Module 7 Units 2-5 Flashcards
Pain progression is an indicator of healing. Why is this?
Tissues, when allowed the time to heal, will usually do so. Improved function and decreases in pain are usually good indicators of healing. Pain that occurs on movement, but that abates (becomes less intense) on rest, are further signs of simple musculoskeletal injuries that likely no not involve neighboring tissues.
What is the purpose of inflammation?
To prepare the healing environment
What are the five cardinal sings of inflammation?
Pain, heat, redness, swelling, loss of function
Why is too much inflammation a bad thing?
Too much inflammation can cause additional injury to the surrounding tissues: treatment protocol: PRICE (protect, rest, ice, compress, elevate)
Swelling can cause tissues that were uninjured or only mildly injured to be stretched, sustain micro-tears, or be compressed (reducing BF)
Homeostasis is disrupted by tissue damage. While inflammation is the first physical response we think of, what are some of the others?
The body is driven by homeostasis: the maintenance of orderly organization. Tissue damage releases energy, and that energy will need to be recovered in order to regain wholeness.
Explain how pain is triggered.
The conscious awareness of pain occurs after several synaptic processes occur, allowing action potentials to release neurotransmitters at the level of the cerebral cortex.
What is Neurogenic Inflammation and how does it occur?
A form of inflammation initiated by activation of the PNS C-fiber neurons. It is mediated by neuropeptides from these C-fibers.
A complex series of molecular events triggered by peripheral release of neuroactive substances initiate inflammation.
Neurogenic Inflammation -> increases vascular permeability, redness, heat/swelling
How does pain travel?
Pain is a perception — tissue damage is a stimulus
Action potentials generated in the tissues at the C-fiber travel to the cord, synapse, cross the midline, and after another synapse in the thalamus, end in the cerebral cortex: the venter of consciousness.
Overview of C-fibres. How do they work?
C-fibers release substances at both ends of their axons. Peripherally, pro- and anti- inflammatory mediators: the Axon Reflex or Antidromic Activation.
Centrally, transmitters initiating the pathway for pain perception and all that accompanies that. Orthodontic Activation.
Neurogenic inflammation activated by C-fiber produces pain.
Can the afferent axon be excited at a point other than at the end?
Yes, this information is of great important to chiropractors: Afferent axons can be activated in the dorsal root ganglion area, and at other points as well. Once this occurs, action potential will be generated in both the orthodromic and antidromic directions.
Action potential
Action potentials can generate inside and outside of body. Chronic pain can be central sensitization.
How to limit tissue damage and managing repair.
In addition to the pro inflammatory chemical that are released from primary afferent axons, there will be anti-inflammatory chemicals released from various cells of the immune system. Rest and limiting further damage will decrease further inflammation and hasten the return of homeostasis.
which of these substances are involved in creating the main features of inflammation?
A. Substance P
B. Enkaphalin
C. Glutamate
D.CGRP
A, D
What is meant by “antidromic condiction of action potential” by the C-fiber?
Conduction of the action potential toward the periphery (the skin, muscle, fascia… etc)
What is a “sprain / strain” injury?
Sprain - Ligament injury (stretching, tearing, lacerating..)
Strain - Muscle, tendon, fascia injury (stretching, tearing, lacerating..)
ICD-10 Code = S39.012
