MSK Diag Mgt 7220 Exam III - Estim

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1
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2

what is the carrier frequency? what is a typical carrier frequency?

frequency of pulses within a burst

50 bursts/second 2500 Hz

3

if you want the current to penetrate more deeply, should you move the electrodes further apart or closer together?

further apart

4

if you want a high current density, should you cut the electrode in half or keep the original size?

cut it in half - smaller electrodes = higher current density.

5

are each of the following good current conductors or poor current conductors

skin

adipose

muscle

bone

blood

peripheral nerve

skin poor

adipose poor

bone worst

muscle good

blood good

peripheral nerve good

higher water content means better conductance

6

precautions of estim

cardiac disease

stimulation across chest

impaired sensation

skin irritation/wounds

pregnancy

excess adipose tissue

7

contraindications of estim

pacemakers/arrhythmias/implanted stimulators

over carotid sinus

thrombophlebitis

pregnancy - at or around the abdomen

malignant tumor

8

phase duration for sensory stimulation

1-80us

9

phase duration used for muscle contraction

150 to 350 us

10

what pulse duration must e stim be under in order for C fibers not to depolarize

1 ms

11

frequencies for muscle contraction

muscle twitch

summation

tetany

<15 pps

15-25 pps

40-80 pps

12

what percentage of MVIC should be achieved for strength gains in estim

50%

13

through what mechanisms does estim treat spasticity

agonist through fatigue

antagonist through reciprocal inhibition

14

FOR STRENGTHENING

waveform

pulse duration

frequency

amplitude

ramp up

ramp down

duty cycle

waveform: symmetrical or assymetrical biphasic pulsed current or burst modulating alternating current

pulse duration 150 - 600 ms

frequency 30-80 Hz

amplitude - enough to obtain a strong muscle contraction

ramp up 1-5 seconds

ramp down 1-2 second

duty cycle 1:3 to 1:5 with on time up to ten seconds

15

if you chose pulsed monophasic as your mode to treat a person, would you put the anode or cathode at the desired site of contraction

the cathode

16

which estim strengthening mode is equivalent to NMES

pulsed biphasic

17

using estim concurrently with movement in order to DF assist during walking or gait retrain after SCI would be examples of

FES functional electrical stimulation

18
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19

pain modulation theory for sensory level TENS

gate control theory

20

pain modulation theory for motor level TENS

endogenous opiate release theory

21

pain modulation theory of noxious TENS

descending pain control

endogenous opiate relief

22

vascular effects of estim for pain

increase in regional blood flow due to mechanical muscle pump (at motor level only)

vasodilation possibly due to increase in sympathetic activity

23

settings for edema tx with estim

frequency 8-30 pps

PD 25 ms

ampltiude

24

in the inflammatory stages of healing, would you want to appy a positive or negative charge to the area of injury? why?

the cells with a role in healing in this phase are macrophages and neutrophils which are negatively charged so you would want to apply a positive charge

25

In the proliferative and remodeling stages, apply neg or pos charge to injury

neg charge because fibroblasts are positive (proliferative) and myofibroblasts and kertinocytes (remodeling)

26

range of penetration for iontophoresis

3-20 mm

27

which drugs common in iontophoresis are negatively charged?

dexamethasone (a common glucocorticoid--> cathode would be active,

acetic acid, iodine, salicylates

28

which drug common in iontophoressis is positively charged?

lidocaine

29

would you use anode or cathode to break up scar tissue? why

cathode

As the anode (+) produces an acid reaction (a weak HCL acid), it is considered sclerotic, which tends to harden tissues, serving as an analgesic agent due to local release of oxygen. On the other hand, as the cathode (-) produces an alkaline reaction (a strong sodium hydroxide), it is then considered sclerolytic, which is a softening agent due to the hydrogen release, serving in the management of scars and burns.

30

which modality is indicated for hiperhidrosis?

iontophoresis

31

typical dosage for iontophoresis?

40mA*min

32

where should the electrodes be placed in electrophysiologica testing?

active recording electrode on muscle belly, reference electode on tendon, and ground electrode between the two.

33

what is the amplitude of response representative of in electrophysiologic testing?

number of functioning motor units innervated by nerve being tested

34

nerve injuries

neurapraxia

axonotmesis

endoneurial

loss of perineurium

neurotmesis

neurapraxia - loss of conduction due to blockage. lasts 6-8 weeks. mild. myelin damage. blunt damage.

axonotmesis -myelin and axon damage. more severe crush,stretch or contusion than neurapraxia. middle severity. recovery 6-12 months.

endoneurial and perineurium - perineurium superficial sheath. endoneurial deeper. (partial neurotmesis)

neurotmesis - entire nerve is damaged. no recovery.

35

clinical indications of UV radiation

psoriasis

wound healing

36

contraindications of UV tx

avoid the eyes

skin cancer, pulmonary tuverculosis, cardiac kidney or liver disease, fever

photosensitivity

37

skin erythema

sun burn --> release of histamine --> microvascular vasodilation

38

MED

minimal erythemal dose

smallest does causing burn within 8 hours of exposure and disappears within 24 hours

39

desired effects of LLLT (low-level laser therapy)

alters cell membrane and function

enzyme activation

increased ATP and nucleic acid production

stimulation of macrophages and fibroblasts --> increased collagen production

change in NCV regeneration

vasodilation

40

for which modality do contraindications and precautions include areas of hemorrhage, epilepsy, fever, lumbar region during pregnancy, and over endocrine gland?

LASER

41

major difference between the capacitive method of SWD and the inductive method. which heats mostly muscle?

capacitive is heating by electric field and inductive is heating by magnetic field. inductive method heats mostly muscle

42

the bacterialcidal and ionizing band of UV radiation

UVC

43

NO METAL IMPLANTS

obesity and excessive adipose tissue

adjacent electronic or magnetic equipment

malignancy

are contraindications and precuations of which modality

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