HUMAN FUNCTIONING MSK Flashcards
What are the main features of the vertebrae?
Vertebral body
Vertebral Foramen
Pedicle
Laminae
Spinous process
Transverse process
Articular process
What is the intervertebral vertebral foramen?
An opening between vertebrae through which nerves leave the spine and extend to other parts of the body. It lies between the pedicles of neighbouring vertebrae.
What is the sagittal plane?
(also known as the longitudinal plane)
It is perpendicular to the ground and divides the body into left and right.
What is the coronal plane?
(also known as the frontal plane)
It is perpendicular to the ground and divides the body into posterior (back) and anterior (front) portions.
What is the transverse plane?
(also known as an axial plane)
It divides the body into head and tail portions. It is parallel to the ground, which in humans, separates the head from the feet.
What is the sagittal axis?
Passes horizontally from the posterior to anterior and is formed by the intersection of the sagittal and transverse planes.
What is the frontal axis?
Passes horizontally from left to right and is formed by the intersection of the frontal and transverse planes.
What is the vertical axis?
PAsses vertically from inferior to superior and is formed by the intersection of the sagittal and frontal planes.
What plane and axis does extension and flexion occur in?
The sagittal plane
The frontal axis
What plane and axis does abduction and adduction occur in?
The frontal plane
The sagittal axis
What plane and axis does rotation occur in?
The transverse plane
The vertical axis
Give an example of a movement that occurs in the sagittal plane and frontal axis?
Walking
Squat
Give an example of a movement that occurs in the frontal plane and sagittal axis?
Jumping backs
Cartwheel
Give an example of a movement that occurs in the transverse plane through the vertical axis?
Shaking your head
Twisting your upper body whilst your feet remained planted on the floor.
Define pain
IASP 2020 - an unpleasant sensory and emotional experience associated with, or resembling that associated with actual or potential tissue damage.
What is pain perception?
The understanding of physiological pain, which is generally invoked by stimulus that elicit or threaten to elicit tissue injury. It involves a combination of sensory, emotional, cognitive and behavioural components that collectively contribute to an individual’s experience of pain.
What is somatogenic pain?
Pain with a cause (usually known) localized in body tissue
What is psychogenic pain?
A pain for which there is no known physical cause but the processing of sensitive information in CNS is disturbed
Explain the multidimensional nature of pain?
The sensory dimension - the physical sensations associated with pain
The emotional dimension - pain is often associated with negative emotions, such as fear, anxiety and depression
The cognitive dimension of pain - dimension of pain that refers to the thoughts and beliefs associated with pain
The behavioural dimension - the observable response to pain such as facial expressions, body posture and activity level
The sociocultural dimension of pain - the impact of social and cultural factors on pain percepton eg gender, ethnicity, socioeconoic status and is affected by all of the above factors.
These factors account for differences in pain tolerance among humans.
What is the timeline fr pain?
Acute - 0-6 weeks
Sub-acute - 6 weeks to 3 months
Persistant (chronic) - 3+ months
What is the organisation of the nervous system?
Central nervous system - brain and spinal cord
Peripheral nervous system - cranial nerves and spinal nerves
Autonomic nervous system - heart muscle, smooth muscle, glands
Somatic nervous system - voluntary skeletal muscles
Parasympathetic division - rest and digest
Sympathetic division - active and alert
What are the 5 steps in the perception of pain by the peripheral nervous system?
- Transduction of noxious stimuli by sensory receptors
- Conduction
- Transmission of nocioceptive information
- Modulation of the incoming noxious information
- Perception of noxious information
What regions of the brain are involved in pain processing?
Somatosensory cortex
Limbic system
Prefrontal cortex
Explain the role of the somatosensory cortex?
Sensory processing of pain
The primary somatosensory cortex processes the physical characteristics of pain, such as location, intensity and quality
The secondary somatosensory cortex integrates sensory inputs and contributes to the perception of pain’s spatial and temporal aspects
What is the role of the anterior cingulte cortex?
Emotional and affective aspects
Integrates sensory, emotional and cognitive aspects of pain, playing a role in the subjective experience of pain intensity and emotional response. Contributes to the distressing and motivational aspects of pain perception.
