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Principles2 > Pain > Flashcards

Pain Flashcards

1
Q

nociceptive pain:

  1. caused by activation or sensitization of what peripheral receptors? (N)
  2. these are specialized receptors that transduce what stimuli? (NS)
A
  1. nociceptors

2. noxious stimuli

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2
Q

neuropathic pain results from injury or acquired abnormalities to what 2 structures? (P, C)

A

peripheral, central

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3
Q

visceral pain is often associated with abnormalities in sympathetic or parasympathetic activity causing what 3 symptoms and changes in what 2 vital sign? (N, V, S)

A

nausea, vomiting, sweating; changes in HR and BP

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4
Q

parietal pain:

  1. typically felt how? (S)
  2. also described as a what sensation (S)
  3. pain is either what to the area around the organ or what to a distant site? (L, R)
A
  1. sharp
  2. stabbing
  3. localized, referred
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5
Q

acute pain:

  1. caused what 3 types of noxious stimulation? (I, DP, AFoM/V)
  2. typically what? (N)
  3. what are the 2 types of somatic pain? (S, D)
  4. which somatic pain is described as sharp?
  5. which somatic pain is described as dull?
  6. what are 3 adjectives to describe visceral pain? (D, D, M)
  7. what are the 4 subtypes of visceral pain? (LV, LP, RV, RP)
A
  1. injury, disease process, abnormal function of muscle or viscera
  2. nociceptive
  3. superficial, deep
  4. superficial
  5. deep
  6. dull, diffuse, midline
  7. localized visceral, localized parietal, referred visceral, referred parietal
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6
Q

chornic pain:

  1. healing period is what range of months?
  2. can it be nociceptive, neuropathic or mixed?
  3. are psychological or environmental factors involved?
  4. are neuroendocrine stress responses enhanced or diminished?
  5. are there prominent sleep and affective disturbances?
A
  1. 1-6 months
  2. yes
  3. yes
  4. diminished
  5. yes
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7
Q

chronic pain:

  1. often what type of pain? (N)
  2. what are 4 characteristics of this pain? (P, L, B, H)
  3. deafferentation pain is associated with loss of what input after amputation? (S)
  4. what system has a major role in sympathetically maintained pain?
  5. hyperpathia can be the presence of what 3 things? (H, A, H)
A
  1. neuropathic
  2. paroxysmal, lancinating, burning, hyperpathia
  3. sensory
  4. SNS
  5. hyperesthesia, allodynia, hyperplasia
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8
Q

Chronic pain forms:

  1. what are 5 forms of chronic pain? (CP, CL, PNS/NRL, CVD, MD)
  2. strokes, spinal cord injuries and multiple sclerosis are what type of chronic pain?
  3. rheumatoid arthritis and osteoarthritis are what type of chronic pain?
  4. diabetic neuropathy, causalgia, phantom limb pain, postherpetic neuralgia are what type of chronic pain?
  5. are RA and OA neuropathic or nociceptive?
  6. are diabetic neuropathy, causalgia, phantom limb pain, postherpetic neuralgia neuropathic or nociceptive?
A
  1. cancer pain, CNS lesions, peripheral nervous system/nerve root lesions, chronic visceral disorders, musculoskeletal disorders
  2. CNS lesions
  3. musculoskeletal disorders
  4. peripheral nervous system/nerve root lesions
  5. nociceptive
  6. neuropathic
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9
Q

neuronal pathway:

  1. this path transmits noxious stimuli from what to what? (P, C)
  2. where is the cell body of the first order neuron? (DRG)
  3. where is the cell body of the second order neuron? (DH)
  4. where is the cell body of the third order neuron? (T)
A
  1. periphery, cortex
  2. dorsal root ganglia
  3. dorsal horn
  4. thalamus
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10
Q

first order neurons:

  1. send proximal end of axons into the SC via what spinal roots at each cervical, thoracic, lumbar and sacral level? (D)
  2. some unmyelinated afferent C fibers enter SC via what nerve motor root? (V)
  3. the entry to this above way accounts for pain after what of the dorsal nerve root called a rhizotomy? (T)
  4. these neurons synapse with 2nd order neurons where? (DH)
  5. axons of the 1st order may synapse with what 3 neurons? (I, SN, VHMN)
A 
1. dorsal
2 ventral
3. transection
4. dorsal horn
5. interneurons, sympathetic neurons, ventral horn motor neurons
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11
Q

second order neurons:

  1. as afferent fibers enter the SC, they segregate according to what? (S)
  2. large, myelinated fibers mediate in what direction? (M)
  3. small unmyelinated fibers mediate in what direction? (L)
  4. pain fibers ascend or descend what range of SC segments before synapsing with 2nd order neurons?
A
  1. size
  2. medial
  3. lateral
  4. 1-3 segments
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12
Q

SC lamina:

  1. the first how many lamina make up the dorsal horn?
  2. these lamina receive all afferent neural activity and represent the principal site for what? (PM)
  3. 2nd order neurons are with what type of specific or what type of neuron? (N, WDR)
  4. nociceptive specific only serve what type of stimuli? (N)
  5. wide dynamic range neurons also receive non-noxious input form what 3 fibers?
A
  1. 6
  2. pain modulation
  3. nociceptive-specific, wide dynamic range
  4. noxious
  5. A-beta, A-delta, C
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13
Q

nociceptors:

  1. first pain input from what fibers?
  2. what are 3 adjectives to describe first pain? (F, S, WL)
  3. is first pain latency short or long?
  4. what test test first pain? (P)
  5. what fibers conduct 2nd pain?
  6. what are 3 adjectives to describe 2nd pain? (SO, D, PL)
  7. most nociceptors are free nerve endings that sense what 3 tissue damages? (H, M, C)
A
  1. A delta
  2. fast, sharp, well localized
  3. short
  4. pinprick
  5. C fibers
  6. slower onset, duller, poorly localized
  7. heat, mechanical, chemical
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14
Q

what 2 fiber inputs sense somatic nociception?

A

A delta, C

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15
Q

cutaneous nociceptors:

  1. present in what 2 tissues? (S, V)
  2. 1st afferent neurons reach tissues by traveling along what 3 nerves? (SS, S, P)
  3. somatic nociceptors include those in what 2 tissues (S, DT)
A
  1. somatic, visceral
  2. spinal somatic, sympathetic , parasympathetic
  3. skin, deep tissue
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16
Q

deep somatic nociceptors:

  1. less or more sensitive to noxious stimuli than cutaneous?
  2. easily sensitized by what? (I)
  3. what are 2 adjectives to describe pain? (D, PL)
  4. specific nociceptors in what tissue and what capsules? (M, JC)
A
  1. less
  2. inflammation
  3. dull, poorly localized
  4. joint capsules
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17
Q

visceral nociceptors:

  1. what are 2 adjectives to describe them? (I, S)
  2. afferent activity enters between what SC range?
  3. what are 5 locations of these nociceptors? (H, L T, BD, I)
  4. nociceptive C fibers from esophagus, larynx, and trachea travel with what nerve to the brainstem? (V)
  5. polymodal nociceptors in the intestines respond to what 3 things? (SMS, I, I)
  6. do these polymodal intestine nociceptors response to surgical stimulation?
A
  1. insensitive, silent
  2. T1-L2
  3. heart, lungs, testis, bile duct, intestins
  4. vagus
  5. SM spasms, ischemia, inflammation
  6. no
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18
Q

Chemical mediators of pain:

  1. what are the 5 excitatory NTs? (C, A, G, A, S)
  2. what are the 5 inhibitory NTs? (S, A, B, E, N)
A
  1. calcitonin gene-related peptide, aspartate, glutamate, ATP, substance P
  2. somatostatin, acetylcholine, beta endorphins, enkephalins, NE
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19
Q

Pain modulation:

  1. what 3 places does this occur? (PN, SC, SS)
  2. in peripheral modulation, nociceptors display what following repeated stimulation? (S)
  3. in primary hyperalgesia, sensitization of nociceptors results in a decreased what 2 things and an increased what? (T, L; RF)
  4. primary hyperalgesia is mediated by release of noxious substances from damaged tissues including what substance from mast cells, basophils and plts, what substance from mast cells and plts, and what substances from tissues after factor 7 activation? (H, S, B)
  5. what substances are produced after tissue damage by action of phospholipase A2 on phospholipids? (P)
  6. the cyclooxygenase pathway converts arachidonic acid into what 2 endoperoxides? (P, P)
  7. which endoperoxide activates free nerve endings?
  8. lipoxygenase pathway converts arachidonic acid into what hydroperoxyl compound? (L)
A
  1. peripheral nociceptors, SC, supraspinal structures
  2. sensitization
  3. threshold, latency, frequency response
  4. histamine, serotonin, bradykinin
  5. prostaglandins
  6. prostacyclin, prostaglandin E2
  7. prostaglandin E2
  8. leukotrienes
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20
Q

pain modulation:

