Heat internal vibration of molecules within the body
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Heat-internal vibration of molecules within the body. Conduction-heat lost or gained by direct contact Convection-movement through air or H2O tranfers heat to our body Radiation-transfer of heat from warmer source to cooler one Evaporation-transfer from liquid to gas state

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Heat-internal vibration of molecules within the body

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Heat-internal vibration of molecules within the body

  • Conduction-heat lost or gained by direct contact

  • Convection-movement through air or H2O tranfers heat to our body

  • Radiation-transfer of heat from warmer source to cooler one

  • Evaporation-transfer from liquid to gas state

  • Superficial heat-HP,W/P paraffin

  • Deep heat-diathermy, ultra sound


  • Thermotherapy-heat modalities, used when goal is to increase temperature

  • Cryotherapy-cold modalities

  • Hydrotherapy-H2O is used as medium to increase or decrease tissue temp.

  • Heat:

    • produces analgesic affect

    • promotes ms. Relaxation

    • increases elasticity

    • decreases viscocity of C.T.

    • Increases local metabolism of A’s and caps

    • inc. blood flow to body part treated, inc. edema

    • inc. Leukocytes and phagocytosis


  • Examples of superficial heat<1cm.

  • Hot packs

    • moist heat-stored in hydrocollator units -165 F

    • 6-8 layers for insulation

    • towel for perspiration

    • consider body part treated, position of pt., weight of HP

    • Cervical, lumbar, small and large

    • describe to pt. what to expect

  • Paraffin

    • 1 cm. Mineral oil and wax (5# wax/1 part oil) temp. 125 F,retains perspiration and softens skin


  • Good for distal parts of extremities

  • Methods

    • Glove-dip 8-10 times, bag, towel, elevate, treatment time 20 min. return wax to unit

    • Immersion-dip once to coat, then immerse remainder of time, temp. Increase is greater than glove-edema may result

    • Advantages

      • Conforms to body part treated

    • Disadvantages

      • can’t use with open wound

    • Fluidotherapy

      • dry, warm air is circulated

      • can use with splints,other things to enhance tx.


  • Contraindications for heat

    • acute inflammation,fever, malignancies, acute hemorrhage, PVD, overradiated pt, cardiac insufficiency, unexplained pain, acute infection coma, int bleed; precautions-impaired circulation, pregnancy, older adults and children<4 yo

    • Precautions: previous existing edema, sensory loss, confused patients


  • Cryotherapy-use of cold-goal it to decrease tiss temp, it dec metabolism, causes vasocon, dec bl flow, nerve ms excitability, ms spindle activity, edema and promotes analgesia

  • Ice-silica gel in frig, cold W/P, ice w/p, massage, cold spray, contrast baths, normal cold progression-cold, stinging, burning, numbness

    Indications-spasticity, acute inf, ms spasm, edema


Contraindications

  • Raynaud’s disease, cardiac dysfunction open wounds after 48-72 hours, arterial insufficiency, cold urticaria


Contrast Baths

-two containers with warm/cool water

-warm 80-104 degrees F

-cool 55-67

-Immerse in warm 3-4 min, then cool 1 min.

-Repeat 5-6 times

-Always finish with warm

-used for chronic edema, infl. conditions, hypersensitization


  • Hydrotherapy-Archimedes principle-an immersed object exerts an upward thrust = wt. Of H2O displaced (buoyancy)

  • viscocity-resistance to flow

  • W/P source of moist heat

  • hydrostatic pressure-exerted agst skin

  • Pascal’s law- fluid exerts = pressure on all surfaces of a body at rest which increases in proportion to depth


Whirlpool

  • Conduction and convection

  • Get inc rate of lymph flow, local met inc., perspiration inc, debridement, vasodiation, ms relax, inc cell perm and assist or resis with ROM

  • Increases hydrostatic pressure which may increase lymph circulation

  • Graded exercise (with or against turbulence

  • Debrides necrotic tissue therefore decreasing bacterial load


Indications

Stage III and IV wounds

Subacute and chronic inflammatory conditions

Early PVD

Peripheral nerve injuried

Muscle weakness


Contraindications

  • Same as those for heat

  • Venous ulcers


Very hot-104-110

Hot-99-104

Mild Warm-96-98

Neutral-92-96

Tepid-79-92

Cold-32-79

Soft tissue extens, chronic

Pain

Burn patients

Open wounds, circ, sensory, cardiac disorder, decrease tone

Exercise, acute inflam (if not able to tol cold)

Acute inflammation

Temperatures


Aquatic therapy

  • Same principles apply

  • Water temp-79-97 degrees F

    • 93-97 for light exercise by elderly deconditoned

    • 79-83 for more intense exercise and recreational pools

    • Should not go below 65 F (may impair ms. contract)

