Electro physical agents

Structure and Properties of Matter

Matter means material such as Pen, Rod,ect. Material or matter is made up of atoms. ATOM: Atom is defined as the smallest indivisible part of matter.

Structure of atom
The Atom can be described having a central nucleus surrounded by cloud of electrons revolving in definite orbits. The Nucleus: This is the central part of the atom, the two most important particles are the proton and the neutron. Proton: it is positive charged particle present in the nucleus, because of this the charge of nucleus is positive.

Structure of atom

Structure of atom
Neutron it is neutrally charged particle present in the nucleus. Electron negative charged particles revolving in orbits around the nucleus. In neutral atom their number is equal to number of protons.

Formation of Compounds
A Compound is a substance formed by the union of two or more elements. Atoms combine to form molecule. Molecules combine to form elements. Elements combine to form compounds. Example: Sodium chloride (Common Salt)

Electro Magnetic Radiation

- when ever any object is heated the electrons from lower orbit takes up energy and goes to higher orbit. - After sometime the electrons return back to its original orbits, while coming back they loose energy in the form of light called as electron magnetic radiation.

Electro Magnetic Radiation

Different kinds of rays

X-rays. Infrared Visible rays-rays coming from sun ,in the early morning. U V rays Gamma rays Radio rays

Different kinds of rays

Forces
Force is defined as push or pull exerted by one object on other object. In a molecule we have two types of forces - Cohesive force. - Kinetic force. Cohesive force-attractive force between two atoms. Kinetic force-force required to move atoms, or the force with which atom can move.

Cohesive force - Kinetic force.

States of matter
Matter can be solid liquid or gas. 1. Solid :Have particular shape, cohesive force is strong ,kinetic force is very less. If energy is given to solids the kinetic energy increases and solids changes to liquids.

States of matter
2.Liquid: Cohesive force is present and it is less, kinetic force is increased, liquid will take the shape of object. If energy is supplied to liquids they transform into gases. 3.Gas : Cohesive force is very less, kinetic force is more.

States of matter
example: Ice (solid) to water (liquid) to vapor (gas).

Latent heat:
Latent heat: The energy required to change from one state to another state is called as latent heat.

Electrical charges
Atom have properties of losing or gaining electrons. When an atom of an element loose electron it becomes positive (cation). When an atom of an element gains electron it becomes negative (anion).

Transmission of heat
Transmission of heat takes place in three forms 1. Conduction. 2. Convection. 3. Radiation.

Transmission of heat
1. Conduction: takes place in case of metals. Heat transfer from high temperature to low temperature.

Transmission of heat
2. Convection: transmission of heat that is taking place in liquids. The electrons at bottom are heated and they will go up, the atom at the top will come down.

Transmission of heat
3. Radiation: Transmission of heat taking place in gases is called as radiation.

Transmission of heat

Physical Effects of heat

1. Expansion: expansion is the result of increased kinetic energy producing a greater vibration of molecules. 2. Change in state: heat causes changes from one state to another. solids to liquid and liquid to gas. 3. Acceleration of chemical reaction: heat increases the chemical reaction.

Physical Effects of heat

4. Electron magnetic radiation: when ever any object is heated the electrons from lower orbit takes up energy and goes to higher orbit after sometime the electrons return back to its original orbits, while coming back they loose energy in the form of light called as electron magnetic radiation.

Physical Effects of heat

5. Decrease in viscosity: heating increases the kinetic movement of the molecules and reduces cohesive forces this makes fluid less viscous.

Electricity

Introduction
Electricity: Flow of electrons is called as electricity. Conductors: These are the elements whose atoms have free electrons in their outer orbits. They allow the electrons to pass through them. Electric current pass through conductors easily. Example: Metals like Iron, human being.

Introduction
Non conductors or insulators: Elements in which the atoms have completely filled electrons In their outer orbit. They will not allow the electrons to pass through them. Electric current can not pass through insulators. Example: wood, clothes.

Static Electricity
Static Electricity: When the charges are held on the surface of a body it is called as static electricity. Production: The simplest way of producing a static electric charge is to rub two suitable materials together. If two insulators such as Glass and Flannel are rubbed together, a positive charge is produced on the flannel and a negative charge on the glass.

Static Electricity
This is because electrons are transferred from the superficial atoms of the flannel to the surface of the glass. As the materials involved are insulators, the charges are held on the surfaces of the objects and spread themselves evenly over the surfaces.

