Nerve Injuries and Pain

Question 1

mildest form of nerve injury usually caused by trauma

what’s usually affected first

examples

Answer 1

neuropraxia

(sensory affected first)

• compression or ischemia - conduction block
• traction - burner or stinger in sports

motor weakness, minimal demyelinization, little atrophy, no wallerian degeneration, rapid recovery

Question 2

result of severe crush or contusion

Answer 2

axonotmesis

nerve fiber damage, motor and sensory loss, wallerian degeneration present, slow recovery

Question 3

contusion, stretch or laceration causing transection of the nerve

Answer 3

neurotmesis

loss of continuity, motor/sensory/autonomic loss

requires surgery

Question 4

most acute pain is result of what

Answer 4

physiological nerve irritation

Question 5

most chronic pain is result of what

Answer 5

pathological pain due to nerve compression

Question 6

what is the term that means pain is amplified

Answer 6

hyperalgesia

Question 7

what fibers recognize inflammation and tissue damage

Answer 7

C fibers

Question 8

what is a potent angiogenic agent that stimulates formation of new capillaries

Answer 8

hyaluronic acid

Question 9

what substances are released when trauma and inflammation occur

Answer 9

substance P
bradykinin
serotonin
leukotrienes

Question 10

what chemicals are released during inflammation

Answer 10

lactic acid
potassium 
histamine 
glycosaminoglycans 
prostaglandin E2

Question 11

what is a transection of a nerve causing multiple synapse recovery

Answer 11

traumatic neuroma

Question 12

chronic instability may result in mechanoreceptors morphing into nociceptors causing hyperconvergence

Answer 12

wide dynamic receiver

Question 13

what decreases threshold which increases action potentials which causes pain

Answer 13

norepinephrine

Question 14

what chemical mediators does connective tissue release (activating peptides) which cause pain and decrease motion

Answer 14

autocoids

Question 15

what alters neurotransmitters and creates a vicious cycle with pain

Answer 15

depression

Question 16

what are pain amplifiers

Answer 16

inflammation 
traumatic neuroma 
wide dynamic receiver 
norepinephrine
connective tissue 
depression

Question 17

what are the antinociceptive systems (things that decrease pain)

Answer 17

descending inhibition 
medications 
electrical stim 
ice 
psychogenic (love, laugh) 
adjustments

Question 18

what is our endogenous drug store that it full of morphine, endorphins, and enkephalins

this process is known as

Answer 18

periaquetductal gray

descending inhibition

Question 19

pain during active movement

passive movement

Answer 19

active - muscle / tendon

passive - ligament, joint (sclerotogenous)

Question 20

pin point pain

Answer 20

bursal irritation

facet tenderness

Question 21

deep and boring pain

Answer 21

viscera

Question 22

burning pain

Answer 22

causalgia (PNE)

Question 23

referred pain

Answer 23

viscerogenic

Question 24

radiating pain

Answer 24

along a nerve

Question 25

radiculo-

Answer 25

nerve root

Question 26

neuro-

Answer 26

peripheral nerve

Question 27

• algia

Answer 27

bouts of pain

Question 28

• itis

Answer 28

constant pain

Question 29

trigeminal neuralgia pain

Answer 29

bouts of pain

Question 30

sciatic neuritis pain

Answer 30

constant pain

Question 31

lancinating calf pain indicates what

Answer 31

myofascial pain

Question 32

pinpoint palpable tenderness at L4 with sclerotogenous pain indicates what

Answer 32

facet

Question 33

dermatogenous pain is described as what

Answer 33

well defined and peripheral

Question 34

opiates from the ___ descend down to bathe dorsal horn and reduce incoming pain messages

Answer 34

periaqueductal gray

descending inhibition

Question 35

facilitation due to acute nerve compression bombardment of dorsal horn with opiates to shake off the pain and get the body ready to respond to immediate threat

Answer 35

descending modulation

Question 36

who came up with gait control theory

Answer 36

Wall

Question 37

inhibiting system occurs when fast conducting proprioceptive and mechanoreceptive message close the gait on slow pain fibers

Answer 37

gate control theory - Wall

Question 38

distraction principle such as rubbing elbow, tens unit

proprioception interpreted faster than nociceptive fibers

Answer 38

afferent inhibition

Question 39

group 3 nociceptors are associated with what terms

Answer 39

deep joint
myelinated
A fibers

Question 40

group 4 nociceptors are associated with what terms

Answer 40

deep joint
unmyelinated
C fibers

Question 41

functional disturbance of pain pathway causes what

Answer 41

neuropathic pain

Question 42

pain due to stimulus which does not normally provoke pain

Answer 42

allodynia

Question 43

the reason why the brain interprets pain from multiple tissues - rationale for referred pain

Answer 43

central convergence projection

Question 44

pressure on the nerve is known as

Answer 44

neurothlipsis

Question 45

what is an autoimmune attack on C1 transverse ligaments

Answer 45

grisel syndrome

Question 46

what is distorted or impaired voluntary movement

Answer 46

dyskinesia

Question 47

what is impairment of viscera due to nervous system which can be measured by skin temperature differentiation

Answer 47

dysautonomia

Question 48

acute nerve compression is caused by what

first thing affected?
what’s the product of this?
left over pain?

Answer 48

focal obstruction or trauma or structural changes in IVF

1. vascular
2. edema - hypoxia leads to necrosis - lowers threshold for action potential firing
3. facilitation or facilitate pain - spillover, ascending inhibition, neuropathic pain left over

Question 49

chronic nerve compression is caused by what

what then occurs

Answer 49

acute –> chronic

axoplasmic transport abberation, descending inhibition

retrograde - diminished nerve transmission

anterade - wallerian degeneration - disstal to proximal death of nerve

local tissue death - Hiltons law - nerve innervates tissues and if nerve dies then goes tissue