  1. secondary hyperalgesia is also called what after the periphery becomes sensitized following injury? (NI)
  2. triple response of lewis includes what around the site of injury, what at local tissue, and what to noxious stimuli? (RF, E, S)
  3. secondary hyperalgesia is d/t antidromic release of what 2 NTs? (S C)
A
  1. neurogenic inflammation
  2. red flushing, edema, sensitization
  3. substance P, calcitonin gene-related peptide
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21
Q

facilitation of central pain:

  1. what are the 3 mechanisms in central sensitization? WU, RFE, H)
  2. in wind up, what neurons increase frequency of discharge with same repetitive stimuli and exhibit prolong discharge? (W)
  3. in receptor field expansion, the receptive field increases where so that adjacent neurons become responsive to the stimuli (DHN)
  4. hyperexcitability has increased response to what reflexes? (F)
A
  1. wind up, receptor field expansion, hyperexcitability
  2. wide dynamic range neurons
  3. dorsal horn neurons
  4. flexion
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22
Q

inihibiton of central pain:

  1. transmission of nociceptive input into the SC can be inhibited by what activity in the SC and what activity from the supraspinal centers? (SA, DNA)
  2. in segmental SC activity, activation of large afferent fibers inhibits what neurons and what tract activity? (WN, STA)
  3. what 2 NTs perform this segmental activity? G, G)
  4. what other NT also modulates in the dorsal horn nociception? (A)
  5. what 3 supraspinal centers are involved with the descending neural activity? (PGM, RF, NRM)
  6. what NT mediates this descending activity via activation of of pre/post synaptic alpha 2 receptors? (N)
A
  1. segmental activity, descending neural activity
  2. wide dynamic range neurons, spinothalamic tract activity
  3. glycine, GABA
  4. adenosine
  5. periaqueductal gray matter, reticular formation, nucleus raphe magnus
  6. NE
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23
Q

chronic pain pathophysiology:

  1. combo of what 3 mechanisms? (P, C, P)
  2. sensitization of nociceptors plays major role in origin of pain from where? (P)
  3. neuropathic pain involved peripheral-central and central-peripheral mechanisms that are complex ad involved what 2 lesion types on peripheral nerves, DRG, nerve roots and other central structions (P, C)
A
  1. peripheral, central, psychological
  2. periphery
  3. partial, complete
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24
Q

neuropathic pain mechanisms:

  1. what are the 2 adjectives to describe neuronal activity in primary afferent neurons, i.e. neuromas? (S, SS)
  2. mechanosensitivity is associated with what? (CNC)
  3. short-circuits between pain fiber and other fibers following demyelination results in what fiber activation by non-noxious stimuli at transmission sites? (N)
  4. there is a reorganization of receptive field in neurons where resulting in sensory inputs from surrounding intact nerves intensifies input from injured areas? (DH)
  5. spontaneous electrical activity in cells where or in what nuclei? (DH, T)
  6. release of what inhibition in the SC? (S)
  7. loss of what inhibitory influences that depend on normal sensory input? (D)
  8. associated with lesions where or in what type of structures? (T, S)
A
  1. spontaneous, self-sustaining
  2. chronic nerve compression
  3. nociceptive
  4. dorsal horn
  5. dorsal horn, thalamus
  6. segmental
  7. descending
  8. thalamus, supraspinal
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25
Q

peripheral mechanisms to chronic pain:

  1. what type of discharge? (S)
  2. sensitization to what 3 types of stimuli? (M, T, C)
  3. up regulation or down regulation of adrenergic receptors?
  4. what type of inflammation? (N)
A
  1. spontaneous
  2. mechanical, thermal, chemical
  3. up regulation
  4. neural
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26
Q

chronic pain:

  1. systemic treatment with what 2 med types suppresses spontaneous firing of sensitized or traumatized neurons? (LA, A)
  2. what are 3 meds that are often effective for neuropathic pain? (L, M, C)
A
  1. LAs, anticonvulsants

2. lidocaine, mexiletine, carbamazepine

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27
Q

central mechanisms chronic pain:

