Leila has pain in her arm

Pain
1. subjective perception
  1. by nociceptors
    1. unimodal
    2. polymodal
    3. silent
2. conscious awareness of actual or potential damage
3. can be affected
  1. cognition
    1. fear of pain
    2. depression
  2. behaviour
    1. belief
    2. attitude
  3. biological
4. localisation of pain
  1. cutaneous
  2. deep somatic
  3. visceral
  4. psyhogenic
5. types of pain
  1. fast (acute)
    1. by mechanical or thermal damage
    2. a (delta) pain fibers
      1. 2-30 m/s
      2. neospinothalamic tract
  2. slow (chronic)
    1. C pain fibers
      1. 0.5-2 m/s
      2. paleospinothalamic tract
    2. chemical damage
Dermatomes
1. distribution of sensory nerve fibres
2. areas of skin supplied by a spinal nerve
Leila's rash was spread on a single dermatome
1. types of rashes and progression
  1. macule
  2. papule
  3. vesicle
  4. pustule
2. a vesicular rash
Peripheral neuropathies
1. caused by virus or bacteria
  1. virus
    1. rabies
    2. polio
    3. HSV
    4. VZV
      1. Chicken pox
        rash begins on head and torso then spreads to extremeties
        IP=10-21 days
        pearl on rose petal
        course of infection- 7-10 days
        blister pops in 1-2 days and it turns into a crusty scab in 2-3 days
      2. Shingles
        VZV produces LATS that remains dormant in sensory neurons
        reactivated decades after it
        Stress
        immunocomprimised people
        from prodrome to postherpetic
        prodrome
        fever
        malaise
        headache
        accompanied with postherpetic neuralgia
        severe pain
        VZV attacks axons and destroys them
        treatment
        acyclovir
        decreases viral load by inhibiting DNA polymerase
        VARIZIG
        Varicells Zoster Immunoglobulin
        indicated to immunocomprimised people
        VARIVAX
        live attenuated VZV
        contraindicated in iCPs
  2. bacteria
    1. mycobacterium leprae
    2. borrelia borgderferi
Pain Management
1. Pharmacotherapy
  1. NSAIDs
  2. antiviral
    1. HSV
  3. OPIOIDS
    1. substance the binds to opiate receptors on afferent pain fibres
      1. preventing pain signal transmission
    2. endogenous
      1. dysnorphins
      2. endorphins
      3. enkelphins
    3. exogenous
      1. morphine
2. Psychotherapy
  1. relaxation therapy
  2. family therapy
  3. mind-body therapies
3. Alternative therapy
  1. acupuncture
  2. chiropractic therapy
  3. diet changes
ANATOMY of the forearm
1. anterior compartment of forearm
2. posterior compartment

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Leila has pain in her arm

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	Created by Salma Mk about 7 years ago