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differential dx > Types of Pain > Flashcards

Types of Pain Flashcards

1
Q

These 3 things contribute to poor encoding of visceral pain origins

A
  1. low receptor density
  2. large overlapping receptor fields
  3. convergence in ascending pathway
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2
Q
  1. Embryologic Development has a primary role in —– ?
    where is pain referred to?
A
  1. visceral pain referral patterns
  2. where organ was located in fetal development
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3
Q
  1. What is visceral organ cross sensitization?
  2. what is it based on ?
A
  1. referred visceral pain to somatic tissues
  2. overlapping/ same segmental projections of spinal AFFERENT neurons to spinal DORSAL HORN
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4
Q

What are the mechanisms of direct pressure the result of ?

A

ganglions from each system bringing info through a cord to plexuses

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5
Q

What structures are involved in cutaneous pain?

A
  • superficial somatic in
    skin + subcutaneous tissue
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6
Q

Pain localization or not in cutaneous pain?

A

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

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7
Q

Organ Pathology in cutaneous pain results in what?

A

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

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8
Q

Somatic pain is produced by

A

nerve ENDINGS of somatic structures
( NOT nerve roots)

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9
Q

Common descriptors of somatic pain

A

dull, aching, gnawing, diffuse pressure

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10
Q

Superficial somatic includes these 4 things

A

skin, superficial fasciae, tendon sheaths, and periosteum

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11
Q

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

A

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

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12
Q
  1. Deep somatic localized or not?
  2. Where may it refer?
  3. associated with what?
A
  1. poorly localized
  2. may refer to cutaneous tissue
  3. associated with autonomic phenomenon
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13
Q

Somatoemotional
occurs when and example

A

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

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14
Q

Viscero-somatic in laymans terms and an example

A
  1. Organ damage results in muscle guarding
  2. example: appendix rupture results in abdominal muscles tightening
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15
Q

Somatovisceral laymans terms and an example

A

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

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16
Q

Visceral pain includes these structures

A

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

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17
Q
  1. Visceral pain well or poorly localized?
  2. produce what type of pain ?
  3. corresponds to what?
A
  1. POORLY localized
  2. produce referred pain
  3. dermatomes from where the organ is innervated
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18
Q

Neuropathic pain is due to damage to

A

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

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19
Q

Neuropathic pain is described as

A

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

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20
Q

Neuropathic pain onset

A

steady or triggered by NON-NOXIOUS stimulus

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21
Q

What are the 4 descriptors of acute nerve root irritation ?

A

severe, burning, shooting, constant

22
Q

Where is referred pain perceived and where is it supplied?

A

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

23
Q

referred pain well or poorly localized ?

A

well localized
poor border though

24
Q

where can referred pain originate?

A

somatic or visceral source

25
Q

Somatic structures innervation pattern

A

unilaterally via spinal nerves

26
Q

Viscera innervation pattern

A

bilaterally through ANS

27
Q

superficial somatic pain described as ?

A

sharp and more local

28
Q

deep somatic pain described as

A

achy/ dull
DOESNT respond to rest

29
Q

Nociceptive pain

A

pain from damage or threatening to non neural tissue

30
Q

examples of nociceptive pain

A
  1. OA
  2. ankle sprain
  3. RA
31
Q

Nociplastic pain

A

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

32
Q

Tension pain is caused by ? key characteristic?

A

caused by distension
difficult to find a comfortable position

33
Q

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

A

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

34
Q

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

A
  1. sudden, intense, constant, progressive
  2. no position is comfortable
    movement/ positional change avoidance
35
Q

Muscle pain (myalgia) is a symptom of —-

A

underlying systemic disorder

36
Q

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

A

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

37
Q

Muscle tension can be caused by

A

visceral pain with viscero somatic

38
Q

Muscle spasm is caused by

A

sudden involuntary contraction of muscle

39
Q
  1. What is Rhabdomyolysis?
  2. what is it caused by?
A
  1. muscle disintegration that releases harmful substances into blood stream
  2. trauma
40
Q

What is a red flag of cancer or neurological impairment?

A

proximal muscle weakness with change in 1+ DTRs

41
Q

what is a trigger point
—– tenderness
—– pain
—– response

A

FOCAL tenderness
REFERRED regional pain
LOCAL TWITCH response

42
Q

What is an active trigger point ?

A
  • refer pain locally to another location
  • cause pain at rest
43
Q

What is a latent trigger point?

A
  • no pain at rest, but can refer pain with applied pressure
44
Q

What is a key trigger point?

A

referral pattern along neural pathways

45
Q

A trigger point is secondary to what

A

sustained low level contractions or dynamic repetitive contractions

46
Q

Hyperalgesia definition

A

increased pain from a stimulus that makes pain mad

47
Q

Hyperesthesia

A

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

48
Q

Sensitization

A

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

49
Q

Central sensitization

A

nociceptor neurons more responsive to AFFERENT INPUT

50
Q

peripheral sensitization

A

nociceptor neurons more responsive and reduced threshold in the periphery

51
Q

5 types of Waddell’s nonorganic signs

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

differential dx (1 decks)

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