Med Surg Pt and Pain Management
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68 terms
Terms | Definitions |
|---|---|
 acute | pain that is usually temporary and results from something specific, such as surgery, an injury, or an infection |
| chronic | pain that lasts beyond the term of an injury or painful stimulus - can also refer to cancer pain, pain from a chronic or degenerative disease, and pain from an unidentified cause |
| referred | pain felt at a site different from the location of injured or diseased part of the body - is due to the fact that nerve signals from several areas of the body may "feed" the same nerve pathway leading to the spinal cord and brain |
| inflammation, infections, ischemia, necrosis, over-stretching, chemical disturbance, burn | what are some things that can cause pain (7)? |
| nociceptors | these are nerve endings activated by noxious stimuli - there are two types |
| a-delta | this is a type of nociceptors - they are small, myelinated fibers - quick onset, short duration - can be sharp/stabbing/prickling pain - located mainly superficially |
| c fibers | this is a type of nociceptors - they are small, unmyelinated fibers - slow onset, long lasting, dull ache, tingling, burning pain - located in deeper structures |
| non-nociceptive | these consist of a-beta - larger, myelinated, FASTER than a-delta. Stretch, vibration, and mechanoreceptors - in joints and skin |
| pain threshold | this is the level of stimulation required to activate the pain perception transmission |
| electrical stimulation | everyone's pain threshold is different and can be manipulated by _____________ ____________ or feedback |
| gate theory | this has been in use since 1965 - it describes the relationship between pain and a-beta, a-delta and c fibers - it is one reason why massage and trigger point release work - also used for TENS |
| numerical ratings | this pain scale assigns a number to degree of pain from no pain to excrutiating |
| visual analog scale | this pain scale the patient marks on a line the amount of pain perceived |
| nonverbal scale | this pain scale uses pictorial faces exhibiting levels of perceived happeness - good for conquering language barriers |
| oswestry disability score | ... |
| limbic system | this is the emotional center of the body - regulates autonomic nervous system - the brain's mind-body-spirit connection |
| autonomic nervous system | this is made up of the sympathetic and parasympathetic - balance of the two maintains homeostatis |
| sympathetic | this nervous system is referred to as fight or flight - it is located in thoracic and upper lumbar spinal cord segments |
| increase cv, neuromuscular, respiratory, neurologic function | what are the functions of the sympathetic nervous system - stimulated by fear, excitement, anger, pain, etc... |
| epinephrine, norepinephrine, cortisol | what is released by the sympathetic nervous system |
| vasoconstrictors | epinephrine and norepinephrine are both ________________ |
| detrimental | prolonged stimulation of the sympathetic nervous system (sns) can be |
| metabolism | cortisol affects _____________ and body alertness |
| parasympathetic | this nervous system is part of the ans - opposes fight or flight - located in midbrain, pons, medulla and sacral spinal segments |
| relaxation | the parasympathetic response is _____________ - it has a calming effect |
| decreased cv, respiratory, neuromuscular, neurological | what are the functions of the parasympathetic system |
| guided imagery | this is a relaxation technique that when used will/can drecrease levels of cortisol |
| desensitization | this type of relaxation technique is used to reach new understanding, less fearful stimulus - introduced slowly |
| exercise, reading, recreational activities, journaling | what are some things that you can do for relaxation |
| fibromyalgia | this is a chronic pain disorder - specifically pain is located within at least 11 predetermined trigger point areas - considered a systemic problem |
| depression, anxiety, trauma, hypothyroidism, viral infection | what is considered the etiology of fibromyalgia (5-multiple factors) - there's no specific diagnostic test - it's a syndrome |
| accessory breathing, hyper | with fibromyalgia theres decreased circulation activity - increased use of ___________ ______________ muscles - physiologically the muscles never rest - there's a constant state of ___________ excitation |
| hpa, ans, rha, immune system | what are the four primary systems that are involved with fibromyalgia |
| hypothalamic pituitary-adrenal axis | what does hpa stand for |
| autonomic nervous system | what does ans stand for |
| reproductive hormone axis | what does rha stand for |
| stress reduction, ergonomics, proper posture, energy conservation, excercise, nutrition | what are some things used for treatment of fibromyalgia |
| chronic fatigue syndrome | this syndrome is not easily diagnosed, it is mostly seen in females, onset age of 29-35 - high risk if pt is neurotic or introverted - starts with fever and general malaise, pain increases as does forgetfullness |
| conserve energy, regular light excercise, stress reduction, proper nutrition, proper posture, ergonomics | you should instruct a patient of chronic fatigue syndrome on the following |
| complex regional pain syndrome (crpt type 1) | this is a syndrome - the sns is out of whack - type 1 develops after trauma - there is an exaggerated pain response - constant state of arousal - no relief |
| variety of tactile cues, light pre, gentle stretching, modalities, education | what are the treatments for complex regional pain syndrome |
| osteoarthritis, rheumatoid arthritis, piriformis syndrome, radiculopathy, chronic lbp, chronic tendonitis | what are some commonly seen chronic orthopedic conditions (6) |
| mental health, changes, challenges | _________ __________ status is one of the most important predictors of physical health - patients perspective is key - better social and physhological skills = better ability to adapt to ___________ and ______________ - patient needs to be convinced that therapy will work |
| environment | the PTA is to promote ___________ thinking and provide an _______________ that is conducive to positive results |
| realistic, intervention, motivational | the therapist's perspective is key - set ____________ goals, ______________ strategies, and have ______________ strategies |
| motivates | try to understand the personality of the person you are working with - you need to understand so you will know what ___________ your patient |
| b | what personality type has a low level of competitiveness, little to no sense of urgency with time management, stops "to smell the roses" - low risk of cardiac disease due to decreased stress levels |
| a | what personality type has a domineering personality - is achievement oriented and focused, they are self critical and have a strong sense of urgency with time management - strong evidence linked to risk of heart attack and coronary artery disease |
| c | what personality type is inhibited, introverted - emotionally constrained - wanting to please others more than self - hypothesized at increased risk of disease due to bottling up of emotions |
| d | what personality type has a negative affect - doom and gloom attitude toward disease - at risk for poor rehab potential |
| locus of control, internal, external | ____________ is the ability to control life conditions and events - with ______________ - outcomes are self determined with _______________ outcomes are determined by others |
| stress | this develops when the person perceives a discrepancy between the current demands of his or her situation and the current resources available to handle the situation - ex. not enought time to complete task successfully |
| malingerer | this is a patient that continues to c/o pain even after stimulus has been removed - in symptomatic form or may have fabricated symptoms in the first place - ex. work comp pt that doesn't want to get better |
| symptom magnifier | this is when a pt focuses on symptoms and is unable to focus on rehab - exaggerated reports of symptoms - always 10/10 |
| major depression | this is a period of at least two weeks during which there is either a depressed mood or loss of interest or pleasure in nearly all activities - can be isolated or fluctuating - will have at least 4 of the following - changes in appetite, weight, sleep, concentration, guilty feelings, energy, significant impairment to ADL's, can contemplate suicide |
| organic | this type of depression results from a biological change in the brain |
| bipolar | this is a disorder with many phases of mood changes throughout life - includes mania/depression |
| schizophrenia | with this theres an inability to interpret reality - commonly have delusions and hallucinations - inappropriate emotional responses - frequesnt alterations in mood - unknown etiology - usually appears in adolescence or adulthood |
| panic attacks, post traumatic stress disorder, obsessive compulsive disorder | what are 3 anxiety disorders - patient usually knows the emotions are irrational, but is unable to control them |
| hypochondriams | this is a somatiform disorder - every symptom is something wrong with them - |
| psychosomatic dysfunction | with this the perceived illness presents as physical illness |
| anorexia nervosa | with this the patients perception of self and body image is distorted to where he/she becomes obsessed with not gaining weight - avoids food, compulsive excercise |
| bullimia nervosa | with this the pt has body image issues - but with compulsive overeating followed by forced vomiting |
| dementia | this is lack of intellect after age 18 - characterized by progressive confusion, disorientation, memory loss, personality changes |
| alzheimers | this is marked by a degeneration of the limbic system and neuronal synapses - progressive from mild to moderate to severe - common causes of death are infeciton or falls |
| comorbidities | as pt's age their __________________ tend to increase and can cause depression issues |
| emotional | pt will have difficulty focusing on PT until their _________________ issues are resolved - those that percieve themselves as active in rehab will have better outcome |
| congenital, traumatic | those with _____________ impairments have a different perspective on rehab that ones who have sustained a _____________ event |
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