Static Electricity

Static Electricity
Charged body and its electric field The charged body is continually seeking to attain neutral state, if negative by loosing electrons, and if positive by gaining electrons. This creates a zone of influence (electric field). This field is made up of lines of force surrounding the body.

Static Electricity
They show certain properties. - The lines of force are straight. - Lines of force repel one another. - Lines of force pass more easily through conductors than through insulators.

Static Electricity
Potential: electrical potential is the electrical condition of the body. Bodies with excess of electrons are negative. Bodies with less electrons are positive. Capacitance: Ability of a body to hold electric charge. It depends on material and surface area of the body.

Static Electricity
Difference of potential (Potential difference) A difference of potential exists between similar bodies charged with different quantities of electricity. If a conducting connection is made between two bodies electrons will flow from the more negative body to less negative body. The force producing the movement is Electromotive force. Electrons flow until both objects are at the same potential.

Current Electricity
Electric current occurs when there is flow of charged particles (electrons). The factors essential for production of electric current are - a difference of potential and - a conducting pathway.

Current Electricity
Electromotive force (EMF): The force which causes electrons to move along a conductor is called as EMF. Resistance: The conductor through which electrons have to flow offers some resistance to their flow.

Current Electricity
Electrical Resistance depends on - material - length of the material - cross sectional area Magnitude of Current (Intensity); The intensity or magnitude of current (i) is the rate of flow of electrons through the conductor per second.

Break Time

Electrical Energy
Anand kumar

All of us agree the importance of electricity in our daily lives. But what is electricity?

Electricity!
Everything in the world is made up of atoms. Each atom has smaller parts in it. One of those parts is called electrons. Electrons can move from atom to atom. When electrons move quickly from one atom to another is it called Electricity!

ELECTRICITY
There are two areas that can be studied

STATIC ELECTRICITY CURRENT ELECTRICITY

This section deals with stationary charge.

This section deals with moving charge.

Static Electricity
The build up of an electric charge on the surface of an object. The charge builds up but does not flow. Static electricity is potential energy. It does not move. It is stored

- -

++ ++

Examples of Static Electricity

Take a comb or plastic pen and rub it on almost any piece of fabric, it will acquire a small electric charge If placed near small pieces of paper, they will be attracted

Examples of Static Electricity

When two objects rub against each other electrons transfer and build up on an object causing it to have a different charge from its surroundings. Like the shoes rubbing against the carpet. Electrons are transferred from the carpet to the shoes.

CURRENT ELECTRICITY
Electricity that moves
Current: The flow of electrons from one place to another. Measured in amperes (amps)

Current Electricity
There are two types of currents Direct current Alternating current Direct current given ( DC) charges moving continually in one direction eg using batteries Alternating current given ( AC) the direction of charge flow is reversing or alternating direction continually eg using mains power at 50 Hz AC

ELECTRIC CIRCUIT
A path that allows electrons to flow from negative to positive

There are two types of circuits

1.series circuit 2. parallel circuit

What is a series circuit?

A series circuit is one which provides a single pathway for the current to flow. If the circuit breaks, all devices using the circuit will fail.

What is a parallel circuit?

A parallel circuit has multiple pathways for the current to flow. If the circuit is broken the current may pass through other pathways and other devices will continue to work.

Electricity
The unit of charge is the coulomb (C) The charge on an electron is -1.6x10-19 C The charge on a proton is +1.6x10-19 C One coulomb is the flow of 6.25x1018 electrons Electric current is the rate of flow of electrons The unit of current is the Ampere (Amp) One Amp is the flow of one coulomb in one second

Electrically, materials are classified as

Insulators Conductors Semiconductors

Insulators
An insulator is a material that current cannot pass through easily, like plastic Insulators have high resistance to current Examples are: rubber glass wood Ceramics

Conductors
A conductor is a material that current can pass through easily, like metals
Conductors have a lower resistance. Examples: metals, copper, silver. Pure water does not conduct well, but water with dissolved salts does conduct

Semiconductors
Semiconductors allow electrons to flow only under certain conditions eg silicon. For silicon the conductivity is increased by the addition of small amounts of elements such as arsenic or boron

Transmission of electricity through solids,eletrolytes,gases

Heat:Heat:Heat is the movement of thermal energy from a substance at a higher temperature to another substance at a lower temperature. Heat moves in only one direction: Under normal conditions and in nature, heat energy will always flow the warmer object to the cooler object

How HEAT moves

Thermal energy in the form of heat can move in three ways: 1. Conduction (solids) 2. Convention (liquids and gases) 3. Radiation

Conduction
The transfer of heat from one particle of matter to another by direct particle contact. Conduction occurs primarily in solids because the particles are tightly packed together. The particles themselves DO NOT change positions.

