Orthopedics (Pain) Flashcards
What are the four types of pain?
referred pain, radiating pain, radicular pain, radiculopathy
What is referred pain?
pain perceived at a site adjacent to or distant from the site of origin
What is radiating pain?
pain that moves from the original area outwards to another part of the body
What is radicular pain?
pain along the dermatomal distribution of a nerve root due to inflammation or irritation of the nerve root (eg. sciatica)
What is radiculopathy?
spinal nerve root irritation along the distribution of a path that leades to pain, numbness or muscle weakness that may be associated with trophic changes/atrophy. detected by abnormal DTRs, muscle strength of sensory tests
A patients broad flat hands rubbing a large area often indicates what type of pain?
referred pain
one or two fingers pointed to a specific spot often indicates what?
exact somatic structure that is damaged
What are the two types of pain onset?
insidious
sudden
What are three qualities of most visceral (organ) pain?
poorly localized
dull
accompanied by autonomic symptoms (diaphoresis, nausea, anxiety, pallor, weakness)
What are four qualities of most somatic pain? (bone/muscle)
sharp or dull
well-localized or diffuse
deep or superficial
usually doesnt have autonomic components
Pain with isometric contraction generally indicates:
that the muscle being contracted is injured/irritated
Pain with passive stretching generally indicates:
injury to either ligaments, muscle or tendon
*if passice stretching in one direction is painful and active isometric contraction in the other direction is painful, injury is likely muscle/tendon
Pain in a muscle belly with direct pressure generally indicates:
trigger point, tendonitis or muscle strain
Pain with joint distraction/gapping or shearing generally indicates:
articular/ligamentous injury
Pain with a joint in compression generally indicates:
cartilaginous injury
Painless crepitus generally indicates:
degenerative joint disease, congential deformity, muscle spasms
Painful crepitus generally indicates:
degenerative joint disease
Tender areas of a muscle belly with referred pain generally indicates:
trigger points
tenderness directly over the joint line generally indicates:
ligamentous injury
tenderness at muscle origin and insertion generally indicates:
chronically weak muscle
Chapmans reflexes that are exquisitely tender, grainy or painful generally indicate:
(visceral malfunction), active Chapmans reflexes
Pain at rest along a meridian or at its alarm point generally indicates:
deficient chi
Tenderness to palpation along a meridian or its alarm point generally indicates:
excessive chi
pain on either side of a spinous process generally indicates:
probably joint dysfunction at that level
tenerness of a muscle belly that decreases with a passive shortening of the muscle generally indicates:
muscle strain
Correct muscoluskeletal diagnosis depends on what four things:
knowledge of functional anatomy,
accurate patient history
diligent observation
thorough exam
How long is considered acute pain?
7-10 days
How long is considered subacute pain?
10 days-7 weeks
How long is considered chronic pain?
greater than 7 weeks
What kind of pain is generally worse with activity and better with rest?
mechanical
What kind of pain is generally worst in the morning with stiffness but better with activity?
chronic inflammation/edema
What kind of pain is generally late-day pain, with or without stiffness?
joint congestion
What kind of pain is worse with initial motion and no better with rest?
acute inflammation
What kind of pain doesnt generally change quality with rest or activity?
bone, cancer, or visceral disease
What is the circle concept of instability?
injury to structures on one side of a joint that cause instability can cause injury to structures on the opposite side. Thus, with trauma the entire joint complex needs to be examined
