NationMaster - Encyclopedia: Chronic pain

Chronic pain was originally defined as pain that has lasted 6 months or longer. More recently it has been defined as pain that persists longer than the temporal course of natural healing, associated with a particular type of injury or disease process.^[1] The term symptom (from the Greek meaning chance, mishap or casualty, itself derived from ÏƒÏ…Î¼Ï€Î¹Ï€Ï„Ï‰ meaning to fall upon or to happen to) has two similar meanings in the context of physical and mental health: Strictly, a symptom is a sensation or change in health function experienced by a patient. ... In medicine, a sign is a feature of disease as detected by the doctor during physical examination of a patient. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // R00-R99 - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R09) Symptoms and signs involving the circulatory and respiratory systems (R00) Abnormalities of heart beat (R000) Tachycardia, unspecified (R001) Bradycardia, unspecified (R002) Palpitations (R008) Other and unspecified abnormalities of heart beat (R01) Cardiac murmurs and other... // R00-R99 - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R09) Symptoms and signs involving the circulatory and respiratory systems (R00) Abnormalities of heart beat (R000) Tachycardia, unspecified (R001) Bradycardia, unspecified (R002) Palpitations (R008) Other and unspecified abnormalities of heart beat (R01) Cardiac murmurs and other... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... Pain redirects here. ...

The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage."^[2] It is important to note that pain is subjective in nature and is defined by the person experiencing it, and the medical community's understanding of chronic pain now includes the impact that the mind has in processing and interpreting pain signals.

Functional Anatomy

The anatomy of the nociceptive system can be grossly divided into the peripheral and central nervous system. The peripheral nervous system consists of small myelinated and unmyelinated nerve fibers. These nerve fibers converge into a region of the spinal cord referred to as the dorsal horn. The dorsal horn is the first relay station in pain signal transmission. The next element of pain transmission includes nerve fibers that then travel to the thalamus. From the thalamus the next order of neurons ascend to the limbic system and sensory cortex. This accounts for the affective elements and discriminative of pain respectively.^[3]^[4]

Nociception

The experience of pain biologically is referred to as nociception. Nociception occurs in any tissue or organ in which pain signals arise secondary to a disease process or trauma. The nociception can also occur if there is dysfunction or damage to nerves themselves.^[2]

The Pathophysiology of Chronic Pain

Under persistent activation nociceptive transmission to the dorsal horn may induce a wind up phenomenon. This induces pathological changes that lower the threshold for pain signals to be transmitted. In addition it may generate nonnociceptive nerve fibers to respond to pain signals. Nonnociceptive nerve fibers may also be able to generate and transmit pain signals. In chronic pain this process is difficult to reverse or eradicate once established.^[5]

Classification

Nociception (pain) may arise from injury or disease to visceral, somatic and neural structures in the body. More broadly pain is described as malignant or non-malignant in origin.^[4]

Diagnoses

Pain may be a response to injury or any number of disease states that provoke nociception. Advances in imaging studies and electrophysiological studies allow us to gain a deeper insight into the characteristics and properties associated with the phenomenon of chronic pain.^[6]^[7]^[8]

Chronic Pain Syndrome

Chronic pain may generate other adversities including affective symptoms of depression and anxiety. It may also contribute to decreased physical activity given the apprehension of exacerbating pain.^[9] Conversely it may itself have psychosomatic or psychogenic component to its cause.^[10]

Management

It is rare to completely achieve absolute and sustained relief of pain. Thus, the clinical goal is pain management. Pain management is often multidisciplinary in nature. A recent journal article by Gatchell and Okifuji recognizes the importance of comprehensive pain programs(CPPs) in the management of chronic pain. They summarize their findings as follows: "CPPs offer the most efficacious and cost-effective treatment for persons with chronic pain, relative to a host of widely used conventional medical treatment." ^[11]^[12]

Medications

"Because patients with chronic pain suffer many consequences of their illness, any treatment with the potential to improve their symptoms should be prescribed and the results carefully studied." conclusion of the Johns Hopkins Arthritis Center.

In the treatment of chronic pain, whether due to malignant or benign processes, the three-step WHO Analgesic Ladder is often used.[1][2][3] This provides guidelines for stepping up the amount of analgesia and maintains a general basis that is used in a number of countries around the world to manage chronic pain conditions. The exact medications recommended will vary with the country and the individual treatment centre, but the following gives an example of the approach to treating chronic pain with medications. If, at any point, treatment fails to provide adequate pain relief, then the doctor and patient move onto the next step.

Paracetamol (INN) (IPA: ) or acetaminophen (USAN), is the active metabolite of phenacetin, a so-called coal tar analgesic. ... Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAIDs, are drugs with analgesic, antipyretic and anti-inflammatory effects - they reduce pain, fever and inflammation. ... Ibuprofen (INN) (IPA: ) (from the earlier nomenclature iso-butyl-propanoic-phenolic acid) is a non-steroidal anti-inflammatory drug (NSAID) originally marketed as Nurofen and since under various trademarks including Act-3, Advil, Brufen, Dorival, Herron Blue, Panafen, Motrin, Nuprin and Ipren or Ibumetin (Sweden), Ibuprom (Poland), IbuHEXAL, Moment (Italy... An analgesic (colloquially known as a painkiller) is any member of the diverse group of drugs used to relieve pain (achieve analgesia). ... Chemical structure of the tricyclic antidepressant amitriptyline Tricyclic antidepressants are a class of antidepressant drugs first used in the 1950s. ... Lidocaine (INN) (IPA: ) or lignocaine (former BAN) (IPA: ) is a common local anesthetic and antiarrhythmic drug. ... Capsaicin (8-methyl-N-vanillyl-6-nonenamide) is the active component of chilli peppers, which are plants belonging to the genus Capsicum. ... An opioid is a chemical substance that has a morphine-like action in the body. ... Codeine (INN) or methylmorphine is an opiate used for its analgesic, antitussive and antidiarrheal properties. ... Tramadol (INN) (IPA: ) is an atypical opioid which is a centrally acting analgesic, used for treating mild to moderate pain. ... This article is about the drug. ... Not to be confused with oxytocin. ... Fentanyl is an opioid analgesic, first synthesized by Janssen Pharmaceutica (Belgium) in the late 1950s, with a potency many times that of morphine. ... A transdermal patch is a medicated adhesive patch that is placed on the skin to deliver a time released dose of medication through the skin and into the bloodstream. ... Heroin or diamorphine (INN) (colloquially referred to as junk, babania, horse, golden brown, smack, black tar, big H, lady H, dope, skag, juice, diesel, etc. ... Hydromorphone is a drug developed in Germany in the 1920s and introduced to the mass market beginning in 1926. ... Methadone is a synthetic opioid, used medically as an analgesic and anti-addictive. ... Pethidine (INN) or meperidine (USAN) (also referred to as: isonipecaine; lidol; pethanol; piridosal; AlgilÂ®; AlodanÂ®; CentralginÂ®; DemerolÂ®; DispadolÂ®; DolantinÂ®; DolarganÂ® (in Poland);[1] DolestineÂ®; DolosalÂ®; DolsinÂ®; MefedinaÂ®) is a fast-acting opioid analgesic drug. ...

Opioids

Opioid medications provide short, intermediate and long acting analgesia depending upon the specific properties of the medication and whether it is formulated as an extended release drug. Opioid medications may be administered orally, by injection, via nasal mucosa or oral mucosa, rectal, transdermal, intravenously, epidurally and intrathecally. In chronic pain conditions that are opioid responsive a combination of a long acting or extended release medication is often prescribed in conjunction with a shorter acting medication for break through pain (exacerbations). An opioid is a chemical substance that has a morphine-like action in the body. ...

Most opioid treatment is oral (tablet, capsule or liquid), but suppositories and skin patches can be prescribed. An opioid injection is rarely needed for patients with chronic pain. This article does not cite any references or sources. ... The word capsule (from the Latin capsula, a small box), has many similar meanings in English: In botany, a capsule is a type of dry fruit as in the poppy, iris, foxglove, etc. ... A suppository is a medicine that is inserted either into the rectum (rectal suppository) or into the vagina (vaginal suppository) where it melts. ... Injection has multiple meanings: In mathematics, the term injection refers to an injective function. ...

Although opioids are strong analgesics, they do not provide complete analgesia regardless of whether the pain is acute or chronic in origin. Opioids are efficacious analgesics in chronic malignant pain and modestly effective nonmalignant pain management. However, there are variable associated adverse effects, especially during the commencement or change in dosing and administration. When opioids are used for prolonged periods drug tolerance, chemical dependency and (rarely) addiction may occur. Chemical dependency is ubiquitous among opioid therapy after continuous administration; however, drug tolerance is not well studied in patients on long term opioid therapy. Addiction rarely occurs as a result of opioid prescription, but they are abused by some individuals, which can cause concern to health care providers. Diversion of opioid medications is another concern for health care providers. An opioid is any agent that binds to opioid receptors found principally in the central nervous system and gastrointestinal tract. ... Drug tolerance occurs when a subjects reaction to a drug (such as a painkiller or intoxicant) decreases so that larger doses are required to achieve the same effect. ... A chemical dependency is such a strong dependency on a substance that it becomes necessary to have this substance just to function properly; The need of a substance developed from abusing the substance, requiring the substance for survival, like the need for food, or water See also: addiction drug tolerance... Heroin bottle An addiction is a recurring compulsion by an individual to engage in some specific activity, despite harmful consequences to the individuals health, mental state or social life. ... A chemical dependency is such a strong dependency on a substance that it becomes necessary to have this substance just to function properly; The need of a substance developed from abusing the substance, requiring the substance for survival, like the need for food, or water See also: addiction drug tolerance... An opioid is a chemical substance that has a morphine-like action in the body. ... Drug tolerance occurs when a subjects reaction to a drug (such as a painkiller or intoxicant) decreases so that larger doses are required to achieve the same effect. ... Heroin bottle An addiction is a recurring compulsion by an individual to engage in some specific activity, despite harmful consequences to the individuals health, mental state or social life. ...

