Passive Rehab Final

The purpose of an infrared lamp that emits energy at frequencies between 700 and 50,000 nanometers is to provide _____________?

Topical heating

Luminous infrared lamps are often known by what AKA

Baker's Lamp

True / False: Non-luminous infrared lamps feel warmer than luminous?

True

Electric heating pads, hydrocollator, paraffin, fluidotherapy, whirlpools and contrast baths are all types of FAR infrared, what 2 types of near infrared did we study?

Luminous and non-luminous IR lamps

In terms of Infrared Radiation physics which law states that "what is not absorbed, goes deeper?

Grotthus Draper Law

In terms of Infrared Radiation physics which law states that triggering a response is an "all or none" proposition?

Arndt Shultz Principle

What is the reddened skin response to an overexposure to infrared?

Erythema ab igne

In terms of Infrared Radiation physics which law states that the most energy will be transmitted when the source is perpendicular, i.e. Riddle calls it the "suntan rule"?

Cosine Law

In terms of Infrared Radiation physics which law stipulates that intensity increases as you decrease distance of the skin to the energy source?

Inverse Square Law

To reduce the intensity of Infrared, the Cosine Law says you should ___________ the angle at which the radiation strikes the treatment area?

Increase

To reduce the intensity of Infrared, the Inverse Square Law says you should increase the ___________ of the source to the skin surface?

Distance

With infrared we expect the heat effects of vasodilation, sweating, muscle relaxation, increased metabolic activity, etc but we have to watch for what detractor?

Dehydration

Protective equipment needed for Infrared use includes: goggles, dry towels for non treatment area and moist towels for treatment area plus (1)?

Ground fault interrupter

Which type of infrared lamp is more common?

Non-luminous

Which type of infrared lamp uses incandescent light and provides better penetration?

Luminous

Prototypical contraindications (HIMS and DEAD A) apply for Infrared treatments plus new scar tissue, rashes plus (2) more?

Systemic lupus and coronary artery disease

Infrared is a good treatment protocol in the case of sprains, strains, backache, bursitis, seeping wounds, Raynaud's, neuritis, sinusitis and what other common skin condition?

Furuncles / folliculitis

There are 3 basic rules for infrared application (D, BP, 3-5) which include making sure skin is dry and checking area every 3-5 min during treatment, what is the 3rd?

Drape or pad bony prominences

Infrared treatments are specifically oriented toward THERMAL change while UV treatments are oriented toward __________ change?

Chemical (mutagenic)

The 2 disadvantages to Infrared that we discussed were that it's hard to focus the ray and?

Drying effect can impede healing

There are 3 ranges of UV rays: UVA at 3200-4000A causes no effect, UVB at 2900-3200A causes a sunburn and UVC causes what type of effect?

Germicidal

Ultraviolet therapies are also called ______________ because of the photochemical and slight thermal effect?

Actinic

In terms of UV wavelengths SHORTER penetrates FURTHER but depends on two factors which are?

Melanin, thickness of epidermis

UV treatment goals can include redness (erythema) within 12 hours of treatment, pigmentation change plus (1)?

Destruction of bacteria in wounds

The metabolic effects of Ultraviolet (UV) therapy include increased metabolism, increased reticulocytosis and (2) more?

Vit D synthesis, release of vasodilators

UVA rays are melanogenic and cause a histamine response, UVB rays are erythemagenic and cause a burn while UVC rays are ______, germicidal and bactericidal?

Cold

UV applications are indicated for folliculitis (like IR), pityriasis rosea, osteomalacia, herpes zoster, fungal infectionas, decubitus ulcers and what common child condition?

Impetigo

Prototypical contraindications (HIMS and DEAD A) apply for therapeutic UV treatments plus ACUTE psoriasis, sarcoidosis, lupus, herpes simplex, CAD plus (3)?

Diabetes, photosensitive drugs, pellagra

What is the name of the skin test to determine the Minimal Effective Dose (MED) of Ultraviolet?

Sleeve / patch test

The Sleeve or Patch test tests for?

UV tolerance

In the Sleeve or Patch test, the MED is defined as?

First exposure with slight reddening

With ultraviolet therapy technician starts at the MED, increases dosage by 15 seconds each time but never exceeds ____ minutes?

Three

Factors affecting MED include the angle of the application (which is ____________) intensity of lamp, distance from lamp, duration of exposure and melanin content of skin?

Cosine Law

What is the clinical definition of suberythemal dosage (SED)?

No reddening at 24 hours

A 2nd degree UV burn or "common sunburn" involves redness and slight peeling persisting ____________ hours?

48-72

A 3rd degree UV burn involves considerable reddening, itching, peeling, blisters all of which persist past ______ hours?

72

Process by which a person becomes overly sensitive to UV as a result of excitation by other chemical or UV exposures?

Photosensitization

Eye inflammation due to UV exposure usually within 6-12 hours after treatment, feels like foreign body in eye with redness and exudate, "snow blindness"?

