Acute musculoskeletal trauma or post surgical swelling and pain and key to cryotherapy. What
are other indications? - ANS-Pain management
Muscle spasms
Myofascial pain syndrome
DOMS
After cold treatment, what things may be negatively affected? - ANS-Muscle performance and
proprioception
An increase in viscosity of blood with lower temperatures results in what? - ANS-Decreased
blood flow
Before heat application we should inspect skin integrity for what qualities? - ANS-Skin
infections, rashes, open wounds
Over burn victim scar areas (okay with incisional scars)
Moderate to severe PVD
Recent applied liniments or sport rubs
Beside the gate control theory, how else do we get pain reduction by means of consensual
heating? - ANS-Alteration of sensory nerve conduction velocity
Can commercial cold pack's be directly placed on skin?? - ANS-NO!
Capillary permeability has shown to increase with heat application leading to what? - ANS-Fluid
shift to extravascular space causing mild inflammatory reactions
Cold may result in a reflex decrease in gamma-motoneuron activity through what process? -
ANS-Stimulation of cutaneous afferents and a decrease in muscle spindle discharge
,Cuteanous vasodilation is most common with what types of heat? - ANS-Moist hot pack
Describe A-delta pain fibers - ANS-Respond to high intensity mechanical stimuli and thermal
stimuli to locate stimuli and have withdraw response
Sensation is sharp, stabbing, prickling
Describe acute pain - ANS-Results from tissue damage or disease, such as infection, trauma,
metabolic disorder or degenerative disease
Describe the A-delta and C-fiber synapses and pathway - ANS-Synapse in dorsal horn of spinal
cord with 2nd order neuron
Describe the cervical traction set-up (10 steps) - ANS-Position traction table at appropriate
height and mount
Assist patient onto table and heat fitting device
Tight traction cradle to fit snug on patient's occiput
Position LE in neutral alignment on pillow
Place support under arms
Explain "stop treatment" and call button options
Emphasize feeling of no pain
After treatment allow slack in cable and slowly release traction cradle from occiput
Request patient lie flat for 4-5 min
If patient has dizziness request them to lie longer
Describe the final stage of maturation of tissue healing? - ANS-Collagen remodeling, as type 1
collagen replaces type 3.
Increase in tissue strength as tissue is sturdy and requires gradual increase in mechanical
stress for collagen alignment
Describe the gate control theory - ANS-Used to explain pain inhibition.
Stimulation of large-diameter A-beta afferent fibers activate local inhibitory circuits in the dorsal
horn of SC and prevent nociceptive input from reaching the higher brain centers.
,Describe the Immersion Bath Method? - ANS-Instruct patient to not touch bottom of sides of
bath
Immerse affected area and hold position
Treatment duration is 15-20 min
Post treatment, remove
Inspect patient's skin for tissue warmth and redness
Return used paraffin to paraffin bath
Describe the Lumbar traction dosage. - ANS-Poundage between 1/3 to 1/2 pts body weight
Static: HNP/Muscle spasm
(5-8 min)
Intermittent: Stenosis/DDD/Face joint hypomobility
(10-20 min with on-off times)
Describe the lumbar traction set up (11 steps) - ANS-Table at appropriate height
Assist patient by aligning PSIS immediately below separation
Position lumbar harness utilizing bony landmarks for appropriate pull
Position trunk harness utilizing bony landmarks
Position LE in neutral with pillow/bolster and hook harness to traction machine
Place support for head
Explain ":call button" "stop treatment effects"
Emphasize patient should feel no pain
Allow slack after treatment to unhook harness
Pt lie flat for 4-5 min
Inquire pt dizziness and may require more post-treatment rest
, Describe the pain C-fibers - ANS-Unmyelinated and conduct more slowly, responding to variety
of stimuli
Describe the parameters for C1-C2 distraction - ANS-0-5 degrees
10 lb. intensity
Describe the parameters for C3-C4 distraction - ANS-10-20 degrees
10-15 lb intensity
Describe the parameters for C5-C7 distraction - ANS-25-30 degrees
14-40 lbs of traction
Describe the process for our practical for cervical traction application - ANS-Select
static/intermittent
Select duration
Select poundage
Position in cervical flexion parameter
Chekc pulley's and rope
Rope and plunger in extended position
connect rope to Saunder's unit
Place towel roll over metal piece of cervical unit pad
Instruct removal of jewelry
Guide patient's head into unit
Position appropriately in cervical tracition unit with towel over forehead for hygiene
Fasten velco strap of forehead unit
Hand patient stop treatment switch and review instructions
Reaffirm call bell in reach
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