Leila has a Pain in the Arm

demography
1. name: Leila
  1. clinical presentation
    1. facial expressions
    2. tenderness
    3. restlessness
    4. Moaning, groaning or whimpering
  2. diagnosis
2. age: 70 years old
Physiology of pain
1. transduction
  1. transmission
    1. to the brain
      1. spinothalamic tract
    2. perception
      1. modulation
        gate control theory
        stimulation produced analgesia
        by releasing enkephalins
  2. through pain receptors
treatment of pain
1. analgesics
  1. opioids/narcotics
  2. NSAIDs
  3. acetaminophen
Anatomy of the forearm
1. Nerves
  1. median
    1. All the muscles of the anterior compartment except flexor carpi ulnaris and the 1/2 of flexor digitorum profundus supplied by ulnar nerve
  2. radial
    1. branch
      1. posterior interosseous
        supplies
        All muscles of posterior compartment except the 3 supplied by radial
    2. supplies
      1. brachioradialis
      2. ECRL
      3. anconeus
  3. ulnar
    1. supplies
      1. flexor carpi ulnaris
      2. 1/2 of flexor digitorum profundus
2. muscles
  1. anterior compartment
    1. superficial
      1. pronator teres
      2. flexor carpi radialis
      3. plamaris longus
      4. flexor carpi ulnaris
    2. intermediate
      1. flexor digitorum superficialis
    3. deep
      1. flexor policis longus
      2. flexor digitorum profundus
  2. posterior compartment
    1. superficial
      1. ECRB
      2. ECRL
      3. Anconeus
      4. brachioradialis
      5. extensor carpi ulnaris
      6. extensor digiti minimi
      7. extensor digitorum
    2. deep
      1. extensor indices
      2. supinator
      3. abductor policis longus
      4. extensor policis longus
        tendons of these muscles are the borders of the anatomical snuff box
      5. extensor policos brevis
Types of pain
1. according to
  1. onset
    1. chronic
    2. acute
  2. reason
    1. tension
    2. psychological
    3. pathological
  3. description
    1. pins and needles sensation
    2. throbbing
    3. stabbing
    4. pressure
    5. colic
    6. electrical
    7. burning
    8. pricking
  4. origin
    1. visceral
      1. pain coming from internal organs
        can refer to certain areas in the skin
        dermatomes
        area of the skin supplied by a single spinal nerve
        C1 is an exception with no dermatome
    2. somatic
      1. pain coming from
        muscles
        skin
        soft tissues
possible causes of pain
1. nerve injury
  1. due to different causes
    1. disease
      1. diabetes
    2. compression due to trauma
    3. trauma
    4. infection
      1. microorganisms affecting nerves
        rabies
        mycobacterium laprae
        herpes
        varicella zoster
        will cause
        shingles
        complications
        vision loss
        postherpetic neuralgia
        skin infections
        neurological problems
        cause
        not completely clear
        mostly due to weakened immunity and old age
        symptoms
        itching
        Pain,numbness,burning
        Sensitivity to touch
        Blisters
        Red rash few days after pain
        treatment
        no cure
        antivirals to prevent complications
        valacyclovir
        acyclovir
        analgesics to relieve the pain
2. tissue injury
  1. Pain is caused by activation of pain receptors
  2. soft tissue injury
    1. ligaments
    2. tendons
    3. muscles
    4. organs and skin
  3. bone injury

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Leila has a Pain in the Arm

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	Created by Abdelrahman Nouh about 5 years ago