  1. loss of what inhibition? (S)
  2. windup of what neurons? (W)
  3. spontaneous discharge in what neurons? (D)
  4. reorganization of what connections? (N)
A
  1. segmental
  2. WDR
  3. deafferentated
  4. neural
28
Q

chronic pain and SNS:

  1. what are 3 S/S? (V, E, H)
  2. what is the name of the phase? (W/E)
A
  1. vasoconstriction, edema, hyperalgesia

2. warm/erythematous

29
Q

Pain effects on body system, increase or decrease

  1. HR
  2. BP
  3. SVR
  4. VO2
  5. CO2 production
  6. sphincter tone
  7. motility
  8. catabolic hormones (NE, epi, cortisol, glucagon)
  9. anabolic hormones (insulin, testosterone)
  10. plt adhesiveness
  11. fibrinolysis
  12. coagulability
  13. immune system
  14. tumor growth
A
  1. increase
  2. increase
  3. increase
  4. increase
  5. increase
  6. increase
  7. decrease
  8. increase
  9. decrease
  10. increase
  11. decrease
  12. increase
  13. decrease
  14. increase
30
Q

what are 6 pain related things to evaluate in chronic pain pts? (H, L, O, Q, AF, EF)

A
  1. history
  2. location
  3. onset
  4. quality
  5. alleviating factors
  6. exacerbating factors
31
Q

what type of eval should be performed if there is an unclear pain cause, or when pain intestisity is disportionate to injury? (PE)

A

psych evals

32
Q

what are the 2 psych evals? (MMPI, BDI)

A
  1. Minnesota Multiphasic Personality Inventory

2. beck depression inventory

33
Q

wong-baker faces, visual analogue scale, mcgill pain questionnaire:

  1. which one uses a 10 cm horizontal line labeled no pain and worst pain imaginable?
  2. which is a checklist of words describing symptoms and defines pain in 3 major dimensions (sensory-discriminative, motivational-affective, cognitive-evaluative)?
  3. which one is designed for children 3 year of age and order but is also useful for communicating with difficult pts?
A
  1. visual analogue scale
  2. mcgill pain questionnaire
  3. wong-baker faces
34
Q

myofascial pain:

  1. what are the discrete areas of marked tenderness and aching muscle pain called? (TP)
  2. what are 2 symptoms? (P, V)
  3. what mL range of LA is injected?
  4. what are the 2 topical cooling sprays? (EC, F)
A
  1. trigger points
  2. piloerection, vasoconstriction
  3. 1-3 mL
  4. ethyl chloride, fluoromethane
35
Q

what are the 3 common causes of low back pain? (LS, DDD, MS)

A
  1. lumbosacral strain
  2. degenerative disc disease
  3. myofascial syndromes
36
Q

herniated disc:

  1. what % of disc herniation are at L4-L5 or L5-S1?
  2. weakness and degeneration of annulus fibrosus and posterior longitudinal ligament can cause herniation of nucleus what into spinal canal? (P)
  3. over what % of herniated discs are treated nonsurgically?
  4. is back surgery correlated with improved clinical outcomes?
  5. disc herniation usually occurs in what direction resulting in compression of adjacent nerve roots? (P)
A
  1. 90%
  2. pulposus
  3. > 75%
  4. no
  5. posterolaterally
37
Q

L3-L4 (L4 nerve) injury

  1. pain distribution (AT, ACtA)
  2. weakness (QF)
  3. reflex affected (K)
A
  1. anterolateral thigh, anteromedial calf to ankle
  2. quadriceps femoris
  3. knee
38
Q

L4-L5 (L5 nerve) injury

  1. pain distribution (LT, AC, MD)
  2. weakness (D)
  3. is there a reflex affected?
A
  1. lateral thigh, anterolateral calf, medial dorsum
  2. dorsiflexion
  3. no
39
Q

L5-S1 (S1 nerve) injury:

  1. pain distribution (GT, PT, LD, FU)
  2. weakness (PF)
  3. reflex affected (A)
A
  1. gluteal region, posterior thigh, lateral dorsum, foot undersurface
  2. plantar flexion
  3. ankle
40
Q

spinal stenosis:

  1. pts may benefit from what injections in their epidural? (S)
  2. degeneration of nucleus pulposus reduces disc what? and leads to the formation of what at endplates of adjoining vertebral bodies? (H, OF)
A
  1. steroid

2. heigh, osteophyte formation

41
Q

Diabetic neuropathy:

