1. ultrasound
    can be used for diagnosis, functional restoration, healing of soft tissue and for tissue destruction
  2. sound waves
    are mechanical pressure waves that are described in terms of their frequency
  3. penetration of US
    depth of penetration is inversely related to thefrequency of the ultrasonic energy
  4. the the frequency the the penetration
    • higher- less penetration
    • lower- greater penetration
  5. attenuation
    • absorption of sound as it penetrates the tissue
    • higher frequency greater att in superficial structures
    • lower frequency greater att in deep tissues
  6. highest to lowest tissues with their ability to absorb US
    • bone
    • cartilage
    • tissue
    • skin
    • blood vessels
    • muscle
    • fat
    • blood
  7. reflextion
    material of one density to another
  8. refraction
    is the deflection of energy waves
  9. velocity
    speed at which the sound wave or ultrasound vibration travels through a medium is directly related to the density of the medium
  10. transducer
    • a device that converts one form of energu into another
    • made up of a metal plate with piezoelectric crystal
  11. piezoelectric crystal
    converts electric energy into sound energy (mechanical energy) and vice versa
  12. condensation phase
  13. refarction phase
  14. ERA
    • effective radiating area
    • portion of the surface of the transducer that generates the sound wave (smaller than head)
    • effectiveness is in an area that is 2 to 3 times the ERA
  15. two types of sound waves
    • continuous
    • pulsed
  16. continuous wave (CW)
    sound intensity remains constant
  17. pulsed wave
    • a wave that is intermittently interrupted
    • 1 wk- no heat acute
    • 2 wk- 10%-20% acute
    • 4 wk- 50% subacute
    • 5 wk- 80% subacute
    • 6wk continuous chronic
  18. pulsed period
    time the wave is on and time off
  19. duty cycle
    • duration of pulse time (time on)/ pulse period (time on and time off)
    • during the off time the heat generated dissipates ad mechanical effects are produced
  20. thermal effects
    • inc collagen tissue extensibility
    • inc blood flow
    • inc pain threshold
    • inc enzymatic activity
    • dec muscle spasm
    • dec joint stiffness
    • change in nerve conduction velocity
    • change in contractile activity of skeletal muscle
  21. non thermal effects
    • change in membranes of cells leading to inc permeability
    • cavitation
    • acoustical streaming
    • standing wave phenomenon
    • separation of collagen
  22. cavitation
    vibrational effects on gas bubbles that may be present in the blood or tissue fluids
  23. acoustical streaming
    mvmt of fluids along boundary of cell membranes as a result of the mechanical pressure wave
  24. standing wave phenomenon
    waves go in and reflect back ip and bounce back and forth when the head is held in one spot
  25. seperation collagen
    can cause inc extensibility of tissues
  26. intensity
    • the rate of which energy is delivered per unit and is expressed in units of watts per square centimeter (w/cm2)
    • greater intensity greater elevation of temp
    • pt should feel slight warmth
    • higher intensity in areas of extensive fat and less intensity in areas of no fat
  27. indications of US
    • soft tissue shortening muscle, jt capsule, scar tissue
    • subacute and chronic inflammation where inc blood flow is needed
    • pain trigger points, spasm and other musculoskeletal pain
    • post traumatic neuromas
  28. contraindications of US
    • infections
    • malignacies
    • over spine, eye, reproductive organs, pregnant uterus, pacemaker
    • dec sensation to pain and temp
    • acute inflammatory
    • tendon undergoing healing
    • growth plate of growing bones
    • jt replacement
  29. technique of application
    • proper positioning and draping
    • treat area 2 to 3 times ERA for 5 min
    • use a coupling medium- conductive gel or water
    • cut power off before removing head
  30. recording data
    • location
    • duration
    • frequency (CW, % pulsed) w/cm2
  31. phonophoresis
    process in which whole medicinal molecules are driven across the skin and into the subcutaneous tissue by means of ultrasound
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