The following are what?
�Hemorrhage
�Infection with suppuration
�Malignancy
Contraindications to
All Modalities
The following are what?
�Diabetes Mellitus
�Encapsulated Swellings
�Active TB
�Decreased thermal sensations
�Edema
�Abdomen and low back during pregnancy
�Acute conditions
Contraindications to all
Heating
What time from indicates acute?
24-48 Hours
What time from indicates subacute?
72 Hours
What time frame indicates Chronic?
Longer than anticipated
PRICE is an acronym meaning:
�Protect
�Rest
�Ice
�Compress
�Elevate
�Support
What healing phase should these measures be taken in?
Acute
The following are what?
�Brain
�Eyes
�Heart
�Carotid Sinuses
�Pacemaker
�Anesthesia (except high volt)
�Pregnancy - Low Back (except TENS)
�Open wounds
Contraindications to all
Electrical
What modalities are used for
superficial heat
?
Note: all heat occurs ?1 million Hz and more (MHz)
�UV
�Infrared
What modalities are used for
Deep Heat
?
Note: all heat occurs ?1 million Hz
�Short Wave Diathermy
�Microwave Diathermy
�Ultrasound (1MHz-3MHz)
What modalities use a medium frequency between 1,000 - 10,000 Hz and is used to penetrate into deeper tissues?
�Interferential
�Russian Stimulation
What modalities use a low frequency <1,000 Hz (1-120)?
�Electric Muscle Stim
�High Volt
�Low Volt Galvanic
�Sine
�Faradic
�Interferential
�TENS
What modality uses an ultra ultra low frequency of around 1Hz?
�Microcurrent Electrical Neuromuscular Stimulations
Is Biphasic AC or DC based current?
AC
Is Monophasic Current AC or DC based current?
DC
With regard to Biphasic and Monophasic current, which one has polarity?
Monophasic
Define
Electro-Induction
One object produces electromagnetic property in another
-charges line up = electrical lines of force
Define
Electromotive Force / EMF
�Measured in
VOLTS
S* - force behind the electrons
�Difference in force between 2 objects
-the greater the charge = Increase
-the greater the distance = Decrease
Define
Resistance
�Property of substance to oppose current
�Measured in
OHMS
-decreasing it = increased conduction (shorter path, lower temp., increased diameter
Define
Impedance
Slow Down or Dampen
What is current measured in?
Amps
This is the unit for charge
Coulomb (C)
What is used to increase or decrease volts?
Transformer
Define Capacitance
The ability of a system to store an electric charge
-measured Farads
What is the wave form made up of?
�Pulse Width
�Interpulse Width
�Frequency
As per Joule's Law, which type of electrical treatment results in microvibration which leads to electrical creation of
Heat
Electrothermal
Which type of electrical treatment results in an alteration of molecules with a DC current?
Electricochemical (Ionto-)
Which type of electrical treatment involves ions pushing other molecules around, shifting Na+ / K+ pump resulting in
contraction
Electrophysical
What occurs when you increase frequency?
Deeper penetration
A medium frequency decreases skin impedance.
You should also use a bigger electrode and do what with voltage?
Increase
When using pads what is the best procedure if you want to
isolate
the muscle?
Motor Point and Muscle Belly
When using pads why would you place them on either side of a muscle?
If the muscle is especially weak
The following describes what:
1 mA (milliamp) per square inch of pad side (3" pad = 9mA)
above formula in shorthand: 1mA/inch^2
Pad Rule
Types of current include Monopolar and Bipolar.
Which one is best used for a large area or trigger / acupuncture point?
Monopolar
Types of current include Monopolar and Bipolar.
Which one is best used for small muscle groups?
Bipolar
Types of current include Monopolar and Bipolar.
Which one uses different pad sizes for Dispersal (large pad) and Active Pads (small size)?
Note: the other type uses pads of the same size
Monopolar
The following is the definition for what?
�Minimum
Volts
s* necessary to excite a nerve
Rheobase (threshold)
The following is the definition for what?
�The
Time
e* necessary for contraction when the rheobase (threshold) is doubled
Chronaxie
What is the best test when testing muscles?
