Non-Neuromusculoskeletal Sources of Skeletal Symptoms Flashcards
What is a sign?
Clinical findings:
- swelling
- RROM
- Strength
- sensation
- joint integrity
What is a symptom:
what the patient reports
- pain
- nausea
- fatigue
- unstable
Referred symptoms
symptoms that are felt at a location other than their site of origin
Radicular symptoms
symptoms associated with nerve root compression/pressure
- irritation or nerve root
- weakness in myotome
- numbness tingling over the dermatome
- and reflexes changes (hypo reflexive)
Pain descriptors of Musculoskeletal origin:
Ache, sore, heavy, hurting, dull, cramping, deep
Pain descriptors of Neurogenic Origin:
Sharp, crushing, pinching, burning, hot, searing, itching, stinging, pulling, jumping, shooting, pricking, gnawing, electrical
Pain descriptors of vascular origin
Throbbing, Pounding, Pulsing, beating
Pain descriptors of emotional origin
Tiring, Miserable, Vicious, agonizing, nauseating, frightful, piercing, dreadful, punishing, torturing, killing, unbearable, annoying, cruel, sickening, exhausting
Pain assessment model
PQRST
P of the pain assessment model
provocation/palliation
- What makes it better or worse
Q of the pain assessment model
quality/type:
- Pain descriptors
R of the pain assessment model
region/radiation
- Where is it located, did the symptoms move
S of the pain assessment model
severity
- Pain scale
T of the pain assessment model
timing
- What brings it on and how long does it stay
what are constitutional symptoms
Theses can be yellow/red flags that the problem may lie outside of your scope of practice
what are examples of constitutional symptoms
Fever
Diaphoresis
Sweats
Nausea
Vomiting
Diarrhea
Pallor
dizziness/syncope
Fatigue
Weight loss (esp. unexplained weight loss)
Non-Neuromuscularskeleatal symptoms:
- sources
- what do they mimic
- what do they represent
- sources can be visceral structures or systemic conditions
- mimic neuromuscular skeletal symptoms in location
- ususally represent a medical condition
What are the mechanisms of referred visceral pain
- embryologic development
- multi-segmental innervation
- direct pressure
Embryologic development of referred pain
- Pain is referred to site where organ was located in fetal development
- As we develop organs and tissue migrate
- Ex: Heart was closer to the cranium but pericardium was closer to the gut
Multi-segmental innervation of of referred pain
- Major visceral organs are innervated by afferent fibers from multiple spinal levels
- More than 1 root level
Direct pressure an shared pathways:
- Organs impinging the respiratory diaphragm can refer pain
- A diseased organ puts pressure on the diaphragm which can cause pain into the neck and shoulder
What commonly refers to the cervical spine
- lung
- liver
- heart
What commonly refers to the shoulder
- lung
- liver
- heart
- gall bladder
- pancreas
- duodenum
What commonly refers to the lumber spine
- GI
- Uterus
- Kidneys
