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_______: application of shortwave or microwave or electromagnetic energy to produce heat and other physiological changes within tissues. Can be used to produce thermal or nonthermal effects.
diathermy
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______ diathermy: 3 kHz-300MHz frequency and 1m to 100 km wavelength. Most commonly used in clinical situations in the US. Delivers electromagnetic energy in the form of heat to the patient. Heats tissue __-__ cm and is considered deep heat. Most common frequency is ____ MHz.
- shortwave diathermy
- 3-5 cm
- 27.12 MHz
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_______ diathermy: 300MHz-300 GHz. Does not penetrate as deep as shortwave diathermy. Not used in the US.
Microwave diathermy
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____ field: invisible lines of force created by electric charges, but concerned with the strength of the charge.
____ field: invisible lines of force created by electric charges, but motion of the charge or current
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Diathermy works through (conduction, convection, conversion or radiation)?
radiation
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(continuous or pulsed) diathermey: heat has a chance to ecape from the tissue during the off cycle, thus is used for (thermal or non thermal effects)?
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Effects of continuous shortwave diathermy (thermal)
(INC or DEC): nerve conduction
(vasodilation or vasoconstriction)
(INC or DEC): pain threshold
(INC or DEC): enzymatic activity
(INC or DEC):muscle circulation
- increase
- vasoconstriction
- increase
- increase
- increase
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Effects of pulsed shortwave diathermy (nonthermal): 4 things
- increase local circulation
- increase local tissue oxygenation
- increase nutrient availability
- increase phagocytosis
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Shortwave diathermy's affects on cell membrane function and cellular activity: 4 things
- 1. affects ion binding to cell membrane which triggers cascade of biological processes
- 2. alters calcium ion binding and affects regulation of cell cycle
- 3. accelerates cell growth and division when too slow
- 4. inhibits cell growth and division when too fast
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Dosiometry: short wave diathermy
-Mild Heating: __-__ min
intensity?
wave frequency ___ MHz
frequency of treatment daily __-__ weeks
- Vigorous heating: __-__ min.
intensity?
____ MHz frequency
frequency of treatment: ___x per week- 1 month.
- 2-5 minutes
- minimal sensation of heat
- 27.12 MHz
- daily for 1-2 wks
- 20-30 minutes
- comfortable level of warmth
- 27.12 MHz
- 2x/wk for 1wk to 1 month
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Dose 1: ______: just below the point of any sensation of heat (acute).
Dose 2: _____: mild heat sensation barely felt (subacute)
Dose 3: _____: moderate, but pleaseant, heat sensation (subacute)
Dose 4: ______: vigorous heating that produces well-tolerated sensation (chronic conditions).
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_______: type of sound, therefore consisting of waves that transmit energy, with a frequency greater than 20,000 cycles per second (hertz).
ultrasound
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therapeutic ultrasound frequencies: between ___ and ___ MHz. This maximizes the energy absorption at a depth of __ to __ cm of soft tissue.
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Ultrasound makes us of high frequency acoustic wakes thus it (does or does not) need a medium for transmission. Diathermy makes use of electromagnetic waves, thus it (does or does not) need a medium for transmission.
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Effects of US:
(INC or DEC): temp of superficial and deep tissues
(INC or DEC): metabolic rate
(INC or DEC): pain and muscle spasm
(INC or DEC): circulation
(INC or DEC):soft tissue extensibility
- increases
- increases
- decreases
- increases
- increases
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Frequency of depth for US:
to penetrate deep structures (up to 5 cm) __ MHz is chosen.
to penetrate more superficial structures (1-2 cm) __ MHz is chosen.
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____ ____: percentage of time that ultrasound is being generated over one pulse pulse period.
____% increases tissue temperatue
____% allows for treatment with only nonthermal effects
-
for US intensity:
1 MHz: ___ to ___ W/cm (squared)
3 MHz: ___ W/cm (squared)
for nonthermal effects: __ to __ W/cm (squared)
for bone healing: __ W/cm (squared)
-
Duration of US: __ to __ minutes per area (thermal effects)
when goal is to facilitate bone healing: __ to __ mins
- 5-10 minutes
- 15-20 minutes
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____ ____ ____: area of the transducer from which the ultrasound energy radiates. Always smaller than the area the transducer head.
____ ____ ____: is the ratio of the spatial peak intensity to the spatial average intesity.
- effective radiating area (ERA)
- beam nonuniformity ration (BNR)
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______: formation, growth, and pulsation of gas-filled bubbles caused by US.
______: microscale eddying that takes place near any small, vibrating object. Occurs around the gas bubbles set into oscillation by caviation.
