Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pain Science > Motor System Pain > Flashcards

Motor System Pain Flashcards

1
Q

What is the vicious cycle theory of pain and motor control?

A
  • muscle activity => increases in pain => ischaemia + accumulation of pain-producing agents
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is another name for the viscous cycle theory

A
  • pain-spasm-pain cycle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the steps involved in the vicious cycle theory?

A
  • pain stress
  • muscle tension
  • decrease in circulation
  • increase in pain
  • even more tension
  • even less circulation
  • more pain
  • muscle tension etc.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the limitation of the vicious cycle theory?

A
  • overly simplistic
  • doesn’t explain increase and decrease of tone in same muscles/groups
  • myalgia (muscle pain) generally has no increase in algesic (pain-producing substances)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the pain adaptation theory?

A
  • activity of painful muscles reduces during voluntary efforts (hypotonic)
  • antagonist muscles increase voluntary efforts (hypertonic)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What effects pain-related inhibition?

A
  • Hilton’s law
  • joint effusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is Hilton’s law?

A
  • nerves that supply the joint, supply muscles that control the joint
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What happens when a joint has effusion?

A
  • neuromuscular inhibition + altered joint mechanics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What happens if the knee joint has effusion?

A
  • neuromuscular inhibition of quads => reduced tone (hypotonic)
  • hamstrings increased activity => increased tone (hypertonic)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What happens to LBP and motor control in the TVA?

A
  • LBP => deficit in motor control of TVA <= due to increased cortical inhibition
  • LBP => TVA unable to increase in cross sectional size when in pain
  • reduction in pain -> TVA fires again
  • need to remove pain first before strengthening TVA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What happens to muscles and proprioception during pain adaptative theory

A
  • strain of small joints/muscles
  • local protective ‘spasm’
  • alters proprioception
  • deep stabilising muscles become hypertonic, weak and flaccid
  • superficial muscles become hyperactive, hypertonic and guarded
  • leads to ischaemic pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is Torticollis?

A
  • head side bends + rotates => shortening neck
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which muscles of the next are important for strength and proprioceptive movement?

A
  • deep flexors => longus colli + longus capitus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What happens when longus colli becomes hypotonic?

A
  • neck pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the craniocervical flexion test?

A
  • pt lines supine
  • chin + forehead level
  • uninflected pressure cuff under neck => inflate to 20mmHg
  • PT nods to increase pressure by 2mmHg, holds for 5 sec
  • repeat up to 30mmHg in 2mmHg increments
  • observe/palpate use of superficial flexors => should be able to nod without using SCM, scalenes, traps
  • good for primary HAs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the relationship between neck pain and migraines?

A
  • neck pain > with > frequency of HAs
  • chronic migraine => tension type HAs
  • increased activity of neck muscles during exercise and mental tasks
  • hypertrophy of rectus capitus posterior minor
  • migraineuse have altered motor control + greater Co activation of flexors
17
Q

When you have an injury, patients often describe feeling stiff, describe how this mechanism comes about and how it can be helpful

A
  • pain injury (Nociception) or threat
  • activity in muscles
  • changes in levels of nervous system
  • change in behaviour in area
  • increase in stiffness (less prone to injury)
  • short term benefit, however, long term consequences e.g. increases load, reduces movement and variability
18
Q

What is the difference between perceived stiffness and actual stiffness?

A
  • LBP patients do not have increase tone of ES muscles
  • LBP patients have increased perception of back muscles feeling stiff
  • LBP patients over estimate pressure on spinal muscles + detect change better
  • manipulation (creaking/grinding) increases perception of stiffness
19
Q

Describe the pathway of cortical pain-related inhibition

A
  • descending cortical inhibition reduces ability of muscle to fire
  • results in reduced muscle strength + motor control => insufficient capacity + control of muscle to perform task => pain + reduced performance

OR

  • sufficient muscle strength but not enough control to perform task => pain + reduced performance or vice versa
  • have to have strength + control to perform task
20
Q

What is the problem with rehabilitation and cortical pain-related inhibition?

A
  • most rehab focuses on improving strength but not descending motor control for cortical inhibition
21
Q

How do you overcome descending motor cortical inhibition?

A
  • external cues rather than counting e.g. metronome
22
Q

What is loss of demarcation in the sensory homunculus

A
  • smudging occurs between cortical zones of the brain and the hand becomes less clear where it starts and ends
23
Q

Where else can smudging happen?

A
  • motor cortex in patients with recurrent low back pain
24
Q

What happens in the cortex (sensory + motor) when playing sport?

A
  • visual cortex identifies object, size, direction, velocity
  • Pre motor cortex develops motor program that will allow approaching the ball and hitting back
  • motor cortex sends signals to spinal cord to activate and inhibit arm+ leg muscles
  • cerebellum fine tunes movements => proprioceptive information from peripheral sensory receptor
25
Q

What does the basal ganglia do during motor programs?

A
  • initiates motor patterns + recalls learned movements
26
Q

What does the amygdala/hippocampus do during motor programs?

A
  • amagydala => adjusts HR, breathing + homeostatic mechanisms
  • amygdala => hypothalamus activated for motivation
  • hippocampus => records details in long-term memory
27
Q

What happens to motor programs when a patient is in pain?

A
  • motor programs = every day
  • pain => alters deep + superficial muscles
  • painful muscles ‘protected’ by agonists
  • inhibited muscles become wasted, fatty and weak
  • new motor-program becomes hard-wired
  • movements pre-tempted by running ‘painful’ neuro tag
28
Q

How does manual therapy help motor control?

A
  • pain => maladaption + reduced proprioception
  • fear => influences recruitment, strength + endurance of muscles
  • treatment aimed at restoration + control of movement
  • MT improves proprioception + range of moment + graded exposure to previously painful stimuli
29
Q

How do you help patients in pain?

A
  • set goals that are comfortable
  • do not exacerbate pain
  • address fears on exercise + movement
  • set goals
  • use imagery (mirrors)
  • slowly increase load/duration
  • muscle strengthening with isometric before eccentric ex
  • use a metronome to avoid anticipation

Pain Science (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions