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Flashcards in Week 3 Deck (49)
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1

Serum sickness

-joint pain as an allergic response
-can occur up to 6 week after taking Rx drug (esp antibiotics)

2

Inflammatory bowel disease

-can present with new onset of joint symptoms
-usually large joints (often a single knee or hip)
-UC and CD can also present with these symptoms

3

Infectious arthritis

-local response to infection
-lyme disease, STDs, hep b, rubella,
-staph, strep, gonocci
-major risk factors; over 80, DM, IV drugs, catheters, RA, oa

4

Reactive arthritis

-nongonoccal urethritis, conjunctivitis, multiple joint involvement ("triad")
-often causes inflammation along tendons (plantar fasciitis, sacroiliits)

5

Radicular pain

-results from direct irritation of axons or a spinal nerve o rneurons in the DRG
-dermatome, sclerotome, myotome

6

Radiating pain

-pain spreads or fans out from the originating point of pain

7

Referred pain

-activation of nociceptive free nerve endings of the nervous system in somatic or visceral tissue

8

Radiculopathy

-neurologic state in which conduction along a spinal nerve or its root is blocked
-numbness or weakness is present instead of pain

9

GI pain if obstruction

-increases with peristalsis or ingestions
-decreases with vomiting or BM

10

GI pain if acid related

-pain relieved by food or other neutralizing material
-pain worse when stomach is empty and secreting acid

11

GI pain if other organs involved

-pain may increase with certain positions that increase internal abdominal pressure

12

Gall bladder position of relief

-slight trunk flexion

13

Kidney position of relief

-flexion and side bending towards involved kidney

14

Pancreas position of relief

-sitting up and leaning forward OR knees to chest

15

5 P's of pain at rest with ischemia

1. pain
2. pallor
3. puleslessness
4. paresthesia
5. paralysis
PVD when in unilateral extremity
-burning, shooting, pain, may have paresthesias

16

Acute vs. chronic nigh pain

Can't lie on involved side=acute
30-60 in=sub-acute
>2hr=chronic

17

Pain lag time

5 to 10 mins between beginning activity and onset of symptoms = vascular/claudication
-immediate pain or symptoms: more likely MS

18

Chronic pain

-greater than 3 months
-6 weeks should be cut off for clinical progress

19

Chronic pain vs. systemic disease

Chronic pain: dull and persistant, usually history of precipitating injury/event
Systemic: more acute with recent onset, sharp, knife-like, deep

20

2 Reasons visceral pain is not well localized

1. Innervation of the viscera is multisegmental
2. There are few nerve receptors in these structures

21

Somatic-somatic reflex responses

Bruise on the leg can cause knee pain

22

Somatovisceral reflex responses

Biomechanical dysfunction at 10th rib can cause gallbladder changes

23

Viscero-somatic reflex response

Gallbladder impairment can result in 10th rib; pelvic floor dysfunction can lead to incontinence; heart attack causes arm or jaw pain

24

Viscero-viscero reflex

Occurs when pain or dysfunction in one organ causes symptoms inanother

25

S/S that accompany visceral pain

- ANS response such as change in vitals, unexplained perspiration (diaphoresis), skin pallor

26

Neuropathic pain

results from damage or pathophysiologic changes of the peripheral or central nervouse system

27

Causes of neuropathic pain

1. acute nerve root irritation (severe, burning, shooting, constant)
2. Chronic nerve root irritation (annoying, nagging)

28

Other s/s of neuropathic pain

-not alleviated by opiates or narcotics
-no muscle spasm
-meds used are often antidepressants, anti-convulsants, antispasmoditcs, adrenergics, anesthetics

29

Referred pain description

-usually well localized, but doesn't have sharply defined borders and can spread or radiate from its origin
-often accompanied with muscle hypertonus

30

Tension Pain

-organ distention
-makes it difficult to find a comfortable position

31

Inflammatory pain

-inflammation of the viscera or parietal peritoneum
-may cause deep/boring pain
-people seek positions of quiet with little movement

32

Ischemic pain

-sudden, intense, constant, progressive
-not relieved by position or analgesics

33

Myofascial pain

-myalgia can be present in anxiety/depressive disorders
-can be a side effect of drugs
-can be symptom of underlying disorder
-joint pain commonly accompanies this

34

Muscle tension

-prolonged muscular contraction or co-contraction results in local ischemia, increased cellular metabolites, pain

35

Muscle spasms

-sudden, involuntary contraction of a muscle or group of muscles

36

Trigger points: jump sign

person physically withdraws from the pressure on teh point

37

Trigger points: active

Refer pain locally or to another location
-can cause pain at rest
-fatigue faster and recover more slowly

38

Trigger points: latent

Do not cause spontaneous pain, but generate referred pain when the affected muscles are put under pressure, palpated or strained

39

Trigger points: key

Have pain-referral pattern along nerve pathways

40

Trigger points: satellite

-set off by key trigger points

41

Pain catastrophizing scale

-negative view of the pain experience/expecting the worst to happen
-person can already be in pain or just be expecting pain
-13 item self report

42

McGill Pain Questionnaire

-measures subjective pain experience in quantitative form
-sensory and affective word descriptors
-helps therapist identify the source of pain (visceral, neurogenic, somatic, pscyhosomatic)

43

Illness Behavior Syndrome

-pain in absence of an identified source of disease or pathologic condition
-present most often in people with chronic pain
-dramatization of complaints, progressive dysfunction, drug misuse, progressive dependency on others

44

Symptom magnification syndrome

-conscious: malingering
-unconscious: illness behavior
-self-destructive, socially re-inforced behavioral pattern

45

Waddell's Nonorganic Signs

3 or more positive signs = nonmovement dysfunction
-non-mechanical, pain focused
-poor outcomes
-does not suggest absence of pain, but behavioral response to pain
-does not confirm malingering

46

5th vital sign

PAIN

47

Most common sites of referred pain from systematic disease

-chest
-back
-shoulder
-scapula
-pelvis
-hip
-groin
-SI joint

48

Verbal descriptor scale (VDS)

-most sensitive and reliable among older adults, including those with mild/mod cognitive impairment

49

Alzheimer's Discomfort Rating Scale

Documents frequency, intensity and duration of client's discomfort based on noisy breathing, facial expressions, and overall body language