Non-steroidal anti-inflammatory drugs

The other major group of analgesics are Non-steroidal anti-inflammatory drugs (NSAID). This class of medications does not include acetaminophen, which has minimal anti-inflammatory properties. However, acetaminophen may be administered as a single medication or in combination with other analgesics (both NSAIDs and opioids). The alternatively prescribed NSAIDs such as ketoprofen and piroxicam, have limited benefit in chronic pain disorders and with long term use is associated with significant adverse effects. The use of selective NSAIDs designated as selective COX-2 inhibitors have significant cardiovascular and cerebrovascular risks which have limited their utilization.^[13]^[14] Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAIDs, are drugs with analgesic, antipyretic and anti-inflammatory effects - they reduce pain, fever and inflammation. ... Acetaminophen (USAN) or paracetamol (INN), is a popular analgesic and antipyretic drug that is used for the relief of fever, headaches, and other minor aches and pains. ...

Antidepressants and Antiepileptic drugs

Some antidepressant and antiepileptic drugs are used in chronic pain management and act primarily within the pain pathways of the central nervous system, though peripheral mechanisms have been attributed as well. These mechanisms vary and in general are more effective in neuropathic pain disorders as well as complex regional pain syndrome.^[15] Drugs such as Gabapentin have been widely prescribed for the off-label use of pain control. The list of side effects for these classes of drugs are typically much longer than opiate or NSAID treatments for chronic pain, and many antiepileptics cannot be suddenly stopped without the risk of seizure. Prozac, a selective serotonin reuptake inhibitor (SSRI) Serotonin-norepinephrine reuptake inhibitor, Venlafaxine An antidepressant, is a psychiatric medication or other substance (nutrient or herb) used for alleviating depression or dysthymia (milder depression). ... The anticonvulsants, sometimes also called antiepileptics, belong to a diverse group of pharmaceuticals used in prevention of the occurrence of epileptic seizures. ... Neuropathy is usually short for peripheral neuropathy, meaning a disease of the peripheral nervous system. ... Complex Regional Pain Syndrome (CRPS) is a chronic progressive disease characterized by severe pain, swelling and changes in the skin. ... Gabapentin (brand name Neurontin) is a medication originally developed for the treatment of epilepsy. ... This article is about epileptic seizures. ...

Interventional therapy

pulsed radiofrequency, Injections, Neuromodulation and Neuroablative Therapy may be used to target either the tissue structures and organ/systems responsible for persistent nociception or the nerves conveying nociception from the structures implicated as the source of chronic pain.^[16]^[17]^[18]^[19]^[20] Pulsed radiofrequency is a development of heat based radiofrequency denervation, both procedures used in medicine to treat especially chronic pain. ... Injection has multiple meanings: In mathematics, the term injection refers to an injective function. ... In neuroscience, Neuromodulation is the process in which several classes of neurotransmitters in the nervous system regulate diverse populations of neurons. ... Pain is both a sensory and emotional experience, generally associated tissue damage, or inflammation. ...

Rehabilitation

As alluded to earlier there are other modalities used in the treatment of chronic pain. These include: physical modalities such as thermal agents and electrotherapy. Complementary and alternative medicine, therapeutic exercise and behavioral therapy are also utilized autonomously or in tandem with interventional techniques and conventional pharmacotherapy. This is most often structured in a multidisciplinary or interdisciplinary program.^[21] Physical medicine and rehabilitation (PM&R) or physiatry is a branch of medicine dealing with functional restoration of a person affected by physical disability. ... Electrotherapy is the use of electrical energy in the treatment of impairments of health and a conditions of abnormal functioning. ...

Controversy

Chronic pain patients are often misdiagnosed. Patients are often ignored, and their pain dismissed as imaginary. Patients, particularly the ones prescribed opioids, are often labeled as drug addicts. Furthermore, chronic pain patients in the United States and other countries, continue to encounter problems caused by their governments' war on illegal drugs (examples include but are not limited to: red tape in applying for/renewal of special prescription pads; government-mandated limits and excessive regulations for hospitals and drugstores; etc.).

References

Footnotes

^ Shipton EA, Tait B (2005). "Flagging the pain: preventing the burden of chronic pain by identifying and treating risk factors in acute pain". European journal of anaesthesiology 22 (6): 405-12. PMID 15991501.
^ ^a ^b Merskey H (1994). "Logic, truth and language in concepts of pain". Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 3 Suppl 1: S69-76. PMID 7866375.
^ Romanelli P, Esposito V (2004). "The functional anatomy of neuropathic pain". Neurosurg. Clin. N. Am. 15 (3): 257-68. PMID 15246335.
^ ^a ^b Vanderah TW (2007). "Pathophysiology of pain". Med. Clin. North Am. 91 (1): 1-12. PMID 17164100.
^ Vadivelu N, Sinatra R (2005). "Recent advances in elucidating pain mechanisms". Current opinion in anaesthesiology 18 (5): 540-7. PMID 16534290.
^ Dunckley P, Wise RG, Fairhurst M, Hobden P, Aziz Q, Chang L, Tracey I (2005). "A comparison of visceral and somatic pain processing in the human brainstem using functional magnetic resonance imaging". J. Neurosci. 25 (32): 7333-41. PMID 16093383.
^ Geha PY, Apkarian AV (2005). "Brain imaging findings in neuropathic pain". Current pain and headache reports 9 (3): 184-8. PMID 15907256.
^ Turton AJ, McCabe CS, Harris N, Filipovic SR (2007). "Sensorimotor integration in Complex Regional Pain Syndrome: a transcranial magnetic stimulation study". Pain 127 (3): 270-5. PMID 17011705.
^ Pruimboom L, van Dam AC (2007). "Chronic pain: a non-use disease". Med. Hypotheses 68 (3): 506-11. PMID 17071012.
^ Sarno, John et al. (2006). The Divided Mind: The Epidemic of Mindbody Disorders. New York: ReganBooks, 11-18. ISBN 0-06-085178-3.
^ Henningsen P, Zipfel S, Herzog W (2007). "Management of functional somatic syndromes". Lancet 369 (9565): 946-55. PMID 17368156.
^ Stanos S, Houle TT (2006). "Multidisciplinary and interdisciplinary management of chronic pain". Physical medicine and rehabilitation clinics of North America 17 (2): 435-50, vii. PMID 16616276.
^ Munir MA, Enany N, Zhang JM (2007). "Nonopioid analgesics". Med. Clin. North Am. 91 (1): 97-111. PMID 17164106.
^ Ballantyne JC (2006). "Opioids for chronic nonterminal pain". South. Med. J. 99 (11): 1245-55. PMID 17195420.
^ Jackson KC (2006). "Pharmacotherapy for neuropathic pain". Pain practice : the official journal of World Institute of Pain 6 (1): 27-33. PMID 17309706.
^ Varrassi G, Paladini A, Marinangeli F, Racz G (2006). "Neural modulation by blocks and infusions". Pain practice : the official journal of World Institute of Pain 6 (1): 34-8. PMID 17309707.
^ Meglio M (2004). "Spinal cord stimulation in chronic pain management". Neurosurg. Clin. N. Am. 15 (3): 297-306. PMID 15246338.
^ Rasche D, Ruppolt M, Stippich C, Unterberg A, Tronnier VM (2006). "Motor cortex stimulation for long-term relief of chronic neuropathic pain: a 10 year experience". Pain 121 (1-2): 43-52. PMID 16480828.
^ Boswell MV, Trescot AM, Datta S, Schultz DM, Hansen HC, Abdi S, Sehgal N, Shah RV, Singh V, Benyamin RM, Patel VB, Buenaventura RM, Colson JD, Cordner HJ, Epter RS, Jasper JF, Dunbar EE, Atluri SL, Bowman RC, Deer TR, Swicegood JR, Staats PS, Smith HS, Burton AW, Kloth DS, Giordano J, Manchikanti L (2007). "Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain" (PDF). Pain physician 10 (1): 7-111. PMID 17256025.
^ Romanelli P, Esposito V, Adler J (2004). "Ablative procedures for chronic pain". Neurosurg. Clin. N. Am. 15 (3): 335-42. PMID 15246341.
^ Geertzen JH, Van Wilgen CP, Schrier E, Dijkstra PU (2006). "Chronic pain in rehabilitation medicine". Disability and rehabilitation 28 (6): 363-7. PMID 16492632.