Convection
 Convection: the transfer of thermal energy (heat) through the bulk movement of matter.  Convection occurs in FLUIDS (liquids and gases).  Convection produces CURRENTS in both gases and liquids.  Example: Heating water  Application: How do convection currents form in a room when the heater is turned on?

Radiation
Radiation: the transfer of (thermal) energy by electromagnetic waves. Radiation does not require matter to transfer thermal energy. Example: Charcoal grill Hot tin roof Burner on a stove top

Household Electricity
What are some types of household electricity? Cords Computers TV Microwave Stove

Safe Use Of Electricity

Don t pull cords Don t put metal in an electrical appliance

How Electricity Impacts Today's Life

We use electricity for light, heat, transportation, everything!

Dangers of static and current electricity Precautions

Dangers of static and current Electricity

Electricity is essential to modern life Some employees work with electricity directly Some indirectly Electricity is a serious workplace hazard

Electrical Shock
A sudden and accidental stimulation of the body s nervous system by an electrical current Current will flow through the body when it becomes part of an electrical circuit

Other Injuries
Burns Falls Injuries when machinery starts suddenly

Electrical Burns
Current passing through tissue generates extreme heat Skin damage at entry and exit Internal tissue damage Result from arcs or flashes Thermal burns from overheated wires or equipment or fires

Falls
Initiated by a shock Muscles contract involuntarily Worker can lose balance and fall

Machinery Injuries
Unexpected activation Shock Pinch Crush Shear

General Safety Rules

1. Do not work when you are tired or taking medicine that makes you drowsy. 2. Do not work in poor light. 3. Do not work in damp areas or with wet or damp clothing and shoes. 4. Use approved tools, equipment, & protective devices. 5. Remove all metal items when working around exposed circuits.

Precautions
A GOOD THING TO KEEP IN MIND!

THE BEST TOOLS EVER INVENTED HANDS!

SAFETY SHIELDS ARE EYE INSURANCE!

SAFETY SHOES ARE NOT FOR DEFEAT!

HEARING PROTECTION IS FOR WINNERS!

Thermal Energy
Units of heat and temperatures Physical effects of heat Transmission of heat

Anand kumar

Temperature
1. Temperature is related to the average kinetic energy of the particles in a substance.

Heat
a. The flow of thermal energy from one object to another. b. Heat always flows from warmer to cooler objects.

Cup gets cooler while hand gets warmer

Ice gets warmer while hand gets cooler

Units of Heat
The SI unit is the joule (J), which is equal to Newton-metre (Nm). Historically, heat was measured in terms of the ability to raise the temperature of water. The calorie (cal): amount of heat needed to raise the temperature of 1 gramme of water by 1 C0 (from 14.50C to 15.50C)
83

Heat Transfer
Conduction, Convection, and Radiation

Review: Temperature
Temperature is:
The quantity that tells how hot or cold something is compared with a standard A measure of the average kinetic energy of the molecules of a substance

Temperature IS NOT energy

If something has a higher temperature, its molecules have more energy, but temperature is not the same thing as energy

Review: Thermal Energy

Thermal Energy is:
The total energy (kinetic plus potential) of the particles that make up a substance.

Review: Heat
Heat is:
The thermal energy that flows from an object at higher temperature to one at lower temperature, commonly measured in calories or Joules.

Heat is exchanged until thermal equilibrium is reached

A Comparison
Temperature Thermal Energy
Measures average kinetic energy. The sum of all the kinetic energies.

Heat
The flow of thermal Energy.

Conduction

Conduction: How does this method work?

Conduction takes place within materials and between different materials that are in direct contact.

Conduction: How does this method work?

Conduction is explained by collisions between atoms or molecules
Warmer atoms move more violently (they have more energy). These warmer atoms bump into nearby atoms and transfer energy, resulting in an increase in the motion of the nearby atoms.

Conduction: How does this method work?

Free electrons that drift through the metal

jostle and transfer energy by colliding with atoms and other free electrons

Conduction: What moves?

Conduction involves the transfer of energy from molecule to molecule; energy moves from one place to another but molecules do not.

Conduction: Heat Conductors

Materials that conduct heat well are known as heat conductors.
Metals are the best heat conductors since metals have loose outer electrons If you touch a piece of metal that is at room temperature it often "feels cold." This is because metal is a good conductor of heat. It quickly conducts heat away from your body.

