Non-Systems_US/TENS

  1. Indications for US - 11
    • Subacute
    • Joint contractures
    • MM spasm, pain
    • Trigger points
    • Scar tissue
    • Plantar warts
    • Calcium deposits
    • Dermal ulcers
    • Chronic inflammation
    • Delayed soft tissue healing
    • Tissue regeneration
  2. Contraindications for US - 8
    • Acute 
    • Healing fx
    • DVT
    • Use of radium or ldioactive isotopes
    • Over abdomen/lower back during pregnancy
    • Directly over plastics, vital areas, pacemakers
    • Infection
    • Areas of malignancy
  3. US - Precaution
    Epiphyseal plate in children
  4. US imaging - used for what? (5) Cannot do what? (1)
    • Partial tendon tears
    • Soft tissue masses (tumors, hematomas) - Lumps in neck mm of infants
    • Swelling - bleeding + other fluid collection within mms; jts (Fluid in painful hip in children)
    • MM abnormalities
    • EARLY changes in RA
    • CANNOT PENETRATE BONE
  5. US - is it allowed over metal? over plastics?
    • Metal - Yes
    • Plastics - No
  6. US - Beam Non-Uniformity Ratio (BNR)
    • Ratio between spatial peak intensity to average intensity
    • Best @ 1:1
    • High BNR >5:1 = periosteal pain or hot spots
    • Low BNR <4:1 = comfortable
  7. US Imaging - Hyperechoic
    • Brighter echoes - LIGHT GRAY or WHITE
    • Ex: bones; stones; fat; ligaments (structures w/more collagen)
  8. US Imaging - Hypoechoic
    • LOW level gray echoes, darker than surrounding tissue - DARK GRAY
    • Ex: lymph nodes; GI tract; liver masses
  9. US Imaging - Anechoic - describe
    • No echoes - BLACK
    • Fluid filled
    • Ex: gallbladder; bladder; cyst; vascular structures
  10. US - Total treatment area - ERA (effective radiating area)
    2x size of sound head per 5 min
  11. US - Intensity - acute vs chronic
    • Acute - low; pulsed @ 20 (acute & deep = 1 MHz; 1 mm intensity; 20% duty cycle)
    • Chronic - high; continuous
  12. US - Frequency - deep vs superficial & cm depth
    • Deep - 1 MHz (2-5 cm depth)
    • Superficial - 3 MHz (1-2 cm depth)
  13. US - Wavelength - 1MHz vs 3 MHz
    • 1 MHz - 1.5 mm
    • 3 MHz - 0.5 mm
    • Superficial tissue - lateral ankle sprain - keep intensity low not to burn; but deep structures intensity needs to INC to reach item
  14. US - Duty cycle - how to determine; importance
    • Ratio of on time to TOTAL time
    • Ex: 2 sec / (2 sec + 8 sec) = .20 (100) =20%
    • If INC in T is needed duty cycle must INC or be continuous
  15. US - Thermal - intensity; duty cycle; time; frequency
    • Intensity - 0.5-1.5 (2 max) w/cm2
    • Duty cycle - Continuous
    • Tx time - 5-10 min
    • Tx frequency 2-3x/wk
  16. US - Indications for continuous (thermal)
    Subacute, chronic conditions w/NO ACTIVE INFLAMMATION
  17. US - Thermal - does what? - 6
    • INC tissue temp
    • INC pain threshold
    • INC enzymatic activity
    • INC tissue perfusion
    • INC collagen tissue extensibility
    • Alteration of nn conduction velocity
  18. US - Nonthermal - intensity; duty cycle; time; frequency
    • Intensity - 0.5-.75 w/cm2
    • Duty cycle - Pulsed (20-50%)
    • Tx time - 3-10 min
    • Tx frequency - 1x/day
  19. US - amount of heat absorbed is LEAST dependent on what?
    Type of coupling agent
  20. US - amount of heat absorbed vs area sonated
    Heat absorbed INC w/DEC in area
  21. US - indications for pulsed (non thermal) - 4
    • Acute conditions
    • Inflammatory responses
    • NN entrapment
    • Neuromas in scar tissue
  22. Nonthermal US - does what? - 5
    • ACCELERATES TISSUE HEALING by:
    • Alteration in cell membrane activity
    • INC cell wall permeability
    • INC intracellular Ca
    • INC macrophage response
    • INC protein synthesis
  23. US - thermal - what can produce discomfort? describe it & do what? Why?
    • Insufficient coupling agent
    • Sudden, strong ache
    • DEC intensity
  24. US - Direct technique - 3
    • Coupling agent - gel
    • Select sound head 1/2 size of treatment area
    • Move head 1.5"/sec in overlapping circles/strokes
  25. US - Indirect technique - 4
    • Emerse in water .5-3cm away - rubber or plastic
    • Intensity - 50%
    • Wipe away bubbles every few minutes
    • Used for bony areas - hands, feet
  26. US - pt feels electric shock - means what? do what?
    • Malfunctioning unit
    • Label “defective, do not use”
  27. US - Phonophoresis
    Using US machine to push medication through skin to penetrate deeper
  28. E-stim - MM re-education - on:off time - initial vs. later
    • Initial - 1:5 - to minimize mm fatigue
    • Later - 1:4 or 1:3
  29. TENS - sensory vs. motor
    • Frequency
    • Phase duration
    • Amplitude
    • Sensory
    • Frequency - higher than motor
    • Phase duration - shorter than motor
    • Amplitude - lower than motor
  30. ES - which TENS provides temporary pain relief? - 2
    • Conventional
    • Brief Intense
  31. ES - which TENS provides long lasting pain relief? - 3
    • Acupuncture-like
    • Burst-Mode
    • Hyperstimulation
  32. TENS - duration of pain relief - Acupuncture-like vs. Brief intense
    • Acupuncture - Long lasting, but onset of relief may be as long as 20-40 min
    • Brief intense - Rapid-onset, short-term pain relief (good for doing right before/during painful procedure)
  33. TENS - Modulation Mode - done when?
    To prevent neural or perceptual adaptation d/t constant ES
  34. FES - spasticity - do what with ramping? Why?
    • Ramp up - over 5s
    • Minimizes mm too quickly & minimizes INC spasticity
Author
Tanuisha
ID
325479
Card Set
Non-Systems_US/TENS
Description
Non-Systems_US/TENS
Updated