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Flashcards in Chapter 7 Deck (40):
1

What are the two methods of testing function?

Nerve conduction study (NCS)
Somatosensory evoked potentials (SEP)

2

What does NCS measure?

peripheral nerve function

3

What does SEP measure?

peripheral nerves and central nervous system pathways

4

What is compared to determine if NCS is normal?

distal latency
amplitude of the evoked potential
conduction velocity

5

What are SEPs used to determine?

verify subtle signs and locate lesions of the dorsal roots, posterior columns, and brainstem.

6

What is ataxia?

incoordination that is not due to weakness

7

What are three types of ataxia?

sensory
vestibular
cerebellar

8

What is the Romberg test used for?

to distinguish between cerebellar ataxia and sensory ataxia

9

What is neuropathy?

general term for dysfunction or the pathologic condition of one or more peripheral nerves

10

What is the sensory loss in peripheral nerve lesions?

1. conscious proprioception and discriminative touch
2. Cold
3. Fast pain
4. Heat
5. Slow pain

11

What are the common causes of dysfunction of the spinal region?

trauma
disease
virus

12

What happens with complete transection of cord?

All sensation is prevented at one or two levels below the lesion
Voluntary motor control below the lesion is also lost

13

What happens with hemisection of the spinal cord?

-complete loss of sensation in contralateral side 2-3 levels below lesion
-discriminative touch and conscious proprioception lost ipsilateral to lesion

14

Lesion in posterior column:

conscious proprioception, 2 point discrimination and vibration lost below level of lesion
-ataxic movements

15

Brainstem region lesion:

mix of ipsilateral and contralateral signs
-sensory loss can be contralateral in upper midbrain after discriminative sensation have crossed midline

16

Somatosensory Cortex Lesion:

Conscious proprioception
Two-point discrimination
Stereognosis
Localization of touch and pinprick (nociceptive) stimuli
-contralateral and decrease of above sensations

17

Fast and slow pain can occur with musculoskeletal injuried via what fibers?

A-delta and C fibers

18

What parts of the brain are included in processing and regulating pain information?

brainstem, amygdala, hypothalamus, thalamus, and areas of the cerebral cortex

19

What does understanding of pain matrix require?

understanding of:
1. discriminative
2. motivational affective
3. congitive-evaluative component

20

Discriminative aspect of pain matrix refers to what?

the ability to localize the site, timing, and intensity of tissue damage or potential tissue damage

21

Motivational affective aspect of pain matrix refers to what?

the effects of the pain experience on emotions and behavior, including increased arousal and avoidance behavior.

22

Cognitive-evaluative aspect of pain matrix refers to what?

meaning that the person interprets /ascribes to the pain (punishment, burden

23

How is pain controlled?

1. gate theory
2. counterirritant theory
3. dorsal horn processing of nociceptive information
4. antinociceptive systems

24

What is the gate theory of pain?

Typical response to hitting one’s thumb with a hammer is to withdraw the thumb, yell, and apply pressure
- TENS

25

What is the counterirritant theory?

explains the inhibition of nociceptive signals by stimulation of non-nociceptive receptors occurs in the dorsal horn of the spinal cord

26

What is the dorsal horn processing of nociceptive information?

Processing of somatosensory information in the dorsal horn can be altered by abnormal neural activity or by tissue injury

27

What are the states of dorsal horn processing?

normal
suppressed
sensitized
reorganized

28

Normal state of dorsal horn processing:

normal physiologic activity

29

Suppressed state of dorsal horn processing:

segmental and descending inhibition

30

Sensitized state of dorsal horn processing:

changes in neurotransmitters and receptors

31

Reorganized state of dorsal horn processing:

cell death, degeneration of C fiber and sprouting that synapses with neurons in the nociceptive pathways

32

Neuropathic pain is produced by what?

neuroplasticity not by stimulation of nociceptors

33

Antinociception:

the suppression of pain in response to stimulation that would normally be painful.

34

What activates antinociceptive mechanisms?

endorphins and endogenous substances

35

Level I of antiociceptive site:

peipheral

36

Level II of antiociceptive site:

dorsal horn

37

Level III of antiociceptive site:

fast acting neuronal pathway from brainstem

38

Level IV of antiociceptive site:

hormonal

39

Level V of antiociceptive site;

descending cortical inhibition

40

What is primary hyperalgesia?

refers to excessive sensitivity to stimuli in injured tissue