Conduction: Heat Insulators

Poor conductors of heat, such as styrofoam and air, are called good insulators.
Liquids and gases are in general good insulators. Porous materials with lots of small spaces are good insulators. A blanket on your bed does not provide your body with heat. It just slows the conduction of your body heat to the colder air. Insulation delays heat transfer, it can not prevent it!

Convection

Convection: How does this method work?

Convection occurs when a fluid is heated.
Fluids are both liquids and gases.

Convection: How does this method work?

When a fluid is heated, it expands and becomes less dense; since it is less dense, it rises.
Warmer fluid floats on top of cooler fluid. Cooler fluid then moves to the bottom and the process continues.

Convection currents keep a fluid stirred as it is heated.

Convection: What Moves

Convection involves the movement of a fluid; if there is not a fluid, convection cannot occur.

Convection: Example
Convection currents stir the atmosphere and produce winds. Convection currents are produced by uneven heating of the air near the surface of the earth.

Convection: Example
Land warms and cools more quickly than water. Thus convection currents are often evident at the shore in sea breezes and lands breezes.

Radiation

Radiation: How does this method work?

Radiation is heat transfer through electromagnetic waves. Any object that has temperature radiates heat. Radiation is the only form of heat transfer that can occur in a vacuum. Heat transfer by radiation takes place from everything to everything, even in empty space.

Radiation: What Moves

With radiation, only energy moves from the warmer object to the cooler object.

Radiation: Wavelengths Emitted

All objects continually emit radiant energy in a mixture of wavelengths. Objects at lower temperatures emit longer waves and objects at higher temperature emit waves of shorter wavelength. Objects of everyday temperatures emit waves mostly in the longer wavelength end of the infrared region.

Radiation: Absorption and Reflection are Opposite Processes

A good absorber of radiant energy reflects very little radiant energy and appears dark. A perfect absorber reflects no radiant energy and appears perfectly black. Good reflectors of radiant energy are poor absorbers. Light colored objects reflect more light and heat than darker colored objects. This is why wear lighter colored clothing in summer to stay cool.

Heat Transfer for a Mouse

Radiant Energy
Electromagnetic spectrum Reflection Retraction Absorption Radiation laws

What Is the Electromagnetic Spectrum (EM)?

The electromagnetic spectrum is the complete range of electromagnetic waves placed in order of increasing frequency.

VISIBLE LIGHT
(part of EM spectrum)

The Electromagnetic Spectrum

More than meets the eye!

Examples from Space!

Wavelength
The distance from one wave crest to the next

Radio waves have longest wavelength and Gamma rays have shortest!

Wavelength Units
Meters (like on last slide and in book, p. 613)
More commonly in nanometers (1 nm = 10-9 meters)

Angstroms still used

Named for Swedish Astronomer who first named these wavelengths 1 nanometer = 10 Ao

How light or electromagnetic radiation is used in Astronomy

Astronomers use a tool called a spectroscope to separate starlight into its colors in this way, they can tell what a star is made of, its temperature, luminosity and so on Astronomers can look at astronomical objects at different wavelengths

Spectra of a Star

TO SEE COLOR
Different colors represent different wavelengths. Blue- smaller wavelengths Red- larger wavelengths Color Order: ROY G BIV red, orange, yellow, green, blue, indigo, violet

WHITE LIGHT
Adding color makes WHITE Deleting color makesBLACK

MANY COLORS = WHITE

Reflection Retraction Absorption Radiation laws

HOW LIGHT MOVES

Straight Line unless altered by what moving in.

LIGHT SCATTERS AS GOES

Light scatters and looses energy the further away from its source.

SCATTERING
Light released and spreads in all directions. Why room is even with light. Sky blue: shortest wavelengths, spread more.

REFLECTION

REFLECTION
Light bounces off surface at same angle it hits.

ABSORPTION

ABSORPTION
LIGHT IS TAKEN IN BY AN OBJECT (MATTER) AND HOLDS IT. ENERGY TRANSFERRED FROM LIGHT TO HEAT. AIR PARTICLES DIMINISH LIGHT.

TRAVELS THRU MATTER

INTERACTS WITH MATTER

TRANSMISSION
Light goes straight unless changes what it travels through. Travels through matter: gases (air) liquids (water) solid (glass)

TRANSMISSION
Terms for mediums
Transparent : allows all light through. Translucent : allows some light through. Opaque : allows no light through.

When Light Strikes an Object

When light strikes an object, the light can be reflected, transmitted, or absorbed.

REFRACTION
The change in direction and speed. Moving from water to air, light changes angles and speed of travel.

