Chronic Pain

Question 1

A-beta fibers:

Answer 1

light touch, pressure, fast, myelinated

Question 2

A-delta

Answer 2

nociceptive: sharp pain (delta dang that hurts!) tingling, fast, myelinated

Question 3

C fibers

Answer 3

dull, burning pain, slow, unmyelinated

Question 4

gate theory:

Answer 4

activation of A-beta fibers inhibits second order nocioceptors

Question 5

central sensitization:

Answer 5

increased capacity for transmission in nociceptive system

Question 6

wind-up

Answer 6

repeated stimulation of C fibers–> increase discharge evoked by each stimulation–>increased spontaneous discharges–>increased pain with same stimulus

Question 7

anterior spinal artery syndrome

Answer 7

ischemia of anterior spinal artery-most commonly from damage to feeder radicular arteries, presents with painless paralysis

Question 8

Brown-sequard syndrome

Answer 8

vertical hemisection of spinal cord- loss of ipsilateral motor, dorsal column, contralateral pain and temperature

Question 9

cauda equina

Answer 9

bundle of spinal nerves L2-coccygeal nerves

Question 10

cauda equina syndrome

Answer 10

• bowel bladder incontenence
• saddle anesthesia
• lower ext weakness
• low back/leg pain
• ED

Question 11

sensory nerve dermatome hands

Answer 11

C6- thumb
C7: middle finger (7 to heaven)
C8: pinkie

Question 12

C5 reflex

Answer 12

biceps

Question 13

c6 reflex

Answer 13

brachioradialis

Question 14

C7 reflex

Answer 14

triceps

Question 15

L4 refelx

Answer 15

patellar

Question 16

S1 refelx

Answer 16

achilles

Question 17

Superior hypogastric block

Answer 17

Lower abdominal pain (pelvis)

Question 18

.CPRS I vs II

Answer 18

I: spontaneous
II: pain AFTER previous nerve injury (2 comes AFTER 1)