Photokeratitis

UVA rays are absorbed in the lens of the eye and can cause?

Cataracts

UVB and UVC rays are absorbed in what structure of the eye?

Cornea

In terms of different types of UV lamps, there are carbon arc, xenon arc and fluorescent "black lamps" but the most common type is what?

Mercury arc

The "Kromayer lamp" used for sleeve testing is a __________ / ____________ mercury arc lamp?

High pressure "hot quartz

With a "hot quartz" lamp pre-warm it for 5 minutes, hold it 30" from skin and if patient misses a treatment you should?

Reduce treatment time or start over at MED

The "hot quartz" lamp emits what UV rays?

UVA and UVB

The "cold quartz" lamp emits what UV rays?

UVC

The "cold quartz" lamp is mainly for ___________ and you hold it 1" off skin and increase treatment times by 1second increments?

Open wounds

Special "black light" for detecting diseases and conditions of the skin, especially fungus and bacteria but also ethylene glycol poisoning?

Woods' lamp

LASER is an acronym that stands for?

Light Amplification by Stimulated Emission of Radiation

Crystal lasers have a synthetic _______ that produces laser light?

Ruby

Gas lasers use a blend of?

Helium and neon (HeNe)

High powered lasers allow for shorter treatment times and (1)?

Enhanced depth of penetration

What class of lasers are rapidly becoming the standard in the rehab field?

Class 3B

The FDA has cleared LLLT for treatment of minor muscle and joint aches, spasms, arthritis and (1)?

Increase of circulation

Most therapeutic lasers operate in what light spectrum?

Infrared

What wavelengths are usually used in LLLT (visible is 600-700 nm)?

600-1000 nm

We don't use Lasers with photosensitivities, directly over thyroid or fetus or uterus during pregnancy, or (plus 2)?

Cancer or directly in eyes

Cut dosage on a Low Level (Cold) Laser when treating over dark tattoo or over dark pigmented skin by what %?

50-75

What is the unit of measurement for the intensity of the laser light energy over the treatment area?

Joules/cm2

Current maximum daily dose of Low Level Laser therapy is?

100 mW/cm2

What is the primary mechanism of change with vibration tools?

Kinetic

What treatment modality is helpful for the following: trigger points, adhesions, muscle spasm, fibromyalgia, stasis, sinus congestion, sciatica, edema and depression?

Vibration

Vibration therapies are contraindicated for persons with TB, cervical spondylosis, thrombophlebitis, anxiety states, pneumothorax, acute LBP, acute inflammation and (3 more)?

Malignancy, advanced heart disease and hemorrhage

High velocity vibration has analgesic effects, will relax spasticity, decrease trigger points, good for pre exercise warming up and superficial circulatory stimulation - what Hz?

30-50

Low velocity vibration is good for chest congestion, edema, drainage, hyperesthesia and stasis and operates at less than 5 hz, what negative effect can be associated with?

Ligamentous creep

If using vibration therapy for a general body massage how much time is recommended for treatment?

3-5 min

If using vibration therapy for trigger points how much time is recommended?

6-8 min

If patient complains of persistent ITCHING (vasomotor response) during a vibration treatment what should you do?

Stop

With a vibration tool where would you contact to increase the parasympathetic Vagus reponses such as increased peristalsis, increased mucosal secretions etc?

C1-C2

With a vibration tool where would you contact to increase the depth of diaphragmatic excursion?

C3

With a vibration tool where would you contact to relax the stomach, inhibit the heart?

T1-T3

With a vibration tool where would you contact to cause pyloric and duodenal dilation (when done on the right)?

T5

With a vibration tool where would you contact to increase PANCREATIC secretions and relax the intestines/colon?

T10-T11

With a vibration tool where would you contact to stimulate the uterus, round ligament and/or bladder?

L1-2-3

Absolute contraindications to massage are: Surgery, mono, ringworms, flu, HTN, hepatitis (very communicable), gout, german measles and (plus 4)?

Fever, diarrhea, chicken pox, shingles

A local contraindication to massage means it's ok to massage just stay away from these areas: blisters, bruises, decubitus ulcers, carpal tunnel, colitis, Crohns plus (3)?

Acne, acute inflammation, any vascular problems

Type of massage: superficial stroking to the heart?

Effleurage

Type of massage: deep kneading, grasping, wringing?

Petrissage

Type of massage: tapping or hacking with ulnar borders of hands?

Tapotement

Pressing deeply in a part and moving the hand in a circular direction across the muscle fiber?

Transverse or cross friction massage

AKA for trigger points?

Myofascial pain syndrome

Type of trigger point that does not yet refer pain actively, but may when pressure or strain is applied; can influence muscle activation patterns.

Latent

Trigger points can develop due to a deficiency of which essential vitamin?

B-6

Treatments for trigger points may include: LLLT, reciprocal inhibition stretching, injection with Novocain or Botox, electric stim, pulsed ultrasound and the most common 2?

