2022 NEW EXAM REVIEW FOR NPTE THERAPEUTIC MODALITIES & NON-
SYSTEMS
Which of the following is NOT a goal or indication for the use of therapeutic ultrasound?
a. increase connective tissue extensibility
b. reduce or eliminate soft tissue inflammation
c. increase healing rate of tissue over recent joint replacement
d. reduce muscle spasm - CORRECT ANSWER c (increase healing rate of tissue over recent
joint replacement)
Which of the following is NOT a precaution for the use of therapeutic ultrasound?
a. acute inflammation
b. over breast implants
c. over a healing fracture
d. over closed epiphyseal plates - CORRECT ANSWER d (over closed epiphyseal plates = fully
matured adult bones, no problemo
over OPEN epiphyseal plates [aka in a growing adolescent] = CONTRAINDICATION)
A PT is putting on an educational workshop about the proper utilization of low-dose ultrasound
in clinical practice. Which of the following conditions is low-dose US considered
contraindicated?
A. Over the distal femur in a 16 y/o with quadricep tendonitis
B. Over the site of a healing proximal humedal Fx in a 34 y/o F
C. Over the lower back in a 31 y/o F who is 2 weeks postpartum
D. Over the hip in a 60 y/o F who had a THA using methyl-methacrylate - CORRECT ANSWER
D (Low dose US = 0.5 W/cm^2 intensity; shouldn't use any type US with plastic THA or THA
with acrylic adhesive that can rapidly heat and lose its properties leading to instability in the
THA)
,(Continuous/Pulsed) ultrasound is applied when NON-THERMAL effects are desired. A duty
cycle of ________ is normal with this type of US. - CORRECT ANSWER pulsed, 2-50%
(Continuous/Pulsed) ultrasound is applied when thermal effects are desired. A duty cycle of
_______ is normal with this type of US. - CORRECT ANSWER continuous, 100%
ULTRASOUND:
___ MHz = *greater heat production* in *superficial* layers
- Used for tissues ______ cm deep
- _____ W/cm^2 intensity for thermal effects - CORRECT ANSWER 3, 1-2.5 (cm), 0.5-1.0
(intensity)
ULTRASOUND:
___ MHz = *greater heat production* in *deeper* layers
- Used for tissues up to ______ cm deep
- _____ W/cm^2 intensity for thermal effects - CORRECT ANSWER 1, 6 (cm), 1.5-2.0 (intensity)
__________________ is the use of *ultrasound* (US) to drive medications through the skin into
the deeper tissues. Local analgesics (lidocaine) and anti-inflammatory drugs (dexamethasone,
salicylates) often used - CORRECT ANSWER phonophoresis
(Application method:
Mode = pulsed 20%
Tx time = 5-10 min
Intensity = 0.5-0.75 w/cm^2
gel medium or transdermal patch [don't use pastes/creams]
, Goals/indications: modulate pain, decrease inflammation in subacute and chronic MSK
conditions)
the change in electrical potential associated with the passage of an impulse along the
membrane of a muscle cell or nerve cell
- the way neurons communicate with each other
- efficiently conveys info over long distance
- also called: spike, nerve impulse, discharge
- *all or nothing phenomenon*
- typical length: ~ 2 millisec - CORRECT ANSWER AP (action potential)
The *action potential* (AP) is generated at the axon __________, where the density of voltage-
gated Na+ channels is greatest. The AP begins when signals from the dendrites and cell body
reach this area and cause the membrane potential there to become more (negative/positive), in
a process called _________ - CORRECT ANSWER hillock, positive, depolarization
______ mV is the threshold for activation of an action potential (AP); anything below (more
negative) than this value with fail to generate an AP - CORRECT ANSWER -55 (mV)
(Point at which enough Na+ channels open to change the net current flow from outward [mostly
K+, Cl-] to inward [Na+])
When a neuron is resting it is said to be ____________.