See also

Suffering is any aversive (not necessarily unwanted) experience and the corresponding negative emotion. ... Pain redirects here. ... Arthritis (from Greek arthro-, joint + -itis, inflammation; plural: arthritides) is a group of conditions where there is damage caused to the joints of the body. ... Back pain (also known dorsalgia) is pain felt in the back that may originate from the muscles, nerves, bones, joints or other structures in the spine. ... Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ... Complex Regional Pain Syndrome (CRPS) is a chronic progressive disease characterized by severe pain, swelling and changes in the skin. ... On the Threshold of Eternity. ... Fibromyalgia (FM or FMS) is a chronic syndrome (constellation of signs and symptoms) characterized by diffuse or specific muscle, joint, or bone pain, fatigue, and a wide range of other symptoms. ... A headache (cephalgia in medical terminology) is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. ... Sciatica is pain caused by general compression and/or irritation of one of five nerve roots that are branches of the sciatic nerve. ... For other uses of painkiller, see painkiller (disambiguation) An analgesic (colloquially known as painkiller) is any member of the diverse group of drugs used to relieve pain. ... The anticonvulsants, sometimes also called antiepileptics, belong to a diverse group of pharmaceuticals used in prevention of the occurrence of epileptic seizures. ... Gabapentin (brand name Neurontin) is a medication originally developed for the treatment of epilepsy. ... Pregabalin (brand name: LyricaÂ®) is a new anticonvulsant drug indicated as an add on therapy for partial onset seizures and for certain types of neuropathic pain. ... Levetiracetam (INN) (IPA: ) is an anticonvulsant medication used to treat epilepsy. ... Topiramate (brand name Topamax) is an anticonvulsant drug produced by Ortho-McNeil Neurologics, a division of Johnson & Johnson. ... Lamotrigine (marketed as Lamictal (IPA: ) by GlaxoSmithKline, called Lamictin in South Africa, (Lamogine)[1] in Israel, and in South Korea) is an anticonvulsant drug used in the treatment of epilepsy and bipolar disorder. ... Zonisamide (brand name ZonegranÂ®) is an anticonvulsant used as an adjunctive therapy in adults with partial-onset seizures. ... An antidepressant is a medication used primarily in the treatment of clinical depression. ... Wikipedia does not yet have an article with this exact name. ... Ketamine is a dissociative anesthetic for use in human and veterinary medicine developed by Parke-Davis (1962). ... Acetaminophen (USAN) or paracetamol (INN), is a popular analgesic and antipyretic drug that is used for the relief of fever, headaches, and other minor aches and pains. ... Wikipedia does not yet have an article with this exact name. ... An opioid is any agent that binds to opioid receptors found principally in the central nervous system and gastrointestinal tract. ... Clonidine is a direct-acting adrenergic agonist prescribed historically as an anti-hypertensive agent. ... Ziconotide is a non-opioid, non local anesthetic used for the amelioration of chronic pain. ... Physical medicine and rehabilitation (PM&R) or physiatry is a branch of medicine dealing with functional restoration of a person affected by physical disability. ... Cryotherapy is used to define several techniques and procedures in the medical community. ... The term Exercise can refer to: Physical exercise such as running or strength training Exercise (options), the financial term for enacting and terminating a contract Category: ... A heating pad is a pad used for warming of parts of the body in order to manage pain. ... Occupational therapy refers to the use of meaningful occupation to assist people who have difficulty in achieving healthy and balanced life; and to enable an inclusive society so that all people can participate to their potential in daily occupations of life. ... Physical therapy (or physiotherapy[1]) is the provision of services to people and populations to develop, maintain and restore maximum movement and functional ability throughout the lifespan. ... TENS (Transcutaneous Electrical Nerve Stimulator) is considered a method of pain relief, and has a wide following for use in obstetric care particularly labour. ... Acupuncture chart from Hua Shou (fl. ... Cognitive therapy or cognitive behavior therapy is a kind of psychotherapy used to treat depression, anxiety disorders, phobias, and other forms of mental disorder. ... Chiropractic (from Greek chiros and praktikos meaning done by hand) is a health care profession whose purpose is to diagnose and treat mechanical disorders of the spine and musculoskeletal system with the intention of affecting the nervous system and improving health. ... In alternative medicine, body work or massage therapy refers to any treatment which involves some form of touching or physical manipulation. ... It has been suggested that this article or section be merged with Sclerotherapy. ... Spinal Cord Stimulator (SCS) or Dorsal Column Stimulator (DCS) is an implantable medical device used to treat chronic pain of neurologic origin. ...

