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Term 3 > Differential Diagnosis Unit 2 > Flashcards

Differential Diagnosis Unit 2 Flashcards

1
Q

What are the Mechanisms of referred Visceral Pain?

A
  • Embryologic Development
  • Multisegmental Innervation
  • Direct Pressure and Shared Pathway
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2
Q

With the Mechanisms of referred Visceral Pain, Where is pain referred to with Embryologic Development?

A

Pain is referred to a site where the organ was located in fetal development

  • Chest structures and pericardium were part of the gut embryology
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3
Q

With the Mechanisms of referred Visceral pain, What is Multisegmented Innervation? Visceral Pain can be referred to the corresponding somatic area because…?

A
  • The visceral afferent fibers mediating pain travel with the sympathetic nerves, except for those from the pelvic organs, which follow parasympathetic of the pelvic nerve.
  • Because sensory fibers for the viscera and somatic structures enter the spinal cord at the same levels converging on the same neuron
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4
Q

With Direct Pressure and Shared Pathways, What referred pain to the shoulder and what referrers pain to the Neck/Upper Trapezius?

A

(Shoulder)
- Direct pressure from any inflamed, infected or obstructed organ in contact with the respiratory diaphragm can refer pain to the ipsilateral shoulder.

(Neck and Upper-Trap)
- Irritation of the Peritoneal (outside) or pleural (inside) surface of the central area of the respiratory diaphragm can refer sharp pain to the upper trapezius muscle, neck and supraclavicular fossa

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5
Q

What are Characteristics of Pain?

A

It helps define the source or type of pain in question

  • Location: localized, diffuse, segmental
  • Description of sensation: dull, achey, burning, etc
  • Intensity: Severe vs. mild
  • Frequency and duration: Constant vs intermittent
  • Patten: Progressive pattern with onset vs. worse or better, or improvement
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6
Q

What are associated symptoms?

A

These are symptoms that occur alone or in conjunction with the pain of systemic disease

For ex: Burning, difficulty breathing, Night sweats, weakness, numbness/tinging, Heart Palpations

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7
Q

What are the 5 sources of pain?

A
  • Somatic: located in skin and subcutaneous tissue, localized with one finger
  • Somatic: 3 layers; Superficial, Deep Somatic, Psychosomatic
  • Visceral: Internal organs in the trunk or abdomen
  • Neurogenic: Injury to the peripheral nerves, spinal cord pathways, or neurons in the brain
  • Referred: Pain is felt in an area far from the site of the lesion but supplied by the same or adjacent neural segments
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8
Q

With the somatic pain mechanism, what is the referral site with a C7, T1-5 vertebrae lesion site?

A

Interscapular area, posterior

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9
Q

With the somatic pain mechanism, what is the referral site with a shoulder lesion site?

A

Neck, upper back

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10
Q

With the somatic pain mechanism, what is the referral site with a L1 and L2 vertebrae lesion site?

A

SI joint and hip

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11
Q

With the somatic pain mechanism, what is the referral site with a Hip joint lesion site?

A

SI and Knee

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12
Q

With the somatic pain mechanism, what is the referral site with a Pharynx lesion site?

A

Ipsilateral ear

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13
Q

With the somatic pain mechanism, what is the referral site with a TMJ lesion site?

A

Head, Neck, Heart

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14
Q

With the Neuropathic pain mechanism, what is the referral site with a nerve or Plexus lesion site?

A

Anywhere in distribution of a peripheral nerve

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15
Q

With the Neuropathic pain mechanism, what is the referral site with Nerve Root lesion site?

A

Anywhere in corresponding dermatome

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16
Q

With the Neuropathic pain mechanism, what is the referral site with Central Nervous System lesion site?

A

Anywhere in region of body innervated by damaged structure

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17
Q

With the Visceral pain mechanism, what is the referral site with Diaphragmatic Irritation?

A

Shoulder, Lumbar Spine

18
Q

With the Visceral pain mechanism, what is the referral site with Heart lesion site?

A

Shoulder, Neck, Upper Back, TMJ

19
Q

With the Visceral pain mechanism, what is the referral site with Urothelial Tract?

A

Back, Inguinal Region, anterior thigh, and genitalia

20
Q

With the Visceral pain mechanism, what is the referral site with Pancreas, Liver, Spleen, and Gallbladder?