EMG (Electromyography)
What is the best test when testing nerves?
NCV (Nerve Conduction Velocity)
This type of heat transmission goes as follows:
�Transmission of heat in gases and liquids (fluids) by circulation of heat particles
Convection
Baths and Infrared employ which type of heat transmission?
Convection
This type of heat transmission goes as follows:
�Transmission of heat without the intervening medium getting warm
Radiation
Lamps including UV, IR and microwave diathermy employ which type of heat transmission?
Radiation
This type of heat transmission goes as follows:
�Conversion of electrical energy into heat or mechanical energy
Conversion
Ultrasound employs which type of heat transmission?
Conversion
This type of heat transmission goes as follows:
�The transfer of heat through a substance, often heating up a
solid
Conduction
Hydrocollator and Paraffin wax are employ which type of heat transfer?
Conduction
Between heat and cold therapy, which one decreases pain sensation?
Both
-cold will do so after an initial increase in pain though
-both may also create pain if too extreme
Between heat and cold therapy, which one decreases muscle strength?
Heat
Between heat and cold therapy, which one decreases endurance?
Both
Between heat and cold therapy, which one decreases motor skills?
Cold
True or False:
Heat should be used to treat headache, as it dilates vessels and results in improved blood flow which alleviates the pain
False:
It does dilate vessels, but this increases headache symptoms
-cold therapy used for headaches
The process of alternating vasoconstriction and vasodilation in extremities exposed to cold
Hunting-Lewis Reaction
The following is a list of indications for which modality:
�Musculoskeletal: synovitis, tenosynovitis, sprains, strains, bursitis, torticolis
�Catarrhal: Bronchitis, sinusitis, laryngitis, coryza
�Infections: Furuncles (boil), Burns, ulcers
�Other: Follic
Infrared
Are Lamps considered short wave or long wave infrared therapy?
Short Wave
Long Wave Infrared therapy uses what type of equipment?
Direct Contact Heating Methods:
Hydrocollator, Heating pads, Hot water bottles, baths, fluidotherapy
Moist heat uses what devise to heat hot packs?
Hydrocollator
What do Cold Lasers do?
Note: Absorption depends on tissue resonance and water content
�Wound Healing: used for open lesions / ulcers
�Analgesic: pain control both acute and chronic
The following is a list of indications for which modality:
�Skin Conditions: Fungal, herpes zoster (shingles), burns, psoriasis, carbuncles (large pus filled cyst), wounds and ulcers
�Bone Conditions: Rickets, Osteomalacia
Ultraviolet (UV)
What medication is a contraindication for UV therapy?
Tetracycline
Which modalities are good for "Deep" conditions including but not limited to:
�Deep Muscle
�Thoracic Cavity
�Middle Ear
�Joints
�PID
�Short Wave Diathermy (direct contact devices): penetrates to Muscle-fat interface
�Microwave Diathermy (lamp like devise): penetrates into fat
Note: Microwave is best for
Hip Conditions
The following is a list of indications for which modality:
�Joint and musculoskeletal inflammation
Mechanical: micro-massage, dispersal of fluids, removes exudates, increases molecular movement
Chemical: increases gaseous exchange and chemical oxidation
N
Ultrasound
-protein absorbs this the most
-do not put over bone, you will burn the periosteum
With regard to intensity for Ultrasound which type of case and tissue thickness matches with the contact method and underwater method with regard to strength of US?
�Contact Method: 0.5-1.0 W/cm2
�Underwater Method: 1.0-1.5 W/cm2
Acute Case
Thin Tissue
With regard to intensity for Ultrasound which type of case and tissue thickness matches with the contact method and underwater method with regard to strength of US?
�Contact Method: 1.0-1.5 W/cm2
�Underwater Method: 1.5-2.0 W/cm2
�Acute Case Thick Tissue
�Chronic Case Thin Tissue
With regard to intensity for Ultrasound which type of case and tissue thickness matches with the contact method and underwater method with regard to strength of US?
