_____: method of afferent nerve fiber stimulation designed to control pain through various mechanisms. Use a pulsed current of asymmetrical, biphasic, square/rectangular or triangular/spike waveforms.
_____ _____ ____: pain is based on an imbalance of excitatory and inhibitory input ot the T cells located withing the spinal cord.
______ _____ ____: morphine induced analgesia. Opiate receptors inhibit the release of substance P from C fiber terminals and depresses pain transmission.
Gate Control Theory
Endogenous Opiate System
Indications for TENS: only 1
Contraindications for TENS: 4 total
Indications: painful conditions of either an acute or chronic nature
Contraindications: 1. pacemakers, 2. pregnancy, 3. over carotid sinus, laryngeal or pharyngeal muscles, sensitive eye areas, or mucosal membranes, 4. and while operating hazardous machinery.
Frequency: 1 MHz or 3 MHz depending on depth of tissue
Duty Cycle: 20% pulsed for non-thermal effects
Intensity: 0 - .5 W/cm²
_______: TENS like device used to deliver electrical stimulit to accomplish a variety of therapeutic purposes. It is different from the other methods of delivering electricla stimuli becuae of the waveform of the current and the voltage of the generator.
High Voltage Pulsed Current (HVPC)
What is the shape of the WAVEFORM of High Voltage pulsed current?
Twin Spike monophasic pulsed current
Advantages of HVPC :2
Advantages: more comfortable because short pulse duration and high voltage bypasses skin impedance
Disadvantages: short pulse duration sor you can't stimulate a denervated muscle or perform iontophoresis
______ ______: two unmodulated sine waves of different frequencies are crossed, causing both constructive and destructive interference. This results in an mplitude modulated sine wave. The frequencies of the waves are commonly between 2000 and 5000 Hz.
For IFC, higher frequencies have shorter phase durations (_____ hz has a _____ microsec phase duration). and are best suited for sensory nerve stimulation. Lower frequencies have longer phase durations (______ hz frequency has a _____ microsec phase duration.) and is more suited for motor stimulation.
4000 Hz has a 125 micro seconds
2000 Hz has a 250 micro seconds
______ Inhibition: with stimuli of constant amplitude and frequencies greater than 1000 Hz, successive stimuli prevent the nerve from repolarizing. This temporary nerve membrane depolarization is responsible for decreased sensation under the electrodes.
______: reciprocal scanning of IFC through an arc of 45 degrees. This allows the current ot perfuse through a greater volume of tissue then if this option was not selected.
________: a mode in which the two currents are mixed within the machine to produce an amplitude modulated frequency output. This mode only uses two electrodes.
__-__ bps: with an amplitude sufficient enough to produce small pulsating muscle contractions, may relieve pain.
__-__ bps: results in tetany of the muscle, may be able to modulate the contractions, but may not be effective for strengthening.
>__ bps: with low amplitudes, causes pain relief.
With hyperstimulation, _____ inhibits pain.
True or false: hyperstimulation is NOT motor stimulation.
True. it is noxious stimulation
3 Common Responses to hyperstimulation:
1. breakthrough phenomena: points inititially tolerate the stimulus but become hypersensitive within 10-20 seconds.
2. points that are not pathological adapt
3. optimal stimulation sites reach noxious threshold levels very quickly with minimum intensity
Several substances are released by acupuncture including
______: alternative medicine in which the goal is to balance functional disorders of the body in general.
______: channel/pathway through which energy flows.
______ Phenomenon: pt has organ dysfunction and corresponding distal meridian points are found to have increase pain threshold and differ in heat sensitivity and electrical permeability.