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musculoskeletal exam four > complex regional pain syndrome > Flashcards

complex regional pain syndrome Flashcards

1
Q

CRPS typically affects what nerve?

A

the ulnar nerve

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2
Q

CRPS maj risk factor is a

A

distal radius fracture

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3
Q

hypertrichosis:

A

abnormal hair growth that occurs in response to an irritated cutaneous nerve

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4
Q

can children get CRPS

A

yes but children under 5 and elderly rarely get CRPS

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5
Q

CRPS s/s 1 - 3

A

prolonged or excessive pain out of proportion to injury
continuous throbbing pain
sensation of burning, stinging, tingling, numbness squeezing

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6
Q

CRPS s/s 4-6

A

sensitivity to heat or cold
swelling
changes in skin temperature - sweaty of cold at times
temps may vary
changes in skin texture, which may become tender thin or shiny in the affected

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7
Q

CRPS s/s 9-12

A

inflammation
skin color changes
stiffness
abnormal hair growth

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8
Q

CRPS s/s 13-16

A

spasms in blood vessels and muscle of the extremities
osteopenia
insomnia/ emotional disturbances

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9
Q

CRPS last two:

A

atrophy

dystonia/ motor planning difficulty

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10
Q

hyperathia:

A

abnormal painful reactions to a stimulus (umbrella term)

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11
Q

allodynia:

A

pain in specific dermatome distribution that is the result of stimulus that is not normally painful

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12
Q

hyperaglesia

A

an increased sensitivity to pain, may be caused by damage to nociceptors or peripheral nerves. more extreme pain than allodynia

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13
Q

hyperesthesia

A

a condition that involves an abnormal increase in sensitive stimuli of the senses

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14
Q

vasomotor:

A

dilation and constriction of blood vessels

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15
Q

sudomotor

A

autonomic function associated with the sweat glands

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16
Q

trophic

A

changes in tissues, due to loss /reduction of nerve and / or blood supply (muscle atrophy, increased nail growth (hypertrichosis) changes in nails, increased hair growth

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17
Q

what causes CRPS:

A

we don’t know

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18
Q

how many types of CRPS are there?

A

two

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19
Q

type 1 CRPS:

A

occurs after an illness or injury that did not directly damage the peripheral nerves of the affected limb

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20
Q

type 2 CRPS:

A

there is an identifiable peripheral nerve injury

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21
Q

grade 1 :

A

algodystrophy - disruption of bone growth combine with sympathetic symptoms

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22
Q

grade 2:

A

sympathetic dystrophy without pain

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23
Q

grade 3

A

sympathetic maintained pain

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24
Q

how many grades are there of CRPS:

A

three

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25
Q

acute phase occurs

A

first 3 months

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26
Q

subacute phase

A

3 more months

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27
Q

chronic phase

A

6 months onward

28
Q

what is of the utmost importance:

A

early diagnosis

29
Q

the patient with CRPS often gets

A

“labeled’ as being a malingerer / magnifier, or having psychological issues

30
Q

IASP:

A

international associate of the study of pain

31
Q

what evaluations could you use?

A

McGill pain questionnaire /

visual analog scale

32
Q

what type of scan would you get?

A

bone scan

33
Q

why would you get a bone scan?

A

evaluate vascular perfusion

34
Q

X - rays are used to

A

evaluate regional osteopenia

35
Q

stage 1 begins

A

at 3 months

36
Q

stage 1 hair growth

A

increases

37
Q

stage 2 hair growth begins at

A

3- 6 months

38
Q

stage 2 hair growth

A

decreases

39
Q

stage 3 begins at

A

6 or more months

40
Q

stage 3 is

A

irreversible

41
Q

_____ of those who receive treatment within the ____ year will have significant improvement

A

80%

first

42
Q

skin =

A

trophic changes

43
Q

vasomotor changes are

A

sensations of warmth or coolness without even touching the pt
skin color change
pain triggered by changes in room temp

44
Q

movement changes are

A

difficulty initiating movement, reports of stiffness tremors
dystonia
cramps/ muscle spasms

45
Q

MCP squeeze test is positive if:

A

the patient pulls away when you grasp MCP and lightly squeeze

46
Q

how do you perform the MCP squeeze test:

A
  • grasp the pt MCP and lightly squeeze
47
Q

drop and swipe test:

A

you drop alcholol swab on pt - positive if they react

48
Q

what two tests could you do with to test CRPS?

A

drop and swipe test

MCP squeeze test

49
Q

dystrophile:

A

device used to measure the amount of weight bearing a person can perform

50
Q

WB goal:

A

bear as much weight as possible through the affected arm

common for pain and swelling to slightly increase 1st few days of the protocol but positive results usually observed

51
Q

intervention ideas:

A

stress loading activities functional activities

maladaptive cortical remapping

52
Q

maladaptive cortical remapping:

A

disorganization of the cortical representation of the affected limb results in pain and dysfunction

53
Q

phase 1 of GMI:

A

laterality

54
Q

laterality means

A

left / right discrimination is the accuracy and speed an identifying whether picture of body part is right or left

55
Q

why is laterality lost in CRPS?

A

the brain tunes out the effective limb

56
Q

four interventions in GMI:

A 
diaphragmatic 
breathing 
meditation 
guide imagery 
biofeedback
57
Q

in CRPS it takes twice as long to :

A

point out the correct body part

58
Q

phase 2 of GMI:

A

imagery

59
Q

phase 3 of GMI:

A

mirror therapy

60
Q

three phases of GMI:

A

laterality
imagery
mirror therapy

61
Q

what modalities do you want to avoid?

A

MOIST HEAT

62
Q

what does moist heat do to CRPS:

A

can increased tissue extensibility followed by exercise - do not use in stage 1

63
Q

what is a good modality to use on CRPS:

A

low level laser light: - EBP are encouraging for treatment and reducing pain

64
Q

what type of splint would you use for CRPS?

A

traction glove

65
Q

pain medications although often prescribed are

A

not effective in alleviating neurogenic pain

66
Q

four surgical interventions include?

A

decompression
sympathectomy
spinal cord stimulation
deep brain stimulation and electrotherapy

musculoskeletal exam four (4 decks)

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