Signs & Symptoms; OPQRST

Question 1

nociception=

Answer 1

-pain sensation

Question 2

nociceptors=

Answer 2

-pain receptors

Question 3

tissue damage results in release of __, __ P, histamine & __ __ (all nociceptive substances).
these substances __ pain signals by acting on __ nerve endings.

Answer 3

• serotonin; substance; kinin peptides

- activate; free

Question 4

__ pain conveyed by thin, __, type A __ fibers.

__, achy, hurting pain via __, slow type __ fibers.

Answer 4

• sharp; myelinated; delta

- dull; unmyelinated; C

Question 5

skin, joints, arterial walls & periosteum have a lot of=

Answer 5

-nociceptors

Question 6

most important for patient to:

Answer 6

-identify where is the pain

Question 7

aching=

Answer 7

muscle, tendon, ligament

Question 8

bounding=

Answer 8

vascular, circulation

Question 9

burning=

Answer 9

nerve root, arterial

Question 10

cramp=

Answer 10

muscle

Question 11

boring deep pain=

Answer 11

cancer, bone pain

Question 12

unrelenting deep pain=

Answer 12

cancer, visceral

Question 13

dull=

Answer 13

musculoskeletal, visceral

Question 14

gnawing=

Answer 14

ulcer

Question 15

radiating (well delineated)=

Answer 15

nerve (causalgia-burning pain from peripheral nerve)

Question 16

radiating (diffuse)=

Answer 16

sclerotogenous or myogenous

Question 17

sharp/localized=

Answer 17

facet, visceral referred

Question 18

stabbing=

Answer 18

visceral

Question 19

shooting=

Answer 19

nerve root, entrapement

Question 20

tearing=

Answer 20

anuerysm or severe pain

Question 21

throbbing=

Answer 21

vascular, circulation

Question 22

tingling (segmental)=

Answer 22

nerve root, peripheral nerve

Question 23

tingling (non-segmental)=

Answer 23

• if bilateral: cord compression, MS, diabetes

- if unilateral: plexus

Question 24

(pain pattern)

dermatogenous=

Answer 24

• pain along the sensory distribution of a nerve root

- sharp, stabbing, well demarcated

Question 25

(pain pattern) | myogenous=

Answer 25

- pain referral within muscular or fascial tissue - trigger points within the muscle will refer pain to a distant site - myofacial

Question 26

(pain pattern) | scleratogenous=

Answer 26

- pain referred from somatic structures (cartilage, ligament, joint capsule or bone) - typically will not follow dermatome - dull, achy, diffuse, difficult to pinpoint

Question 27

(timing of pain) | with use, better with rest=

Answer 27

-mechanical

Question 28

(timing of pain) | night pain=

Answer 28

- serious (cancer) | - if aggravated by motion= mechanical

Question 29

(timing of pain) | pain at rest & worse w/ beginning of use=

Answer 29

-inflammatory

Question 30

(timing of pain) | constant=

Answer 30

-cancer, visceral

Question 31

(referred pain) Site of referral: right shoulder inferior scapula Organ?

Answer 31

-right lung, liver, gallbladder

Question 32

(referred pain) Site of referral: left shoulder Organ?

Answer 32

-left lung, stomach, spleen

Question 33

(referred pain) Site of referral: jaw, neck, left shoulder & arm Organ?

Answer 33

-heart

Question 34

(referred pain) Site of referral: either shoulder Organ?

Answer 34

-diaphragm

Question 35

(referred pain) Site of referral: flank Organ?

Answer 35

-kidney

Question 36

(referred pain) Site of referral: substernal Organ?

Answer 36

-esophagus, heart, lung

Question 37

(referred pain) Site of referral: spine at T10 Organ?

Answer 37

-pancreas

Question 38

(referred pain) Site of referral: suprapubic Organ?

Answer 38

-bladder

Question 39

(referred pain) Site of referral: occiput, forehead Organ?

Answer 39

-eye

Question 40

(referred pain) Site of referral: temporal HA Organ?

Answer 40

-TMJ

Question 41

O=

Answer 41

- Onset - WHEN did this problem occur? - if traumatic, ask the MOI - if chronic, ask prior episodes

Question 42

P=

Answer 42

- Provocative/Palliative - WHAT makes it WORSE or BETTER? - does the problem interfere with daily living activities?

Question 43

Q=

Answer 43

- Quality - DESCRIPTION of Pain (what kind of pain?) - bright, pricking, sharp, cutting, knifelike, lightning like - burning, hot, stinging - deep, aching, boring, pounding, sore, heavy, constricting, gnawing

Question 44

R=

Answer 44

- Radiating - WHERE else? - does the pain stay in one place? - does the pain encompass a large area? - does the pain move from one location to another location?

Question 45

S=

Answer 45

- Site/Severity - WHERE & HOW BAD? - can you show specifically where? - what other feelings occur at this site? - have pt rate the intensity (0-10 pain scale)

Question 46

T=

Answer 46

- Timing - HOW OFTEN does it hurt? - is it all the time? come & go? - if intermittent: ask about frequency & duration of episodes - constant or occasiona? seasonal? certain time of day?