Pain & Pain Syndromes Flashcards
A nerve is completely transected. How would you describe the level of damage?
Neurotmesis
What is the cause of giant cell arteritis?
Granulomatous inflammation of cranial branches of the temporal artery
Hyper-reflexive reflexes and antalgic gait may be indicative of what spinal disorder?
Spinal stenosis
What is axontmesis?
Focal demyelination of a nerve and axonal damage
What may be the causes of spinal stenosis?
Facet hypertrophy, ligamentum flavum hypertrophy, disc bulge
A patient presents with weakness along the anterolateral of the shin and dorsum of the foot. The foot is dropped, with weak F/E. What is a possible diagnosis?
Peroneal Neuropathy
The myelin sheath of a nerve is affected, but the nerve remains undamaged. How would the level of damage be described?
Neuropraxia
Temporomandibular disorders are characterized by…?
Pain around the TMJ
How do trigger points differ from CS points?
Trigger points are caused by local hypoxia and result in referred pain. CS points do not refer pain
How does fibromyalgia present?
Chronic, prolonged, severe pain often in women causing poor sleep and brain fog
True/False. Symptoms of spinal stenosis improve with extension.
False. Symptoms improve with flexion. This is called the shopping cart sign
This type of pain arises from disc infection or herniation and presents in a dermatomal pattern.
Discogenic pain
Prompt diagnosis of this pain disorder is necessary to prevent blindness.
Giant cell arthritis - poor blood flow to the eye leads to optic ischemia
What is sympathetically-mediated pain?
Pain maintained by the sympathetic NS or circulating catecholamines
This type of pain is accompanied by fatigue, sleep, memory, and mood changes.
Nocioplastic pain
Where is radiculopathy most likely to occur?
C5-C6, C6-C7, L4-L5, L5-S1
What are the symptoms of a migraine?
Unilateral, moderate to severe pain. Photophobia, phonophobia, nausea. Improves with rest and medication. May or may not have aura.
What medication can be used to treat trigeminal neuraliga?
Carbamazepine
How does nociceptive pain differ from neuropathic pain?
Nociceptive pain is a result of the activation of nociceptors. Neuropathic pain arises from damage to the nerves.
Who is at greatest risk of meralgia paresthetica?
Pregnant women and obese persons sitting for prolonged periods (ex: truck drivers)
What is carpal tunnel syndrome?
Compression of the median nerve passing between the carpal bones and flexor retinaculum characterized by tingling/numbness of the first four fingers
What are red flags for back pain that may be indicative of a more serious or emergent issue?
Weight loss, fever/night sweats, saddle anesthesia, incontinence
What is phantom pain?
Pain the appears to be from an amputated limp
What type of complex regional pain syndrome is not caused by trauma/defined event?
Type 1 CRPS. Type 2 is caused by a triggering event
What nerve is compressed in cubital tunnel syndrome?
Ulnar nerve
What is radicular pain?
Pain caused by irritation of a nerve root due to a herniated nucleus pulposus or neuroforaminal narrowing
How does tarsal tunnel syndrome present?
Numbness and pain in the sole of the foot that spares the heel
A 30yo man with a 10 pack-year history presents pain around the eye, ptosis, and rhinorrhea. What is a possible diagnosis?
Cluster headache
What symptoms are associated with trigeminal neuralgia?
Unilateral, episodic pain around branches of the trigeminal nerve. Quickly fades, with persisting aching feeling. May have lacrimation.
True/False. Phantom pain does not present in patients with a congenial limb deficiency.
True
A patient presents with a headache. They have been under a lot of stress at work and have pericranial tenderness. What is the likely diagnosis?
Tension type headache
True/False. Chronic regional pain syndrome follows a dermatomal pattern.
False. CRPS does NOT follow a dermatomal pattern and often presents in just one limb
What symptoms are associated with radiculopathy?
Sensor and motor deficits, decreased reflexes