External links

Categories: All articles with unsourced statements | Articles with unsourced statements since June 2007 | Nociception | Pain The term symptom (from the Greek meaning chance, mishap or casualty, itself derived from ÏƒÏ…Î¼Ï€Î¹Ï€Ï„Ï‰ meaning to fall upon or to happen to) has two similar meanings in the context of physical and mental health: Strictly, a symptom is a sensation or change in health function experienced by a patient. ... In medicine, a sign is a feature of disease as detected by the doctor during physical examination of a patient. ... // R00-R99 - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R09) Symptoms and signs involving the circulatory and respiratory systems (R00) Abnormalities of heart beat (R000) Tachycardia, unspecified (R001) Bradycardia, unspecified (R002) Palpitations (R008) Other and unspecified abnormalities of heart beat (R01) Cardiac murmurs and other... For transport in plants, see Vascular tissue. ... The Respiratory System Among four-legged animals, the respiratory system generally includes tubes, such as the bronchi, used to carry air to the lungs, where gas exchange takes place. ... This article or section does not cite any references or sources. ... Bradycardia, as applied to adult medicine, is defined as a resting heart rate of under 60 beats per minute, though it is seldom symptomatic until the rate drops below 50 beat/min. ... This article does not cite any references or sources. ... Murmurs are abnormal heart sounds that are produced as a result of turbulent blood flow which is sufficient to produce audible noise. ... For the plant referred to as nosebleed plant, see Yarrow. ... Hemoptysis (US English) or haemoptysis (International English) is the expectoration (coughing up) of blood or of blood-stained sputum from the bronchi, larynx, trachea, or lungs (e. ... Dyspnea (R06. ... Orthopnoea is breathing difficulty which occurs when lying flat. ... Stridor is a high pitched sound heard on inspiration that is indicative of airway obstruction. ... A wheeze is a continuous, coarse, whistling sound produced in the respiratory airways during breathing. ... Cheyne-Stokes respiration is an abnormality of the pattern of breathing. ... In medicine, hyperventilation (or hyperpnea) is the state of breathing faster or deeper (hyper) than necessary, and thereby reducing the carbon dioxide concentration of the blood below normal. ... Mouth breathing refers to the state of inhaling and exhaling through the mouth. ... For information on Hydrophobic Interaction Chromatography, see Chromatography. ... Bradypnea refers to an abnormally slow breathing rate. ... In medicine, hypoventilation (also known as respiratory depression) occurs when ventilation is inadequate (hypo means below) to perform needed gas exchange. ... In medicine, chest pain is a symptom of a number of conditions and is generally considered a medical emergency, unless the patient is a known angina pectoris sufferer and the symptoms are familiar (appearing at exertion and resolving at rest, known as stable angina). When the chest pain is not... Suffocation redirects here, for the band, see Suffocation (band). ... Pleurisy, also known as pleuritis, is an inflammation of the pleura, the lining of the pleural cavity surrounding the lungs, which can cause painful respiration and other symptoms. ... Respiratory arrest is the cessation of the normal tidal flow of the lungs due to paralysis of the diaphragm, collapse of the lung or any number of respiratory failures. ... This article does not cite any references or sources. ... Bruit is the term for the unusal sound that blood makes when it rushes past an obstruction in an artery when the sound is observed with a stethoscope. ... A carotid bruit is a bruit or sound heard over the carotid artery area, usually by a nurse or physician during auscultation. ... Rales,crackles or crepitation, are the clicking, rattling, or crackling noises heard on auscultation of the lungs with a stethescope during inhalation. ... what was here was sick and improperly spelled. ... The human abdomen (from the Latin word meaning belly) is the part of the body between the pelvis and the thorax. ... Abdominal pain can be one of the symptoms associated with transient disorders or serious disease. ... The term acute abdomen refers to a sudden, severe pain in the abdomen that is less than 24 hours in duration. ... For other uses, see Nausea (disambiguation). ... Emesis redirects here. ... Dysphagia () is a medical term defined as difficulty swallowing. ... Flatulence is the presence of a mixture of gases known as flatus in the digestive tract of mammals expelled from the rectum. ... Burping, also known as belching, ructus, or eructation is the release of gas from the digestive tract (mainly esophagus and stomach) through the mouth. ... Fecal incontinence is the loss of regular control of the bowels. ... Encopresis is involuntary fecal soiling in children who have usually already been toilet trained. ... Hepatomegaly is the condition of having an enlarged liver. ... Splenomegaly is an enlargement of the spleen, which usually lies in the left upper quadrant (LUQ) of the human abdomen. ... Hepatosplenomegaly is the simultaneous enlargement of both the liver (hepatomegaly) and the spleen (splenomegaly). ... Jaundice, also known as icterus (attributive adjective: icteric), is a yellowing of the skin, conjunctiva (a clear covering over the sclera, or whites of the eyes) and mucous membranes caused by hyperbilirubinemia (increased levels of bilirubin in red blooded animals). ... Fecal occult blood is a term for blood present in the feces that is not visibly apparent. ... Halitosis, oral malodor (scientific term), breath odor, foul breath, fetor oris, fetor ex ore, or most commonly bad breath are terms used to describe noticeably unpleasant odors exhaled in breathing â€“ whether the smell is from an oral source or not. ... For other uses, see Skin (disambiguation). ... The subcutis is the layer of tissue directly underlying the cutis. ... Hypoesthesia refers to a reduced sense of touch or sensation, or a partial loss of sensitivity to sensory stimuli. ... Paresthesia or paraesthesia (in British English) is a sensation of tingling, pricking, or numbness of a persons skin with no apparent long-term physical effect, more generally known as the feeling of pins and needles or of a limb being asleep (but not directly related to the phenomenon of... Hyperesthesia (or Hyperaesthesia) is a condition that involves an abnormal increase in sensitivity to stimuli of the senses. ... A rash is a change in skin which affects its color, appearance, or texture. ... Cyanosis refers to the bluish coloration of the skin due to the presence of deoxygenated hemoglobin in blood vessels near the skin surface. ... This article does not cite any references or sources. ... For a person to flush is to become markedly red in the face and often other areas of the skin, from various physiological conditions. ... minor Petechia A petechia (IPA pronunciation: ), plural petechiae (IPA pronunciation: ) is a small red or purple spot on the body, caused by a minor hemorrhage (broken capillary blood vessels). ... Desquamation is the shedding of the outer layers of the skin. ... Induration (indoo rÄshÉ™n, -dyoo-), a noun, means, in terms of pathology, (a) hardening of an area of the body as a reaction to inflammation, hyperemia, or neoplastic infiltration, or (b) an area or part of the body that has undergone such a reaction. ... Diaphoresis is excessive sweating commonly associated with shock and other medical emergency conditions. ... The Human Nervous System. ... The musculoskeletal system (also known as the locomotor system) is an organ system that gives animals the ability to physically move using the muscles and skeletal system. ... For the film see Tremors (film). ... A spasm is a sudden, involuntary contraction of a muscle, a group of muscles, or a hollow organ, or a similarly sudden contraction of an orifice. ... It has been suggested that this article or section be merged with Twitching. ... Athetosis is a continuous stream of slow, sinuous, writhing movements, typically of the hands and feet. ... Persons suffering from peripheral neuropathy experience numbness and tingling in their hands and feet. ... For other uses, see Ataxia (disambiguation). ... Dysmetria (Greek: dificult to measure) is a symptom exhibited by patients after cerebellar injury. ... Dysdiadochokinesia is the medical term for an inability to perform rapid, alternating movements. ... Hypotonia is a condition of abnormally low muscle tone (the amount of tension or resistance to movement in a muscle), often involving reduced muscle strength. ... Diseases and other conditions that increase action potential frequency cause unwanted contraction of muscles. ... Meningism is the triad of nuchal rigidity, photophobia (intolerance of bright light) and headache. ... Hyperreflexia is defined as overactive or overresponsive reflexes. ... It has been suggested that this article or section be merged into Excretory system. ... In medicine, specifically urology, dysuria refers to any difficulty in urination. ... This article needs to be cleaned up to conform to a higher standard of quality. ... The tone or style of this article or section may not be appropriate for Wikipedia. ... Urinary retention also known as ischuria is a lack of ability to urinate. ... Oliguria and anuria are the decreased or absent production of urine, respectively. ... Polyuria is the passage of a large volume of urine in a given period. ... Nocturia is the need to get up during the night in order to urinate, thus interrupting sleep. ... Look up Cognition in Wiktionary, the free dictionary. ... In psychology and the cognitive sciences, perception is the process of acquiring, interpreting, selecting, and organizing sensory information. ... In psychology and common terminology, emotion is the language of a persons internal state of being, normally based in or tied to their internal (physical) and external (social) sensory feeling. ... Behavior or behaviour refers to the actions or reactions of an object or organism, usually in relation to the environment. ... Anxiety is a physiological state characterized by cognitive, somatic, emotional, and behavioral components (Seligman, Walker & Rosenhan, 2001). ... Somnolence (or drowsiness) is a state of near-sleep, a strong desire for sleep, or sleeping for unusually long periods. ... For other uses, see Coma (disambiguation). ... For other uses, see Amnesia (disambiguation). ... Anterograde amnesia is a form of amnesia, or memory loss, in which new events are not transferred from short-term memory to long-term