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Passive Care > Final-2 Neuromuscular Control/Biofeedback > Flashcards

Final-2 Neuromuscular Control/Biofeedback Flashcards

(56 cards)

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1
Q

Categories of pain

A

Nociceptive: somatic or visceral
Neuropathic: peripheral or central
Psychogenic
Carcinogenic

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2
Q

Kubler-Ross death and dying model

A

DABDA
5 states of response to terminal illness
Denial, anger, bargaining, depression, acceptance

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3
Q

Cognitive appraisal models to injury

A

Response to injury depends on understanding of injury and not neatly divided into stages

**reponse to injury influenced by actions/message of doctor

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4
Q

Parts of cognitive appraisal models with injury

A
  1. Ability to cope with injury influenced by family, friends, stress level etc
  2. Knowledge and understanding alter the response
  3. Find the right level
    (Don’t oversimplify but don’t overwhelm)
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5
Q

Using EPAs and reducing pain thoughts

A
  • reduce pain to enable patient to start therapeutic exercises and allow full functional recovery
  • reduce pain to avoid subclinical adaptations that can led to subluxation patterns and long term patients
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6
Q

Peripheral sensory receptors categories

A

Special
Visceral
Superficial
Deep

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7
Q

Superficial peripheral sensory receptors

A

Sight, taste, smell, hearing and balance

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8
Q

Visceral peripheral sensory receptors

A

Hunger
Nausea
Distension
Visceral pain

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9
Q

Superficial sensory receptors

A

Mechanoreceptors and thermoreceptors

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10
Q

Mechanoreceptors

A

Meissner’s corpuscles (pressure and touch)
Pacinian
Merkle cells (skin stretch/pressure)

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11
Q

Deep sensory receptors

A

Proprioceptors

Nociceptors

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12
Q

Proprioceptors

A

GTO: change in muscle length and spindle tension

Pacinian: change in joint position

Ruffini endings: joint end range

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13
Q

Meissner’s

A

Pressure and touch

Mechanoreceptor, superficial sensory

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14
Q

Merkle

A

Mechanoreceptor-superficial sensory

Stretch and pressure

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15
Q

GTO

A

Proprioceptors-deep sensory

Muscle length change and spindle tension

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16
Q

Pacinian

A

Proprioceptors-deep sensory

Change in joint position

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17
Q

Ruffini endings

A

Proprioception-deep sensory

Joint end range, possible heat

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18
Q

Transduction

A

Changing energy of nociception into electrical action potential in the neuron

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19
Q

First order afferents-peripheral transmission of pain

A

AB
AD
C

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20
Q

A-beta fibers what receptors?

A

Hair follicles, meissner’s, pacinian, merkle, ruffini

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21
Q

Characteristics of AB fibers

A

Touch, vibration

  • large diameter
  • myelinated (fast velocity and low threshold)
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22
Q

