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DPT 715: Modalities > Exam 1- Pain Management > Flashcards

Exam 1- Pain Management Flashcards

1
Q

what is an acute type of pain

A

less than 30 days
localized/defined

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2
Q

what is chronic type pain

A

3-6 months
nociceptive (PNS, CNS, SNS)

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3
Q

what is most reliable indicator for pain

A

subjective

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4
Q

what do we need to consider when choosing a measurement for pain

A

pt cognitive ability
symptom duration
time

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5
Q

what can we ask a patient to figure out their pain

A

location
duration
intensity
type
worse or better factors
radiates
sleep patterns
effects on ADLs

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6
Q

what are non verbal factors of pain

A

sighs
gasp
facial
restlessness
rubbing the area
vital sign

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7
Q

what is the primary sensation interpreted by the anterolateral spinothalamic pathway

A

crude touch
pain
temperature

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8
Q

what receives the signals in the anterolateral spinothalamic pathway

A

mechanoreceptors
nociceptors
thermoreceptors

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9
Q

what n/fibers are in the anterolateral spinothalamic pathway

A

c fibers

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10
Q

what is nociception

A

neural process of encoding noxious stimuli

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11
Q

what is pain

A

output of the brain triggered by action potential of nociceptor

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12
Q

what can inhibit nociception

A

modalities

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13
Q

what are the 3 dimensions of pain experience in the brain

A

sensory discriminative- where pain, how it feels
motivational affective- how the pt feels about the pain
cognitive evaluative- what the pt thinks about the pain and what they expect

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14
Q

what is located at the end of the afferent n

A

sensory receptors

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15
Q

what are free n endings

A

type of nociceptor/mechanoreceptor that sense pain

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16
Q

what are nociceptors triggered by

A

intense thermal, chemical, or mechanical
extrogenous
endogenous

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17
Q

what are afferent neurons of PNS

A

c fibers
a delta fibers

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18
Q

what are c fibers

A

small unmyelinated
dull, throbbing, aching
slow onset, long lasting symptoms
emotionally difficult
blocked by opiod

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19
Q

what are A delta fibers

A

longer, myelinated
sensitive to high intensity
sharp, stabbing
quick onset, short
localized
not blocked by opiods

