Laila has a pain in the arm

Laila has a pain in the arm

1. Anatomy of the forearm

   • Anterior Compartment
   • Posterior compartment

2. Dermatomes

3. Pain

   • Pain perception could be influenced by:
     • Behavioral responses
     • Emotional reactions
     • Past or present experiences
   • Localization of Pain
     • Cutaneous Pain
     • Deep Somatic Pain
     • Psychogenic Pain
     • Visceral Pain
   • Types of pain
   • Stimuli Excite Pain Receptors
     • Thermal
     • Mechanical
     • Chemical
   • Pattern of pain perception
     • 1. Transduction
     • 2.Transmission
     • 3. Central processing
     • 4. Modulation
   • Pain receptors - Nociceptors
     • Sensory receptors that detect signals from damaged tissue
     • Free nerve endings with large receptive fields
     • Found in the skin , muscle, joints, bone and viscera.
     • Hyperalgesia
     • No nociceptors are found inside the CNS.
   • Treatment
     • NSAIDs
     • Acetaminophen
     • Antidepressants
     • Anti-seizure medications
     • Steroids

4. Psychological aspect

   • Psychological effects of pain
     • Increase in negative feelings
     • Pain and depression
     • Pain catastrophizing
     • Social stigma
   • Psychological management of pain
     • Relaxation Techniques
       • Relax muscle groups one at a time
       • Learn and remember what relaxation feels like
       • Practice and repetition
       • Used for stress and anxiety
       • Combine with deep breathing exercises
     • Cognitive Therapy = Distraction or diversion of attention
     • Biofeedback = Provides bio-physiological feedback to patient about bodily process
     • Hypnosis = a technique to help a patient reach a focused state

5. Shingles

   • What is it?
     • An infection of a nerve area caused by the varicella-zoster virus. It causes pain and a rash along a band of skin supplied by the affected nerve.
   • Risk Factors
     • History of having had chickenpox
     • Being older than 50
     • Undergoing cancer treatments
     • Taking certain medications
     • Having certain diseases (Such as HIV\AIDS)
   • Signs and symptoms
     • Pain, burning, numbness or tingling
     • Sensitivity to touch
     • Sensitivity to light
     • Fatigue
   • Pathophysiology
   • Complications
     • Vision loss of eye problems
     • Neurological problems
     • Skin infections
     • Scarring and skin discoloration
     • Bacterial infection of the blisters
     • Post herpetic neuralgia
       • Pain that does not go away within 1 month. It may last for months or even years after shingles heals
       • Types of this pain experienced
         • Constant burning, aching, throbbing, stabbing, or shooting pain
         • Allodynia
         • Hyperalgesia
   • Prevention & Treatment
     • NSAIDs
       • Usually used for the treatment of acute or chronic conditions where pain and inflammation are present.
       • Mechanism of action
         • COX 2 Is inhibited.
         • Cox1 and 2 are enzymes that produce prostanglandins (are produced from arachadonic acids)
       • Side effect
         • Nausea
         • Vomitting
         • Diahrrea
         • Constipation
         • Decreased appetite
         • Rash
         • Dizziness
         • Headache
         • Drowsiness
       • Types

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