Refraction of Light
When light rays enter a medium at an angle, the change in speed causes the rays to bend, or change direction.

REVIEW Light with Matter

TRANSMISSION- light going through REFRACTION- light bending. ABSORBTION- light absorbed. REFLECTION- light bouncing off.

LIGHT - WHAT WE SEE

LIGHT- energy by wavelengths at a level we can see. EM Spectrum- variety of wavelengths and frequency.
Light is small band within.

Internal energy and heat

Laws of gases. Boyle s law and

Charle s law
Exchange of energy. Concept of heat. Latent heat.

Heat and Internal Energy

Internal Energy U is the total energy associated with the microscopic components of the system
Includes kinetic and potential energy associated with the random translational, rotational and vibrational motion of the atoms or molecules Also includes the intermolecular potential energy Does not include macroscopic kinetic energy or external potential energy

Heat refers to the transfer of energy between a system and its environment due to a temperature difference between them
Amount of energy transferred by heat designated by symbol Q A system does not have heat, just like it does not have work (heat and work speak to transfer of energy)

Units of Heat
The historical unit of heat was the calorie
A calorie is the amount of energy necessary to raise the temperature of 1 g of water from 14.5C to 15.5C A Calorie (food calorie, with a capital C) is 1000 cal

Since heat (like work) is a measure of energy transfer, its SI unit is the joule
1 cal = 4.186 J ( Mechanical Equivalent of Heat ) New definition of the calorie

The unit of heat in the U.S. customary system is the British thermal unit (BTU)
Defined as the amount of energy necessary to raise the temperature of 1 lb of water from 63F to 64F

More About Heat

Heat is a microscopic form of energy transfer involving large numbers of particles Energy exchange occurs due to individual interactions of the particles
No macroscopic displacements or forces involved

Heat flow is from a system at higher temperature to one at lower temperature

Flow of heat tends to equalize average microscopic kinetic energy of molecules

When 2 systems are in thermal equilibrium, they are at the same temperature and there is no net heat flow Energy transferred by heat does not always mean there is a temperature change (see phase changes)

Ideal Gas Law

An ideal gas is defined as one in which all collisions between atoms or molecules are perfectly elastic and in which there are no intermolecular attractive forces. One can visualize it as a collection of perfectly hard spheres which collide but which otherwise do not interact with each other. In such a gas, all the internal energy is in the form of kinetic energy and any change in internal energy is accompanied by a change in temperature. An ideal gas can be characterized by three state variables: absolute pressure (P), volume (V), and absolute temperature (T). The relationship between them may be deduced from kinetic theory and is called the
Where: n = number of moles R = universal gas constant = 8.3145 J/mol K N = number of molecules k = Boltzmann constant = 1.38066 x 10-23 J/K = 8.617385 x 10-5 eV/K k = R/NA NA = Avogadro's number = 6.0221 x 1023

Ideal Gas Law

PV=nRTZ n = Mass R = Universal gas constant T = Temperature Z = Supercompressability (P1V1/T1)Z1=(P2V2/T2)Z2

Ideal Gas Law

An Ideal Gas (perfect gas)is one which obeys Boyle's Law and Charles' Law exactly. An Ideal Gas obeys the Ideal Gas Law (General gas equation): PV = nRT where P=pressure, V=volume, n=moles of gas, T=temperature, R is the gas constant which is dependent on the units of pressure, temperature and volume

Boyle s Law
At constant temperature, the volume of a given quantity of gas is inversely proportional to its pressure : V 1/P So at constant temperature, if the volume of a gas is doubled, its pressure is halved. OR At constant temperature for a given quantity of gas, the product of its volume and its pressure is a constant : PV = constant, PV = k

At constant temperature for a given quantity of gas : PiVi = PfVf where Pi is the initial (original) pressure, Vi is its initial (original) volume, Pf is its final pressure, Vf is its final volume Pi and Pf must be in the same units of measurement (eg, both in atmospheres), Vi and Vf must be in the same units of measurement (eg, both in litres).

All gases approximate Boyle's Law at high temperatures and low pressures. A hypothetical gas which obeys Boyle's Law at all temperatures and pressures is called an Ideal Gas. A Real Gas is one which approaches Boyle's Law behaviour as the temperature is raised or the pressure lowered.