What is the role of the insular cortex?
Emotional and affective aspects
Integrates sensory, emotional and cognitive aspects of pain, playing a role in the subjective experience of pain intensity and emotional responses.
What is the role of the prefrontal cortex?
Cognitive and evaluation attention
Assesses the significance of pain, incorporates evaluations and influences the decision to engage with or disengage from pain-related stimuli.
Explain the role of the prefrontal and anterior cingulate cortex?
Cognitive and evaluation of attention
Regulate attention, cognitive control, and coping strategies related to pain perception.
INFLUENCESDECISION TO ENGAGE WITH PAIN
Explain the role of the periaqueductal gray (PAG)?
Modulation of pain perception
Initiates descending pain modulation pathways, influencing pain transmission and perception through the endogenous pain control mechanisms
Explain the role of the restroventral medulla?
Modulation of pain perception
Contributes to pain modulation by inhibiting or facilitating pain signal as they travel up the spinal cord.
Explain the role of the somatosensory cortex, ACC and Insula?
Integration and pain matrix
Form the core of the pain matrix, integrating sensory, emotional, and cognitive aspects to create the overall pain experience.
Explain the role of the thalamus?
Integration and pain matris
Acts as a relay station, directing pain signals to relevant brain regions for processing.
What are the individual variables in pain perception?
Genetic factors
Cultural factors
Experiential factors
Individuals differences
Psychological factors
Define anterior
Forward, in front of of
Define posterior
Behind, further back
What is the axial body?
Head, neck and trunk
What is the appendicular body
The limbs
Define proximal
Closer to the axial body (toward the trunk)
Define distal
Further from the axial body (further away from the trunk) eg the foot is distal to the thigh
What is an isotonic muscle contraction?
Characterised by a change in length of muscle during contraction without a change in load or resistance
Concentric contraction and eccentric contraction are both types of isotonic muscle contraction
Concentric contraction - muscles shortening under load eg flexion phase of bicep curl
Eccentric - muscle is lengthened under load eg extension phase of a bicep curl
What is isometric muscle contraction?
There is no change in muscle length during contraction eg rectus adbominus during the plank. It is a static muscle contraction, eg holding a bicep curl at one point.
What is isokinetic contraction?
The muscle changes length during contraction. They produce movement at a constant speed. Eg breastroke when swimming when the water provides a constant, even resistance to at adduction movement. To provide this type of contraction you would need to be using an isokinetic dynamoeter system
What are antagonistic muscle pairs?
When muscles work in pairs to produce a movement. Eg flexion at the elbow the bicep contracts and shortens and the tricep lengthens. The bicep is called the agonist and is the main muscle (the prime mover doing the work) and the tricep is the antagonist relaxing and lengthening.
Kicking a football the hamstrings are the antagonists
What are some differential diagnosise for lower back pain?
Alternative conditions that may present with low back pain include:
Neurological - sciatica, higher cord lesion, peroneal palsy, deep gluteal syndrome, spinal stenosis
Systemic - vascular claudication, ankylosing spondylitis
Other - abdominal aortic aneurysm, facet joint arthropathy, osteoporosis, osteoarthisitis, rheumatoid arthisitis, shingles
What is nocioception?
The neural process of encoding and processing noxious stimuli. (a stimulus strong enough to threaten the body’s integrity). Nocioception refers to a signal arriving at the CNS as a result of the stimulation of specialised sensory receptors in the peripheral nervous system.
Nocioceptors can be activated by three types of stimulus: temperature, mechanical and chemical.
The cell bodies of nociceptors are located in the dorsal root ganglia. Their axons extend into the peripheral nervous system.
How are nocioceptors divided?
A delta fibres - large, myelinated, fast conducting fibres, concerned with localized, sharp and fast sensation of pain
Type I As: mechanically sensitive afferants
Type II As: lower heat thresholds but higher mechanical thresholds
C fibres - are small, unmyleinated, slow conducting nerve fibres, concerned with dull, and slow pain sensation.
A-beta are myelinated, large diameter, and have the fastest conduction velocity. These fibrs respond to non-painful stimuli such as: touch sensation, mild pressura and vibration.