�Contact Method: 1.5-2.0 W/cm2
�Underwater Method: 2.0-2.5 W/cm2
Chronic Case
Thick Tissue
The following is the definition of what:
�For US the sound head consists of crystals which converts electrical energy to mechanical vibrations
Reverse Piezoelectric Effect
Where does ultrasound peak?
Bone Muscle Interface
Why would you used a pulsed ultrasound as opposed to continuous ultrasound?
It allows for massage
without heat
This delivery mechanism uses ultrasound to increase the absorption of certain substances across the skin.
Phonophoresis
With regard to depth of Ultrasound what does the following result in:
�1 MHz
Less Heat
More Depth /
Penetrates Deeper
With regard to depth of Ultrasound what does the following result in:
�3 MHz
More Heat
Less Depth /
Superficial Penetration
With regard to
Low Volt Galvanic
which pole goes as follows:
�Vasoconstricts
�Produce acid reaction in skin
�Repels alkaline and H2
�Attracts O2
�Causes ischemia - less blood
�Hardens tissue
�Pain relief
�Astringent - causes contraction
Notes:
�shallowest
Positive Pole
With regard to
Low Volt Galvanic
which pole goes as follows:
�Vasodilates
�Produces alkaline reaction in skin
�Repels acid and O2
�Attracts H2
�Hyperemia
�Softens tissue
�Relieves chronic pain
�Increases digestion
Notes:
�shallowest of all Electrical Musc
Negative Pole
This is the process of forcing soluble ionic salts into the body by electrical charge.
Low volt galvanic is used for this, and the polarity of the electrode determines which ions will go into the tissue
Iontophoresis
-+ pole pushes + ions and - pole pushes - ions
True or False:
For high volt galvanic a decrease in sensation is not a contraindication
True
The following is a list of indications for which modality:
�Acute and subacute injuries to
reduce edema
�Analgesia
�Spasms
�Reduce muscle atrophy especially in cases of casts and disuse atrophy
Electrochemical (opiate, pain)
Electrokinetic (contraction)
N
High Volt Galvanic
When using Electric Muscular Stimulation the following is true:
Low frequency:
�1-10pps for edema
�15-20pps for muscle exercise
�>20pps for fatigue
Pain relief:
�1-10 pps for endorphin release - low and slow
�80-120 enkephalin production - high and fast
W
Wi Believe I can Fi
When using High Volt Galvanic what mode should be used for the following:
�Edema, Pain and Neuritis
Continuous
When using High Volt Galvanic what mode should be used for the following:
�Permits alternating contracture of agonist and antagonist
�Limits accommodation
Reciprocal Mode
When using High Volt Galvanic what mode should be used for the following:
�Used when Re-educating and exercise is desired
Surge On / Off
This is an Alternating current with
equal
proportions of positive and negative phase charges. This has a deep penetration due to a longer duration or width.
Indications / uses:
�Muscle spasms and tension
�Edema
�Hysterical paralysis - UMNL with intact LMN
Sinusoidal Current
This is an Alternating current, but the positive and negative charges are
not equal
: usually the negative phase is much less intense than the positive phase. There is also a sharper spike or rise to the positive phase than the negative phase
Indications:
Faradic Current
TENS units are used for Superficial pain control and can use both AC and DC biphasic currents.
What type of nerve fiber goes as follows:
�Large, fast and responsible for
Proprioception
A beta fiber
TENS units are used for Superficial pain control and can use both AC and DC biphasic currents.
What type of nerve fiber goes as follows:
�Small, slow and responsible for
Sharp Pain
A delta fiber
TENS units are used for Superficial pain control and can use both AC and DC biphasic currents.
What type of nerve fiber goes as follows:
�Small, slowest and responsible for
Dull Pain
C fiber
Microcurrent is used to increase tissue healing and includes increases protein, and DNA synthesis as well as a decrease in certain inflammatory markers
What type of Waveform (current) is used?
Direct Current
The following describes what:
�Used for pain control, but changes frequency so patient does not accommodate to frequency
�2 Frequencies used include a
Carrier Frequency
y* which is typically lower (2,000-10,000Hz) and Higher frequency
�2 Frequencies will
Interferential
What is biphasic used for?
Muscle strengthening and spasm
The following are what?