Boyle s Law
P1V1=P2V2

Charles Law
At constant pressure, the volume of a given quantity of gas is directly proportional to the absolute temperature : V T (in Kelvin) So at constant pressure, if the temperature (K) is doubled, the volume of gas is also doubled. OR At constant pressure for a given quantity of gas, the ratio of its volume and the absolute temperature is a constant : V/T = constant, V/T = k

At constant pressure for a given quantity of gas : Vi/Ti = Vf/Tf where Vi is the initial (original) volume, Ti is its initial (original) temperature (in Kelvin), Vf is its final volme, Tf is its final tempeature (in Kelvin) Vi and Vf must be in the same units of measurement (eg, both in litres), Ti and Tf must be in Kelvin NOT celsius. temperature in kelvin = temperature in celsius + 273 (approximately)

All gases approximate Charles' Law at high temperatures and low pressures. A hypothetical gas which obeys Charles' Law at all temperatures and pressures is called an Ideal Gas. A Real Gas is one which approaches Charles' Law as the temperature is raised or the pressure lowered

Charles Law
V1/V2=T1/T2 P1V1/T1=P2V2/T2

Latent Heat
When a solid melts or a liquid boils, energy must be added but the temperature remains constant! (This can be explained by considering that it takes energy to break the bonds holding the material together.) The amount of energy it takes to melt or boil a certain amount of material is called a latent heat.

Latent Heat
For water, the latent heat of fusion (heat needed to melt ice to water) is 79.7 cal/gm. For water, the latent heat of vaporization (heat needed to boil water) is 540 cal/gm. For alcohol, the latent heat of vaporization is less at 204 cal/gm.

Introduction superficial heat and cold therapy

Physiological effects that produce pain relief direct result of the temp elevation on the tissue and cellular function. And through a reflex reaction Heat reduce pain & muscle spasm while decreasing joint stiffness and contractures Produce hyperemia , speed metabolic process & hematoma resolution Heat is useful for bursitis and tensoynovitis along with superficial thrombophlebitis Causes an introduction of reflex vasodilatation

Superficial heat
While the physical properties differ, none of these agents are able to overcome the combination of skin tolerance , tissue thermal conductivity , and the body s response to produce localized temperature elevations of more than a few degrees at depths of a few centimeters Conduction ,conversion & convection

Heat indications

Pain Muscle spasm Decreased joint stiffness and contractures Myofascial pain and fibromyalgia Production of hyperemia Acceleration of metabolic process Hematoma resolution Bursitis and tenosynovitis Superficial thrombophlebitis Induction of reflex vasodilatation

Heat contraindication
Acute inflammation , abscess, trauma, edema or hemorrhage Bleeding disorders Insensitivity Inability to communicate or respond Poor thermal regulation Areas of malignancy Ischemia (inadequate blood supply) Atrophic skin & scar tissue

Superficial cold-cryotherapy
Reduce blood flow Decreases metabolic activity Lessens muscle tone spasm Decreased swelling Inhibits spasticity and clonus Increase gastrointestinal motility Slows nerve conduction Produces analgesia

Cryotherapy
Restricted to superficial agents that are inexpensive , but effective including: -ice ,cold water, refrigerated units, vaporizing liquids (vapo-Coolant spray ), and chemical packs Chilling cause an initial period of vasoconstriction until subcutaneous tissues reach 15 degree C

cryotherapy
Thereafter , vasodilatation occur ,however vessels are still constricted compared to normal Temp to 13- 15 degree C for 10 to 20 minutes are used Cold should be provide just long enough to prevent swelling and bleeding but prolonged use should be avoided as cold can retard healing

Cold indications
Musculoskeletal trauma Edema / hemorrhage control & analgesia Pain Muscle spasm Spasticity Adjunct in muscle re-education Reduction in metabolic activity

Cold contractions
Ischemia Cold intolerance /hypersensitivity Reynaud's Severe cold pressor responses Cold allergy Insensitivity

Cryotherapy cold therapy

Cold modalities range in temp between 32 degree F 65 F Heat is removed from the body & absorbed by the cold modality Tissue temperature is LOWERED Cold therapy applied is thought to activate a mechanism used to conserve heat in the body s core This mechanism triggers a series of metabolic & vascular events that produce the beneficial effects of cryothorepy . Can be used during all stages of healing

Pain control
Cold therapy acts as a counterirritant Cold application affects pain perception & transmission by: -interrupting pain transmission (stimulatediameter A-beta n. fibers) Decreasing n . Conduction velocity Reducing m. spasm Reducing or limiting edema

Systemic effects of cold exposure

If circulating blood temperature decrease to 0.2 degrees,then the hypothalamus(body s thermoregulatory center) kicks in General vasoconstriction in response to cooling of the posterior hypothalamus. Decreased respiratory and heart rates - Heart rate decreases (wants to localize the cold area) Shivering &increased muscle tone -if the heart decrease too much where the core temperature. reaches hypothermia

