injury response
primary: direct trauma and tissue destruction
secondary: from ischemia and causes swelling/capillary rupture
what are modalities
interventions used to assist the body in healing
what frequency range is used for deep tissue heating
1-3 MHz
what are the methods of heat transfer
bonus points to describe or give an example of each one
conduction: direct contact (hot to cold) ex: heat/ice pack
convection: movement of gas and fluid ex: whirlpool
conversion: other energy to heat ex: ultrasound
radiation: heat transfer to space ex: hand over fire
evaporation: liquid to gas (uses body heat) ex: coolant spray
difference between pain and nociception
pain: unpleasant sensory and emotional experience associated with possible tissue damage
nociception: neural process detecting the pain
what are the goals and timeframe of each phase
inflammatory: immediate-day 4, goals: protect, localize, eliminate damaged tissue
proliferation: day 4- week 6, goals: RRR
maturation: week 6- 2+ yrs, goals: strengthen, remodel tissue
what are the types of modalities
thermal (heat and cold)
mechanical (ultrasound)
exercise (rehab)
invasive (surgery)
what is ultrasound used for
what does CBAN stand for
cold, burning, aching, numbness
what are the first-order afferent neurons (in order)
A-alpha fiber, A-Beta fiber, A-delta fiber, C fiber
what is the difference between swelling and edema
swelling: observable increase in tissue volume
edema: fluid accumulation in interstitial space
wolffs law: bone and tissue adapt to stress
PST: adapts to the level of physical stress
true or false: >100% is a continuous (thermal) duty cycle
False! >100% is pulsed (non-thermal)
cold effect: decrease metabolism and decrease damage
heat: increase metabolism, increase inflammation
what are the facilitators and inhibitors
facilitators: serotonin
inhibitors: serotonin, norepinephrine, enkephalin
what is the vascular reaction
vasoconstriction - vasodilation - exudate/stasis
What type of modality do we tend to use in each phase
inflammatory: cold
proliferation: heat, stim, ultrasound, traction
maturation: exercise, traction, strength--anything to help
what are the effects of thermal (continuous) US
increase blood flow, cell metabolism and elasticity
good for chronic conditions
what does cold and heat do during the inflammtory phase
cold: suppresses mediators
heat: enhances healing and mediator delivery
difference between pain tolerance and pain threshold
tolerance: maximum level of pain a person can handle
threshold: minimum stimulus for pain recognition
what are the key cellular mediators in injury response and what do they do
histamines: triggers inflammation, vasodilation and increase capillary permeability
leukotrienes: margination and permeability
cytokines: macrophage activation and immune regulation
what are the modality goals for each healing phase (why do we use said modality in the phase)
inflammatory: decrease swelling/pain, promote non-thermal healing
proliferation: increase circulation, assist in lymphatic flow
maturation: increase ROM and circulation (sometimes strength)
what are non-thermal (pulsed) US effects
cavitation: stable bubbling
miscrosteaming: fluid movements (increases membrane permeability)
thermal energy effects on tissue
cold: decrease metabolism, decrease blood flow, good for acute
heat: increase metabolism, increae blood flow, good for chronic
What are the theories of pain control
gate control theory, central biasing, and endogenous opioids