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Leila’s Pain

Abdulrahman Khalil English

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Leila’s Pain

Anatomy of the forearm
- Joints
  - Elbow joint
    - articulations
      - humeroradial
        Radius
        Humerus
      - humeroulnar
        Humerus
        Ulna
    - Type
      - Synovial
    - Variety
      - Hinge
    - Range of movement
      - Uniaxial
    - Ligaments
      - Ulnar collateral Lig
        Bands
        oblique
        posterior
        lateral epicodyle
        Olecranon process
        anterior
        Medial Epicodyle
        coronoid process
      - Radial collateral lig
        lateral epicondyle
        Annular lig
  - Superior radioulnar joint
    - Type
      - synovial
    - Variety
      - Pivot
    - Ligaments
      - quadrate lig
      - Annular lig
- Muscles
  - Front
    - Superficial
      - pronator teres
        Origin
        coronoid proccess
        medial supracondylar ridge
        Insertion
        Lateral surface of radius
        Action
        pronation, flexion
      - Flexor Carpi Radialas
        origin
        Medial epicondyle
        Insertion
        Bases of metacarpal bones 2-3
        Action
        Flexion
      - Palmaris Longus
        Insertion
        Palmar aponeurosis
        origin
        Medial epicondyle
        Action
      - Flexor Carpi Ulnaris
        Insertion
        Carpal bones, base of metacarpal bone 5
        origin
        Medial epicondyle
        Action
        flexion
      - Flexor Digitorum Superficialis
        Insertion
        middle phalanges of digits 2-5
        origin
        Action
        flexion
    - Deep
      - Flexor Digitorum Profundus
        Insertion
        distal phalanges of digits 2-5
        origin
        anterior surface of Ulna
        Action
        Flexion
      - Flexor Pollicis Longus
        Insertion
        distal phalanx of thumb
        origin
        interosseous membrane
        Action
        flexion
      - Pronator Quadratus
        Insertion
        Distal anterior surface of radius
        origin
        Distal anterior surface of ulna
        Action
        pronation
  - back
    - Brachioradialis
      - origin
        Upper ⅔ of the Lateral supracondylar ridge
      - Insertion
        above styloid process of radius
    - ECRL
      - origin
        Lower ⅓ of the Lateral supracondylar ridge
      - Insertion
        2nd metacarpal bone
    - ECRB
      - origin
        Front of Lateral epicondyle
      - Insertion
        3rd metacarpal bone
    - Extensor digitorum
      - origin
        Front of Lateral epicondyle
      - Insertion
        medial 4 middle & distal phalanges
    - Extensor digiti minimi
      - origin
        Front of Lateral epicondyle
      - Insertion
        Extensor expansion of little finger
    - Extensor carpi Ulnaris
      - origin
        Front of Lateral epicondyle
      - Insertion
        base of the 5th metacarpal bone
    - Anconeus
      - origin
        Back of Lateral epicondyle
      - Insertion
        Lateral side of the olecranon
    - Action
      - extension of forearm
    - Deep muscles
      - Abductor pollicis longus
      - Extensor pollicis brevis
      - Extensor pollicis longus
      - Extensor indicis
      - Supinator
Dermatomes of the upper limb
- Dermatome
  - area of skin innervated by sensory axons of a spinal nerve
Pain
- Physiology
  - pain receptors
    - sensory receptors
    - found
      - skin
      - muscles
      - visceral organs
  - How do we perceive pain
    - transduction
      - Stimulus
        electrical impulse
        opening Na channels
    - transmission
      - axons
        Myelinated
        Fast pain
        unmyelinated
        slow pain
    - Central processing
      - Thalamus
        perception of pain
      - hypothalamus
        autonomic responses
      - brain stem
        presence and perception
      - cortex
        quality of pain
    - modulation
      - releasing inhibitory neurotransmitters
        Enkephalins
  - Referred pain
    - feeling pain in part other than the abnormal part
- Psychology
  - Effects on patient
    - psychological morbidities
      - depression
      - anger
      - anxiety
    - societal consequences
      - disability
      - health care costs
    - social consequences
      - isolation
      - intimacy
    - physical functioning
      - sleep problems
- unpleasant experience associated with tissue damage
Shingles
- pathological features
  - common complication of chicken pox
  - single dermatome distribution
  - needs stimulus
  - unilateral
  - heals without scarring
- Clinical presentations
  - Headache
  - fever
  - redness
  - fatique
- complication of shingles
  - post herpetic neuralgia
    - Sensitivity to light touch
    - Itching and numbness
    - Pain
    - Risk factors
      - age
      - Severity
      - other ilnesses
      - location
- Treatment
  - Antiviral medications
    - acyclovir
    - famiciclovir
    - valacyclovir
  - NSAIDs
    - Ibuprofen
  - lotions
    - calamine lotion
  - Steroids
    - speed healing of the rash
  - Antidepressants
Analgesics
- Narcotics
  - Morphine
    - Effects
      - Sedation
      - vomiting
      - miosis
      - euphoria
      - physical dependancy
  - Fentanyl
    - highly potent anesthetic
  - tramadol
  - Naloxone
    - pure antagonist
    - opioid overdose
- NSAIDs
  - act on COX
  - examples
    - Aspirin
      - side effects
        salicylism
        reduced GFR
    - ibuprofin
- paracetamol
- Opioid receptors
  - Mu
    - Most important
  - Sigma
    - false opioid receptor
  - Delta
    - Few ADRs
  - Kappa
    - central analgesia
    - ADR: Dysphoria

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Description: Mind Map on Leila’s Pain, created by Abdulrahman Khalil on 07/02/2022.
Created by: Abdulrahman Khalil
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Leila’s Pain

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