Deck 4: Therapeutic Heat and Cold

Question 1

Conversion refers to the temperature change that results from energy transformed from one form to another, such as the conversion from mechanical or electrical energy to heat. Which of the following examples of a physical agent modality represents a form of heat by conversion?

A)Fluidotherapy
B)Exposure to an infrared lamp
C)Continuous ultrasound
D)Hot pack application

Answer 1

C

Question 2

What is the mechanism for heat transfer from a hot pack, and how does it influence the application of a hot pack?

A)Conversion; and the hot pack within its cover must be moved.
B)Conduction; and the hot pack within its cover must make direct contact with the treatment area.
C)Convection; and the hot pack within its cover must make direct contact with the treatment area.
D)Conduction; and the hot pack application is irrelevant.

Answer 2

B

Question 3

Temperature regulation occurs to maintain homeostasis through the interaction of local and central neural mechanisms. Where in the brain is this information processed?

A)In the cerebellum
B)In the hypothalamus
C)In the thalamus
D)In the cortex

Answer 3

B

Question 4

Metabolic rate changes in association with changes in tissue temperature. Which of the following statements is most accurate?

A)An increase in metabolic rate delays tissue healing.
B)An increase in metabolic rate may be used advantageously to facilitate tissue healing.
C)An increase in metabolic rate may adversely affect oxygen consumption and delay tissue healing.
D)An increase in oxygen prevents clearing of bacteria from the wound site.

Question 5

Based on the physiological effects of therapeutic heat, intervention goals are easy to identify. Therapeutic heating agents are used as adjunctive intervention techniques for achieving functional goals. Which of the following goals would NOT be facilitated by the application of therapeutic heat?

A)Increased strength to perform functional activities
B)Alleviation of pain
C)Increased motion and improvement in activities of daily living
D)Increased tissue extensibility

Question 6

What is the mechanism for heat transfer from paraffin, and how does it influence the application of paraffin?

A)Conversion; and the paraffin must be moved.
B)Conduction; and the paraffin must make direct contact with the treatment area.
C)Convection; and the paraffin must make direct contact with the treatment area.
D)Conduction; and the paraffin application is irrelevant.

Question 7

The local application of heat to the low back may also cause which of the following to occur?

A)Reflex heating in other areas of the body, an increase in subcutaneous blood flow, and vasodilation in the distal extremities
B)Reflex cooling of the distal extremities through vasoconstriction
C)Vasoconstriction in the proximal areas to maintain heat
D)None of the above

Question 8

Which of the following statements is most accurate regarding heat and exercise?

A)A greater increase in blood flow is reported with heat.
B)A greater increase in blood flow is reported with exercise.
C)A greater increase in blood flow is reported with heat and exercise.
D)There is no difference in blood flow with the application of heat or if a patient exercises.

Question 9

Convective heat sources differ from radiant heat sources in what way?

A)Convective heat sources rely on the movement of air, matter, or liquid around or past the body, and radiant heat sources do not require movement of anything.
B)Convective heat sources do not require movement, and radiant heat sources rely on the movement of air, matter, or liquid around or past a body.
C)Radiant heat sources heat by conduction, and convective heat sources use fans.
D)Radiant sources heat or cool, and convective sources only cool.

Question 10

Physiological changes in response to heat application vary according to the intensity of the agent, the duration of application, and the area being treated. Hyperemia is a sign of vigorous heating. At what tissue temperature would there be irreversible tissue damage due to protein being denatured?

A)45^oC (113^oF)
B)43^oC (109^oF)
C)37^oC (98.6^oF)
D)38^oC (100^oF)

Question 11

Heat has been shown to elevate pain threshold and increase nerve conduction velocity. What is the clinical relevance of an elevated pain threshold?

A)Delayed recovery from injury
B)Delayed onset of pain perception
C)Improvement in functional activities and faster recovery
D)Improvement in ability to perform objective tests

Question 12

What must take place between the physical agent and the patient's skin if conduction is the method of thermal exchange?