�Hemorrhage
�Infection with suppuration
�Malignancy
Contraindications to
All Modalities
The following are what?
�Diabetes Mellitus
�Encapsulated Swellings
�Active TB
�Decreased thermal sensations
�Edema
�Abdomen and low back during pregnancy
�Acute conditions
Contraindications to all
Heating
What time from indicates acute?
24-48 Hours
What time from indicates subacute?
72 Hours
What time frame indicates Chronic?
Longer than anticipated
PRICE is an acronym meaning:
�Protect
�Rest
�Ice
�Compress
�Elevate
�Support
What healing phase should these measures be taken in?
Acute
The following are what?
�Brain
�Eyes
�Heart
�Carotid Sinuses
�Pacemaker
�Anesthesia (except high volt)
�Pregnancy - Low Back (except TENS)
�Open wounds
Contraindications to all
Electrical
What modalities are used for
superficial heat
?
Note: all heat occurs ?1 million Hz and more (MHz)
�UV
�Infrared
What modalities are used for
Deep Heat
?
Note: all heat occurs ?1 million Hz
�Short Wave Diathermy
�Microwave Diathermy
�Ultrasound (1MHz-3MHz)
What modalities use a medium frequency between 1,000 - 10,000 Hz and is used to penetrate into deeper tissues?
�Interferential
�Russian Stimulation
What modalities use a low frequency <1,000 Hz (1-120)?
�Electric Muscle Stim
�High Volt
�Low Volt Galvanic
�Sine
�Faradic
�Interferential
�TENS
What modality uses an ultra ultra low frequency of around 1Hz?
�Microcurrent Electrical Neuromuscular Stimulations
Is Biphasic AC or DC based current?
AC
Is Monophasic Current AC or DC based current?
DC
With regard to Biphasic and Monophasic current, which one has polarity?
Monophasic
Define
Electro-Induction
One object produces electromagnetic property in another
-charges line up = electrical lines of force
Define
Electromotive Force / EMF
�Measured in
VOLTS
S* - force behind the electrons
�Difference in force between 2 objects
-the greater the charge = Increase
-the greater the distance = Decrease
Define
Resistance
�Property of substance to oppose current
�Measured in
OHMS
-decreasing it = increased conduction (shorter path, lower temp., increased diameter
Define
Impedance
Slow Down or Dampen
What is current measured in?
Amps
This is the unit for charge
Coulomb (C)
What is used to increase or decrease volts?
Transformer
Define Capacitance
The ability of a system to store an electric charge
-measured Farads
What is the wave form made up of?
�Pulse Width
�Interpulse Width
�Frequency
As per Joule's Law, which type of electrical treatment results in microvibration which leads to electrical creation of
Heat
Electrothermal
Which type of electrical treatment results in an alteration of molecules with a DC current?
Electricochemical (Ionto-)
Which type of electrical treatment involves ions pushing other molecules around, shifting Na+ / K+ pump resulting in
contraction
Electrophysical
What occurs when you increase frequency?
Deeper penetration
A medium frequency decreases skin impedance.
You should also use a bigger electrode and do what with voltage?
Increase
When using pads what is the best procedure if you want to
isolate
the muscle?
Motor Point and Muscle Belly
When using pads why would you place them on either side of a muscle?
If the muscle is especially weak
The following describes what:
1 mA (milliamp) per square inch of pad side (3" pad = 9mA)
above formula in shorthand: 1mA/inch^2
Pad Rule
Types of current include Monopolar and Bipolar.
Which one is best used for a large area or trigger / acupuncture point?
Monopolar
Types of current include Monopolar and Bipolar.
Which one is best used for small muscle groups?
Bipolar
Types of current include Monopolar and Bipolar.
Which one uses different pad sizes for Dispersal (large pad) and Active Pads (small size)?
Note: the other type uses pads of the same size
Monopolar
The following is the definition for what?
�Minimum
Volts
s* necessary to excite a nerve
Rheobase (threshold)
The following is the definition for what?
�The
Time
e* necessary for contraction when the rheobase (threshold) is doubled
Chronaxie
What is the best test when testing muscles?