memory. ... Retrograde amnesia is a form of amnesia where someone will be unable to recall events that occurred before the onset of amnesia. ... // Pre-syncope is a sensation of feeling faint. ... For other uses, see Vertigo. ... Anosmia is the lack of olfaction, or a loss of the ability to smell. ... Ageusia (pronounced ay-GOO-see-uh) is the loss of taste functions of the tongue, particularly the inability to detect sweetness, sourness, bitterness, and saltiness. ... This page is a candidate to be moved to Wiktionary. ... Parageusia is the medical term for a bad taste in the mouth. ... Bold text This article does not cite any references or sources. ... The word voice can be used to refer to: Sound: The human voice. ... Speech disorders or speech impediments, as they are also called, are a type of communication disorders where normal speech is disrupted. ... Dysphasia is a speech disorder in which there is an impairment of speech and of comprehension of speech. ... For other uses, see Aphasia (disambiguation). ... Look up dysarthria in Wiktionary, the free dictionary. ... This article is about developmental dyslexia. ... Alexia (from the Greek , privative, expressing negation, and = word) is an acquired type of sensory aphasia where damage to the brain causes a patient to lose the ability to read. ... Agnosia (a-gnosis, non-knowledge, or loss of knowledge) is a loss of ability to recognize objects, persons, sounds, shapes, or smells while the specific sense is not defective nor is there any significant memory loss[1][2]. It is usually associated with brain injury or neurological illness, particularly after... Apraxia is a neurological disorder characterized by loss of the ability to execute or carry out learned (familiar) movements, despite having the desire and the physical ability to perform the movements. ... This article or section is in need of attention from an expert on the subject. ... Dysgraphia (or agraphia) is a deficiency in the ability to write, regardless of the ability to read, not due to intellectual impairment. ... Speech disorders or speech impediments, as they are also called, are a type of communication disorders where normal speech is disrupted. ... Lisp may mean: Lisp programming language Lisp (speech) This is a disambiguation page â€” a list of pages that otherwise might share the same title. ... Aphasia is a loss or impairment of the ability to produce or comprehend language, due to brain damage. ... The term symptom (from the Greek meaning chance, mishap or casualty, itself derived from ÏƒÏ…Î¼Ï€Î¹Ï€Ï„Ï‰ meaning to fall upon or to happen to) has two similar meanings in the context of physical and mental health: Strictly, a symptom is a sensation or change in health function experienced by a patient. ... In medicine, a sign is a feature of disease as detected by the doctor during physical examination of a patient. ... An analogue medical thermometer showing the temperature of 38. ... In medicine, hyperpyrexia is an excessive and unusual elevation of body temperature above 107. ... A headache (cephalgia in medical terminology) is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. ... Malaise is a feeling of general discomfort or uneasiness, an out of sorts feeling, often the first indication of an infection or other disease. ... Exhaustion redirects here. ... It has been suggested that Central Ischaemic Response be merged into this article or section. ... Vasovagal syncope is the most common cause of syncope, also known as fainting. ... A febrile seizure, also known as a fever fit or febrile convulsion is a generalized convulsion caused by elevated body temperature. ... This article is about the medical condition. ... Cardiogenic shock is based upon an inadequate circulation of blood due to primary failure of the ventricles of the heart to function effectively. ... Lymphadenopathy is a term meaning disease of the lymph nodes. ... This page is about the condition called edema. ... Peripheral edema ... Anasarca is a medical symptom characterised by widespread swelling of the skin due to effusion of fluid into the extracellular space. ... Primary hyperhidrosis is the condition characterized by abnormally increased perspiration, in excess of that required for regulation of body temperature. ... Sleep hyperhidrosis, more commonly known as the night sweats, is the occurrence of excessive sweating (hyperhidrosis) during sleep. ... The term Delayed milestone (or developmental delays) is used to describe the condition where a child does not reach one of these stages at the expected age. ... Failure to thrive is a medical term which denotes poor weight gain and physical growth failure over an extended period of time in infancy. ... Anorexia (deriving from the Greek Î±(Î½)- (a(n)-, a prefix that denotes absence) + ÏŒÏÎµÎ¾Î· (orexe) = appetite) is the decreased sensation of appetite. ... Polydipsia is a medical condition in which the patient ingests abnormally large amounts of fluids by mouth. ... Phagy or phagia is an ecological term that is used to identify particular nutritional systems. ... Xerostomia is the medical term for a dry mouth due to a lack of saliva. ... Clubbing is also used to refer to the activity of gathering socially at nightclubs. ...

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Functional Anatomy GA_googleFillSlot("encyclopedia_square");