Application of Cryotherapy
Ice massage: should not be applied during Acute inflammatory stage as it is not compatible with compression 5-15 min.-reduces pain ,desensitizes the trigger points Vigorous ice massage Ice pack : type of ice- cubed,flaked Commercial cold packs chemical reusable _ Be aware of frostbite;use insulating layers between cryo-cuff/Polar care:provide approx.40mm hg Cold water immersion - Ice bucket 40 degrees 50 degree F - Whirlpool 50 degrees 60 degrees F Vapour coolent spray: superficial rapid cooling through evoporation,verttically no temperature change below epidermis,will numb the area breifly( trigger points ).

T E N S

What is TENS?
Transelectrical Neuro Stimulation The application of low voltage electrical pulses to the nervous system through the skin via electrodes

Purpose of TENS
Pain relief
Acute Chronic Post op obstetrical

Mechanism of action
Gate control theory: Conventional Natural opiates: Acupuncture like settings Primary indication: PAIN

 An Approach to pain control Trancutaneous Electrical Nerve Stimulation: Any stimulation in which a current is applied across the skin to stimulate nerves 1965 Gate Control Theory created a great popularity of TENS TENS has 50-80% efficacy rate TENS stimulates afferent sensory fibers to elicit production of neurohumneral substances such as endorphins, encephalin and serotonin (i.e. gate theory)

CONTRAINDICATIONS
1st Trimester pregnancy Epilepsy avoid head and neck Eyes Open skin Over the chest if patient has any cardiac condition High BP High fever Tuberculosis Numb skin Carotid sinus

Indications
Control Chronic Pain Management post-surgical pain Reduction of post-traumatic & acute pain

Precautions
Can mask underlying pain Burns or skin irritation prolonged use may result in muscle spasm/soreness caffeine intake may reduce effectiveness Narcotics decrease effectiveness

Biophysical Effects
Primary use is to control pain through Gate Control Theory May produce muscle contractions Various methods High TENS (Activate A-delta fibers) Low TENS (release of F-endorphins from pituitary) Brief-Intense TENS (noxious stimulation to active C fibers)

Common Modes of TENS for Nerve Stimulation

CONVENTIONAL Frequency 10100 Hz Amplitude low to medium STRONG low rate Frequency < 10 Hz Pulse duration 100300usec Place electrodes at perimeter Of pain, over nerve Segment Over nerve related to m in or remote Pt perceives a distinct parethesia on painful region or segment Uncomfortable rhythmic muscle contractions

MODES
Brief intense Freq. 60-150Hz. Pulse duration50250usec Over nerve related Uncomfortable to m in or remote tetanic from pain contractions that fatigues, at patient tolerance Weak to strong intermittent tetanic muscle contract and paresthesias

Pulse Burst

Modulated Freq.: As above HIGH 60-100, Low .5-4Hz 50-200usec

MODES
MODULATED Freq, Pulse duration and Amplitude Are modulated separate or together Any of previously Mentioned sites Weak to strong sensation, with or without muscle contraction

Hyperstimulation

Freq. 1-100 Pulse Duration Up to 500 ms Amplitude High

Accupuncture points

Sharp burning sensation at tolerance. No muscle contraction

Acceptable Electrode Placement

Directly over pain Superficial peripheral nerve Over dermatomes Acupressure point Over myotomes Motor points Placement can be unilateral, bilateral or crossed.

ULTRASOUND
A Deep Thermal & Non-thermal Mechanical Modality

What is Ultrasound?
May be used for diagnostic imaging, therapeutic tissue healing, or tissue destruction Thermal & Non-thermal effects We use it for therapeutic effects Can deliver medicine to subcutaneous tissues (phonophoresis)

Ultrasound
Waveform
Therapeutic ultrasound waves range from 750,000 to 3,000,000 Hz (0.75 to 3 MHz)

Transducer
A device that converts one form of energy to another Piezoelectric crystal: a crystal that produces (+) and (-) electrical charges when it contracts or expands
Crystal of quartz, barium titanate, lead.