If membrane potential moves more *towards zero* it is ______________
if membrane potential moves *more negative* it is ______________ - CORRECT ANSWER
polarized, depolarized (inward current of Na+), hyperpolarized (outward current of K+)
SYSTEMS
Which of the following is NOT a goal or indication for the use of therapeutic ultrasound?
a. increase connective tissue extensibility
b. reduce or eliminate soft tissue inflammation
c. increase healing rate of tissue over recent joint replacement
d. reduce muscle spasm - CORRECT ANSWER c (increase healing rate of tissue over recent
joint replacement)
Which of the following is NOT a precaution for the use of therapeutic ultrasound?
a. acute inflammation
b. over breast implants
c. over a healing fracture
d. over closed epiphyseal plates - CORRECT ANSWER d (over closed epiphyseal plates = fully
matured adult bones, no problemo
over OPEN epiphyseal plates [aka in a growing adolescent] = CONTRAINDICATION)
A PT is putting on an educational workshop about the proper utilization of low-dose ultrasound
in clinical practice. Which of the following conditions is low-dose US considered
contraindicated?
A. Over the distal femur in a 16 y/o with quadricep tendonitis
B. Over the site of a healing proximal humedal Fx in a 34 y/o F
C. Over the lower back in a 31 y/o F who is 2 weeks postpartum
D. Over the hip in a 60 y/o F who had a THA using methyl-methacrylate - CORRECT ANSWER
D (Low dose US = 0.5 W/cm^2 intensity; shouldn't use any type US with plastic THA or THA
with acrylic adhesive that can rapidly heat and lose its properties leading to instability in the
THA)
,(Continuous/Pulsed) ultrasound is applied when NON-THERMAL effects are desired. A duty
cycle of ________ is normal with this type of US. - CORRECT ANSWER pulsed, 2-50%
(Continuous/Pulsed) ultrasound is applied when thermal effects are desired. A duty cycle of
_______ is normal with this type of US. - CORRECT ANSWER continuous, 100%
ULTRASOUND:
___ MHz = *greater heat production* in *superficial* layers
- Used for tissues ______ cm deep
- _____ W/cm^2 intensity for thermal effects - CORRECT ANSWER 3, 1-2.5 (cm), 0.5-1.0
(intensity)
ULTRASOUND:
___ MHz = *greater heat production* in *deeper* layers
- Used for tissues up to ______ cm deep
- _____ W/cm^2 intensity for thermal effects - CORRECT ANSWER 1, 6 (cm), 1.5-2.0 (intensity)
__________________ is the use of *ultrasound* (US) to drive medications through the skin into
the deeper tissues. Local analgesics (lidocaine) and anti-inflammatory drugs (dexamethasone,
salicylates) often used - CORRECT ANSWER phonophoresis
(Application method:
Mode = pulsed 20%
Tx time = 5-10 min
Intensity = 0.5-0.75 w/cm^2
gel medium or transdermal patch [don't use pastes/creams]
, Goals/indications: modulate pain, decrease inflammation in subacute and chronic MSK
conditions)
the change in electrical potential associated with the passage of an impulse along the
membrane of a muscle cell or nerve cell
- the way neurons communicate with each other
- efficiently conveys info over long distance
- also called: spike, nerve impulse, discharge
- *all or nothing phenomenon*
- typical length: ~ 2 millisec - CORRECT ANSWER AP (action potential)
The *action potential* (AP) is generated at the axon __________, where the density of voltage-
gated Na+ channels is greatest. The AP begins when signals from the dendrites and cell body
reach this area and cause the membrane potential there to become more (negative/positive), in
a process called _________ - CORRECT ANSWER hillock, positive, depolarization
______ mV is the threshold for activation of an action potential (AP); anything below (more
negative) than this value with fail to generate an AP - CORRECT ANSWER -55 (mV)
(Point at which enough Na+ channels open to change the net current flow from outward [mostly
K+, Cl-] to inward [Na+])
When a neuron is resting it is said to be ____________.
If membrane potential moves more *towards zero* it is ______________
if membrane potential moves *more negative* it is ______________ - CORRECT ANSWER
polarized, depolarized (inward current of Na+), hyperpolarized (outward current of K+)
