Central Chest Pain Flashcards
(23 cards)
Somatic pain
Muscle bone joint intervertebral nerves
What kind of pain is somatic?
Sharp localised stabbing
Visceral pain
Heart tracheae abdominal
What kind of pain is visceral?
Dull aching nauseating poorly localised
Radiating pain
Pain felt at the site of injury but also spreading out
Referred pain
Pain only felt at site away from the injury
What is the area of the brain that turns pain into consciousness ?
Somatosensory postcentral gyrus
What is the area of the brain that controls muscle movement?
Somatomotor gyrus
What divides the two areas that control motor and sensory functions?
Central sulcus
What is herpes zoster?
Shingles
Why does herpes zoster cause somatic pain?
The virus is in the posterior root ganglion, so pain felt in dermatome affected, pain proceeds blisters
When could herpes zoster cause central chest pain?
When the T4/T5 posterior ganglion are infected
Why does radiating pain occur?
As the somatic sensory nerves for the body wall and the visceral afferent nerves both return via T1/5 and lower cervical vertebra brain gets confused and pain is related to entire dermatome
Why does referred pain occur?
Shared input between somatic and visceral afferent nerves brain chooses to believe pain occurs from the body wall
Example of radiating pain?
Left arm and upper chest pain during heart attack or angina
GI tract differential
reflux burning acid sudden flow of saliva, provoked by food, epigastric, boring point to the pain relieved by antacids
Causes of GI central pain
Peptic ulcer, oesophageal spasm, biliary colic
Muscoskeletal differential
Injury location is tender, exasperated by breathing, nerve root pain
Pericarditis
Pain often associated with posture, sharp stabbing worse upon breathing, often feverish
pleuritic
Focal exasperated by breathing sharp catching pain
MI
Sever crushing pain despite >10mg of morphine
Associated with nausea impending doom spreading up to left jaw and arm
Pulmonary Embolis
Breathlessness, dull possibly pleuritic pain, haemoptysis
Dissection of the aorta
Severe excruciating tearing but then dulls, collapse, pale