AB transmit what information

A

Touch vibration

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23
Q

AD transmit what information

Study These Flashcards
A

Touch, pressure, temperature, pain

24
Q

AD receptors

Study These Flashcards
A

Warm and cold receptors, hair follicles, free nerve endings

25
Characteristics of AD fibers
Myelinated | Smaller diameter than (AB) so slower velocity
26
C fibers transmit what
Touch, pressure, temperature, pain From MUSCLE and skin Unmyelinated and small diameter (SLOW)
27
Peripheral transmission refers to what anatomy?
Peripheral nerve fiber | Cell body in DRG and synapse in spinal cord
28
Central transmission anatomy
First order neuron synapses in dorsal horn - cell body of second order neuron (T CELL) in dorsal horn and many tracts carry info to brain - cell bodies of third order neurons in thalamus - VPL and VPM of thalamus for pain
29
Parts of thalamus important for pain
VPL and VPM
30
VPL
Ascending pain fibers from body synapse here
31
VPM
Fibers from head and face synapse (pain)
32
Thalamus and pain
Modulated input and transmits to somatosensory cortex Relays to Limbic system (emotion, autonomic and endocrine responses to pain)
33
Modulation phase of pain
Activity after cortex received input of pain -excitatory/inhibitory role on new impulses Hypothalamus, pituitary, reticular formation, raphe nucleus
34
Anatomy involved of modulation phase
Hypothalamus, pituitary, raphe nucleus, reticular formation If not inhibited may exacerbate pain and lead to “windup”
35
Peripheral pain modulation
Targeted at desensitizing peripheral nocioceptors to make more difficult to stimulate and slower transmission Ex: Ice —decrease effects of chemical mediators and decrease speed
36
Peripheral pain modulation-gate theory
- non-painful stimulus can block transmission of pain. - substantia gelatinosa in dorsal horn “switches” Interneuron uses enkephalin to inhibit transmition within dorsal horn (found in SG)
37
What fiber is responsible for gate theory that inhibits pain
AB Stimulate AB fibers to inhibit pain (recall touch and vibration) TENS (ERA method)
38
Central pain modulation
Low frequency, high intensity stimulation of peripheral nerves (motor TENS) activate reticular formation and pituitary gland and DEOS (descending endogenous opioid endorphin release) occurs that inhibit effect of pain Descending pain modulation (analgesia)
39
Central pain modulation path
AD/C fibers simulated Stimulate reticular formation that stimulates pituitary. Pituitary inhibits hypothalamus/cortison and stimulated endorphin that stimulated raphe nuclues that releases serotonin and causes enkephalin release
40
Central pain modulation: AD/C fibers stimulate 2nd order afferent that go to the ___ ____ and stimulate the ____. The ____ releases ___ and _____ which stimulate the ____ nucleus and causes release of _____, _____ that inhibit pain
Reticular formation Pituitary Pituitary releases B lipotropin and B endorphin Raphe nucleus releases serotonin and enkephalin
41
Noxious pain modulation
Stimulation of C fibers in injury area (Noxious TENS) Activates PAG (periaqueductal gray space) and raphe nucleus. Serotonin in dorsal horn inhibit second order neuron directly or through interneuron (enkephalin) Ex: ice, stimulate C fibers during burning and aching sensation
42
Nerve block pain modulation
When stimulation encroaches on refractory period of sensory nerve and causes inhibitiation by continual stimulation “Wedenskis inhbition/action potential failure” =anesthesia between electrodes aka IF***
43
Wedenskis inhibition/action potential failure established though what and how
Interferential current Stimulation during refractory period and continual stimulation inhibits
44
Exercise induced hypoalgesia
Decreased pain during physical activity Increased endogenous opioids (endorphins) and catecholamines (EP/NE) during
45
What effect should you consider when evaluating injured athletes
EIH | Exercise induced hypoalgesia
46
3 components of neuromuscular control that need to be addressed during rehabilitation
- conscious muscle contraction - reflex responses - complex movement patterns
47
Example of conscious muscle contraction and shoulder injury
Shoulder injury preventing motion= substitute upper trap muscle and cause inhibition of lower trap Inability to voluntarily contract and causes muscle atrophy and then scapular instability
48
Reflex responses post injury
Usually work as portenctive spinal reflex but post injury afferent signals are decreased and lose proprioception = difficult to reflexively contract and to control balance
49
Complex movement patterns and injury
Athlete/piano practice until unconscious pattern and do without thinking. Injury causes Loss of unconscious patterns
50
Swelling causes what in regards to muscle function
Joint effusion sends signals to CNS and inhibit reflexes of muscles
51
When exercises cause pain the ___ _____ change which perpetuates ___ ___ ___ and slows recovery and may lead to more injury
Motor patterns | Abnormal motor control
52
What are affected with injury
``` Balance Protective reflex Force output Joint stability Position sense ```
53
Restoring neuromuscular control
Active rehab EPA to give pain free exercises e-stim for muscle activation EMG biofeedback for retraining
54
Biofeedback
Use of information to bring physiological events to conscious awareness to patient Ex: mirror, video, EMG, clinician etc, measure stress
55
Electromyographic biofeedback
E-activity in muscles detected - relearn motor patterns/control - relax muscle space and guarding
56
Indicators for electromyographic biofeedback
Back, shoulder, knee injury Learn to control muscles and facilitate contraction

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