  1. is it the most common type of neuropathic pain?
  2. is it a major cause of morbidity?
  3. what 2 contributors occur d/t chronic hyperglycemia? (M, PG)
  4. most commonly peripheral mononeuropathy or polyneuropathy with symmetric numbness?
  5. what is name for distribution? (S&G)
  6. proprioception loss leads to what disturbances? (G)
  7. sensory deficits can lead to what type of injuries? (T)
A
  1. yes
  2. yes
  3. microangiopathy, protein glycation
  4. polyneuropathy
  5. stocking and glove
  6. gait
  7. traumatic
42
Q

CRPS:

  1. is CRPS 1 or 2 also known as reflex sympathetic dystrophy syndrome (RSD)?
  2. is CRPS 1 or 2 also known as causalgia?
  3. what type of pain is causalgia? (B)
  4. CRPS most common precipitant from what 4 things? (S, F, CI, S)
  5. what is allodynia?
  6. can this develop after a minor surgery?
A
  1. 1
  2. 2
  3. burning
  4. surgery, fractures, crush injuries, sprains
  5. pain response from stimuli that doesn’t normally produce pain
  6. yes
43
Q

CRPS 1 or 2:

  1. which one has confirmed nerve damage?
  2. which one does not have confirmed nerve damage?
A
  1. 2

2. 1

44
Q

CRPS:

  1. what are 2 types of treatment? (SB, IVRS)
  2. pts may require what range number of blocks?
  3. cure rate is high if pt receives treatments within how many months of onset?
  4. what 2 types of stimulation may help? (TENS, SCS)
  5. a tunneled epidural catheter in what phase? (A)
  6. percutaneous electrodes for extended trials of SC stimulation to help pts tolerate what? (PT)
A
  1. sympathetic blocks, IV regional sympatholytic
  2. 3-7 blocks
  3. 1 month
  4. Transcutaneous electrical nerve stimulation, spinal cords stimulation
  5. acute phase
  6. physical therapy
45
Q

trigeminal neuralgia:

  1. unilateral or bilateral?
  2. can effect what 2 segments of the trigeminal nerve?
  3. what are 3 meds for treatment? (C+P, B, G)
  4. what are 3 procedures? (RA, BCGG, MD)
A
  1. unilateral
  2. V2, V3
  3. carbamazepine+phenytoin, baclofen, glycerol
  4. radiofrequency ablation, balloon compression gasserian ganglion, microvascular decompression
46
Q

what drug type is most useful for neuropathic pain? (A)

A

antidepressants

47
Q

anticonvulsants:

  1. useful for what type of pain?
  2. especially useful in what 2 pain disorders? (TN, DN)
A
  1. neuropathic

2. trigeminal neuralgia, diabetic neuropathy

48
Q

IM narcotics not preferred d/t variability in what? (SA)

A

systemic absorption

49
Q

tunneled opioid epidural catheter is used when life expectancy is what? (W)

A

weeks

50
Q

implantable opioid delivery system when life expectancy is several what or longer? (M)

A

months

51
Q

Transdermal fentanyl patch:

  1. patches are available in 25, 50, 75 and 100 mcg/hr that provide drug for what day range?
  2. largest patch is equivalent to how many mg of IV morphine per day?
A
  1. 2-3 days

3. 60 mg/day

52
Q

trigeminal nerve block, occipital nerve block, suprascapular nerve block, lumbar paravertebral blocks, cervicothoracic (stellate) block, celiac plexus block, lumbar sympathetic lock, cervical paravertebral nerve block, and IV regional block:

  1. indicated for painful conditions involving the pelvis, lower extremities or some pts with peripheral vascular disease
  2. pts with occipital HA and neuralgias
  3. for pain arising from abd viscera, especially intraabdominal cancers
  4. painful conditions arising from the shoulder
  5. indication for trigeminal neuralgia and intractable cancer pain
  6. pts with cervical disc displacement, cervical foraminal stenosis or cancer-related pain from c-spine or shoulder
  7. used for pts with head, nekc, arm and upper chest pain
  8. used to interrupt sympathetic innervation to an extremity
A
  1. lumbar sympathetic lock
  2. occipital nerve block
  3. celiac plexus block
  4. suprascapular nerve block
  5. trigeminal nerve block
  6. cervical paravertebral nerve block
  7. cervicothoracic (stellate) block
  8. IV regional block
53
Q

cervical paravertebral nerve block:

  1. unintentional intrathecal or epidural anesthesia at this level causes what 2 things to occur rapidly? (P, H)
  2. what syndrome can occur?
  3. Injecting small amts of local anesthetic into vertebral artery causes what 2 things? (U, S)
A
  1. paralysis, hypotension
  2. horner’s syndrome
  3. unconsciousness, seizures
54
Q

cervicothoracic (stellate) block:

  1. usually blocks upper thoracic as well as all cervical what? (G)
  2. what technique is most commonly used? (P)
  3. what spinal level?
  4. with correct needle placement, what syndrome is seen and what happens to the ipsilateral arm? (HS, IST)
  5. hoarseness can be a complications if what nerve is blocked? (RL)
A
  1. ganglia
  2. paratracheal
  3. C7
  4. horner’s syndrome, increased skin temp
  5. recurrent laryngeal nerve
55
Q

what are the 4 signs of horner’s syndrome? (M, A, P, E)

A
  1. miosis
  2. anhidrosis
  3. ptosis
  4. enophthalmos
56
Q

celiac plexus block should pass under what rib and position anteriorly to what vertebral body?

A

12th rib, L1

57
Q

what are the 7 complications of stellate ganglion block? (P, H, IVI, SI, EA, BPB, H)

A
  1. pneumothorax
  2. hematoma
  3. IV injection
  4. subarachnoid injection
  5. epidural anesthesia
  6. brachial plexus block
  7. hoarseness
58
Q

lumbar sympathetic block is a single needle technique at what lumbar level?

A

L3

59
Q

IV regional block:

  1. how many mL of 0.5% lido is used?
  2. what mcg of clonidine can be used?
  3. what mg range of ketorolac can be used?
  4. solution needs to be left in place for at least how many minutes?
  5. premature tourniquet release can result in what 6 symptoms? (S,H,A,E,D,N)
A
  1. 50 mL
  2. 150 mcg
  3. 15-30 mg
  4. 30 minutes
  5. seizure, hypotension, arrhythmias, edema, diarrhea, nausea
60
Q

epidural injection:

  1. used to relieve pain associated with what? (NRC)
  2. is epidural steroids more effective than LA alone?
  3. most effective when given within what number weeks of pain onset?
  4. what is methylprednisolone mg range?
  5. what is triamcinolone mg range?
  6. provides good, temporary relief with next injection needed within what week range?
  7. should fluoro be used?
A
  1. nerve root compression
  2. yes
  3. 2 weeks
  4. 40-80 mg
  5. 40-80 mg
  6. 2-4 weeks
  7. yes
61
Q

chemical neurolysis:

  1. neurolytic blocks used in pts with severe, what type of pain? (I)
  2. is it used when conventional therapy is inadequate?
  3. is it used when conventional analgesics have unacceptable SEs?
  4. what are the 3 common techniques? (CP, LSC, HP)
  5. potential morbidity is related to loss of what 2 functions? (M, S)
  6. initial relief may be good, but can pain come back within weeks to months?
  7. chemical neurolysis is the chemical destruction of nerve fibers with what 2 things? (A,P)
A
  1. intractable
  2. yes
  3. yes
  4. celiac plexus, lumbar sympathetic chain, hypogastric plexus
  5. motor, sensory
  6. yes
  7. alcohol, phenol
62
Q

TENS:

  1. used for how many minutes several times a day?
  2. a current with what mA range with pulse of what microsec range applied at a frequency of what Hz range?
A
  1. 30 minutes

2. 10-20 mA, 50-80 microsec, 80-100 Hz

63
Q

spinal cord stimulation:

  1. pts with persistent pain after what type of surgery appear to benefit from this? (B)
  2. temporary electrodes are initially placed in post epidural space and connected to evaluate efficacy for what day range?
  3. if pt has a favorable response, what is inserted? (FIS)
A
  1. back
  2. 5-7 days
  3. fully implantable system
64
Q

Occipital nerve stimulators are one form of what stimulator that help treat occipital neuralgia and migraine HAs? (PNS)

A

peripheral nerve stimulator

65
Q

acupuncture:

  1. insertion of needles into discrete anatomically defined points called what? (M)
  2. may release endogenous what? (O)
  3. is insertion points related to conventional nervous system anatomy?
  4. is useful for chronic musculoskeletal disorders and headaches?
A
  1. meridians
  2. opioids
  3. no
  4. yes

Principles2 (21 decks)

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