Term
| What is the action of the scalen muslce groups |
|
Definition
| neck flexion, rib elevation |
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|
Term
| Where does the Rectus Capitus anterior attach |
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Definition
| C1 to cranial base, anterior to occipital condyle |
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Term
| What is the innervation of the Longus Coli |
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Definition
|
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Term
| What makes up the roof of the suboccipital triangle |
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Definition
|
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Term
| What is the inferior lateral boundary of the subooccipital triangle |
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Definition
|
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Term
| What is the superior lateral boundary of the suboccipital triangle |
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Definition
|
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Term
| What is the superior medial boundary of the suboccipital triangle |
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Definition
|
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Term
| What is the accepted idea for why occipital neuralgia |
|
Definition
| Chronic entrapment of occipital nerve |
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Term
| The sensation in the posterior neck is supplied by what? |
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Definition
| medial branches of dorsal primary rami of C2,C3,C4, C5 |
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Term
| If a jabbing pain is occuring in the head, and the individual has a headache, what type of issue could there be |
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Definition
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Term
| What cranial nerve does not have a sensory effect on the head |
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Definition
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Term
| Pain coming after a dislocation is probably from what type of origin? |
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Definition
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Term
| Pain coming after a fracture is probably from what type of origin |
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Definition
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Term
| Back pain originating from muscle spasms can result in _____ of that area |
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Definition
|
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Term
| Deep back muscles and synovial joints are innervated by |
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Definition
|
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Term
| What is the insertion of the obliqus capitis superior |
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Definition
|
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Term
| What is the origin of the obliqus capitis inferior |
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Definition
|
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Term
| What is the origin of the obliqus capitis superior |
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Definition
|
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Term
| The iliocostalis is innervated by the |
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Definition
|
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Term
| What are the 5 basis back pain |
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Definition
| fibroskeletal muscles, meninges, synovial fluids, muscles, nervous tissue |
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Term
| What are the 5 categories for the anatomical basis of back pain (FMMNS)? |
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Definition
| Fibroskeletal, Meninges, Muscles, Synovial Joints, Nervous Tissue |
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Term
| Fibroskeletal components (ligaments, annulus fibrosis, ect...) of the back and meninges of the CNS are innervated by...? Meninge pain is rare, but if so, in which layer is it most likely? |
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Definition
| Recurrent Meningeal Branches of Spinal Nerves; Dura Mater |
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Term
| How do we determine bone density |
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Definition
| We use DXA to measure mineral content by gram. |
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Term
| What are characteristics of non-BMD quality |
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Definition
| Bone turnover, architecture, damage accumulation,matrix property, mineral property |
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Term
| What pathology are we primarily concerned with for people that have osteoperosis? |
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Definition
|
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Term
| Where do osteovertebral fractures normally occur? |
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Definition
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Term
| Low bone mass will be a characteriziation of what pathology? |
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Definition
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Term
| What type of osteoperosis is associated with post-menopausal women? What part of bone is more affected? |
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Definition
|
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Term
| What type of osteoperosis is associated with age related osteoperosis |
|
Definition
| Type II, Trabeculae and Cortical |
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Term
| 60 year old woman comes in with history of osteoperosis. Pain in her right leg. What hormones would you expect to be decreased in this individual? What cyotokines would you expect to be released? |
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Definition
| Estrogen, IL-1, IL-6, and TNF-Alpha |
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Term
|
Definition
| defective minerzliatsion of the growth plate( from the cartilagenous matrix). |
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|
Term
| Osteomalacia is defined as |
|
Definition
| inadequate mineralization |
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|
Term
| What chemicals signal the regulation of active osteoclasts? |
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Definition
|
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Term
| What are the 3 most common fractures associated with osteoperosis? |
|
Definition
| Hip, wrist, and vertebral |
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|
Term
| What type of fractures are more likely to lead to avascular necrosis of the femoral head? |
|
Definition
| nonunion fractures(intracapsular fractures) |
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Term
| 65 year old patient comes in with history of osteoperosis. Patient complains of pain at the dorsal placement of the wrist. Upon observation there is a "dinner fork" appearance. What is type of fracture is this most likeliy? |
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Definition
|
|
Term
| What does wind signaling do? |
|
Definition
| Wind signnaling helps differentiating osteoblasts from osteoclasts |
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|
Term
| What are at least risk factors for osteperotic fractures |
|
Definition
| older age, female sex, history of fractures as an adult, white or asian race, alcohol usage, dementia, androgen deprivation therapy |
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Term
