Laila has a pain in the arm

pain
1. an unpleasant sensory & emotional experience associated with actual or potential tissue damage
2. influenced by
  1. emotional reactions
  2. past or present experiences
  3. behavioral responses
3. Types
  1. fast pain (acute)
    1. felt after 0.1 second
    2. sharp, pricking, electric pain
  2. slow pain (chronic)
    1. felt after 1 second
    2. burning, aching, throbbing pain
4. localization
  1. cutaneous pain
  2. visceral pain
  3. deep somatic pain
  4. psychogenic pain
5. how do we perceive pain
  1. transduction
  2. transmission
  3. modulation
6. pain receptors (Nociceptors)
  1. found in
    1. skin
    2. muscle
    3. bone
    4. viscera
  2. sensory receptors that detect signals from damaged tissue
  3. Types
    1. thermal
    2. mechanical
    3. chemical
    4. polymodal nocieptors
    5. silent nociceptors
7. pain perception
  1. not everyone exposed to the same stimulus had the same intensity
  2. factors
    1. Age
    2. Gender
    3. previous experience
    4. attention
    5. anxiety
    6. expectations
8. managment of pain
  1. first line
    1. nonopioids
      1. NSAIDs
  2. second line
    1. mild opioids
  3. third line
    1. major opioids
  4. opioids
    1. side effects
      1. confusion
      2. nausea
      3. dry mouth
      4. sweats
    2. mechanism of action
      1. mimick the action of naturally ocurring pain-reducing chemicals (endrophins)
history taking
1. ask about
  1. exact location
  2. severity
  3. type
  4. onset mode
  5. continuity
  6. provocative
  7. effects of posture
  8. associated cpmplaints
2. adequate time must be given to the patients to express their problems
3. physician should be empathetic
4. physician should listen carefully
shingles
1. caused by
  1. varicella-zoster virus
    1. also cause chickenpox
      1. after recovery
        the virus enter the nervous system and lie dormant for years
        it may reactive and cause
2. signs and symptoms
  1. painful, blistering skin rash
  2. vestibular rash
  3. affect one side of the body
3. epidemiology
4. management
  1. medications
    1. antiviral
      1. acyclovir
        action
        specific inhibitor of herpesvirus DNA polymerase
  2. antidepressants
    1. benzaiazepines
      1. enhance the action of neurotransmitter GABA
        GABA calm things down
  3. sedatives
  4. psychological aspects
    2. pain management
      1. problem focused coping
        information seeking
      2. emotion focused coping
        distracting yourself
      3. psychoeducation
        relaxation therapy
5. duration
  1. last 3 to 5 weeks
6. result in
  1. postherpetic neuralgia
    1. burning pain that lasts long after the rash and blisters of shingles disappear
      1. results from the damaged nerves of the skin
7. prevention
  1. avoid sharing towels or flannels
  2. swimming
  3. chickenpox can be dangerous in
    1. pregnant women
    2. weak immune system
    3. babies less than one month
  4. vaccine (zostavax)
dermatomes
2. an area of the skin supplied by nerves from a single spinal root
3. importance
  1. symptoms that follow a dermatome may indicate a pathology of nerves roots

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Laila has a pain in the arm

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	Created by yasmin alkhatib almost 8 years ago