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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
Q

where does the 3rd order neuron on the spinothalamic tract to terminate in the brain to be perceived as pain

A

primary somatosensory cortex

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26
Q

what can decrease the perception of pain

A

rubbing
moist heat
massage
increase stimulation of A beta fibers

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27
Q

how do endorphins work in the peripheral system

A

inhibitory actions causing presynaptic inhibition
act on C fibers

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28
Q

how do endorphins work in the central system

A

relieve pain naturally as they attach to reward centers in the brain

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29
Q

what is the role of the release of opiopetins

A

controlling pain during emotional distress

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30
Q

what are pain management goals

A

control inflammation
alter nociceptive sensitivity
increase opiod receptors
modify n conduction
management

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31
Q

what are the drawbacks of pharmacological agents

A

adverse side effects
may not be sufficient
risk of dependence
patient adherence

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32
Q

how does drugs control pain

A

modify inflammation mediators at periphery
alter pain transmission
alter central perception of pain

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33
Q

what are systemic agents

A

primary method of pain management
NSAIDS, etc

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34
Q

what are spinal analgesia

A

epidural or subarachnoid space of spinal cord

35
Q

what are local injections

A

into structures or painful/inflamed area

36
Q

what is the purpose of massage in rehab

A

local m excitation
increase mobility of adherent or shortened connective fascia

37
Q

what can restrict motion

A

contracture
edema
adhesions

38
Q

what is a contracture

A

soft tissue shortening of contractile or noncontractile
immobilization

39
Q

what is scar tissue

A

over proliferation during this phase of healing causing too many cross-links

40
Q

what is a muscle contracture

A

permanent shortening of m due to deformity
prolonged m spasm
guarding
m imbalance
immobilization

41
Q

what is intraarticular edema

A

excessive fluid formation inside a joint capsule
restricts a capsular motion

42
Q

what is extraarticular edema

A

outside a joint capsule
restricts motion in noncapsular pattern

43
Q

what are adhesions

A

abnormal joining of different types of tissues causing resection

can cause scar tissue

44
Q

what are treatment approaches to restricted motions

A

stretching
motion
sx
physical agents

45
Q

what is plastic deformation

A

elongation produced under loading that remains after load is removed

46
Q

what can cause plastic deformation over time

A

creep
stress relaxation

47
Q

what interventions promote stretching

A

passive with thermotherapy
PNF
ballistic

48
Q

what is massage used to treat

A

motion restrictions to increase soft tissue extensibility, control inflammation, control pain and facilitate motion

49
Q

what motion treatments help limit motion restrictions

A

A/Prom
massage
thermotherapy

50
Q

what can surgical release be used for

A

adhesions, contractures, of tissue limited by spasicity limitations

51
Q

what physical agents help increase soft tissue extensibility

A

thermotherapy
massage

52
Q

what physical agents help control pain and inflammation

A

cryotherapy
thermotherapy
ultrasound
light therapy

53
Q

what physical agents help facilitate motion

A

traction
massage

54
Q

what are physiological effects of massage

A

stretching/loosening adhesions
increased venous and lymphatic flow
decrease neuromuscular excitability
sedation
modulate pain
restore jt mobility

55
Q

what are psychological effects of massage

A

sedation
lowers tension and anxiety
feeling of being helped

56
Q

what are mechanical effects of massage

A

stretching a m
elongating fascia
mobilize adhesions

57
Q

what are reflexive effects of massage

A

ANS
pain and circulation

58
Q

what are indications for massage

A

swelling/edema
decreased ROM
m spasm
pain
HA
trigger point

59
Q

what is effleurage

A

stroke glides over the skin lightly without attempting to move deeper m masses

60
Q

what does effleurage help pinpoint

A

tightness
trigger point
m spasm

61
Q

how does effleurage happen in UE/LE

A

stroking begins at peripheral and move toward heart

62
Q

what is the purpose of effleurage

A

create warmth
flush out at end
create length in m

63
Q

when does effleurage happen during the massage

A

beginning and end

64
Q

what is petrissage

A

kneading manipulation that press and roll m

65
Q

what is the process of petrissage

A

milking effect of tissue and loosening adhesions and increase venous return

66
Q

what is the purpose of petrissage

A

increase venous and lymphatic
reduce m tension
press metabolic waste out

67
Q

when is petrissage best used for treatment

A

break up adhesions
loosen adherent fibrous tissue
increase skin elasticity
perform distal to proximal

68
Q

what is tapotement

A

brisk bouncy firm contact used to tone the m, form sagging skin, and increase circulation

69
Q

what is the purpose of tapotement

A

increase circulation
stimulate subcutaneous structures
tone and firm m

70
Q

what are the types of strokes for tapotement

A

hacking
cupping
beating

71
Q

what is vibration

A

fine tremulous movement occuring to assist secretion removal from airway

72
Q

when is vibration massage used

A

cystic fibrosis
COPD

73
Q

how does friction massage affect the body

A

heavy compression over soft tissue will stretch scars and loosen adhesions

74
Q

what is the purpose of friction massage

A

trigger point release
loosen fibrous scar tissue
aid in absorption of local edema

75
Q

what is cross friction massage

A

used to treat chronic tendon inflammation
chronic overuse

76
Q

what is the purpose of cross friction massage

A

increase inflammation to progress healing
break up adhesions

77
Q

what is latent trigger point

A

no spontaneous pain but can restrict movement

78
Q

what is active trigger point

A

causes pain at rest
TTP
referred pain

79
Q

what is a jump sign

A

patient reacts to the over the trigger point

80
Q

how do we treat a trigger point with massage

A

circular motion held longer and shorter treatment

81
Q

what are the indications for IASTM

A

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
Q

what is functional massage

A

combines passive or active mobilization of the jt
good for stretch and collagen alignment
adds stretch and m compression

83
Q

what is a strain counterstrain

A

preposition in a relaxed initial position by shortening the m

84
Q

what is active release technique

A

combo of specific m movement and specific direct pressure

DPT 715: Modalities (2 decks)

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