is a superficial heating modality? ultrasound paraffin microwave diathermy shortwave diathermy
paraffin
What type of symptoms would you expect from a grade II (axonotmesis) nerve injury? complete rupture of nerve tissue w/ permanent motor and sensory loss partial rupture of nerve tissue with associated sensory only partial tear of a nerve tissue w/ temporary motor and sensory loss temporary motor and sensory loss without nerve damage
partial tear of a nerve tissue w/ temporary motor and sensory loss
Which of the following is not an indication for ultraviolet? rickets osteomalcia pellagra acne
pellagra
Cold whirlpool is used when: gravity is an issue peripheral nerves have been injured a cold allergy exists a patient suffers from circulatory insufficiency
peripheral nerves have been injured
Contraindications for diathermy include which of these? joint inflammation subacute inflammation peripheral vascular disease osteoarthritis
peripheral vascular disease
Compression-like massage movements are characterized by which type? effleurage petrissage vibration tapotement
petrissage
Conduction (in cooling) is essentially the process of losing heat through:
physical contact w/ another object such as frozen -when applying cooling agents (cryocup) the body part comes in direct contact w/ the cold source (thus making conduction the form of energy transfer)
Pulsed Current (PC) has a waveform that is referred to as: monophasic bi-directional polyphasic biphasic
polyphasic
Russian pulse has which type of waveform? polyphasic monophasic biphasic bi-directional
polyphasic
Russian stimulation and interferential have waveforms that are described as: monophasic biphasic polyphasic bi-directional
polyphasic
Myofascial release technique is accomplished by using gentle stretch and: force contraction pressure release
pressure
PRICE stands for:
protection, rest, ice, compression, elevation
Proteolytic enzymes break down: fats carbs proteins sugars
proteins
The time that occurs from the start to the end of one particular wave is referred to as: rise time pulse duration decay time ramp time
pulse duration
Specific lumbar traction contraindications include all except: hiatal hernia radiating pain active peptic ulcers pregnancy
radiating pain
During gait maturation, by the age of 2: -upper limbs are abducted w/ elbows extended -reciprocal arm motion begins to develop -hips are externally rotated through the gait cycle -the adult pattern has matured
reciprocal arm motion begins to develop
Acetate is a negtive ion used in ionotophoresis for which purpose? reduce pain reduce calcium deposits reduce inflammation block nerve transmission
reduce calcium deposits
All statements about isometric exercise are true except: can be performed while in a cast requires little or no equipment does not require a full range of motion to perform replaces isotonic exercise in a rehabilitation program
replaces isotonic exercise in a rehabilitation program
The principle of specificity applies to: use of physical therapy modalities resistance training flexibility training Piezoelectric effect
resistance training
The greater the temp gradient between the skin and the cooling source, the greater the:
resulting tissue temp change 15 min immersion of the forearm in a water bath of 34 deg causes subcutaneous tissue temp drop by 43 deg 15 min immersion of the forearm in a water bath of 63 deg causes subcutaneous tissue temp drop by 11 deg
Indications for traction include all except: apophyseal joint impingement disc protrusion rheumatoid arthritis foraminal encroachment
rheumatoid arthritis
The time that it takes for a waveform to arrive at the peak amplitude is called: decay time duty cycle rise time pulse duration
rise time
Strengthening of the vastus medialis is a primary treatment for which of the following conditions? runner's knee achilles tendonitis anteriorlateral shin splints posteriormedial shin splints
runner's knee
Muscle strengthening, output modulation and pulsed current are all factors involved in: ultrasound russian stimulation shortwave diathermy microwave diathermy
russian stimulation
Which is medium frequency modality? infrared ultraviolet microcurrent russian stimulation
russian stimulation
Plantar warts is best treated with _____________ in iontophoresis salicylate (-)cathode lidocaine (+) anode vinegar acetate (-) cathode
salicylate (-)cathode
Contraindications to cervical traction include: Disc herniation osteoarthritis severe muscle spasm severe sprain
severe sprain
Codman's exercises are usually for a specific conditions involving the: wrist hand shoulder low back
shoulder
Heat loss moves from the __________ first then draws from underlying tissues, adipose, fascia and finally muscle
skin
Which of the following offer the most current resistance? bone muscle blood skin
skin
Which of the following should not be recommended for a patient with OA? straight-backed chairs firm mattress soft mattress paraffin bath
soft mattress
Which muscle is the prime plantar flexor of the ankle when the knee is flexed? gastrocnemius soleus tibialis posterior triceps surae
soleus
Laser has the same wavelengths that travel in all the same direction. This is referred to as: temporal coherence spatial coherence monochromatic collimation
spatial coherence
The most common recommendations for lumbar traction is in cases of? disk prolapse spondylolisthesis spinal stenosis sequestered disk
spondylolisthesis
Which is not contraindication to massage? Osteomyelitis thrombosis acute arthritis sprain
sprain
All of the following are types of progressive neuromuscular facilitation techniques except: static stretch hold -relax contract-relax slow reversal hold-relax
static stretch
The first form of stretching which should be performed when a patient has an acute injury is: active resisted stretching dynamic stretching static stretching proprioceptive neuromuscular stretching
static stretching
The sarcoplasmic reticulum stores intracellular calcium is associated w/ the mitochondria holds the actin fibers are responsible for muscle contractions
stores intracellular calcium
Which of the following is a treatment for Chondromalacia Patellae? strengthen vastus medialis williams exercise increase Q-Angle Wall Climbing
strengthen vastus medialis
All of the following are associated with petrissage except: friction kneading vibration superficial stroking
superficial stroking
The description of interreferential electrical stimulation is: -2 completing currents enter the body and produce medium frequency therapy - 2 medium frequency currents blend to produce a stronger electric field -superimposition of 2 separate medium frequency sinusoidal currents -a medium frequency which reduces pain
superimposition of 2 separate medium frequency sinusoidal currents
Which type of massage movement is characterized by percussion? effleurage tapotement petrissage tapping
tapotement
All of the following are types of petrissage except: vibration tapping friction kneading
tapping
The 2 broad categories of nerve injury are: neuralgia and neuritis direct and indirect tension and compression
tension and compression
During the relaxation phase of a muscle contraction : the muscle cannot contract contractile proteins hydrolyze the muscle lengthens, decreasing muscle tension
the muscle lengthens, decreasing muscle tension
During the Swing phase of gait: the pelvis rotates forward and flexes the knee is fully extended the hip is extended and internally rotated slightly the ankle is held rigidly in plantar flexion
the pelvis rotates forward and flexes
During the swing phase of gait: the pelvis rotates forward and flexes the knee is fully extended the hip is extended and internall rotated slightly the ankle is held rigidly in plantar flexion
the pelvis rotates forward and flexes
You cannot bill for Hot/ cold therapy without:
therapeutic stretch or exercise billed in conjunction
Action of Shortwave and Microwave Diathermy
thermal (DEEP HEATERS)
Why do you have to move slowly with TherapeutIC Ultrasound
these waves ripple out from the center (like dropping something in water) it ripples out and then reflects/ bounces off bone and back to the head! You have to move slowly bc you have to pick all of this up!
Which of the following is an indication for microcurrent? osteomyelitis pregnancy tissue repair wound infection
tissue repair
Which of the following changes electrical energy into acoustic energy? transducer electrodes water bladder radio waves
transducer
Which of the following has the highest aerobic capacity? type 1 type 2a type 2b fast glycolytic
type 1
_______________ is a type of muscle fiber that is slow-twitch and least fatigable fast, oxidative type 1 type 2 a type 2b
type 1
_____________________ is a type of muscle fiber that is most fatigable type 1 type 2 a type 2 b fast oxidative
type 2 b
Intensity is expressed in watts per square centimeter for diathermy ultrasound ultraviolet infrared
ultrasound
The deepest heat penetrating modality is which of the following? infrared ultrasound shortwave diathermy russian stimulation
ultrasound
Which of the following modalities are operated at a frequency above 100,000 Hz? faradic ultrasound microcurrent interferential
ultrasound
Combination (Combo) therapy utilizes: ultrasound and electric stimulation Electric stimulation and phonophoresis electric stimulation and diathermy diathermy and galvanic stimulation
ultrasound and electric stimulation
Psoriasis, Herpes Zoster, and Acne are all indications for: ultrasound cryotherapy ultraviolet TENs
ultraviolet
Skin condaditions like herpes Zoster (vesicles), dermatological conditions, carbuncles, wounds, decubitus ulcers and fungal infections are indicators for _____________________ therapy. Rickets and Osteomalacia also are indicatros for ____________________ therapy
ultraviolet; ultraviolet
Faradic current is useful in muscle reeducation used for edema control effective in wound healing effective when applied transthoracic
useful in muscle reeducation
Microcurrent Electrical Nerve Stimulation (MENS) : is the same as MNES depolarizes nerves cannot be used over wounds uses constant or pulsed direct current at an extremely low amperage
uses constant or pulsed direct current at an extremely low amperage
Phonophoresis: utilizes ions to deliver drugs into a target tissue utilizes sound waves to deliver drugs into a target tissue is used for chronic conditions only is used to decrease edema and increase blood flow
utilizes sound waves to deliver drugs into a target tissue
Which of the following is a contraindication to massage? tendonitis strain subacute sprain vascular disease
vascular disease
Which type of massage is considered the nerve stroke? effleurage tapping cupping vibration
vibration
A wavelength of 390 - 470 nm corresponds to the color range of: red yellow-orange blue-green violet- deep blue
violet- deep blue
The distance from the apex of one wave to the apex of the next wave is called the: wavelength frequency pulse duration surged modulation
wavelength
A paraffin bath contains mostly ___________ and small amounts of _________________
wax; oil
Mechanical cervical traction requires a harness: which fits over the ears which supports the cervical spine in flexion which allows for mild cervical extension which can exert a maximum pull of 50 pounds
which allows for mild cervical extension
MENS suggested uses include: wound healing edema reduction muscle reeducation scar reduction
wound healing
Microcurrent is most effective in the treatment of: Edema wound healing muscle atrophy muscle spasms
wound healing
Which of the following is a contraindication to cryotherapy? wound healing analgesia fever burns
wound healing
____________ is an indication for the use of ultrasound wry neck malignancy hemorrhage pregnancy
wry neck