Massage or tapotment, vibration

Trigger points can be causually linked to: bad posture, bad mechanics, repetitive motion or (plus 2)?

Structural (limb length difference) or nutritional deficiency

Common causes of trigger points in the glutes include: Prolonged standing, uphill walking, side sleeping and acute overload plus (1)?

Sitting on wallet

Common cause of trigger points in the occipitals is whiplash, reading, watching TV on couch and (2 paired neck movements)?

Prolonged flexion and excessive extension

Movement based muscle lengthening technique that removes and breaks up adhesions, most popular form is ART?

Dynamic pin and stretch

Goal of ART is to __________ and improve ___________ of painful tissues related to activity intolerance or mechanical sensitivities?

Unload, gliding

Manipulation of soft tissue and fascia in a cause and effect pattern to produce balance, and regain structural alignment to area of dysfunction?

Rolfing

AKA for trigger point therapy or receptor-tonus technique, named for doctor that developed in the 1950s?

Nimmo

The application of a force or a system of forces to the spine that separates or attempts to separate the vertebra and elongate the surrounding tissue?

Traction

The goals of traction are to: Decompress, Mobilize, reduce inflammation and _____________ circulation?

Increase

Decompression and traction treatments are good for DJD, subacute pain, hyperlordosis and (main 3)?

Nerve root impingement, joint hypomobility, healed compression fx

Decompression and traction treatments are contraindicated in the event of pregnancy, hiatal hernia, peptic ulcer, aortic aneursym, acute sprains, unstable fractures and (plus 2)?

Diabetes mellitus, structural disease w/ RA, osteoporosis, infection

True / False: Centralization of the pain after a trial of manual traction is an indicator of favorable outcomes?

True

If you pull too hard in traction, you'll invoke?

Myotatic stretch reflex

Continuous spinal traction is a light weight for prolonged periods of time, ineffective at producing separation but aligns and stabilizations with fracture or dislocation; name one?

Halo device

What type of spinal traction is helpful in early phases of traction when there is muscle guarding?

Sustained

Type of traction that alternates applies traction force and releases, good for imbibing or pumping the disc?

Intermittent

Contraindications to inversion tables include: Coronary artery disease (CAD), history of aneurysm, pregnancy and 2 more?

Cataracts, glaucoma

Intersegmental traction is more correctly called a passive modality but its primary benefit is?

Relaxation

In terms of LUMBAR traction, begin with ____ of patients body weight and increase _____ each treatment; max force is 150 pounds or patient tolerance?

25%, 5 lbs

The table used for lumbar traction does not do any work per se, for traction of LOWER LUMBARS what angle of pull?

30-50 degrees

For traction of patient with LUMBAR HYPERLORDOSIS what angle of pull?

30-50 degrees

Lumbar traction is typically applied in sessions of ___ minutes?

20

First lumbar traction of a herniated disc should only be about __________ minutes; never exceed 20 with this type patient?

3-5

Treatment frequency for BOTH cervical and lumbar traction patients is?

Daily for 3 days, then 3x week for 2-3 weeks

In terms of CERVICAL traction, begin with ____ of patients body weight and increase _____ each treatment; max force is 50 pounds or patient tolerance?

5%, 2 lbs

For UPPER CERVICAL traction of patient, what angle of pull?

0-15 degrees

For MIDDLE CERVICAL traction, what angle of pull?

10-20 degrees

For cervical traction the harness is placed where?

Under occipital ridge

Devices that support or correct musculoskeletal deformities or abnormalities of the human body?

Orthoses

Spinal orthotics may be appropriate in the event of joint instability, DJD, postural backache, scoliosis, compression fractures and (2 more)?

Hyperkyphosis or hyperlordosis

Type of brace that prevents spinal flexion?

Jewett

Type of brace one wears post spinal fusion surgery?

Knight Taylor

Type of brace for scoliosis?

Milwaukee

Brace that extends from the neck to the pelvis, consisting of plastic pelvic girdle and neck ring connected by metal bards in the front and back of the brace?

Milwaukee

Plastic form fitting brace for thoracic scoliosis?

Boston

Type of brace that limits lateral flexion and rotation, similar to corset?

Chairback

Type of support that limits SI ROM, used for piriformis syndrome and LBP?

Trochanteric belt

Brace used often with carpal tunnel?

Cock up splint

Brace used often with inverse ankle sprains?

Louisiana (figure 8)

De-rotational brace used often with ACL and PCL stability needs?

Lennox Hill

CASTING for foot orthotics is done in ____________ position and is ____ weightbearing?

Neutral, non

FOOT IMPRESSIONS are done standing and semi weightbearing based on MASS (maximum arch subtalar supination); this model of correction has a goal of?

Restoring optimal arch height

What type of orthotics are used to control foot drop?

Rigid

What type of orthotics are most often used for diabetics?

Soft

What types of orthotics are most often used to treat athletes?

Semi-rigid

Type of orthotic that calculates in the individuals weight, foot flexibility and activity level to deliver a custom level of support with functional control?

Calibrated