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What is the first law of thermodynamics?
conservation of energy
- heat-formed from random molecular movement; has to be a different temp for heat to be transferred
- temperature-measurement of average kinetic energy of a substance
- therapeutic temperature ranges
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What is the second law of thermodynamics?
heat transfer (from hot to cold)
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What does the Arndt-Schultz principle state?
you must give enough heat/cold to make a difference, but not too much to cause damage. any amount below level will have no therapeutic effect
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What are the 5 methods of heat transfer?
- conduction-HP, CP, paraffin
- convection-fluidotherapy, whirlpool
- evaporation-vapor coolant spray
- conversion-ultrasound, diathermy
- radiation-infrared
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What are some factors that affect your choice of treatment method?
- consider body part
- depth of target tissue
- ease of application
- ability to do exercises with modality on
- duration of treatment
- expense, operation, and maintenance of machine
- always rely on research, not salesperson
- insurance
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What is thermoregulation of the body?
- how body handles temp.
- fluctuations of temp thru out the body
perspiration, shivering (vasodilation/constriction)
temp decreased in morning, increased in evening
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When applying thermal agents to small areas the effects remain local; how does treating large areas affect the body?
affects systemically....vitals..bp, heart rate etc
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What are the 4 effects on blood flow while applying local heat?
- 1.increased blood flow bc of vasodilation(bodys way to get rid of excess heat)
- 2.increased capillary permeability (better exhange of chemicals across barrier)
- 3.increased nutrients(o2, rbc, etc to the tissues)
- 4.effects on the skin
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Within what amount of time do you see the greatest increase of skin temp?
within first 4 mins and then continues to increase for the next 3 mins
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Within what time frame do most burns occur?
4-7 mins
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How does local heat effect metabolism?
- 1.locally increases
- 2.which aids in healing process (brings good to injured area and helps take junk away)
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What are the properties of connective tissue (collagen)?
- ability to deform and elongate with stretch
- viscosity allows it to remain at slightly greater lenth after stretch
- stretched only within the limits of tissues elasticity
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What happens if we heat up collagen?
its viscosity (thickness) decreases and the elasticity increases
effects collagen best if goal of tx is to stretch out tissues
put heat on prior to stretching, heat while we stretch, continue stretching after heat is removed
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What 2 effects on pain does heat have?
counterirritant-gate theory-pt doesnt feel as much pain
pain-spasm-pain cycle- increases blood flow and helps remove waste to help stop pain cycle
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What effects does heat have on motor?
- decreases muscle spindle excitability (makes muscles contract)-alters strength for 30 mins (less strong)
- decreases spasm
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How does heat effect skin resistance?
- decreases resistance (impedence)
- things can pass thru skin easier after heat
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What kind of systemic effects does heat produce?
- increases core body temp
- heart rate increases (10bmp/every 1 degree F increase), metabolism and blood volume, o2 consumption increases
- *depends on treatment time, area of size treated
- *usually see at end of tx, take awhile to kick in
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What are some pathologic (bad) effects of heat?
- increases pain for some people
- tissue necrosis
- burn pt
- mottle erythema (blotchy)
- heat cramps
- fainting bc of bp change
- hemorrhaging
- heat exhaustion
- heat stroke
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What are some indications of heat stroke?
- no sweat
- hot, red, dazed
- body temp increases and keeps increasing (104-107)
- rapid pulse (130-160)
- respiratory rate increases
*drastically lower body temp immerse in cold water and elevate head
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What are some indications of heat exhaustion?
- profuse sweating
- cold and clammy
- shallow respirations
- normal body temp or slightly below
- fainting/collapsing
- intense thirst, fatigue, weakness, discomfort, anxiety or impaired judgement
cool pt gradually, shock position (flat with legs elevated), massage LEs to prevent venous pooling, fluid and salt replace gradually
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What are 4 reasons why we use heat?
- POST acute stage of traumatic conditions
- increase ROM, elasticity, flexability
- chronic pain-analgesia
- muscle spasm
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What are some contraindications of not using heat?
- acute trauma
- areas of decreased sensations/circulation
- dvt (deep vein thrombosis)
- malignancies
- fever
- new scar
- hemorrhaging
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What are some precautions of using heat?
- pregnancy
- poor thermoregulation
- heart insufficiency
- metal in the area
- topical counterirritant
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What is a fever called?
hyperpyrexia
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What is prickly heat?
minor skin infection caused by ducts of acitive sweat glands
- pinpoint sized lesions, prickly type itching
- avoid by allowing to dry thoroughly after heat tx
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What is a net decrease in body fluids when intake is insuffienct to compensate for fluid loss through sweat, urine, respiration, and feces?
dehydration
normal fluid intake-2qts/day
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What results from imbalance of electrolytes or water depletion?
heat cramps
sever cramps in extremities, abdomen
rest and gradual replacementof fluid balance with small amts of salt ...gatorade
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What are types of superficial heat?
- HP
- CP
- paraffin
- WP
- IR
- fluidotherapy
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What are types of deep heat?
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What are HPs filled with?
silica gel or betonite
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What is the water temp of HP storage?
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How long does it take for a HP to regain normal temp?
20-30 mins
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How many layer of terrycloth do you need between a HP and a pt?
6-8
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What do you document after a HP?
- patient position
- body part
- condition skin pre and post
- time
- pt tolerance
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What is the temp of paraffin kept at?
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What is the paraffin dip and wrap method?
dip 8-10 times, cover with plastic bag, wrap towel around, elevate
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What is the paraffin dip and immerse method?
dip then reimmurse and keep in wax for entire treatment
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What do you document after a paraffin treatment?
- skin pre and post-color, integrity
- timer-method of application
- time
- pt tolerance
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