Pain boards Flashcards
Opioid receptor subtypes
Mu-1: supraspinal analgesia & physical dependence
Mu-2: reduces GI motility, respiratory depression, miosis, euphoria, physical dependence
Kappa: spinal analgesia, sedation, miosis
Delta: analgesia, euphoria, physical dependence
Oxycodone metabolism and metabolites?
Hepatic via CYP2D6
Converted into active metabolite oxymorphone (mu agonist) and inactive metabolite noroxycodone
NMDA receptors blocked by which ions
Magnesium
zinc
L2 radiculopathy
Weakness of hip flexion (iliopsoas) and sensory loss on anterior groin and thigh
No loss of DTRs
L3 radiculopathy
Weakness of leg extension (quadriceps)
Sensory loss medial epicondyle of the femur
L4 radiculopathy
Weakness of ankle dorsiflexion (tibialis anterior)
Sensory loss medial malleoli
Reduced patellar reflex
L5 radiculopathy
Weakness of dorsiflexion of big toe (EHL), sensory loss to dorsum of foot and reduced medial hamstring reflex
S1 radiculopathy
Weakness of ankle plantar flexion (gastroc)
Sensory loss on lateral foot
Loss of Achilles reflex
Type 1 vs 2 CRPS
TYpe 1 - most common, 90%, no physical damage/defect
Type 2 - 10%, documented injury or defect to a nerve
radiculopathy EMG findings
Paraspinal fibrillations
Normal sensory action potentials
Neurogenic motor units
Radiation injury EMG findings
myokymia
Myopathy EMG findings
Increased recruitment and small motor unit potentials
Early radiculopoathy EMG
Normal sensory action potentials
Reduced recruitment
Normal motor unit potentials
Artery of adamkiewicz
Suppies lower 2/3rd of the anterior spinal cord
left aorta between T8 and L1
Mortons neuroma
most commonly betwen 3rd and 4th toes