_____ _____: the steady, circular flow of cellular fluids induced by US.
- cavitation
- microstreaming
- acoustic streaming
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____ _______: application of electromyography to give a patient info- in the form of visual or auditory signals about muscle activity.
EMG biofeedback
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3 phases of EMG:
____ phase: electrodes pick up electrical activity of the muscle.
____ phase: electrical signal is amplified.
____ phase: electrical signal is converted to visual or auditory signals for the purpose of giving feedback.
- input phase
- processor phase
- output phase
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_____ of a sarcolemma is what the EMG is detecting.
Depolarization
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The recording electrodes in biofeedback should be securely placed on the muscle being recorded ____ to the direction of the muscle fibers.
parallel
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In biofeedback, the _______ refers to the predetermined level of muscle contraction that the patient should be able to achieve during the process. (should be attainable)
threshold
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When using biofeedback for relaxation, it is best to postion the patien _____.
The microvolt goals for total body relaxation is a range from __ to __ mV.
Dosage: ___ to ___ mins.
- supine
- 1 to 3.5 mV
- 30-60 minutes
-
for Home Temperature training Biofeedback:
ideal temp for hands is ___ to __ degrees
ideal temp for feet is ___ degrees
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______: use of information from electrical activity of the obdy to determine a diagnosis in a patient with suspected neurological or neuromuscular dysfunction. Tests may include nerve conduction studies that measure peripheral motor, sensory and mixed nerve function.
electrodiagnostics
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_____ ____: at the atomic level, it is the balance between protons( positively charged cations) and electrons (negatively charged anions) Like charges repel and unlike charges attract. These can't be created or destroyed. Measured in coulombs (C).
electrical charge
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______: unit used to express the force exerted between two electrical charges. ______'s Law states that the larger the respective charges or the closer the two charges, the larger the force between them.
Coulomb (C)
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______ _____: work that must be done to move a unit of charge (1 coulomb) from one point to the other point. measured in volts.
potential difference
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____: energy required to move 1 coulomb a distance of 1 meter against a force of 1 newton. Represents the driving force that makes charged particles move.
Volts (V)
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______: movement of charged particles through a conductor in response to an applied electric field. _____ flow is defined as the net movement of positive charges per unit time and is measured in amperes.
current (I)
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_____: movement of 1 coulomb of charge per second.
ampere
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______: any object through which electric charges can flow easily, determined by the ability to give up electrons from the outer orbital shell when placed in an electric field. Tissues containing Na, K, and Cl are good ______ (nerves, muscle).
conductor
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______ (G): the ease with which tissues move through a medium and conduct electricity.
conductance (G)
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_______: poor conductors of electricity (fat and skin). Does not allow easy movement of charged particles in an electric field.
insulator
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______- reciprocal of conductance, ameasure of the resistance to current flow, measured in ohms. The relative opposition to movement of charged particles in a conductor.
resistance
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____ ____: current= voltage/resistance; therefore, current increases as the voltage increases or as resistance decreases.
Ohm's Law
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_______: ability to store charges of opposite signs. A capacitor consists of two conductors separated by insulators. The nerve membrane is an example of a capacitor. Measured in farads.
Capacitance
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______: the opposition to alternating currents. It is dependent on resistance and capacitance. Measured in ohms.
Impedance
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______ ______: point where a nerve enters the muscle, and is usually near the bell of the muscle. If intact, can assume the nerve is intact.
motor point
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Area of _____ _____: when a nerve is damaged, this is the area on the muscle where you can get most of the fibers to fire with electical stimulation. This area is usually where the most muscle fibers are arranged, close to its tendon.
area of optimal response
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_____ of _____ testing: how a muscle responds to a particular current and provides info on the integrity of alpha motor neurons. The test is based on differences between reactoins of innervated and denervated muscle to short and long duratoin electrical stimulation.
Reaction of degeneration
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_____ RD: present if there is a sluggish or diminished resonse to AC or DC.
_____ RD: no response to AC or DC
-
Degeneration of a nerve may take up to ___ days and the extent of degeneration can't be assessd for ___ wks.
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____-____ curve: represents the amount of time it takes the body to respond to a stimulus that is applied at the motor point of a muscle. Different amplitueds of current can be applied to get the different responses. This diagnostic test is used to determine how well the patient's nervous system is working. For long duration pulses, less current will be required to obtain the threshold to elicit a contraction.
strength-duration curve
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______: amount of current, at a very long pulse duration to produce a minimal response in a muscle. Normal is __-__ mA.
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_____- amount of time it takes to produce a minimal response at twice rheobase. The normal range is ____ microseconds. In a denervated muscle it may be ___ to ___ msec.
