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PT Passive Care > PainNMSControl and Biofeedback > Flashcards

PainNMSControl and Biofeedback Flashcards

1
Q

stages of the death and dying model

A

Denial, anger, bargaining, depression, acceptance

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2
Q

How applicable is death and dying model for athletic injury?

A

not good

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3
Q

Cognitive Appraisal Models of pain state that response to injury depends on?

A

understanding of the injury

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4
Q

What is the purpose of pain?

A
  • warns of impending injury
  • essential for survival
  • protects body
  • signifies something is wrong
  • limits further injury
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5
Q

Which superficial mechanoreceptors are associated with pressure and touch?

A

meissners corpuscles, pacinian corpuscles

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6
Q

Which superficial mechanoreceptors are associated with skin stretch/pressure?

A

Merkle cells, Ruffini endings

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7
Q

What deep sensory/proprioceptors are associated with change in muscle length and spindle tension?

A

Golgi Tendon organs

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8
Q

Which deep sensory/proprioceptors are associated with change in joint position and vibration?

A

pacinian corpuscles

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9
Q

Which proprioceptors are associated with joint end range and possible heat?

A

Ruffini endings

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10
Q

Pain can occur at the

A
  • periphery
  • spinal level
  • ascending pathway
  • supraspinal level
  • descending pathway
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11
Q

sight, taste, smell, hearing and balance are examples of what type of receptors

A

Special sensory receptors

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12
Q

Hunger, nausea, distension are examples of what

A

visceral receptors

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13
Q

Process of changing energy of nociception

into electrical action potential in the neuron

A

transduction

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14
Q

First order afferents are typed according to structural and functional
characteristics such as:

A

• Diameter of nerve (velocity of transmission)
• Degree of myelination (velocity of transmission)
• Function of nerve (determines type of info carried
by nerve)
– Light touch, pressure, pain or temperature

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15
Q

Examples of A-beta first order afferents

A

Hair follicles, Meissners corpuslces, Pacinian
corpuscles, Merkle cell endings, Ruffini
endings

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16
Q
  • Touch, vibration, and hair deflection
  • Large diameter (6-12 micrometer um)
  • Myelinated
A

A-beta fibers

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17
Q

Myelinated 1st order afferent
– Fast conduction velocity 36-72 microseconds
– Low threshold

A

A-beta fibers

18
Q

Warm and cold receptors, hair follicles, free nerve endings
• Touch, pressure, temp and pain
• Free nerve endings respond to noxious stimuli such as pricking, pinching and crushing

A

A-delta fibers

19
Q

Myelinated first order afferents
– Smaller diameter (1-6 um)
» Slower conduction velocity (6-36 usecs)

A

A-delta fibers

20
Q

Pain, touch, pressure, temperature (skin)
– Pain (receptors of muscle)
• Include efferent postganglionic fibers of SNS, mechanoreceptors, nociceptors and thermoreceptors
• Smallest peripheral nerves associated with pain

A

C fibers

21
Q

Unmeylinated first order afferent

– Small diameter

A

C fiber

22
Q

First order neuron synapses in ___

A

spinal cord dorsal

horn

23
Q

Cell body of second order neuron (T cell) is in ___

A

the dorsal horn

24
Q

Multiple tracts carry information through the SC to the brain • cell bodies of third order neurons are located in

A

VPL (ventral posterior lateral) and VPM (ventral posterior

medial) of the thalamus

25
Q

Ascending pain fibers from body synapse in this part of the thalamus

A

VPL

26
Q

Fibers from the head and face synapse in this part of the thalamus

A

VPM

27
Q

Thalamus modulates input and transmits to ___ where localization and discrimination occur in the ___.

A

somatosensory cortex, post central gyrus

28
Q

Regulates emotional, autonomic and endocrine

responses to pain (affective motivational component

A

limbic system

29
Q

Phase where any activity after the cortex has received input

A

modulation phase

30
Q

When these areas are not inhibited can lead to

affective emotional response similar to shock

A

Hypothalamus, pituitary, reticular formation,

Raphe nucleus

31
Q

Network of messages and activation of brain centers may exacerbate the painful event and lead to

A

“windup”

32
Q

Increases threshold
• More difficult to stimulate
• Fewer pain impulses transmitted to SC
• May try to decrease effects of chemical mediators in inflammatory process

A

Pain modulation targeted at desensitizing of

peripheral nociceptors

33
Q

– Decrease effects of chemical mediators

– Decrease speed of pain transmission

A

ice

34
Q

Non-painful stimulus can block the transmission of noxious stimulus

A

Gate Theory

35
Q

in dorsal horn of spinal cord acts as a “switch operator”

A

Substantia gelatinosa

36
Q

Interneuron that utilizes ___is present in substantia gelatinosa – Inhibits pain transmission w/in dorsal horn

A

enkephalin

37
Q

Shaking your hand gives ___stimulation. This can cause inhibitory interneurons to be stimulated
– Blocks pain transmission
– TENS gives sensory feedback at a non painful level to stimulate A-beta fibers

A

A-beta

38
Q

– Low frequency, high intensity stimulation of peripheral nerves (Motor TENS)
– Causes activation of Reticular Formation and pituitary gland
– Descending Endogenous Opiate System (DEOS)
• Endogenous opioid (endorphin) release
– Inhibitory effect on lower pain pathways
– Descending pain modulation (analgesia)

A

Motor Pain Modulation

39
Q

– Electrical stimulation of C fibers in the injury area (Noxious TENS)
– Activates Periaqueductal Gray (PAG) and Raphe nucleus
– Serotonin neurons in dorsal horn inhibit second order neuron directly or through an interneuron
– Also ice stimulation of C fibers during burning and aching sensation

A

Noxious Pain Modulation

40
Q

When stimulation encroaches on the refractory period of the sensory nerve and causes inhibition by continual stimulation • Russian stimulation, Interferential current

A

Nerve Block/ Wedenskis Pain Modulation

41
Q

decreased pain sensation during physical activity

Increased endogenous opioids (endorphins) and catecholamines (epinephrine/norepinephrine) during exercise

A

Exercise Induced Hypoalgesia

PT Passive Care (8 decks)

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