1. Elektrofisika & Sumber Fisis 1 Muthiah Munawwarah

2. Content 1.HEAT AND SKIN 2.CONDUCTIVE AND CONVECTIVE HEATING 3.CONVERSIVE HEATING 4.CRYOTHERAPY 5.ULTRASONIC THERAPY 6.TRACTION 7.DIRECT CURRENT 8.LOW FREQUENCY CURRENT 9.MEDIUM FREQUENCY CURRENT 10.ELECTRODIAGNOSIS 11.PHOTOTHERAPY

3. CLASSIFICATION OF PHYSICAL AGENTS EFFECTSTYPE OF AGENTMODALITIES THERMALCONDUCTION HEATING HEATING BY RADIATION HOT PACKS, PARAFFIN WAX, INFRARED THERMAL AND NON THERMAL DIATHERMY PRODUCING CONVERSIVE HEATING AND NON THERMAL EFFECTS SHORT WAVE DIATHERMY, MICROWAVE DIATHERMY, ULTRASONIC ENEREGY STIMULATION OF NERVE OR MUSCLE LOW FREQUENCY CURRENT, MEDIUM FREQUENCY CURRENT FARADIC TYPE CURRENT, SINUSOIDAL CURRENT, DIRECT CURRENT, INTERFERENTIAL CURRENT, TENS STIMULATION CIRCULATORY MECHANISMS COMPRESSION UNIT, LOW FREQUENCY CURRENT, MEDIUM FREQUENCY CURRENT INTERMITTENT PRESSURE, SINUSOIDAL CURRENT, INTERFERENTIAL CURRENT, DIADYNAMIC CURRENTS EFFECTS ON SKIN AND SUPERFICIAL TISSUE FOR INFECTION AND SKIN LESIONS ULTRAVIOLET RAYS DIATHERMY MERCURY VAPOR LAMPS, SHORT WAVE DIATHERMY, INFRARED RADIATION BY:HILARY WADSWORTH

4. STRUCTURE OF THE SKIN Pembungkus Elastis Yang Melindungi Kulit Dari Pengaruh Lingkungan. Organ Terberat Dan Terbesar Dari Tubuh. Seluruh Kulit Beratnya Sekitar 16 % Berat Tubuh, Pada Orang Dewasa Sekitar 2,7 – 3,6 Kg Dan Luasnya Sekitar 1,5 – 1,9 Meter Persegi.

6. LAPISAN KULIT EPIDERMIS IS NON VASCULAR, 0.07-0.12mm THICKNESS MOST OF THE BODY 0.8-1.4mm PALMS AND SOLES PIGMENTATION OF THE SKIN HYPODERMIS IS A DEEPER 30mm IN ABDOMEN, CONTAINS FAT CELL MANY BLOOD VESSELS AND NERVE ENDING DERMIS HIGHLY ELASTIC 1-2mm THICKNESS, 3mm PALMS AND SOLES HAIR FOLLICLES, SEBACEOUS, AND SWEAT GLANDS

7. CIRCULATIORY SYSTEM OF THE SKIN CIRCULATIORY SYSTEM OF THE SKIN HEAT CONDUCTION SYSTEMNUTRITIVE SYSTEM 1.Arteriovenous Anastomoses 2.Blood Flow 3.Lymphatic System Arteries that supply the skin FIBER TYPE SERNSATIONNERVESIGN AND SYMPTOMS CUTANEOUS SENSATION Pain Temperature Exteroceptors All sensory Nerve All Sensory Nerve Decrease HYPOAESTHESIA Complete Loss ANASTHESIA Sensation Pain HYPOALGESIA Sensation HYPERALGESIA Loss ANALGESIA Complete Loss ATHERMAESTHESIA Decrease HYPO Increase HYPER DEEP SENSATION Proprioceptors Mototr Branches of spinal nerve Loss of muscle BATHAESTHESIA Joint tendon VISCERAL SENSE Organic Sensation Visceral Pain Visceroceptors autonomic Nerve Hunger, Nausae Referred Pain Sensory receptors of the skin

8. Mechanoreceptors TYPESITE TOUCH AND PRASSURE RECEPTORS Free nerve ending MEISSNER’S tactile PACINIAN HAIR END ORGANS PROPRIOCEPTORSTendon Of Muscle PRESSORECEPTORS AND STRETCH RECEPTORS

9. Type of Sensory Receptors Mechanoreceptor Chemoreceptors Thermoreceptor Electromagnetic radiation and pain

10. Thermoreceptors Kulit menerima sensasi Dingin dan Panas Suhu akan mengaktifkan Group IIIA Fiber dan C Fiber Spesific receptor Krause untuk panas, Ruffini untuk dingin Temperatur Panas 20-45C, >45C reseptor pain aktif Temperatur Dingin 15-29C,

11. Stimulasi Pain: electrical, mechanical, extremes of heat and cold, and chemical Electromagnetic receptors are neuroepithelial cell ex: retina terhadap cahaya Pain receptors are nociceptors. Three kind of pain are sense: - Deep Pain from: muscle, tendon, joint and fascia - Superficial or cutaneus pain - Visceral pain

12. Biophysical Properties of the Skin Electrical properties of skin: water with salt dissolved from sweat glands, chemically pure water does not conduct electricity, moist skin conducts electricity ex: palm and soles, Surface electrical Resistance of skin Thermoregulatory Sweating Electrolyte conductivity in skin

13. Regulation of body temperature Thermostatic control of temperature occurs in spinal cord and hypothalamic Reflex thermoregulatory include: autonomic, spmatic, endocrine and behavioural pattern Control cold from the posterior hypothalamus Control warmth from the anterior hypothalamus Increase catecholamine from adrenal is an important endocrine respone to cold Increase heating would increase reflexly the blood supply

14. Physiological Effects of heat and Cold Vascular control in skin: hyperaemia (increase blood flowing into dilated makes skin become fiery red Vasodilatation with heating release of histamine like substance that dilate the capillaries and axon reflex Type of mechanism VasoconstrictionVasodilatation NeuralSympathetic nerveAxon reflex HormonalL-epinephrin Norepinephrin Bradikinin Acetylcholine Local ChemicalHistamine RadiationsUV, IRR

15. Vascular control in muscles: relation to muscle oxygen requirements Evidence base showing that muscle blood flow is not increased by heat. Heat and exercise will increase blood flow more than exercise alone Local heating over 45C increase capillary permeability and dilatation cause redness and oedema, blister formation is due to activity of proteolytic enzymes in skin, and denaturation and death of cells and tissue

16. Summary of the local physiological effects of heating Increase in temperature 39-44C Analgesic Efffects on sensory Nerve endings Capillary Dilatation Axon reflex Reduction of pain And muscle spasm Increased Capillary filtration Clearing of metabolism Reduction of oedema Arteriole dilatation Increased vasodilatation Increase nutrient Antibodies leucotysosis Cronic inflammation OR Acute inflammation Increase Skin blood Flow INCREASED METABOLISM Biochemical And biopysical Reaction stimulated DECREASED VISCOSITY OF COLLAGEN Increased extensibility Of tendon and capsule Ligament is produced by Stretch and load adhesions