Mind map
Pain
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Pain
Pain
- An unpleasant sensory & emotional experience associated with actual or potential tissue damage, or described in terms of such damage
- Pain Perceptions determined by
- Psychological
- Fear of pain
- Pain “catastrophizing”
- Depression
- stress
- Biological
- Person’s sex, genetics and number of nociceptors, in the body.
- Social components
- Person’s beliefs, attitudes or expectations
- Psychological
- Subjective sensation
- Localization
- Cutaneous Pain
- sharp, bright, burning
- Deep Somatic Pain
- tendons, fascia, muscles, joints, periosteum, and blood vessels
- Visceral Pain
- internal organs; diffused first & later may be localized
- Psychogenic Pain
- emotional rather than physical
- Cutaneous Pain
- Referred Pain
- pain felt in a part of the body other than its actual source.
- Types
- Fast
- Acute
- Myelinated and a nerve fiber with a large diameter
- Aδ fiber axons (NeospinothalamicTract)
- Myelinated and a nerve fiber with a large diameter
- Acute
- Slow
- chronic
- Unmyelinated and a nerve fiber with a small diameter
- C fiber axons (Paleospinothalamic Pathway)
- Unmyelinated and a nerve fiber with a small diameter
- chronic
- Fast
- How is pain perceived?
- 1-Transduction of stimulus to action potentials (receptor potential)
- 2-Transmission of action potentials to the cerebral cortex.
- 3-interpretation of this input through association areas.
- 4-Modulation by intrinsic neurons or by descending input from higher centers
- 3-interpretation of this input through association areas.
- 2-Transmission of action potentials to the cerebral cortex.
- 1-Transduction of stimulus to action potentials (receptor potential)
- Central processing of pain
- cortex, thalamus and brainstem
- Interconnected with
- hypothalamus and autonomic nervous system,
- associated with an autonomic response
- hypothalamus and autonomic nervous system,
- Interconnected with
- cortex, thalamus and brainstem
- Pain Perceptions determined by
- Nociceptors or pain receptors
- Unimodal- nociceptors
- Polymodal nociceptors
- Silent Nociceptors
- Pain suppression
- Analegisa
- Endogenous opiates released from descending analgesic pathway bind with opiate receptors at the synaptic knob of the afferent pain fiber
- This binding Inhibits the release of substance P, thereby blocking transmission of pain Impulses along the ascending pain pathways.
- This binding Inhibits the release of substance P, thereby blocking transmission of pain Impulses along the ascending pain pathways.
- Endogenous opiates released from descending analgesic pathway bind with opiate receptors at the synaptic knob of the afferent pain fiber
- Analegisa
- An unpleasant sensory & emotional experience associated with actual or potential tissue damage, or described in terms of such damage
Dermatomes
- -Distribution of sensory nerve fibers
- two dermatome maps
- Foerster (1933) :correlates with clinical findings
- Keegan and Garret (1948):correlates with development
- two dermatome maps
- -Distribution of sensory nerve fibers
History Taking
- basic patient details and statement of presenting problem.
- Onset and Duration
- Where
- Progression
- Quality
- Quantity
- Aggravating factors
- Alleviating factors
- Beliefs
- basic patient details and statement of presenting problem.
physical Examination of the upper limb
- Inspection
- Initially there was no signs of any rash
- a vesicular rash has appeared.
- Types of Rashes
- A macule
- a flat, distinct, discolored area of skin less than 1 centimeter (cm) wide.
- vitiligo, rubella, measles
- a flat, distinct, discolored area of skin less than 1 centimeter (cm) wide.
- A papule
- is an area of abnormal skin tissue that is less than 1 centimeter around
- dermatitis, chicken pox, eczema
- is an area of abnormal skin tissue that is less than 1 centimeter around
- Pustules
- small bumps on the skin that contain fluid or pus
- acne
- small bumps on the skin that contain fluid or pus
- A macule
- small, fluid-filled sacs that can appear on your skin
- cold sores, contact dermatitis, impetigo
- Types of Rashes
- a vesicular rash has appeared.
- Initially there was no signs of any rash
- Palpation
- ROM
- Clinical Diagnosis
- pink or red blotchy patches on one side of your body
- rash quickly develops fluid-filled blisters similar to chickenpox
- Blisters sometimes erupt and ooze
- Shingles often appears around the rib cage or waist, and may look like a “belt,” or a half belt
- Most people can expect the rash to heal within two to four weeks.
- Shingles often appears around the rib cage or waist, and may look like a “belt,” or a half belt
- Blisters sometimes erupt and ooze
- rash quickly develops fluid-filled blisters similar to chickenpox
- pink or red blotchy patches on one side of your body
- Inspection
shingles
- painful condition that makes it difficult to sleep
- LATS in neurons and sensory ganglia. single dermatome distribution
- often with the accompanying condition postherpetic neuralgia
- classic, rash that begins on the head and torso and then spreads to the arms and legs.