A)An extended period of exposure between the heat agent and the skin
B)Direct contact between the thermal agent and the patient's skin
C)Sufficient movement of air between the thermal agent and the patient's skin
D)The transformation from a liquid to a gas state

Question 13

Therapeutic heat or cold is delivered to the target tissue by all of the following mechanisms except?

A)Evaporation
B)Conversion
C)Radiation
D)None of the above; all are mechanisms for the delivery of therapeutic heat.

Question 14

Shortening of connective tissue may result from injury or immobilization. The viscoelastic properties of muscle, tendon, and ligament are also affected. How does heat affect the viscosity (thickness or resistance to movement) and elastic properties of connective tissue?

A)It increases viscosity and increases the elastic properties.
B)It decreases viscosity and decreases the elastic properties.
C)It increases viscosity and decreases the elastic properties.
D)It decreases viscosity and increases the elastic properties.

Question 15

Hydrocollator packs, or hot packs, are one of the most commonly applied forms of superficial moist heat in the clinical environment. After a 20-minute application of a hot pack on a patient, how long will it take for the pack to reach the temperature of the water in the storage unit?

A)20 to 30 minutes
B)30 to 40 minutes
C)60 minutes
D)5 to 10 minutes

Question 16

Muscle guarding is a protective mechanism to protect against potential pain and further injury or pain associated with joint movement. Heat application to relieve muscle guarding accomplishes all but which of the following?

A)Muscle relaxation
B)Increase in range of motion
C)Increase in pain perception
D)Reduction of pain

Question 17

When sensory information reaches the brain, the information is integrated and interpreted along with information about the temperature of the blood circulating through the hypothalamus. Which of the following mechanisms regulates temperature?

A)Vasodilation or vasoconstriction of blood vessels
B)Shivering to maintain heat
C)Sweating to lose heat
D)All of the above are examples of temperature regulation.

Question 18

Elevating the tissue temperature results in an increase in blood flow to the area, attributable in part to the vasodilatory response in surface blood vessels. What mechanism normally prevents excessive heat accumulation?

A)The decreased blood flow removes heat from the area, and blood that is relatively cooler from the circulatory system flows into the area.
B)The increased blood flow moves heat into the area, and blood that is relatively warmer from the circulatory system flows into the area.
C)The increased blood flow removes heat from the area, and blood that is relatively warmer from the circulatory system flows into the area.
D)The increased blood flow removes heat from the area, and blood that is relatively cooler from the circulatory system flows into the area.

Question 19

According to Melzack and Wall's gate control theory of pain, how does the application of therapeutic heat reduce the perception of pain?

A)The theory has not been proven; therefore the application of therapeutic heat does not reduce pain perception.
B)Thermal stimuli inhibit nociceptor input to the spinal cord and open the gate in the spinal cord.
C)Thermal stimuli override sensory input and open the gate in the spinal cord.
D)Thermal stimuli override painful stimuli and inhibit pain transmission.

Question 20

Residual elongation of connective tissue is dependent upon which of the following?

A)Sufficient increase in tissue temperature
B)Type of stretch applied
C)The timing of the application
D)All of the above

Question 21

Cryotherapy refers to the practice of using cold to achieve therapeutic goals. What is the reflex response to lowered skin temperature?

A)Vasoconstriction
B)Shivering
C)Vasodilation
D)Pain

Question 22

How does the application of superficial heat administered through a fluidotherapy differ from the application of a hot pack or paraffin?

A)A fluidotherapy loses heat over time and heats by conduction.
B)A fluidotherapy loses heat over time and heats by convection.
C)A fluidotherapy does not lose heat over time and heats by convection.
D)There is no difference between them except cost.

Question 23

Cold is commonly used in the management of acute inflammation and edema. Which of the following interventions has been the most successful in controlling pain and edema in the management of acute ankle sprains?

A)Cold
B)Compression
C)Cold and compression
D)No difference has been identified between the use of cold or compression, separately or together.

Question 24

Air-activated heat wraps are capable of continuously delivering low-level heat and can be worn during activity and sleep for up to 8 hours at a time. Of what potential advantage is this form of superficial heat?

A)Patients can use the modality during activities of daily living.
B)Patients can safely apply the modality themselves.
C)Patients are not at risk for burns.
D)All of the above are potential advantages.