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20
Q

what structural difference makes fibers faster than c fibers

A

myelin

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21
Q

where are the 1st order neurons housed

A

dorsal root ganglion

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22
Q

where do the 1st order neurons go after DRG

A

continue to spinal cord to Dorsal Horn turns to 2nd order

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23
Q

what neuro pathway does pain sensory travel in the CNS

A

spinothalamic tract

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24
Q

where do 2nd order neurons go after dorsal horn

A

anterolateral spinothalamic tract to thalamus where 3rd order is

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25
where does the 3rd order neuron on the spinothalamic tract to terminate in the brain to be perceived as pain
primary somatosensory cortex
26
what can decrease the perception of pain
rubbing moist heat massage increase stimulation of A beta fibers
27
how do endorphins work in the peripheral system
inhibitory actions causing presynaptic inhibition act on C fibers
28
how do endorphins work in the central system
relieve pain naturally as they attach to reward centers in the brain
29
what is the role of the release of opiopetins
controlling pain during emotional distress
30
what are pain management goals
control inflammation alter nociceptive sensitivity increase opiod receptors modify n conduction management
31
what are the drawbacks of pharmacological agents
adverse side effects may not be sufficient risk of dependence patient adherence
32
how does drugs control pain
modify inflammation mediators at periphery alter pain transmission alter central perception of pain
33
what are systemic agents
primary method of pain management NSAIDS, etc
34
what are spinal analgesia
epidural or subarachnoid space of spinal cord
35
what are local injections
into structures or painful/inflamed area
36
what is the purpose of massage in rehab
local m excitation increase mobility of adherent or shortened connective fascia
37
what can restrict motion
contracture edema adhesions
38
what is a contracture
soft tissue shortening of contractile or noncontractile immobilization
39
what is scar tissue
over proliferation during this phase of healing causing too many cross-links
40
what is a muscle contracture
permanent shortening of m due to deformity prolonged m spasm guarding m imbalance immobilization
41
what is intraarticular edema
excessive fluid formation inside a joint capsule restricts a capsular motion
42
what is extraarticular edema
outside a joint capsule restricts motion in noncapsular pattern
43
what are adhesions
abnormal joining of different types of tissues causing resection can cause scar tissue
44
what are treatment approaches to restricted motions
stretching motion sx physical agents
45
what is plastic deformation
elongation produced under loading that remains after load is removed
46
what can cause plastic deformation over time
creep stress relaxation
47
what interventions promote stretching
passive with thermotherapy PNF ballistic
48
what is massage used to treat
motion restrictions to increase soft tissue extensibility, control inflammation, control pain and facilitate motion
49
what motion treatments help limit motion restrictions
A/Prom massage thermotherapy
50
what can surgical release be used for
adhesions, contractures, of tissue limited by spasicity limitations
51
what physical agents help increase soft tissue extensibility
thermotherapy massage
52
what physical agents help control pain and inflammation
cryotherapy thermotherapy ultrasound light therapy
53
what physical agents help facilitate motion
traction massage
54
what are physiological effects of massage
stretching/loosening adhesions increased venous and lymphatic flow decrease neuromuscular excitability sedation modulate pain restore jt mobility
55
what are psychological effects of massage
sedation lowers tension and anxiety feeling of being helped
56
what are mechanical effects of massage
stretching a m elongating fascia mobilize adhesions
57
what are reflexive effects of massage
ANS pain and circulation
58
what are indications for massage
swelling/edema decreased ROM m spasm pain HA trigger point
59
what is effleurage
stroke glides over the skin lightly without attempting to move deeper m masses
60
what does effleurage help pinpoint
tightness trigger point m spasm
61
how does effleurage happen in UE/LE
stroking begins at peripheral and move toward heart
62
what is the purpose of effleurage
create warmth flush out at end create length in m
63
when does effleurage happen during the massage
beginning and end
64
what is petrissage
kneading manipulation that press and roll m
65
what is the process of petrissage
milking effect of tissue and loosening adhesions and increase venous return
66
what is the purpose of petrissage
increase venous and lymphatic reduce m tension press metabolic waste out
67
when is petrissage best used for treatment
break up adhesions loosen adherent fibrous tissue increase skin elasticity perform distal to proximal
68
what is tapotement
brisk bouncy firm contact used to tone the m, form sagging skin, and increase circulation
69
what is the purpose of tapotement
increase circulation stimulate subcutaneous structures tone and firm m
70
what are the types of strokes for tapotement
hacking cupping beating
71
what is vibration
fine tremulous movement occuring to assist secretion removal from airway
72
when is vibration massage used
cystic fibrosis COPD
73
how does friction massage affect the body
heavy compression over soft tissue will stretch scars and loosen adhesions
74
what is the purpose of friction massage
trigger point release loosen fibrous scar tissue aid in absorption of local edema
75
what is cross friction massage
used to treat chronic tendon inflammation chronic overuse
76
what is the purpose of cross friction massage
increase inflammation to progress healing break up adhesions
77
what is latent trigger point
no spontaneous pain but can restrict movement
78
what is active trigger point
causes pain at rest TTP referred pain
79
what is a jump sign
patient reacts to the over the trigger point
80
how do we treat a trigger point with massage
circular motion held longer and shorter treatment
81
what are the indications for IASTM
when hands can not create the necessary force or depth excessive scar tissue forms tendinitis or opathy m and lig strains plantar fascitis and ITB
82
what is functional massage
combines passive or active mobilization of the jt good for stretch and collagen alignment adds stretch and m compression
83
what is a strain counterstrain
preposition in a relaxed initial position by shortening the m
84
what is active release technique
combo of specific m movement and specific direct pressure

DPT 715: Modalities (2 decks)

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