Types of Pain

Question 1

These 3 things contribute to poor encoding of visceral pain origins

Answer 1

1. low receptor density
2. large overlapping receptor fields
3. convergence in ascending pathway

Question 2

1. Embryologic Development has a primary role in —– ?
   where is pain referred to?

Answer 2

1. visceral pain referral patterns
2. where organ was located in fetal development

Question 3

1. What is visceral organ cross sensitization?
2. what is it based on ?

Answer 3

1. referred visceral pain to somatic tissues
2. overlapping/ same segmental projections of spinal AFFERENT neurons to spinal DORSAL HORN

Question 4

What are the mechanisms of direct pressure the result of ?

Answer 4

ganglions from each system bringing info through a cord to plexuses

Question 5

What structures are involved in cutaneous pain?

Answer 5

• superficial somatic in
  skin + subcutaneous tissue

Question 6

Pain localization or not in cutaneous pain?

Answer 6

well localized
( can point with a finger to a specific spot)

Question 7

Organ Pathology in cutaneous pain results in what?

Answer 7

sudomotor changes resulting in TROPIC changes ( itching, dysesthesia, skin temp. changes, dry skin)

Question 8

Somatic pain is produced by

Answer 8

nerve ENDINGS of somatic structures
( NOT nerve roots)

Question 9

Common descriptors of somatic pain

Answer 9

dull, aching, gnawing, diffuse pressure

Question 10

Superficial somatic includes these 4 things

Answer 10

skin, superficial fasciae, tendon sheaths, and periosteum

Question 11

Deep somatic includes these structures (many these are a few)

Answer 11

cancellous bone, nerve, muscles, ligaments, blood vessels, and joint capsules

Question 12

1. Deep somatic localized or not?
2. Where may it refer?
3. associated with what?

Answer 12

1. poorly localized
2. may refer to cutaneous tissue
3. associated with autonomic phenomenon

Question 13

Somatoemotional
occurs when and example

Answer 13

emotional or psychological distress produces physical symptoms
example: anxiety and panic attacks

Question 14

Viscero-somatic in laymans terms and an example

Answer 14

1. Organ damage results in muscle guarding
2. example: appendix rupture results in abdominal muscles tightening

Question 15

Somatovisceral laymans terms and an example

Answer 15

myalgic conditions affect viscera
Example: Trigger point of abdominal muscles cause diarhea

Question 16

Visceral pain includes these structures

Answer 16

ALL body organs in the trunk/ abdomen
= lung, GI organs, spleen, heart, blood vessels

Question 17

1. Visceral pain well or poorly localized?
2. produce what type of pain ?
3. corresponds to what?

Answer 17

1. POORLY localized
2. produce referred pain
3. dermatomes from where the organ is innervated

Question 18

Neuropathic pain is due to damage to

Answer 18

PNS or CNS
injury / destruction to peripheral nerve, pathways in spinal cord, or brain neurons

Question 19

Neuropathic pain is described as

Answer 19

sharp, shooting, burning, tingling, “electric shock” sensation

Question 20

Neuropathic pain onset

Answer 20

steady or triggered by NON-NOXIOUS stimulus

Question 21

What are the 4 descriptors of acute nerve root irritation ?

Answer 21

severe, burning, shooting, constant

Question 22

Where is referred pain perceived and where is it supplied?

Answer 22

shows up in area far from the leison site but is supplied by the same or adjacent neural segments

Question 23

referred pain well or poorly localized ?

Answer 23

well localized
poor border though

Question 24

where can referred pain originate?

Answer 24

somatic or visceral source

Question 25

Somatic structures innervation pattern

Answer 25

unilaterally via spinal nerves

Question 26

Viscera innervation pattern

Answer 26

bilaterally through ANS

Question 27

superficial somatic pain described as ?

Answer 27

sharp and more local

Question 28

deep somatic pain described as

Answer 28

achy/ dull DOESNT respond to rest

Question 29

Nociceptive pain

Answer 29

pain from damage or threatening to non neural tissue

Question 30

examples of nociceptive pain

Answer 30

1. OA 2. ankle sprain 3. RA

Question 31

Nociplastic pain

Answer 31

****altered nociception but no evidence of tissue damage or disease

Question 32

Tension pain is caused by ? key characteristic?

Answer 32

caused by distension difficult to find a comfortable position

Question 33

Inflammatory pain described as ---- with 2 types ? key characteristic?

Answer 33

description: deep or boring with viscera (poor localization) or parietal (more localized) peritoneum - movement avoidance

Question 34

Ischemic pain type 1. description? 2. key characteristic?

Answer 34

1. sudden, intense, constant, progressive 2. no position is comfortable movement/ positional change avoidance

Question 35

Muscle pain (myalgia) is a symptom of ----

Answer 35

underlying systemic disorder

Question 36

Muscle tension is ----- ---- and results in these 3 things

Answer 36

prolonged contraction results in 1. ischemia 2. increased cellular metabolites, and 3. subsequent pain

Question 37

Muscle tension can be caused by

Answer 37

visceral pain with viscero somatic

Question 38

Muscle spasm is caused by

Answer 38

sudden involuntary contraction of muscle

Question 39

1. What is Rhabdomyolysis? 2. what is it caused by?

Answer 39

1. muscle disintegration that releases harmful substances into blood stream 2. trauma

Question 40

What is a red flag of cancer or neurological impairment?

Answer 40

proximal muscle weakness with change in 1+ DTRs

Question 41

what is a trigger point ----- tenderness ----- pain ----- response

Answer 41

FOCAL tenderness REFERRED regional pain LOCAL TWITCH response

Question 42

What is an active trigger point ?

Answer 42

- refer pain locally to another location - cause pain at rest

Question 43

What is a latent trigger point?

Answer 43

- no pain at rest, but can refer pain with applied pressure

Question 44

What is a key trigger point?

Answer 44

referral pattern along neural pathways

Question 45

A trigger point is secondary to what

Answer 45

sustained low level contractions or dynamic repetitive contractions

Question 46

Hyperalgesia definition

Answer 46

increased pain from a stimulus that makes pain mad

Question 47

Hyperesthesia

Answer 47

increased sensitivity to stim (doesn't include the special senses)

Question 48

Sensitization

Answer 48

nociceptive neurons do more and recruit more in response to normally subthreshold inputs

Question 49

Central sensitization

Answer 49

nociceptor neurons more responsive to AFFERENT INPUT

Question 50

peripheral sensitization

Answer 50

nociceptor neurons more responsive and reduced threshold in the periphery

Question 51

5 types of Waddell's nonorganic signs

Answer 51

1. tenderness 2. simulation test 3. distraction test 4. regional disturbances 5. overreaction