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Flashcards in Pain Lecture Deck (41)
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1

What are the four sources of pain?

Cutaneous (somatic)

Deep somatic

Visceral

Referred

2

What are the characteristics of cutaneous pain?

Refers to pain along the skin

Localized with one finger

Associated with referred or deep somatic pain but again, localized

3

What are the characteristics of deep somatic pain

Bone, nerve, muscle, tendon, ligament, arteries, joints, spongy or cancellous bone, periosteum

Poorly localized

Often referred

4

What are the characteristics of visceral pain?

Internal organs, heart
muscle

Poorly localized because of multi-segmental innervation (cardiac pain: C3-T4)

Pain corresponds to dermatomes from which organ receives its innervations

Few nerve endings

Visceral pleura insensitive to pain

Associated with ANS response

5

What are the characteristics of referred pain?

From cutaneous, soma, viscera

Pain felt in area far from site of lesion but supplied by same or adjacent neural segments

Includes all structures: cutaneous, deep somatic, and visceral

Most of the time, it refers distally

Usually well-localized

Can spread or radiate from point of origin

Can occur alone but usually preceded by visceral pain when organ is involved

6

What are the mechanisms of referred visceral pain?

Embryologic development

Multisegmental innervation

Direct pressure and shared pathways

7

What are the possible visceral pathologies with pain in the RIGHT SHOULDER?

Liver

Perforated duodenal ulcer

8

What are the possible visceral pathologies with pain in the RIGHT POSTERIOR AXILLA?

Penetrating duodenal ulcer

9

What are the possible visceral pathologies with pain in the MIDDLE POSTERIOR BACK?

Penetrating duodenal ulcer

10

What are the possible visceral pathologies with pain in the RIGHT POSTERIOR FLANK?

Cholecystitis

11

What are the possible visceral pathologies with pain in the LOW BACK?

Pancreatitis

Renal colic

12

What are the possible visceral pathologies with pain in the SACRUM?

Rectal lesions

13

What are the possible visceral pathologies with pain in the LEFT POSTERIOR SHOULDER?

Pancreatitis

14

What are the possible visceral pathologies with pain OVER LEFT BREAST, MEDIAL ARM?

Heart

GERD

15

What are the possible visceral pathologies with pain UNDER RIGHT BREAST?

Biliary colic

16

What are the possible visceral pathologies with pain in the RIGHT UPPER ABDOMEN?

Cholecystitis

Pancreatitis

Duodenal ulcer

17

What are the possible visceral pathologies with pain UNDER LEFT BREAST?

Peptic ulcer

Renal ulcer

18

What are the possible visceral pathologies with pain in the RIGHT LOWER ABDOMEN (Erb's point)?

Appendicitis

19

What are the possible visceral pathologies with pain OVER THE NAVAL?

Small intestine

Appendicitis

20

What are the possible visceral pathologies with pain OVER THE PUBIC REGION?

Colon

21

What are the possible visceral pathologies with pain in the LEFT GROIN?

Ureteral colic

22

What are the possible visceral pathologies with pain in the SHOULDER AND LOW BACK?

Diaphragm

23

What are the possible visceral pathologies with pain in the SHOULDER, NECK, UPPER BACK, and GENITALIA?

Urogenital tract

24

What are the possible visceral pathologies with pain in the SHOULDER, MIDTHORACIC/LOW BACK?

Pancreas

Liver

Spleen

Gall bladder

25

If you have a lesion at C7 or between T1 and T5, what somatic representation of that pain should be expected?

Pain in inter-scapular area

Pain in posterior shoulder

26

If you have a lesion at the shoulder, what somatic representation of that pain should be expected?

Pain in neck

Pain in upper back

27

If you have a lesion at L1 or L2, what somatic representation of that pain should be expected?

Pain in the SI joint

Pain in hip

28

If you have a lesion in the hip joint, what somatic representation of that pain should be expected?

Pain in SI joint

Pain in knee

29

If you have a lesion around the pharynx, what somatic representation of that pain should be expected?

Pain in the ipsilateral ear

30

If you have a lesion at the TMJ, what somatic representation of that pain should be expected?

Pain in the head

Pain in the neck

Pain in the heart