Reverse (indirect) piezoelectric effect: occurs when an alternating current is passed through a crystal resulting in contraction & expansion of the crystal
US is produced through the reverse piezoelectric effect

Types of Current
Direct Current: the uninterrupted unidirectional flow of electrons Alternating Current: the uninterrupted bidirectional flow of electrons
Ultrasound is produced by this type of current flowing through a piezoelectric crystal

Pulsed Current: the flow of electrons interrupted by discrete periods of noncurrent flow

 Longitudinal waves travel in solids & liquids Transverse waves cannot pass through fluids; found in the body only when ultrasound strikes bone

Frequency
Frequency: number of times an event occurs in 1 second; expressed in Hertz or pulses per second
Hertz: cycles per second Megahertz: 1,000,000 cycles per second
In the U.S., we mainly use ultrasound frequencies of 1, 2 and 3 MHz 1 = low frequency; 3 = high frequency

q frequency = o depth of penetration o frequency = sound waves are absorbed in more superficial tissues (3 MHz)

Movement of the Transducer

4 cm2/sec Remaining stationary can cause problems If patient complains of pain or excessive heat, then decrease intensity but increase time Apply constant pressure not too much & not too little

Coupling Agents
Optimal agent distilled H20 (.2% reflection)
Improperly coupled head causes o temp.

Types of agents:
Direct H20 immersion Bladder

Direct Coupling
Effectiveness is q if body part is hair, irregular shaped, or unclean Must maintain firm, constant pressure Various gels utilized

Water Immersion
Used for odd shaped parts Place head approx. 1 away from part Operator s hand should not be immersed No metal on part or operator s hand Ceramic tub is recommended If nondistilled H20 is used, intensity can be o .5 w/cm2 because of air & minerals Don t touch skin except to briefly sweep skin when bubbles form

Bladder
H20 filled balloon or plastic bag coated with coupling gel Use on irregular shape part Place gel on skin, then place the bladder on the part, and then place gel on bladder

Indications
Soft tissue healing & repair Joint contractures & scar tissue Muscle spasm Neuroma Trigger areas Warts Sympathetic nervous system disorders Postacute reduction of myositis ossificans Acute inflammatory conditions (pulsed) Has been shown to be ok to use following the stopping of bleeding with an acute injury (pulsed)

Contraindications
Acute conditions (continous output) Ischemic areas or impaired circulation areas Tendency to hemorrhage Around eyes, heart, skull, or genitals Over pelvic or lumbar areas in pregnant or menstruating females Cancerous tumors Spinal cord or large nerve plexus in high doses Anesthetic areas Stress fracture sites or over fracture site before healing is complete (continuous); epiphysis Acute infection

Thermal Effects
o blood flow o sensory & motor nerve conduction velocity o extensibility of structures (collagen); q joint stiffness o collagen deposition Mild inflammatory response q muscle spasm q pain

Nonthermal Effects
o cell membrane permeability o vascular permeability o blood flow Synthesis of protein q edema Diffusion of ions Tissue regeneration Formation of stronger CT

Pulsed Ultrasound
Stimulates phagocytosis (assists q of chronic inflammation)

Clinical Applications Soft Tissue & Plantar Warts

Pitting edema - o temp. makes thick edema liquefy thus promoting lymphatic drainage o fibroblasts = stimulation of collagen production = gives CT more strength Plantar Warts - 0.6 W/cm2 for 7-15 min.

Clinical Applications Scar Tissue, Joint Contracture, & Pain Reduction

o mobility of mature scar o tissue extensibility Softens scar tissue o pain threshold o n. conduction velocity

Clinical Applications
Chronic Inflammation - Pulsed US has been shown to be effective with q pain & o ROM
1.0 to 2.0 W/cm2 at 20% duty cycle

Bone Healing Pulsed US has been shown to accelerate fracture repair

0.5 W/cm2 at 20% duty cycle for 5 min., 4x/wk

Treatment Duration & Area

Length of time depends on the
Size of area Output intensity Goals of treatment Frequency

Area should be no larger than 2-3 times the surface area of the sound head ERA If the area is large, it can divided into smaller treatment zones When vigorous heating is desired, duration should be 10-12 min. for 1 MHz & 3-4 min. for 3 MHz Generally a 10-14 day treatment period

Phonophoresis
US is used to deliver a medication via a safe, painless, noninvasive technique Opens pathways to drive molecules into the tissues Not likely to damage or burn skin as with iontophoresis Usually introduces an anti-inflammatory drug

Phonophoresis
Factors affecting rate of medication diffusion
Hydration higher water content = skin more penetrable Age better with younger ages Composition better near hair follicles, sebaceous glands & sweat ducts Thickness thinner skin is better

Types of medications
Corticosteroids hydrocortisone, dexamethasone Anesthetics - lignocaine

Even they have the right to stay healthy.....