  • % of WB with depth immersion:

    • C7-8%

    • Xiphoid-28%

    • ASIS-47%


Advantages

  • Ease of movement, weightlessness

  • Progressive WB

  • Can facilitate, support or resist mvmt

  • Ease of pt handling

  • Total body mvmt

  • Easy to progress program

  • Can perform many types of exercise


Laws for dosage of EM radiation

  • Cosine law-absorption of ray is optimal when it strikes the surface at the perpendicular

  • Inverse square law-Intensity of radiation at any distance is inversely proportional to the square of the distance b/w the sure face and the source of radiation

  • Arndt-Schultz law-a certain minimum stimulus is needed to initiate a biological process


Diathermy

  • To heat through (3-5 cm.)

  • Converts hi fx electromag E to heat in tissues

  • Frequency 27.12 MHz

  • Contraindications

    • General for heat

    • Pacemakers

    • Metal implants

    • Epiphyses

    • Eyes, testes, malignancy, pregnancy


Disadvantages

  • Pool cost/ maintenance and upkeep

  • Time in commuting/changing

  • Limited carryover

  • Additional risk


Precautions

  • Bowel/bladder incontinence

  • Open wounds

  • Infectious disease

  • Seizures

  • Tracheotomy tubes

  • Severe cardiovascular disease

  • Orthopedic instability


  • Induction field-places pt in the EM field produced by the equipment ; current is induced in conductive tissues-heats superficial ms., heat is produced in deeper ms. from overlying ms. (drums or induction coil)

  • Condensor field (capacitance)- pt. is placed b/w 2 e’s in the electrical circuit (air spaced plates)


Radiant Heat

  • Infrared and ultraviolet

  • Infrared-form of radiant heat which emits infrared waves (outside visible spectrum)

  • 2 types-

  • Luminous-emits short infrared waves

  • Non-luminous-emits long infrared waves

  • Indications-seeping wounds,chronic conditions

  • Contra-same for heat


Ultraviolet

  • Causes a chemical change in tissues

  • Both UV and infrared possess these characteristics

  • Direction of travel is in straight line that can be reflected, refracted, absorbed or passed through depending on the medium they strike


  • Light is characterized by:

  • Wavelength-measured in nanometers

  • Visible-b/w 400-800 nm

  • UV light-180-400

  • Infrared-800-1500

  • Frequency-# of oscillations or vibrations in 1 second-expressed in hertz

  • The higher the frequency, the shorter the wavelength


  • UVA-320-400 nm.-penetrates furthest (into dermis)

  • UVB-290-320-psoriasis

  • UVC-<290, cold quartz-operates at low temps. Used to promote bacteriocidal effects, wound debridement, tissue regeneration

  • UV is used to promote erythemal response w/in 12 hours of exposure-causes chemical reaction that impacts on the immune system


  • Indications

  • -pressure sores, acne, wound care, psoriasis, to decrease bacteria in pressure sores (especially after pulsed lavage)

  • Contraindications

  • -photosensitivity, cancer, systemic lupus errythmatosis, cardiac, kidney or liver disease active TB, fever, acute diabetes, drugs, direct eye contact


Precautions

  • Photosensitivity as a result of drugs

  • Drugs such as gold salts, psoralens, tetracyclines

  • Syphilis

  • Alcohol

  • Elevated levels of estrogen

  • Foods such as shellfish, strawberries


  • Must establish MED-exposure time necessary to produce mild erythemal dose-lasts to 48 hours

  • SED-no erythema

  • MED-smallest dose producing erythema

  • Appears 1-6 hrs, fades in 24


Technique

  • Goggles

  • Place body part perpedicular

  • Protect skin not treated

  • Use same lamp

  • Cover genitals, nipples

  • Place lamp 24-36 inches away

  • Use test strip to test-uncover each hole so 1st hole will have greatest exposure


Procedure

  • Cut six holes with different shapes

  • Use skin not exposed to uv light

  • Remove clothing, jewelry, wash area

  • Attach MED strip and cover with towel

  • Position lamp perpend to treated surface

  • 30 sec hole 1,2. 15 sec. 3-6


  • Instruct pt. to check arm in bright area every 2 hrs. and document which symbols appear and fade

  • Dosage time should be increased by 25% next treatment as long as effects of previous dose have disappeared


Lasers

  • EM E within visible spectrum

  • Low level laser therapy

  • Used for tissue healing and pain management

  • Contraindicated for pregnant women, unclosed fontanelles of children, cancerous lesions, cornea, endocrine glands and hemorrhaging lesions


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