- an area of redness with a small, superficial blister in the center
- blister ruptures and the lesion will form a crusty scab that will fall off
- an area of redness with a small, superficial blister in the center
- signs and symptoms
- Pain, burning, numbness or tingling
- Sensitivity to touch and light
- A red rash that begins a few days after the pain
- Fluid-filled blisters that break open and crust over
- Fever
- Itching
- Headache
- Fatigue
- LATS in neurons and sensory ganglia. single dermatome distribution
- Caused or activated by (low immunity)
- old age
- physical and emotional stress
- HIV & AIDS
- bone marrow transplant
- chemotherapy
- Complications
- Allodynia
- Hyperalgesia
- Constant / intermittent burning, aching, throbbing, stabbing or shooting pain
- Eye problems
- Vaccination
- Zostavax.
- The vaccine won't treat a current outbreak of shingles, but it can prevent future attacks if you have already had shingles
- Zostavax.
- painful condition that makes it difficult to sleep
Peripheral Neuropathy
- Viruses: VZV HSV HSV Rabies virus Polio HIV
- A late complication of chickenpox is
- Mechanism of spread of VZ
- A late complication of chickenpox is
- Bacteria: Mycobacteria leprae Lyme disease
- Auto-immune:Gullian Barre syndrome
- Viruses: VZV HSV HSV Rabies virus Polio HIV
Management of Pain
- Nonpharmacological
- Transcutaneous Nerve Stimulation (TENS)
- Heat and cold
- Physical and occupational therapy
- Lifestyle changes
- Psychotherapy
- Cognitive and behavioral therapy
- Behaviour: when specific goals can be established
- Mind-Body therapies
- ‘talking cures’ to treat mental disorders over time
- Relaxation therapy-exercises, meditation
- Coping: remove or reduce the cause of the stressor (loneliness, isolation)
- Cognitive and behavioral therapy
- Rest
- Dietary approaches to treating pain:
- Acupuncture
- Pharmcological
- NSAIDS
- Aspirin-voltaren (diclofenacl)
- MoA ,Inhibit cyclooxygenase enzymes
- Gastric problems(nausea-pain-ulcers-bleeding)
- Paracetamol
- Not known weak inhibitor of the synthesis of prostaglandins (PGs)
- Normal dose: 2 tablets(500mg) 4 times a day More then 4000mg: serious liver damage
- Not known weak inhibitor of the synthesis of prostaglandins (PGs)
- Opoids
- Mild opioids: codeine, hydrocodone, oxycodone.
- Major opioids: Morphine, Demerol, Hydromorphone, Fentanyl, Methadone
- Opiates
- Narcotics: (numbness)
- Antiviral drugs
- Classified based on the type of infection
- HIV
- HSV
- Acyclovir
- is used to decrease pain and speed the healing of sores or blisters in people who have varicella (chickenpox)), herpes zoster
- it can Prevent complications of shingles , such as postherpetic neuralgia
- is used to decrease pain and speed the healing of sores or blisters in people who have varicella (chickenpox)), herpes zoster
- Acyclovir
- Hepatitis
- Respiratory viral infections
- Classified based on the type of infection
- NSAIDS
- Nonpharmacological
Anatomy
- Capsule of the elbow joint
- Humerus
- Radius
- Ulna
- Ligaments
- Ulnar collateral ligament
- thick triangular ligament
- a-Anterior band
- b-Posterior band
- c-Oblique band
- thick triangular ligament
- Radial collateral ligament:
- band that connect the lateral epicondyle with the annular ligament
- Ulnar collateral ligament
- Elbow Anastomosis
- In front of the lateral epicondyle
- Anterior descending of the profunda A
- Radial recurrent A
- Behind lateral epicondyle:
- Posterior descending of profunda A
- Interosseous recurrent A.
- Infront of the medial epicondyle:
- Ant. Br. Of inferior ulnar collateral A.
- Anterior ulnar recurrent A.
- Behind the medial epicondyle:
- Posterior ulnar recurrent A.
- In front of the lateral epicondyle
- Cubital Fossa
- It is a triangular space in front of the elbow
- Base: An imaginary line between the two Humeral epicondyle
- Medial side: It is formed by the lateral border of pronator teres M
- Lateral side: It is formed by the medial border of brachioradialisM .
- The apex of the triangle is directed downwards, where the brachioradialis overlaps the pronator teres.
- The Roof: It is formed by: -Skin -Superficial fascia median cubital vein, Part of cephalic and basilic veins, The medial and lateral cutaneous nerves of the forearm. -The deep fascia Bicipital aponeurosis.
- It is a triangular space in front of the elbow
- Muscles of the anterior of the forearm
- Muscles of the posterior of the forearm
- Capsule of the elbow joint
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- Description
- Mind Map on Pain, created by kholod haj hussain on 17/02/2020.
- Created by
- kholod haj hussain
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- History
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- Created by Fatma Shwaylia · Mar 11, 2017
- Copied by kholod haj hussain · Feb 17, 2020
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