Apex- Misc: Pain

Question 1

Pain from a stimulus that does not normally produce pain

example

Answer 1

Allodynia

Fibromyalgia

ALL things cause pain

Question 2

A stimulus expected to produce pain

example

Answer 2

Algogenic

surgical incision

Question 3

No pain sensed when met with a painful stimulus

example

Answer 3

Analgesia

opioid analgesics to relieve kidney stone pain

Question 4

Abnormal and unplesant sense of touch

example

Answer 4

Dysethesia

Dys= abnormal/dysfunctional

burning senssation from diabetic neuropathy

Question 5

Exaggerated pain response to a painful stimulus

example

Answer 5

hyperalgesia

opioid-induced hyperalgesia (remi)

Question 6

Pain localized to a dermatome

example

Answer 6

Neuralgia

Herpes zoster (shingles)

Question 7

Impaired nerve function

example

Answer 7

neuropathy

silent MI from diabetic neuropathy

Question 8

Abnormal sensation described as pins and needles

example

Answer 8

Parasthesia

P = Pins

nerve stimulation during regional anesthesia

Question 9

Burning sensation from diabetic neuropathy is classified as:

A. Neuralgia
B. Neuropathy
C. Dysesthesia
D. Paresthesia

Answer 9

C. Dysethesia

abdormal or unpleasant sense of touch

neuralgia is pain localized to a dermatome (herpes zoster)
neuroapthy is impaired nerve function (silent MI from diabeti neuropathy)
parasthesia is abnormal sensation described as pins and needles (nerve stim during regional)

i guess neuropathy just describes the imapred nerve function but the actual sensation being felt is dysethesia = altered/abnormal/unplesant

Question 10

Explain how SSRIs and SNRIs can treat chronic pain

Answer 10

Okay so pain modulation occurs in the spinal cord
> with central sensitization, the efficacy of the descending inhibitory pain pathway is impaired
> the descending inhibitory pain pathway uses** norepi and serotonin **as inhibitory transmitters

okay so
1. SSRIs prevent reuptake of serotonin - more available
2. SNRIs prevent the reuptake of norepi - more available

more inhibitory neurotransmitters available to treat chronic pain

Question 11

Where does pain modulation occur?

Answer 11

in the spinal cord

Question 12

Names for type 1 and type 2 complex regional pain syndromes

what is the key distinction between the two?

Answer 12

1. Reflex sympathetic dystrophy
2. Causalgia

Type 2 is always preceeded by nerve injury
Type 1 is not

(Causualgia = CAUSED by nerve injury)

Question 13

Which CRPS is ALWAYS preceeded by a nerve injury, type 1 or type 2?

Answer 13

Type 2

Type 1 = Reflex sympathetic dystrophy
Type 2 = CAUSALGIA - nerve pain CAUSES the issue

Question 14

What is characterized by neuropathic pain with autonomic involvement?

Answer 14

Complex regional pain syndrome

Question 15

Match the following regional blocks: thoracic paravertebral, celiac plexus, superior hypogastric plexus block:

• for breast surgery, thoracotomy, and rib fractures
• -for cancer pain of the pelvic organs
• for caner pain of the upper abdomen

Answer 15

Thoracic paravertebral = breast surgery, thoracotomy, rib fxs
Superior hypogastric plexus = cancer pain of the pelvic organs
Celiac plexus block = cancer pain of the upper abdomen

Question 16

What kind of block is used for postdural puncture headaches?

Answer 16

Sphenopalantine

Question 17

T/F: the optic nerve is enveloped by the meningeal sheath and is bathed in CSF

Answer 17

True

Question 18

3 risk factors for complex regional pain syndrome

Answer 18

1. female (cait)
2. previous trauma (cait)
3. previous surgery (cait)

neuropathic pain with autonomic invovlement

Question 19

T/F: the paravertebral space is a potential space

local anesthetic deposited here targets what?

Answer 19

True

the ventral ramus of the spinal nerve as it exits the vertebral foramen

Question 20

What kind of block can be used for cancer pain of the pelvic organs

Answer 20

superior hypogastric plexus block

urterus, ovaries, prostate, descending colon

Question 21

label

Answer 21

sphenopalantine ganglion

Question 22

What type of block can cause contralateral amaurosis

Answer 22

Retrobulbar

amaurosis = blindness

LA injected itno the optic sheath can migrate towards the optic chiasm, where it can anesthetize CN2 and 3 on the oppsite side of the block