Nerve Injuries and Pain Flashcards
mildest form of nerve injury usually caused by trauma
what’s usually affected first
examples
neuropraxia
(sensory affected first)
- compression or ischemia - conduction block
- traction - burner or stinger in sports
motor weakness, minimal demyelinization, little atrophy, no wallerian degeneration, rapid recovery
result of severe crush or contusion
axonotmesis
nerve fiber damage, motor and sensory loss, wallerian degeneration present, slow recovery
contusion, stretch or laceration causing transection of the nerve
neurotmesis
loss of continuity, motor/sensory/autonomic loss
requires surgery
most acute pain is result of what
physiological nerve irritation
most chronic pain is result of what
pathological pain due to nerve compression
what is the term that means pain is amplified
hyperalgesia
what fibers recognize inflammation and tissue damage
C fibers
what is a potent angiogenic agent that stimulates formation of new capillaries
hyaluronic acid
what substances are released when trauma and inflammation occur
substance P
bradykinin
serotonin
leukotrienes
what chemicals are released during inflammation
lactic acid potassium histamine glycosaminoglycans prostaglandin E2
what is a transection of a nerve causing multiple synapse recovery
traumatic neuroma
chronic instability may result in mechanoreceptors morphing into nociceptors causing hyperconvergence
wide dynamic receiver
what decreases threshold which increases action potentials which causes pain
norepinephrine
what chemical mediators does connective tissue release (activating peptides) which cause pain and decrease motion
autocoids
what alters neurotransmitters and creates a vicious cycle with pain
depression
what are pain amplifiers
inflammation traumatic neuroma wide dynamic receiver norepinephrine connective tissue depression
what are the antinociceptive systems (things that decrease pain)
descending inhibition medications electrical stim ice psychogenic (love, laugh) adjustments
what is our endogenous drug store that it full of morphine, endorphins, and enkephalins
this process is known as
periaquetductal gray
descending inhibition
pain during active movement
passive movement
active - muscle / tendon
passive - ligament, joint (sclerotogenous)
pin point pain
bursal irritation
facet tenderness
deep and boring pain
viscera
burning pain
causalgia (PNE)
referred pain
viscerogenic
radiating pain
along a nerve
radiculo-
nerve root
neuro-
peripheral nerve
- algia
bouts of pain
- itis
constant pain
trigeminal neuralgia pain
bouts of pain
sciatic neuritis pain
constant pain
lancinating calf pain indicates what
myofascial pain
pinpoint palpable tenderness at L4 with sclerotogenous pain indicates what
facet
dermatogenous pain is described as what
well defined and peripheral
opiates from the ___ descend down to bathe dorsal horn and reduce incoming pain messages
periaqueductal gray
descending inhibition
facilitation due to acute nerve compression bombardment of dorsal horn with opiates to shake off the pain and get the body ready to respond to immediate threat
descending modulation
who came up with gait control theory
Wall
inhibiting system occurs when fast conducting proprioceptive and mechanoreceptive message close the gait on slow pain fibers
gate control theory - Wall
distraction principle such as rubbing elbow, tens unit
proprioception interpreted faster than nociceptive fibers
afferent inhibition
group 3 nociceptors are associated with what terms
deep joint
myelinated
A fibers
group 4 nociceptors are associated with what terms
deep joint
unmyelinated
C fibers
functional disturbance of pain pathway causes what
neuropathic pain
pain due to stimulus which does not normally provoke pain
allodynia
the reason why the brain interprets pain from multiple tissues - rationale for referred pain
central convergence projection
pressure on the nerve is known as
neurothlipsis
what is an autoimmune attack on C1 transverse ligaments
grisel syndrome
what is distorted or impaired voluntary movement
dyskinesia
what is impairment of viscera due to nervous system which can be measured by skin temperature differentiation
dysautonomia
acute nerve compression is caused by what
first thing affected?
what’s the product of this?
left over pain?
focal obstruction or trauma or structural changes in IVF
- vascular
- edema - hypoxia leads to necrosis - lowers threshold for action potential firing
- facilitation or facilitate pain - spillover, ascending inhibition, neuropathic pain left over
chronic nerve compression is caused by what
what then occurs
acute –> chronic
axoplasmic transport abberation, descending inhibition
retrograde - diminished nerve transmission
anterade - wallerian degeneration - disstal to proximal death of nerve
local tissue death - Hiltons law - nerve innervates tissues and if nerve dies then goes tissue