EMG (Electromyography)
What is the best test when testing nerves?
NCV (Nerve Conduction Velocity)
This type of heat transmission goes as follows:
�Transmission of heat in gases and liquids (fluids) by circulation of heat particles
Convection
Baths and Infrared employ which type of heat transmission?
Convection
This type of heat transmission goes as follows:
�Transmission of heat without the intervening medium getting warm
Radiation
Lamps including UV, IR and microwave diathermy employ which type of heat transmission?
Radiation
This type of heat transmission goes as follows:
�Conversion of electrical energy into heat or mechanical energy
Conversion
Ultrasound employs which type of heat transmission?
Conversion
This type of heat transmission goes as follows:
�The transfer of heat through a substance, often heating up a
solid
Conduction
Hydrocollator and Paraffin wax are employ which type of heat transfer?
Conduction
Between heat and cold therapy, which one decreases pain sensation?
Both
-cold will do so after an initial increase in pain though
-both may also create pain if too extreme
Between heat and cold therapy, which one decreases muscle strength?
Heat
Between heat and cold therapy, which one decreases endurance?
Both
Between heat and cold therapy, which one decreases motor skills?
Cold
True or False:
Heat should be used to treat headache, as it dilates vessels and results in improved blood flow which alleviates the pain
False:
It does dilate vessels, but this increases headache symptoms
-cold therapy used for headaches
The process of alternating vasoconstriction and vasodilation in extremities exposed to cold
Hunting-Lewis Reaction
The following is a list of indications for which modality:
�Musculoskeletal: synovitis, tenosynovitis, sprains, strains, bursitis, torticolis
�Catarrhal: Bronchitis, sinusitis, laryngitis, coryza
�Infections: Furuncles (boil), Burns, ulcers
�Other: Follic
Infrared
Are Lamps considered short wave or long wave infrared therapy?
Short Wave
Long Wave Infrared therapy uses what type of equipment?
Direct Contact Heating Methods:
Hydrocollator, Heating pads, Hot water bottles, baths, fluidotherapy
Moist heat uses what devise to heat hot packs?
Hydrocollator
What do Cold Lasers do?
Note: Absorption depends on tissue resonance and water content
�Wound Healing: used for open lesions / ulcers
�Analgesic: pain control both acute and chronic
The following is a list of indications for which modality:
�Skin Conditions: Fungal, herpes zoster (shingles), burns, psoriasis, carbuncles (large pus filled cyst), wounds and ulcers
�Bone Conditions: Rickets, Osteomalacia
Ultraviolet (UV)
What medication is a contraindication for UV therapy?
Tetracycline
Which modalities are good for "Deep" conditions including but not limited to:
�Deep Muscle
�Thoracic Cavity
�Middle Ear
�Joints
�PID
�Short Wave Diathermy (direct contact devices): penetrates to Muscle-fat interface
�Microwave Diathermy (lamp like devise): penetrates into fat
Note: Microwave is best for
Hip Conditions
The following is a list of indications for which modality:
�Joint and musculoskeletal inflammation
Mechanical: micro-massage, dispersal of fluids, removes exudates, increases molecular movement
Chemical: increases gaseous exchange and chemical oxidation
N
Ultrasound
-protein absorbs this the most
-do not put over bone, you will burn the periosteum
With regard to intensity for Ultrasound which type of case and tissue thickness matches with the contact method and underwater method with regard to strength of US?
�Contact Method: 0.5-1.0 W/cm2
�Underwater Method: 1.0-1.5 W/cm2
Acute Case
Thin Tissue
With regard to intensity for Ultrasound which type of case and tissue thickness matches with the contact method and underwater method with regard to strength of US?
�Contact Method: 1.0-1.5 W/cm2
�Underwater Method: 1.5-2.0 W/cm2
�Acute Case Thick Tissue
�Chronic Case Thin Tissue
With regard to intensity for Ultrasound which type of case and tissue thickness matches with the contact method and underwater method with regard to strength of US?