- chronaxie
- 100 microseconds
- 10-100 msec
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_____-neuropathy: damage to a single nerve or nerve group, and results in a loss of movement, sensation, and other fucntions of the nerve.
_____-neuropathy: neurological disorder that occurs when many peripheral nerves in the body malfunction simultaneously.
- mono neuropathy
- poly-neuropathy
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_____-neuropathy: damage to a single nerve or nerve group, and results in a loss of movement, sensation, and other fucntions of the nerve.
_____-neuropathy: neurological disorder that occurs when many peripheral nerves in the body malfunction simultaneously.
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_____ ______ ______: mainly used when looking at the PNS. Essential in distinguishing btw poly and mono-neuropathy. In mono- it helps to verify and localize. In addition, helps rule out PNS problems, and shift focus to CNS.
Nerve conduction velocity test
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NCV are affected by: 4 things
age, skin condition, temperature, and testing consistency
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Conduction velocities:
Nerve: ___-___ m/sec
Muscle: ___-___ m/sec
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3 basic characteristics of an adequate stimulus:
1._____: individual stimulus must be high enough to deplarize the cell membrane.
2._____: of individual stimulus must be long enough so that the excitation process can take place.
3._____: must be sufficiently rapid to prevent accomodation.
- amplitude
- duration
- speed of rise (waveform)
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______ _____: frequency of motor level stimulation which a smooth tetanic contraction is produced (30-50 pps).
fusion frequency
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______ ______: maximum current value reached in a monophasic pulse or for any single phase of a biphasic pulse.
____-____ ____: maximum current value measured from peak of the first phase to the peak of the second phase of a biphasic pulse
- peak amplitude
- peak to peak amplitude
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The average amplitude is the average current flow for duration of phase for a sine wave which is ___% of peak.
Root-mean square amplitued (RMS) is an engineering term corresponding to an equivalent amount of direct current in terms of heating power for a sine wave it is ___% of peak.
-
____ _____: elapsed time between the beginning and end of one phase.
_____ _____: elapsed time between the beginning and end of all phases in a single pulse; on the clinical stimulators, the pulse duration is often labeled pulse width; can be responsible for patient discomfort.
- phase duration
- pulse duration
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______ ______: elapsed time between two successive phases of a pulse; also known as the ______ interval.
____ ____: time for the leading edge of the phase to increase in amplitude from the zero current baseline to peak amplitude of one phase.
- interphase interval (intrapulse interval)
- rise time
-
_____ ____: time for the training edge of the phase to return the zero current baseline from the peak or maximum amplitude of the phase.
decay time
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______ _____: time integral of current for a single phase; represented by the area under a single phase waveform.
____ _____: time integral of a single pulse for the current waveform over the entire pulse.
-
_______ _______: time between the end of one pulse and the beginning of the next pulse in a series; time between successive pulses.
_______: number of pulses per unit of time.
_______: elapsed time from a reference point on a pulse waveform to the identical point on the next successive pulse. It is also equal to the pulse duration plus the interpulse interval.
- interpulse interval
- frequency
- period
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_______ _______: electronic changes in current characteristics, either sequential, intermittent, or variable in nature of a prescribed fashion (amplitude, phase duration, frequency, ramp).
current modulation
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time modulations:
______: continuous repetitive series of pulses
______: finite series of pulse; an envelope of alternating current delivered at a specified frequency over a specified time.
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Timing modulations:
_____ _____: the ratio of on-time to total time of trains or pulses or bursts. formula is on-time/on-time+off time x 100%.
duty cycle
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_____ _____: the amount of current flow per unit area.
Law of ____ ____: current density is the amount of current flow per unit area. To effeciently stimulate a nerve, there must be a sudden variation in current flow. Current density is affected by 3 things:
- current density
- dubois raymond
- electrode size, tissue impedance, electrode spacing
-
Burns occur when electricity exceeds ____ mA
Respiratory or cardiac occurs at ___ mA
Coagulation and ischemia occurs at ____mA
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Therapeutic currents:
Low voltage direct current used for 4 things:
- wound/soft tissue healing
- denervated muscles
- iontophoresis
- electrodiagnostic testing
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Therapeutic currents:
Low voltage AC used for 4 things:
pain, strengthening, functional retraining, fracture healing
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Therapeutic currents:
High voltage pulsed current used for 5 things:
pain, tissue healing, muscle-re ed, edema control, muscle strengthening (small)
-
Therapeutic currents:
Interferential current used for three things:
pain, edema, soft tissue healing
-
Therapeutic currents:
Russian stimulation used for 2 things:
Progressive exponential current used for 1 thing:
- muscle strengthening and re ed (for russian stim)
- denervated muscle
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