complex regional pain syndrome

Question 1

CRPS typically affects what nerve?

Answer 1

the ulnar nerve

Question 2

CRPS maj risk factor is a

Answer 2

distal radius fracture

Question 3

hypertrichosis:

Answer 3

abnormal hair growth that occurs in response to an irritated cutaneous nerve

Question 4

can children get CRPS

Answer 4

yes but children under 5 and elderly rarely get CRPS

Question 5

CRPS s/s 1 - 3

Answer 5

prolonged or excessive pain out of proportion to injury
continuous throbbing pain
sensation of burning, stinging, tingling, numbness squeezing

Question 6

CRPS s/s 4-6

Answer 6

sensitivity to heat or cold
swelling
changes in skin temperature - sweaty of cold at times
temps may vary
changes in skin texture, which may become tender thin or shiny in the affected

Question 7

CRPS s/s 9-12

Answer 7

inflammation
skin color changes
stiffness
abnormal hair growth

Question 8

CRPS s/s 13-16

Answer 8

spasms in blood vessels and muscle of the extremities
osteopenia
insomnia/ emotional disturbances

Question 9

CRPS last two:

Answer 9

atrophy

dystonia/ motor planning difficulty

Question 10

hyperathia:

Answer 10

abnormal painful reactions to a stimulus (umbrella term)

Question 11

allodynia:

Answer 11

pain in specific dermatome distribution that is the result of stimulus that is not normally painful

Question 12

hyperaglesia

Answer 12

an increased sensitivity to pain, may be caused by damage to nociceptors or peripheral nerves. more extreme pain than allodynia

Question 13

hyperesthesia

Answer 13

a condition that involves an abnormal increase in sensitive stimuli of the senses

Question 14

vasomotor:

Answer 14

dilation and constriction of blood vessels

Question 15

sudomotor

Answer 15

autonomic function associated with the sweat glands

Question 16

trophic

Answer 16

changes in tissues, due to loss /reduction of nerve and / or blood supply (muscle atrophy, increased nail growth (hypertrichosis) changes in nails, increased hair growth

Question 17

what causes CRPS:

Answer 17

we don’t know

Question 18

how many types of CRPS are there?

Answer 18

two

Question 19

type 1 CRPS:

Answer 19

occurs after an illness or injury that did not directly damage the peripheral nerves of the affected limb

Question 20

type 2 CRPS:

Answer 20

there is an identifiable peripheral nerve injury

Question 21

grade 1 :

Answer 21

algodystrophy - disruption of bone growth combine with sympathetic symptoms

Question 22

grade 2:

Answer 22

sympathetic dystrophy without pain

Question 23

grade 3

Answer 23

sympathetic maintained pain

Question 24

how many grades are there of CRPS:

Answer 24

three

Question 25

acute phase occurs

Answer 25

first 3 months

Question 26

subacute phase

Answer 26

3 more months

Question 27

chronic phase

Answer 27

6 months onward

Question 28

what is of the utmost importance:

Answer 28

early diagnosis

Question 29

the patient with CRPS often gets

Answer 29

"labeled' as being a malingerer / magnifier, or having psychological issues

Question 30

IASP:

Answer 30

international associate of the study of pain

Question 31

what evaluations could you use?

Answer 31

McGill pain questionnaire / | visual analog scale

Question 32

what type of scan would you get?

Answer 32

bone scan

Question 33

why would you get a bone scan?

Answer 33

evaluate vascular perfusion

Question 34

X - rays are used to

Answer 34

evaluate regional osteopenia

Question 35

stage 1 begins

Answer 35

at 3 months

Question 36

stage 1 hair growth

Answer 36

increases

Question 37

stage 2 hair growth begins at

Answer 37

3- 6 months

Question 38

stage 2 hair growth

Answer 38

decreases

Question 39

stage 3 begins at

Answer 39

6 or more months

Question 40

stage 3 is

Answer 40

irreversible

Question 41

_____ of those who receive treatment within the ____ year will have significant improvement

Answer 41

80% | first

Question 42

skin =

Answer 42

trophic changes

Question 43

vasomotor changes are

Answer 43

sensations of warmth or coolness without even touching the pt skin color change pain triggered by changes in room temp

Question 44

movement changes are

Answer 44

difficulty initiating movement, reports of stiffness tremors dystonia cramps/ muscle spasms

Question 45

MCP squeeze test is positive if:

Answer 45

the patient pulls away when you grasp MCP and lightly squeeze

Question 46

how do you perform the MCP squeeze test:

Answer 46

- grasp the pt MCP and lightly squeeze

Question 47

drop and swipe test:

Answer 47

you drop alcholol swab on pt - positive if they react

Question 48

what two tests could you do with to test CRPS?

Answer 48

drop and swipe test | MCP squeeze test

Question 49

dystrophile:

Answer 49

device used to measure the amount of weight bearing a person can perform

Question 50

WB goal:

Answer 50

bear as much weight as possible through the affected arm | common for pain and swelling to slightly increase 1st few days of the protocol but positive results usually observed

Question 51

intervention ideas:

Answer 51

stress loading activities functional activities | maladaptive cortical remapping

Question 52

maladaptive cortical remapping:

Answer 52

disorganization of the cortical representation of the affected limb results in pain and dysfunction

Question 53

phase 1 of GMI:

Answer 53

laterality

Question 54

laterality means

Answer 54

left / right discrimination is the accuracy and speed an identifying whether picture of body part is right or left

Question 55

why is laterality lost in CRPS?

Answer 55

the brain tunes out the effective limb

Question 56

four interventions in GMI:

Answer 56

``` diaphragmatic breathing meditation guide imagery biofeedback ```

Question 57

in CRPS it takes twice as long to :

Answer 57

point out the correct body part

Question 58

phase 2 of GMI:

Answer 58

imagery

Question 59

phase 3 of GMI:

Answer 59

mirror therapy

Question 60

three phases of GMI:

Answer 60

laterality imagery mirror therapy

Question 61

what modalities do you want to avoid?

Answer 61

MOIST HEAT

Question 62

what does moist heat do to CRPS:

Answer 62

can increased tissue extensibility followed by exercise - do not use in stage 1

Question 63

what is a good modality to use on CRPS:

Answer 63

low level laser light: - EBP are encouraging for treatment and reducing pain

Question 64

what type of splint would you use for CRPS?

Answer 64

traction glove

Question 65

pain medications although often prescribed are

Answer 65

not effective in alleviating neurogenic pain

Question 66

four surgical interventions include?

Answer 66

decompression sympathectomy spinal cord stimulation deep brain stimulation and electrotherapy