Miscellaneous

Question 1

Tectorial membrane

Answer 1

Is in the cervical region

Continuation of posterior longitudinal ligament

Covers dens of C2

Question 2

Corticosteroids

Answer 2

Anti-inflammatory

Can be used to reduce inflammation and edema around nerve roots or spinal cord to treat spinal stenosis

Can weaken bone and ligaments

Don’t want to give corticosteroid injection too frequently because can deteriorate tendons and ligaments

Question 3

Epidural injection

Answer 3

Inject steroid into epidural space

May help with radicular (spinal nerve root) pain by reducing inflammation around nerve root

Question 4

Can the nucleus pulposus become inflamed?

Answer 4

No, because it doesn’t have blood vessels within it!

Question 5

Myofascial Pain Syndrome

Answer 5

Chronic pain caused by trigger points and fascial constriction

Have a knot and every time you press on it, pain shoots in the same direction (elsewhere)

Can get rid of pain by deep tissue massage or trigger point injections

Can tell difference between MPS and muscle strain because muscle strain does not produce pain elsewhere, only local

Trigger points are caused by chronically strained muscles

Question 6

Can pain from radiculopathy be reproduced with palpation?

Answer 6

No, because can’t push your finger down far enough to hit the nerve

Question 7

Why do you get muscle spasm when you have pain?

Answer 7

Body reacts to protect you when you’re in pain, and does this by producing muscle spasms (working all the time)

Question 8

Glaucoma drugs

Answer 8

Acetazolamide

Brimonidine

Dorzolamide

Lantanoprost

Mannitol

Timolol

Question 9

NSAIDs

Answer 9

Aspirin

Diclofenac

Ibuprofen

Indomethacin

Ketorolac

Naproxen

Sulindac

Meloxicam

Celecoxib (COX2)

Question 10

Opioids for diarrhea

Answer 10

Diphenoxylate

Loperamide

Question 11

Opioide that is antitussive (anti-cough)

Answer 11

Dextromethorphan

Question 12

Opioids for mild to moderate pain

Answer 12

Propoxyphene (taken off US market)

Codeine

Question 13

Opioids that are mixed partial agonist/antagonist for moderate to severe pain

Answer 13

Pentazocine, aka Talwin (not commonly used in practice; but was for moderate to severe pain)

Buprenorphine (also called partial agonist; for moderate to severe pain)

Question 14

Opioid that is strong mu AND kappa agonist for moderate to severe pain

Answer 14

Fentanyl (80x more potent than morphine!!)

Question 15

Opioids that are mu agonists for moderate to severe pain

Answer 15

Morphine

Hydromorphone

Hydrocodone

Meperidine

Methadone

Oxycodone

Question 16

Opioid antagonists/blockers

Answer 16

Naloxone

Naltrexone

Question 17

Weak mu agonist that is NOT an opiate derivative

Answer 17

Tramadol (Ultram)

Question 18

Local anesthetics

Answer 18

Benzocaine

Cocaine

Lidocaine

Bupivacaine

Ropivacaine

EMLA

Question 19

Adjuvant analgesics

Answer 19

Topiramate (AED)

Gabapentin (AED)

Pregabalin (AED)

Amitryptiline (TCA)

Capsaicin (topical)

Question 20

Skeletal muscle relaxants

Answer 20

Baclofen

Carisoprodol (Soma)

Cyclobenzaprine

Tizanidine (centrally acting alpha 2 agonist)

Question 21

Weak mu opioid agonists

Answer 21

Tramadol (but not an opiate derivative!)

Propoxyphene (withdrawn from US market!)

Question 22

Moderate mu opioid agonists

Answer 22

Hydrocodone

Codeine

Question 23

Moderate-strong mu opioid agonists

Answer 23

Oxycodone

Hydromorphone (more potent than morphine which is a strong agonist…)

Meperidine

Question 24

Strong mu opioid agonists

Answer 24

Morphine

Fentanyl (also strong kappa agonist)

Methadone

Question 25

Anatomy pairs in leg/ankle/foot

Answer 25

Deep peroneal nerve + anterior tibial artery (in anterior compartment of leg)

Sural nerve + small saphenous vein (in cutaneous part of posterior compartment of leg)

Tibial nerve (of sciatic nerve) + posterior tibial artery (in posterior compartment)

Question 26

Anatomy pairs in orbit

Answer 26

Nasociliary nerve + ophthalmic artery (run lateral to medial over the optic nerve)