Clinical Synthesis, Pain, 2

Front 1

For the following referral site,what lesion site can it be associated with:
Interscapular area and posterior shoulder

Back 1

C7, T1-T5

Front 2

For the following referral site,what lesion site can it be associated with:
Neck, upper back

Back 2

shoulder

Front 3

For the following referral site,what lesion site can it be associated with:
SI and Hip

Back 3

L1-L2

Front 4

For the following referral site,what lesion site can it be associated with:
SI and knee

Back 4

Hip joint

Front 5

For the following referral site,what lesion site can it be associated with:
Ipsil ear

Back 5

pharynx

Front 6

For the following referral site,what lesion site can it be associated with:
Head, Neck,heart

Back 6

TMJ

Front 7

For the following referral site,what lesion site can it be associated with:
distribution of peripheral N

Back 7

Nerve or plexus

Front 8

For the following referral site,what lesion site can it be associated with:
anywhere in dermatome

Back 8

Nerve root

Front 9

For the following referral site,what lesion site can it be associated with:
any region supplied by a damaged structure

Back 9

CNS

Front 10

generally speaking what type of data do you need to collect for your pain assessment

Back 10

-cultural, age and gender differences of pain perception
-complete history
-physical exam
-medications history
- CAM

Front 11

Questions related to:
location of pain

Back 11

-where is it
-is it localized
-does it spread, to where
-what causes pain to spread

Front 12

Questions related to:
description of pain

Back 12

-what does it feel like
-has it changed in intensity or quality

Front 13

What are some descriptors used for systemic pain

Back 13

-comes in waves
-knife like
-boring
-deep aching feeling

Front 14

what are some descriptors used for musculoskeletal pain

Back 14

-aching
-increased with palpation, movement or related movement, positioning
-Sore
-heavy
-hurting
-dull
-cramping
-deep

Front 15

what are some descriptors used for vascular issues

Back 15

-throbbing
-pounding
-pulsing
-beating

Front 16

Questions to help a pt describe the pattern of pain

Back 16

-to describe sxs
-how did the pain start
-take me through a typical day
-is your pain ever better or worse, it is constant
-how does your pain change with time, movement,medication, alternative therapies

Front 17

questions about aggravating relieving factors

Back 17

-what brings your pain on
-what makes your pain worse
-what makes it better
-how does rest affect the pain
-how has this affected your ability to move

Front 18

what are associated symptoms

Back 18

-burning
-heart palpitations
-numbness/tingling
-difficulty swallowing
-dizziness
-difficulty breathing
-hoarseness
-Nausea
-night sweats
-visual disturbances
-N & V
-weakness

Front 19

what are sources of pain

Back 19

-somatic (cutaneous, deep somatic)
-visceral
-neuropathic
-referred

Front 20

somatic pain includes what

Back 20

-skin
-fascia
-tendons
-periosteum

Front 21

where does deep somatic pain come from

Back 21

-fascia
-bone
-muscle
-nerve
-ligaments
-tendons
-blood vessels
-joint capsule
-parietal wall
-deep pain is poorly localized and can manifest as cutaneous pain
-often has ANS signs and N & V

Front 22

describe visceral pain

Back 22

-comes from internal organs and heart muscle
-poorly localized
-can produce referred pain
-ANS changes (vital sign changes, diaphoresis, pallor)

Front 23

Describe Neuropathic pain

Back 23

-PNS and CNS damage
-not from a frank injury to a structure, it is a pathyway or transmission function
-can be brought on by drug use,metabolic cause, trauma to nervous system
-described as shocking, electric, burning, tingling pain
-associated with allodynia
-meds usually consists of anti-depressants,anesthesi, anti-convulstant

Front 24

what is allodynia

Back 24

a pain caused by a normally non-noxious stimulus

Front 25

Describe referred pain

Back 25

-felt in area distant from site of lesion
-supplied by same neural segments
-can occur with or without visceral involvement
-lacks sharply defined borders
-usually increased mm tone at area of referred pain

Front 26

Psychogenic pain screening

Back 26

-sxs of proportion to injury
-sxs persist beyond normal healing time
-no position is comfortable

Front 27

sx modification and illness behavior

Back 27

-dramatization of complaints
-progressive dysfunction
-drug misuse
-progressive dependency on others
-income disability

Front 28

what can myofascial pain be a symptom of

Back 28

cancer,renal failure, hepatic disease endorcrine disorders, side effect of drugs, prolonged use of immunosuppresants and corticosteriods

Front 29

when can myofascial pain be present

Back 29

in anxiety and depression disorders

Front 30

Describe muscle tension

Back 30

-sustained muscle tone
-leads to local ischemia, increased cellularmetabolist and pain.
-can turn into mm spasm

Front 31

Describe mm spasm

Back 31

-sudden involuntary contraction
-usually occuring as an overuse injury

Front 32

Describe trigger points, usually comes with

Back 32

-usually come with a hx of immobility, prolonged or vigorous activity such as bending or lifting, or forceful abdominal breathing

Front 33

what is a jump sign

Back 33

general pain response as the client physcially withdrawals from the pressure on the point and may wince

Front 34

what is local twitch response

Back 34

is the visible contraction of tense mm fibers in response to stimulation

Front 35

what happens when trigger points are compressed

Back 35

local tenderness with possible referred pain and often remote from the its source

Front 36

T/F:muscles with trigger points fatigue faster

Back 36

True

Front 37

T/F: visceral disease can create tender points

Back 37

Ture

Front 38

What other conditions that joint pain could be a symptom for

Back 38

-fibromyalgia, leukemia, sexualty transmitted infections, infectious arthritis.
-may be red flags for anxiety, depression and cancer.
-too much statins.

Front 39

Symptoms in IBS

Back 39

-low back
-sacrum
-SIjoint

Front 40

What are the sxs of infectious arthritis

Back 40

-fever
-recurrent sore throat
-lymphadenopathy
-persistent joint pain
-single painful swollen joint
-multiple joint involvement
-pain on WB
-back pain
-skin lesions
-conjunctivitis
-other muscloskeletal symptoms

Front 41

what are reactive arthritis

Back 41

-joint problems can occur 1-4 weeks after either a GI or GU.
-often causes inflammation along tendons attach to the bone resulting in persistent pain from plantar fascitis and sacroiliitis

Front 42

describe radicular pain

Back 42

-direct irritation of axons of a spinal nerve or neurons in dorsal root ganglion and is experineced in musculoskeletal system in dermatome, scelrotone or myotome.

Front 43

T/F: If the pain originates in arterial, pleural, tracheal pain will palpation elicit pain

Back 43

False

Front 44

when the pain is GI what can change the levels of pain

Back 44

positioning,depending on what is under more pressure

Front 45

where can pain at rest come from

Back 45

-ischemia
-neoplasms
-cancer
-bone pain