�Contact Method: 1.5-2.0 W/cm2
�Underwater Method: 2.0-2.5 W/cm2
Chronic Case
Thick Tissue
The following is the definition of what:
�For US the sound head consists of crystals which converts electrical energy to mechanical vibrations
Reverse Piezoelectric Effect
Where does ultrasound peak?
Bone Muscle Interface
Why would you used a pulsed ultrasound as opposed to continuous ultrasound?
It allows for massage
without heat
This delivery mechanism uses ultrasound to increase the absorption of certain substances across the skin.
Phonophoresis
With regard to depth of Ultrasound what does the following result in:
�1 MHz
Less Heat
More Depth /
Penetrates Deeper
With regard to depth of Ultrasound what does the following result in:
�3 MHz
More Heat
Less Depth /
Superficial Penetration
With regard to
Low Volt Galvanic
which pole goes as follows:
�Vasoconstricts
�Produce acid reaction in skin
�Repels alkaline and H2
�Attracts O2
�Causes ischemia - less blood
�Hardens tissue
�Pain relief
�Astringent - causes contraction
Notes:
�shallowest
Positive Pole
With regard to
Low Volt Galvanic
which pole goes as follows:
�Vasodilates
�Produces alkaline reaction in skin
�Repels acid and O2
�Attracts H2
�Hyperemia
�Softens tissue
�Relieves chronic pain
�Increases digestion
Notes:
�shallowest of all Electrical Musc
Negative Pole
This is the process of forcing soluble ionic salts into the body by electrical charge.
Low volt galvanic is used for this, and the polarity of the electrode determines which ions will go into the tissue
Iontophoresis
-+ pole pushes + ions and - pole pushes - ions
True or False:
For high volt galvanic a decrease in sensation is not a contraindication
TRUE
The following is a list of indications for which modality:
�Acute and subacute injuries to
reduce edema
�Analgesia
�Spasms
�Reduce muscle atrophy especially in cases of casts and disuse atrophy
Electrochemical (opiate, pain)
Electrokinetic (contraction)
N
High Volt Galvanic
When using Electric Muscular Stimulation the following is true:
Low frequency:
�1-10pps for edema
�15-20pps for muscle exercise
�>20pps for fatigue
Pain relief:
�1-10 pps for endorphin release - low and slow
�80-120 enkephalin production - high and fast
W
Wi Believe I can Fi
When using High Volt Galvanic what mode should be used for the following:
�Edema, Pain and Neuritis
Continuous
When using High Volt Galvanic what mode should be used for the following:
�Permits alternating contracture of agonist and antagonist
�Limits accommodation
Reciprocal Mode
When using High Volt Galvanic what mode should be used for the following:
�Used when Re-educating and exercise is desired
Surge On / Off
This is an Alternating current with
equal
proportions of positive and negative phase charges. This has a deep penetration due to a longer duration or width.
Indications / uses:
�Muscle spasms and tension
�Edema
�Hysterical paralysis - UMNL with intact LMN
Sinusoidal Current
This is an Alternating current, but the positive and negative charges are
not equal
: usually the negative phase is much less intense than the positive phase. There is also a sharper spike or rise to the positive phase than the negative phase
Indications:
Faradic Current
TENS units are used for Superficial pain control and can use both AC and DC biphasic currents.
What type of nerve fiber goes as follows:
�Large, fast and responsible for
Proprioception
A beta fiber
TENS units are used for Superficial pain control and can use both AC and DC biphasic currents.
What type of nerve fiber goes as follows:
�Small, slow and responsible for
Sharp Pain
A delta fiber
TENS units are used for Superficial pain control and can use both AC and DC biphasic currents.
What type of nerve fiber goes as follows:
�Small, slowest and responsible for
Dull Pain
C fiber
Microcurrent is used to increase tissue healing and includes increases protein, and DNA synthesis as well as a decrease in certain inflammatory markers
What type of Waveform (current) is used?
Direct Current
The following describes what:
�Used for pain control, but changes frequency so patient does not accommodate to frequency
�2 Frequencies used include a
Carrier Frequency
y* which is typically lower (2,000-10,000Hz) and Higher frequency
�2 Frequencies will
Interferential
What is biphasic used for?
Muscle strengthening and spasm