| What is the function of osteoprotegerin |
|
Definition
| It helps with the reduction of osteoclast |
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Term
| A person comes in for a bone diagnosis test in relation. Their T score is less than -2.5 What bone evaluation would we be inclined to give? |
|
Definition
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Term
| Patient comes in for a bone diagnosis, clinical evaluation. Their T score is less than -1 and their SD value is greater than -2.5 What bone evaluation would we be inclined to give? |
|
Definition
|
|
Term
|
Definition
| The T score is the representation of the number of SD that the patient's BMD is above or below the BMD of young adult(30 year old reference age population) |
|
|
Term
|
Definition
| represents the number of SD's the patient's BMD above or below the mean BMD of a patient's population matched for age, sex, ethnicity |
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|
Term
| In premenopausal women which score(T or Z) would we prefer to use? |
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Definition
|
|
Term
| When do we use recommended screening for women aged 65 years or older |
|
Definition
| It is when USPTF recommended screening for osteoperosis after the age of 65 |
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Term
| FRAX analyzes that treatment should be considered if there is ____% osteoperotic fracture risk |
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Definition
|
|
Term
| What are some factors that can provide lifestyle changes with osteoperosis |
|
Definition
| Cigarette cessation, alcohol moderation, weight loss, nutritional support, medication, frequent exercise |
|
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Term
| List 3 exercises that that can be utilized in osteroperotic patients |
|
Definition
| 90/90 rest position, hyperextension exercise, posterior pelvic tilt |
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|
Term
| _____ intermittent use of this has been known to stimulate bone proliferation. What is the synthetic drug name for this? |
|
Definition
|
|
Term
| What osteoperotic drugs can play a role in assisting fractures |
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Definition
|
|
Term
| Helena Kaminsky is a 72 year old cauaisn female. smokes 1 pack x 40 years. postemaenopausal. takes calcium 800 mg per day. she doesn't exercise, no drugs, doesn't like vegetables or fruits, lactose tolerant. What should we do next? |
|
Definition
| Monitor Calcium levels, Vitamin D levels(25-Hydroxy Vitamin D), location of back pain, absent babinkkis, reflex 2+ bilaterally, monitor vital signs, |
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|
Term
| Bone mass is affected by what 5 main factors (P.iG. M.A.N.)? |
|
Definition
| Physical activity, Genetics, Menopause, Aging, Nutrition |
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Term
| Patient comes in with complaint of 6 weeks of pain. Is this considered acute or chronic? |
|
Definition
| It is acute. Acute measurement is 4-6 weeks. |
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Term
| Patient comes in with complaint of pain for at least 6 months. Is this considered chronic or sharp. |
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Definition
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Term
| Patient complains of pain for at least 3- 6months duration. The pain is described as sharp. What type of component is this describing in relation to the pain? |
|
Definition
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Term
| Patient comes in with complaint of pain for at least 6 weeks. Patient describes pain as cruel. What type of component is this describing in relation to the pain? |
|
Definition
|
|
Term
| What are the four "A" levels of pain medication. |
|
Definition
| Analgesia, activity, adverse effects, abberant behavior, |
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Term
| Patient comes in with unrelenting pain. Patient complains with pain to the brain due to injury at the occipital lobe. What type of pathway scheme are we looking at? Pain in absence of tissue damage is considered?? |
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Definition
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Term
| Patient comes in with electrical pain that shoots up when extension of the neck occurs. Burning sensation also within the neck region. What type of pain woudl this be considered? |
|
Definition
|
|
Term
| Pain from a stimulus which normally does not evoke pain, exaggerated response is defined as |
|
Definition
|
|
Term
| Pain from an excessive perception of pain with noxious stimulus is defined as |
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Definition
|
|
Term
| Hyperpathia is defined as |
|
Definition
| exaggerated and prolonged pain heightened perception with noxious stimulus |
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Term
| Opoids, GABA, Glutamate, Substance P, are all neurotransmitters that participate in what type of pathway? |
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Definition
|
|
Term
| Repetitive noxious stimulus of (unmyleniated C fibers/mylinated alpha-delta fibers) in prolonged discharge of dorsal horn |
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Definition
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Term
| If we injure the index finger and we find pain in the surrounding digits. What is this described as? |
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Definition
|
|
Term
| When we have a sensation and recruit other stimulation from the surrounding fibers or area. This is known as what phenomenon? |
|
Definition
|
|
Term
| Partial or incomplete of pain impulses is known as what term? |
|
Definition
| denervation hypersensitivity |
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|
Term
| Phantom limb where there is a an issue between dorsal column and spinothalamic tracts may be provide evidence for what hypothesis? |
|
Definition
|
|
Term
| An individual that may experience nerve injury due to a crush injury may experience what type of pain syndrome? |
|
Definition
| Type II Comple Regional pain syndromes |
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|
Term
| Strokes of the thalamus, diabetic polynueropathy, multiple scelrosis, trigeminal neuarlgia, are all examples of what? |
|
Definition
| Neuropathic pain in certain conditions |
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|
Term
| Patient comes in with the pain to cervical region due to injury of the semispinalis capitus. What type of pain would we consider this, as in where would it arise from? |
|
Definition
|
|
Term
| Tendon inflammation, muscle spasms, bone trauma, are all etiologies for what type of pain? |
|
Definition
|
|
Term
| List at least 4 examples of visceral pain |
|
Definition
| Kidney stones, gall bladder stone, bowel dysfunction, appendicitis, |
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|
Term
| Where is the pain located directly in regards to syringomyelia |
|
Definition
|
|
Term
| Thenar atrophy can occur when what nerve is entrapped? |
|
Definition
| Ulnar nerve is entrapped during carpel tunnel syndrome |
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|
Term
| Patient comes in with burning pain. What pharmaceutical agent would we use to try to decrease the burning sensation? |
|
Definition
|
|
Term
| What pharmaceutical agent would we use to try to decrease lacinating pain? |
|
Definition
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|
Term
| A 56 year old woman with history of insulin dependent diabetes and complains of progressive foot paint that feels a burning sensation. Pain is 7/10 in the daytime. Pain is out of 10 at night. From a pharmacological perspective and a nonpharmacalogical perspective how would we treat this? |
|
Definition
Pharmacologically-tricyclic peptides.
nonpharmacaologically-foot care, rigorous foot management |
|
|
Term
| What are some common regions for distribution of pain in patients with post-herpetic neuroplagia |
|
Definition
| Cervical dermatomes, lumber dermatomes, thoracic dermatomes, |
|
|
Term
| Clonezapam, carbamezapime, gabapentin, pregablin, are all exampls of what drug type? |
|
Definition
|
|
Term
| What is the mechanism of action for amitrypoline and what previous pharmcalogical agent would we want to avoid using in order to prvent serotonin syndrome? |
|
Definition
| It decreases norepinephrine uptake and serotonin uptake. linezolid |
|
|
Term
| A spinal chord stimulator is more effective in (central nervous system pain or peripheral nervous system pain) |
|
Definition
|
|
Term
| What are 3 central effects of opoids? |
|
Definition
| 3 central effects of opoids are nausea, vomiting, RESPIRATORY DEPRESSION! sedative/hypnotic effect |
|
|
Term
| what are 3 peripheal effects of opoids? |
|
Definition
| CONSTIPATION, bronchospasms, urticaria, puriritis, |
|
|
Term
| If I were to want a local anesthetic that would block the effect of a specfic area in my body. what type of pharmaceutical agent would I prefer? |
|
Definition
| Lidocaine..."caine" it inhibits Na channel blocker |
|
|
Term
| Can we convert IV to PO or backwards for giving opoids |
|
Definition
| YES! roughy 3 to 1 ratio. oral dose is 30 mg for example, parenteral would be 10 mg |
|
|
Term
| A 40 year old heroin addict finally gets his long awaited heroin used after a drug deal finally went good for him. He can finally dance the night away without any feeling pain that he has experienced in his knee. What interaction is occuring at the dorsal horn(presynaptic area specifically)? |
|
Definition
| Calcium intake is decreased. |
|
|
Term
| If i were to want to use an anticonvulsant that blocks Calcium channels what would be my drug of preference? |
|
Definition
|
|
Term
| If my patient were to go into to much respiratory depression and I wanted to reverse the effects of this what drug would I think of administering? |
|
Definition
|
|
Term
| True or False: Morphine, hydromorphone, oxycodon, and fentanyl are Kappa receptor agonists |
|
Definition
| FALSE...if this is hammad reading this, false .....ass clown |
|
|
Term
| Why would we give antidepressants for people in pain? |
|
Definition
| They inhibit NE and Serotonin reuptake as well as have angelsic properties independent of this reuptake prevention. |
|
|
Term
| What three receptors are common analgesics targets in the Presynapse and Postsynapse to block pain transduction? What is resultant effect in the Presynapse? Postsynapse? |
|
Definition
| GABA A,A2, and B; Presynapse = decrease in calcium influx, resulting in decreased neurotransmitter release; Postsynapse = hyperpolarization to decrease excitability (GABA A increase Cl- influx and GABA A2/GABA B decrease K+) |
|
|
Term
| What is inhibited by common analgesic MOA to block the CONDUCTION of pain? |
|
Definition
| Inhibit voltage gated sodium, channels |
|
|
Term
| Is the drug Obecalp likely to have perceptive effects in the cortex or modulating effects in the brainstem? How about Endogenous opioids? |
|
Definition
| Perception/Cortex; Modulation/Brainstem |
|
|
Term
| What is "Disinhibition" in regard to pain modulation? |
|
Definition
| Mechanism to block the reuptake of descending pain modulators, allowing them to more (ie- antidepressants on serotonin). |
|
|
Term
| Methadone, Meperidine, Fentanyl are all what subtype of Opioid? |
|
Definition
|
|
Term
| Why are K(kappa) receptor subtypes often combined with u (Mu) for agonist/Atagonist effects (ie- morphine)? |
|
Definition
| K (kappa) has fewer side effects but is weaker than u (Mu). |
|
|
Term
| If you found Uma Thurman overdosing on Opioids, what would you give here to reverse the opioid effects? Why would you need to continuously redose thereafter? |
|
Definition
| Naloxone (Narcan)- because its half-live is less than Opioids. |
|
|
Term
| Stimulation of what brain function produces selective analgesia for pain but leaves touch, sensation and temperature intact? |
|
Definition
| Periaquaductal . blocks withdrawal reflexes. inhibits lamina I, V and nociceptive cells in the spinal cord |
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