MSK Principles

Question 1

What are the 3 sources of referred pain?

Answer 1

• Secondary hyperalgesia from inflammation
• secondary pain from myofascial trigger point (dense fibers)
• convergence of sensory input from the same dorsal horn

Question 2

What type of pain decreases with rest and is relieved with a change in position?

Answer 2

Mechanical pain

Question 3

What can morning pain and stiffness potentially represent?

Answer 3

-Inflammation if lasting longer than 1 hour (stiffness)
- ligamentous injury (Pain)
-

Question 4

What are the components of an objective assessment?

Answer 4

Observation, upper/lower quadrant scan, regional objective exam (more in-depth, PROM, etc)

Question 5

What elements do you want to observe during an objective assessment?

Answer 5

bruising, swelling, bony contours, soft-tissue contours, patient behavior, posture, skin condition

Question 6

Explain the difference between parallel elastic and series elastic components of a muscle.

Answer 6

Parallel, non-contractile components of a muscle while like parallel the muscle fibers which contribute to tension during stretch
- Epi, Peri, Endomysium

Series elastic > stretch exerted when pulling on a tendon

Question 7

List 5 factors contributing to muscle breakdown

Answer 7

Contusions or strains
Inadequate flexibility, strength, endurance
uncoordinated muscle contraction
lack of warm-up
poor rehab

Question 8

What are the 3 stages of tissue healing?

Answer 8

1) Inflammatory stage
2) Repair Stage - regenerative or reparative
3) Remodeling State

Question 9

List and describe the 4 pain stages of the pain response

Answer 9

1) Transduction, physical injury and nerve response
2) Transmission, of the pain signal to the brain
3) Perception, of the pain signal and it’s location interperted in the pain
4) Modulation, what is being done to decrease the pain signal i.e. module the pain.

Question 10

What type of primary afferent fibers send noxious pain signals?

Answer 10

A delta (fast pain signal) and C beta, slow dull pain singla

Question 11

What type of primary afferent fibers send noxious pain signals?

Answer 11

A delta (fast pain signal) and C beta, slow dull pain signal

Question 12

What are the three classes and role of endogenous opioids?

Answer 12

Enkephalins, Endorphins, Dynorphins

- help to modulate pain

Question 13

What are the three components of Melzack’s pain experience?

Answer 13

Motivational Affective - unpleasant sensation of pain

Cognitive Evaluative (Perception)
- cognitive state/cultural values towards pain

Sensory Determinative (Reaction)