kms013's version from 2016-02-01 01:58


Question Answer
Acute p!p! from a direct result of actual tissue injury; resolves when tissue damage passes; typically 3-6 mo depending on the pathology
Acute p! is typically how many months?3-6
Acute p! results in increasedmm tone, heart rate, BP, other SNS
Chronic p!does not resolve in the usual time it takes for the disorder to heal (continues on past the noxious stimuli or tissue damage)
criteria of chronic p!enduring or recurrent, persisting longer than typical for a condition, inadequate response to appropriate care, significant impairment of fxl status
what is referred p!a p! that is felt at a location distant from the source of p! without neurological connection/diffuse, variable in distribution and character (CP: find/address the source of p! or it will come back)
Referred p!MS- trigger points (travell's referral patterns_ facet jt referral patterns
referred p!: non-MS internal organs?gall bladder, spleen, heart, kidney if you can recreate the p! with mvmt, its possible its not this
Referred p!: Gall bladderp! R shoulder/infer angle of scapula or R low back
Referred p!: spleenL shoulder
Referred p!: Heartchest/L shoulder/jaw
Referred p!:Kidneylow back/hip
nociceptive p!p! caused by stimulation of p! receptors (nocieceptors, not the nerves) by mechanical, chemcial, or thermal stimuli (associated w ongoing tissue damage, usually felt at site of injury although it can be reffered to other areas of body, can be referred, myofascial, viscerogenic, discogenic, facetogenic, inflammatory, or ischemic, can become chronic if prolonged
Neuropathic p!p! resulting from direct insult to the nerve; "Burning" or lancinating p! quality, accompanied by other s/s including paresthesia, anesthesia, itching, weakness, consistent distribution that can be associated w a hx of lesion or disease process that matches sx
Radicular p!neuropathic p! associated w compression, distortion, or inflammation of spinal nerve root (p! is felt in specific nerve distribution, often accompanied by sensory and motor abnormalities in the appropriate dermatome or myotome
Why do we use the LQS?to help us "Hone in and rule out" if the pts neurological sx are any of the last 2 types of p! (nerve root issue or peripheral nerve issue); also to rule out if its a more severe neurological issue (UMN)
Nerve root issue is what type of p!radicular p!
Peripheral nerve issue is what type of p!neuropathic p!
objective of screening (3)1. ID signs of peripheral or CNS compromise (should be performed any time you suspect a nerve is involved) 2. Determine which areas can be ruled out or deferred for evaluation at a later time and which areas or regions of the body will require a more detailed examination (in other words-- hon in on the problems so a more focused & specific examination can be performed) 3. ID medical problems which may preclude further PT evaluation or tx (Red flags)
When do you perform LQS? when the sx extend pass....upper trapezius (cervical spine) or buttocks (lumbar spine)
LQS componentsHORNS (Hx, observation, ROM (active) or Spine/peripheral jt, Neurological tests (motor-myotomes, sensory-dermatomes, deep tendon reflexes- DTRs), special test (neural tests--straight leg raise test/slump test/femoral nerve traction test) vascular (pulses)-->dorsalis pedis, posterior tibials
What is considered by many the LQS main componentNeurological test
L2hip flexors
L3knee extensors
L4great toe extensor
L5great toe extensor
S1S1 Ankle plantar flexors and evertors
why do we use neurological tests?1. to determine the presence and extent of neurologic compromise (collaboration of results from resisted testing, sensory testing and DTRs 2. to distinguish b/w an UMN/LMN issue 3. if LMN- to distinguish b/w a nerve root or peripheral nerve issue
hyporeflexia (areflexia) indicates a lesion of a peripheral nerve or smpinal nerve root (LMN) (impingement, entrapment, injury)
clonusindicates upper motor neuron lesions (UMN) (Neurological disease, SC impairment, Cerebral/brain stem impairment)

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