MIDTERM EXAM-LECTURE 1

Question 1

What are 2 pain chemicals

Answer 1

Potassium and serotonin

Question 2

What are 2 red flag signs

Answer 2

Unexplained weight loss and night sweats

Question 3

Chronic pain is pain that persists for more than?

Answer 3

3 months

Question 4

2 mechanisms that can account for chronic pain:

Answer 4

Mechanical and chemical, chronic nerve entrapment

Question 5

What types of TX are best for chronic pain

Answer 5

Biopsychosocial
Medication, counselling, group program.

Question 6

Example of an objective way to evaluate pain:

Answer 6

Pain scales (VAS) and (MPQ)

Question 7

C Fibers conduct pain that is:

Answer 7

Longer lasting or burning

Question 8

Gate control theory?

Answer 8

Decrease of sensation of pain: A beta fibers

Question 9

The area in the spinal cord where “gating of pain” occurs is called:

Answer 9

Substantia Gelatinosa

Question 10

3 stages of tissue healing:

Answer 10

Inflammation
Proliferative
Remodelling

Question 11

Time lines for tissue healing:

Answer 11

I- 4-6 days
P-4-24 days
R-21 days- 2 years

Question 12

What is a cytokine? Name one?

Answer 12

Chemicals that are produced by WBC signal other white blood cells to come and get things moving
TGF **

Question 13

A hyperirritable spot in muscle or fascia is known as a:

Answer 13

trigger point

Question 14

CPTBC Standard 18- what is it?

Answer 14

The physical therapist is responsible and accountable
for the physical therapy services provided by
personnel working under their supervision
(supervisees)

Question 15

What is evidence-based practice?

Answer 15

best available evidence with clinical judgement

Question 16

Adverse effects of pain:

Answer 16

spasm, weakness, decreased ROM, fatigue, insomnia, etc.

Question 17

Common mechanisms to account for chronic pain

Answer 17

Mechanical – nerve entrapment
Chemical – previously mentioned chems
Regeneration – as nerves are re-growing can be a period of increased nerve irritation.
Reflexes – persistent motor reflexes after acute inflammation gone
Inhibitory failure – failure of the CNS to release endogenous opiates – eg MS, SCI pain.

Question 18

Referred Pain

Answer 18

Pain arising from deep structures but felt at another distant site

Question 19

A delta

Answer 19

sharp and pricking sensation – well localized and of sharp sensation

Question 20

Endogenous Opioids

Answer 20

endorphins, dopamine, serotonin, enkephalins

Question 21

Delays in wound healing

Answer 21

to compromised immunity
Certain meds such as NSAIDS, Steroids and anti-rejection drugs will slow the healing process
Radiation and chemotherapy will also delay the healing process.
Aging will also delay healing

Question 22

trigger point?

Answer 22

Muscle knots are hyperirritable spots in muscle or fascial tissue known as myofascial trigger points

Question 23

Trigger points typically fall into one of two categories:

Answer 23

Active. These active trigger points produce intense pain in the body.
Latent/hidden. You don’t feel pain from these latent/dormant trigger points unless you press on them

Question 24

Treatments for myofascial trigger points

Answer 24

Therapeutic massage or relaxation massage
Myofascial release/fascial rolling
Therapeutic stretching techniques
Dry-needling
Low level laser therapy
Electrostimulation
Pulsed ultrasound
Mechanical vibration
Ischemic compression
“Spray-and-stretch” cooling spray

Question 25

most reliable and most potent physiological stimulator of myofibroblast contraction?

Answer 25

TGF-beta-1

Question 26

Dry cupping in North America ?

Answer 26

“Western-medicine” perspectives involves dry cupping to trigger points or areas of myofascial restriction or soft tissue pain