A

Shoulder, Mid-thoracic or low back

21
Q

With the Visceral pain mechanism, what is the referral site with Peritoneal or Abdominal Cavity?

A

Hip pain from abscess of psoas or obturator muscle

22
Q

What can be the underline factor or mimic system that can cause visceral or Neuro-Muscular conditions?

A

Physiological factors such as anxiety, depression and panic disorder

23
Q

What 3 things can influence patient demographics on the condition?

A
  • Sex and Gender
  • Race and Ethnicity
  • Substance Abuse
24
Q

During the Integumentary Screening, what is Hemosiderin Straining?

A

Rusty brown darkening of skin
- Vein valves fail
- Regurgitated blood forces RBCs out of capillaries
- Dead RBCs release iron

Lipodermatosclerosis
- Inflammation of sub-cutaneous fat
- Skin induration (hardening)

Most common: Distal Lower Extremities

25
Q

During the Integumentary Screening, what is Pitting Edema?

A

A depression (“Pit”) remains in the edema for some minutes after firm fingertip pressure is applied

26
Q

During the Integumentary Screening, what is Skin Turgor?

A

A test to pinch the skin and see how quickly the skin goes back to normal

  • A decrease on skin turgor is a late sign of dehydration
27
Q

During the Integumentary Screening, what is the Capillary Refill Test?

A
  • Have the pt. hand or foot above heart level
  • Compress tip of digit until it blanches (Can press nail bed or tip of finger)
  • Release pressure, color (Blood) should return in 2 seconds
  • Check local arterial circulation, dehydration, shock, PAD
28
Q

During the Integumentary Screening, what is the Cellulitis?

A

A bacterial infection that affects the skin’s deeper layers and underlying tissue
- Can make the skin hot
- Can be acutely painful
- Can cause edema
- Can cause induration
- Can have spreading of redness
- May cause irregular, sharp, or elevated borders

29
Q

During a Nail Bed assessment, what can cause Koilonychia?

A

“Spooning of the nail”

Can be caused by Anemia, Thyroid, and syphilis

30
Q

During a Nail Bed assessment, what can cause Beau’s Lines?

A

Alcohol, Nutrition, MI

31
Q

During a Nail Bed assessment, what can cause Nail Pitting?

A

Psoriasis

32
Q

During a Nail Bed assessment, what can cause Nail Thickening?

A

Circulation issues and fungus

33
Q

During a Nail Bed assessment, what can cause Melanoma?

A

Malignancy

34
Q

What are the different Skin Cancer Types?

A
  • Actinic Keratoses (Pre-Cancerous Growth)
  • Basal Cell Carcinoma
  • Squamous Cell Carcinoma
  • Melanoma
35
Q

What is Melanoma? What are the 2 growth phases?

A

Out of control melanocyte growth

  • Radial Growth Phase
  • Vertical Growth Phase

Lifetime risk 2.6%

36
Q

What are some Rick Factors for Skin Cancer?

A

Ultraviolet Light (Sun) Exposure
- Intensity
- Duration
- Age at which exposure occurs
- Tanning bed
- Cumulative (Multiple severe sunburns)
- Degree of pigmentation in that person

  • Weakened Immune System
  • Family or Personal History of Skin Cancer
37
Q

What are the characteristics of Normal Moles (Nevus)?

A
  • Round or close to round
  • Nice even border
  • Brown or tan
  • Stable - Not changing over time
  • 1/4 diameter (Size of pencil eraser)
38
Q

When Screening for Skin Cancer, What is the ABCDE of Melanoma?

A
  • Asymmetry: One half of a mole or birthmark does not match the other
  • Border: The edges are irregular, ragged, notched, or blurred
  • Color: The color is not the same all over and may include different shades of brown or black, or sometimes with patches of pink, red, white or blue
  • Diameter: The spot is larger than 6mm across, although melanomas can sometimes be smaller than this
  • Evolving: The mole is changing is size, shape or color
39
Q

What are warning signs of Melanoma?

A
  • Itching
  • Pain
  • Elevation
  • Bleeding
  • Crusting
  • Swelling
  • Oozing
  • Ulcerations
40
Q

What should you look out for, for Nodular Melanoma? Who is more susceptible for this?

A

Look for
- Elevation
- Firmness
- Growth
(Can happen in any part of the body, can be aggressive)

Men > 60 are more susceptible

Term 3 (51 decks)

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