superficial heat

  1. superficial heat can only penetrate
    through epidermis and dermis
  2. conduction
    • energy or heat being transferred from object to another contacting object to equalize temp
    • ex: hotpack or hotpad
  3. convection
    • a body part heated or cooled due to moving molecules in liquid or gaseous form
    • ex: fluidotherapy or blood from heart warm body
  4. radiation
    • heated element gives off radiant heat, which can be absorbed by the body if close to the object
    • ex: infrared lamp
  5. factors affecting heat transfer
    • intensity of the heat applied
    • time of heat exposure
    • thermal medium
    • depths of heat transfer
  6. the skin temp can rise __
    the skin temp can rise ___ at 1 cm depth
    the skin temp can rise ___ at 3 cm depth
    • 18
    • 6
    • <1
    • at depth of 3 cm little or no therapeutic change
  7. suprerficial heat may ______ intra articular temp of ______, _____, _____ and _____
    • increase
    • hands wrist foot ankle
    • but it will not in big joints such as knee
  8. superficial heat can raise the target tissue to a therapeutical level or
    • 105.8-113 F (41-45 C)
    • temp reached in 8-10 min
    • in 30 reach equilbrium
  9. physiologic response to heat
    • inc metabolism, perspiration, O2 intake
    • muscle relaxation
    • extensibility of connective tissues coupled with stretching exercises
    • inc body temp, pulse rate, respiration, to maintain thermal equibrium
  10. indications for superficail heat
    • subacute and chronic inflammation
    • muscle injury
    • muscle tension (spasm)
    • clean ulcers or wounds
    • conditions that require relaxation
    • pre-treatment modality for exercise, stretching, electrical stim, traction, massage, ultrasound, jt mob
  11. contraindication for superficial heat
    • acute inflammation (strains)
    • fever
    • malignancis
    • active bleeding
    • cardiac insufficiences
    • very young or old
    • PVD
    • spasticity
    • loss of sensation
    • deep vein trombophlebitis
  12. precautions for superficial heat
    • repeated strong doses
    • edema (use mild heat and elevate of extremity recommended)
    • confused pt
    • pt with poor judgement of heat level
  13. hot packs (HP)
    • canvas filled with silicon gel
    • delivers heat by conduction
    • maintained in water at 158-167 F (70-75 C)
  14. dosage of HP
    • intensit depends on pt tolerance and and layers of towels
    • 6-8 (6-12)layers of towels (commercial cover= 3 towels 5 if envelope contains a sponge insert
    • duration 15-20 min
    • frequency can be daily or more for subacute problems
  15. advantages for HP
    • safe
    • convenient to treat local areas
    • easy to prepare and apply
    • inexpensive
    • moist, comfortable heat
  16. disadvantage for HP
    • may be too heavy for tender areas
    • source of infection
    • difficult to monitor skin conditions
    • unable to control temp once applied
    • heat retention dimiishes after 20 min
    • passive treatment
  17. paraffin bath
    • a tank containing medical paraffin and mineral oil
    • temp maintained at 129 F (54 C)
    • it conducts heat slower than water at the same temp, allowing tissue to heat up more slowly
  18. paraffin and oil are mixed in a ratio of
    • 5lbs wax 1pt oil
    • 7 parts paraffin to 1 part mineral oil
    • adding more oil can lower temp
  19. advantages to paraffin bath
    • used for distal extremities (fingers, hand, wrist, elbows, toes, foot, ankle)
    • helps soften skin
    • allows even distribution of parts to be treated
  20. disadvantages of paraffin bath
    • may be too hot
    • messy
    • limited mvmt
    • intracapsular heating may damage articular cartilage in RA
    • open wounds can not be immersed
  21. methods of paraffin bath treatment
    • immersion bath
    • dip immersion
    • dip and wrap or glove technique
  22. immersion bath
    • the pt holds the part in the bath for the duration of treatment.
    • this technique produces the greatest heat
  23. dip immersion
    • pt dips the part to be treated into tank once or twice and allow to harden, then immerse the part in tank for immersion bath
    • skin temp not as high as the immersion bath
  24. dip and wrap or glove technique
    imersion is done 6-12 times, the part is then covered with plastic wrap or plastic bag and then with several layers of towel most commonly used least effective for raising skin temp
  25. treatment time and frequency for paraffin
    • duration 20 min
    • frequency daily for subacute less for chronic
  26. infrared
    radiant method of heating with the medium (air) being unaffected
  27. two types of infrared generators
    • non luminuos
    • and luminous
  28. non luminous
    • long or far, infrared
    • wavelength 1,500-15,000 nm
    • penetrates 1-2 mm (epidermis)
    • source distance 30-36 in at R angle
    • warm up 5-10 min
    • heat produced by high resistant metal coil
  29. luminous
    • short, or near infrared
    • wavelength 800-1500 nm
    • penetrates 10mm (dermis)
    • source distance 24-30 in at R angle
    • no warm up time
    • tungsten filament light bulbs mounted in metal reflectors are the luminous generators
    • protect pt eyes
    • may feel slightly less heat than non luminuous
  30. inverse square law
    the intensity of the waves from a point source varies inversly with the square of the distance from the source
  31. cosine law
    the absorption of rays is optimal when they strike the surface on the perpendicular. as the angle between the beam and teh perpendicular is increased, efficiency is decreased in proportion to the cosine of that angle
  32. frequency of infrared
    may be given once or twice daily for subacute cases and less for chronic
  33. anodyne therapy
    • emits monochromatic infrared photo energy (MIRE) to significantly increase local circulation and temporarily reduce pain
    • light emitting diodes (LED's) placed in direct skin contact
  34. fluidotherapy
    • convectional heat, use in providing dry superficial heat that uses very fine cellulose particles through which heated air is blown
    • temp stays high the whole time
    • temp delivered at 105-125 F (41-52 C)
  35. three different sizes
    • single extremity
    • bilateral UE/ LE
    • entire LE
  36. advantage of fluidotherapy
    • exercise both active and passive possible
    • constant temp
    • wound managemtent if dressed and covered
    • particles can be steralized in the unit
  37. disadvantages of fluidotherapy
    • messy
    • treatment part not very visible
  38. time and frequency of fluidotherapy
    • subacute may be daily for 20 min
    • chronic less time for 20-30 min
  39. contrast bath
    • alternate applications of warm (100-110)for 6 min and cold treatment (55-65) for 4 min till a total time of 30 min
    • end with either cold or heat based on condition
  40. physiological effects of contrast bath
    • alternate constriction and dilation of local blood vessels
    • stimulates peripheral blood flow and stimulates healing
  41. indications of contrast bath
    • impaired venous circulation
    • subacute or chronic traumatic inflammation conditons, transitional treatment
    • edema
    • sinus or congestive headache (apply to both feet)
Card Set
superficial heat
superficial heat