Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Anesthesia Basics > Ch. 43 Chronic Pain Management > Flashcards

Ch. 43 Chronic Pain Management Flashcards

1
Q

What is nonciceptive pain?

A

pain caused by activity in peripheral pain neurons due to ongoing tissue injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is neuropathic pain?

A

pain caused by abnormal function of the nervous system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Osteoarthritis is an example of what type of pain?

A

nonciceptive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Diabetic neuropathy is an example of what type of pain

A

neuropathic pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is hyperalgesia?

A

severe pain to a normally minimally painful stimulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is allodynia?

A

pain to normally nonpainful stimulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is radicular pain?

A

leg pain (usually in regards to lower back pain) AKA sciatica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is time period after which acute low back pain becomes chronic low back pain?

A

3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What occurs with the majority of episodes of acute low back pain?

A

they resolve without treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is nucleus pulposus?

A

jelly-like substance in the middle of the spinal disc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is HNP?

A

herniated nucleus pulposus or DISC HERNIATION - when some of the gelatinous central nucleus pulposus spills out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the annulus fibrosus?

A

the fibrous surrounding that of the vertebral disc that contains the gel-like nucleus pulposus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is radiculopathy?

A

signs of dysfunction including numbness, weakness, or loss of deep tendon reflexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is spontaneous pain?

A

pain that occurs with no stimulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What type of pain is spontaneous, hyperalgesia andallodynia associated with?

A

neuropathic pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Postherpetic neuralgia is a result of what condition?

A

damage of small unmyelinated nerves from shingles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is postherpetic neuralgia usually treated with?

A

TCA’s and anticonvulsants (e.g. gabapentin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the most common cause of neuropathic pain?

A

DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What happens in diabetes to cause pain?

A

small unmyelinated nerve are damaged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Is diabetic neuropathy painful or painless?

A

it can be both; it may result in chronic neuropathic pain or in sensory loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Incidence of painful diabetic neuropathy is directly related to what?

A

control of glucose levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Complex regional pain syndrome typically occurs from what?

A

traumatic injury, generally of an extremity

23
Q

What is the only available COX-2 drug?

A

celecoxib

24
Q

Why is a COX-2 inhibiting drug preferred over a non-specific COX inhibiting drug?

A

lower risk of GI complications such as ulcers

25
Q

What type of drugs are venlafaxine and duloxetine

A

venlafaxine (Effexor) and duloxetine (Cymbalta) are seratonin and norepinephrine reuptake inhibitors (SNRI’s)

26
Q

What type of antidepressants can be used to treat chronic pain?

A

TCA’s and some SNRI’s

27
Q

What are side effects of TCA’s?

A

anticholinergic effects and worsening of heart block

28
Q

What anticonvulsants are used to treat chronic pain?

A

gabapentin and pregabalin

29
Q

How might chronic opioid use worsen pain?

A

by inducing hyperalgesia

30
Q

Ketamine has what method of action (in regards to analgesia)?

A

it is a NMDA receptor antagonist

31
Q

What is one limit to the effectiveness of injected steroids?

A

they stop working after about three months of treatment

32
Q

What are two routes that epidural injection of steroids?

A

interlaminar route and transforaminal route

33
Q

How does radiofrequency treatment work?

A

energy is delivered through a needle that denervates the facet joint

34
Q

How often does radiofrequency denervation need to be repeated?

A

every 6-12 months

35
Q

How does provocative diskography work?

A

a small amount of fluid is injected into each intervertebral disc until a painful stimulus is achieved and the offending disc can be located

36
Q

How does intradiscal electrothermal therapy (IDET) work?

A

a steerable thermal wire is placed along the posterior annulus fibrosus and thermal energy is applied to destroy penetrating nociceptive fiber and to change the cross-linking of glycosaminoglycans, thereby stiffening the intervertebral disk

37
Q

What does percutaneous plasma disk decompression consist of?

A

removing a portion of the central nucleus pulposus associaded with a disk bulge

38
Q

What type of block can last weeks to months?

A

neurolytic celiac plexus block

39
Q

The stellate ganglion provides nerves to what parts of the body?

A

head, neck and upper extremities

40
Q

The stellate ganglion fuses what two spinal ganglia?

A

inferior cervical and first thoracic sympathetic

41
Q

What is hyperhidrosis and how does it relate to the stellate ganglion block?

A

excessive sweating of the hands; can be controlled by stellate ganglion block

42
Q

Stellate ganglion block can improve blood flow in what conditions?

A

angina pectoris, Raynaud’s, frostbite, vasospasm, occlusive embolic vascular disease

43
Q

Blocking the single recurrent laryngeal nerve would lead to what? bilateral?

A

single - hoarseness, difficulty swallowing; bilateral - loss of laryngeal reflexes, respiratory compromise

44
Q

What is the most likely placement complication with a stellate ganglion block? What would be the side effects?

A

Placement in posterior tubercle and spread of LA into epidural space; possible partial/profound neuraxial block w/ high spinal or epidural including loss of consciousness and apnea

45
Q

Why is it important to monitor a patient for at least 30 min after stellate ganglion block?

A

maximal LA effects occur at around 15-20min and apnea can occur if improperly placed

46
Q

What ganglia innervates all of the abdominal viscera (with the exception of the descenting & sigmoid colon, rectum and pelvic viscera)?

A

celiac ganglia

47
Q

What are some advantages of splanchnic nerve block over celiac plexus block?

A

no risk of puncturing the aorta, smaller volumes of solution, not affected by tumors of the pancreas

48
Q

In general, celiac plexus and splanchnic nerve blocks are used to control pain arising from where?

A

intra-abdominal structures (pancreas, liver, gallbladder, from stomach to transverse colon)

49
Q

What are side effects of a correctly placed celiac plexus block?

A

diarrhea, orthostatic HoTN

50
Q

What is sympathectomy?

A

removal of sympathetic ganglion

51
Q

What treatment has the best outcomes for unilateral radicular pain?

A

spinal cord stimulation

52
Q

What is ziconotide and what is it used for?

A

non-opioid calcium channel blocker used intrathecal for continuous infusion for pain

53
Q

Where are intrathecal drug delivery devices usually placed?

A

within the abdominal wall

54
Q

What opioid is approved for intrathecal use?

A

morphine

Anesthesia Basics (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions