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Pain: An unpleasant sensation induced by noxious stimuli which are detected by Nerve endings of Nociceptive neurons.

Development of Recombinant Proteins to Treat Chronic Pain

1Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, 2Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht University, 3Laboratory of Neuroimmunology and Developmental Origins of Disease, University Medical Center Utrecht, Utrecht University

JoVE 57071


 Medicine

A Quantitative Sensory Testing Paradigm to Obtain Measures of Pain Processing in Patients Undergoing Breast Cancer Surgery

1Department of Anesthesiology, Pain, and Palliative Medicine, Radboud University Medical Center, 2Mech-Sense, Department of Gastroenterology & Hepatology, Aalborg University Hospital, 3Medical Technology & Clinical Physics, Radboud University Medical Center

JoVE 56918


 Medicine

Use of the Operant Orofacial Pain Assessment Device (OPAD) to Measure Changes in Nociceptive Behavior

1Department of Oral and Maxillofacial Surgery, University of Florida College of Dentistry, 2Department of Neuroscience, McKnight Brain Institute, University of Florida College of Medicine, 3Stoelting Co., 4Department of Orthodontics, University of Florida

JoVE 50336


 Behavior

Abdominal Exam IV: Acute Abdominal Pain Assessment

JoVE 10120

Source: Joseph Donroe, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT

Abdominal pain is a frequent presenting concern in both the emergency department and the office setting. Acute abdominal pain is defined as pain lasting less than seven days, while an acute abdomen refers to the abrupt onset of severe abdominal pain with features suggesting a surgically intervenable process. The differential diagnosis of acute abdominal pain is broad; thus, clinicians must have a systematic method of examination guided by a careful history, remembering that pathology outside of the abdomen can also cause abdominal pain, including pulmonary, cardiac, rectal, and genital disorders. Terminology for describing the location of abdominal tenderness includes the right and left upper and lower quadrants, and the epigastric, umbilical, and hypogastric regions (Figures 1, 2). Thorough examination requires an organized approach involving inspection, auscultation, percussion, and palpation, with each maneuver performed purposefully and with a clear mental representation of the anatomy. Rather than palpating randomly across the abdomen, begin palpating remotely from the site of tenderness, moving systematically toward the tender region, and thi


 Physical Examinations II

Intraoperative Detection of Subtle Endometriosis: A Novel Paradigm for Detection and Treatment of Pelvic Pain Associated with the Loss of Peritoneal Integrity

1Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Greenville Hospital System, 2Department of Pathology, Duke University Health System, 3Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Duke University

JoVE 4313


 Medicine

Elbow Exam

JoVE 10207

Source: Robert E. Sallis, MD. Kaiser Permanente, Fontana, California, USA

The elbow is a hinged joint that involves the articulation of 3 bones: the humerus, radius, and ulna. It is a much more stable joint than the shoulder, and because of that, the elbow has less range of motion. The elbow and its structures are prone to significant injuries, particularly with repetitive motion. Lateral and medial epicondylitis (also called tennis elbow and golfer's elbow) are two common diagnoses and often occur as a result of occupational activities. When examining the elbow, it is important to remove enough clothing so that the entire shoulder and elbow can be inspected. It is important to compare the injured elbow to the uninvolved side. A systematic evaluation of the elbow includes inspection, palpation, range of motion (ROM) testing, and special tests, including maneuvers to evaluate ligamentous stability and stretch tests to accentuate pain caused by epicondylitis.


 Physical Examinations III

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex

1Multidisciplinary Pain Center, Anesthesiology and Critical Care Medicine, Antwerp University Hospital (UZA), University of Antwerp (UA), 2Multidisciplinary Pain Center (PCT), Antwerp University Hospital (UZA), 3Critical Care Medicine, Antwerp University Hospital (UZA), University of Antwerp (UA)

Video Coming Soon

JoVE 57972


 JoVE In-Press

Knee Exam

JoVE 10203

Source: Robert E. Sallis, MD. Kaiser Permanente, Fontana, California, USA

The knee is a hinged joint that connects the femur with the tibia. It is the largest joint in the body, and due to its location in the middle of the lower leg, it is subjected to a variety of traumatic and degenerative forces. Examination of the knee can be quite complex, owing to the fact it is an inherently unstable joint held together by various ligaments and supported by menisci, which act as shock absorbers and increase the contact area of the joint. In addition, the patella lies in front of the knee, acting as a fulcrum to allow the forceful extension of the knee needed for running and kicking. As the largest sesamoid bone in the body, the knee is a common source of pain related to trauma or overuse. When examining the knee, it is important to remove enough clothing so that the entire thigh, knee, and lower leg are exposed. The exam begins with inspection and palpation of key anatomic landmarks, followed by an assessment of the patient's range of motion (ROM). The knee exam continues with tests for ligament or meniscus injury and special testing for patellofemoral dysfunction and dislocation of the patella. The opposite knee should be used as the standard to evaluate the injured knee, provided it has not been previousl


 Physical Examinations III

Technique and Considerations in the Use of 4x1 Ring High-definition Transcranial Direct Current Stimulation (HD-tDCS)

1Laboratory of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, 2School of Medicine, Pontifical Catholic University of Ecuador, 3Charité University Medicine Berlin, 4The City College of The City University of New York, 5Headache & Orofacial Pain Effort (H.O.P.E.), Biologic & Materials Sciences, School of Dentistry, University of Michigan

JoVE 50309


 Medicine

Home-Based Transcranial Direct Current Stimulation Device Development: An Updated Protocol Used at Home in Healthy Subjects and Fibromyalgia Patients

1Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), 2Laboratory of Pain & Neuromodulation, Hospital de Clínicas de Porto Alegre (HCPA), 3School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), 4Faculdade de Desenvolvimento do Rio Grande do Sul (FADERGS), Health and Wellness School Laureate International Universities, 5Biomedical Engineering Department, Hospital de Clínicas de Porto Alegre (HCPA), 6Pharmacology Department, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul (UFRGS), 7Department of Physical Medicine and Rehabilitation, Harvard Medical School, 8Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, 9Pain and Palliative Care Service, Hospital de Clínicas de Porto Alegre (HCPA), 10Department of Surgery, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS)

Video Coming Soon

JoVE 57614


 JoVE In-Press

Automated Gait Analysis in Mice with Chronic Constriction Injury

1Department of Physiology and Medical Science, College of Medicine and Brain Research Institute, Chungnam National University, 2KM Fundamental Research Division, Korea Institute of Oriental Medicine (KIOM), 3Department of Neuroscience and Cell Biology, University of Texas Medical Branch at Galveston

JoVE 56402


 Neuroscience

Systematic Assessment of Well-Being in Mice for Procedures Using General Anesthesia

1Institute of Animal Welfare, Animal Behavior and Laboratory Animal Science, Department of Veterinary Medicine, Freie Universität Berlin, 2Institute of Pharmacology and Toxicology, Department of Veterinary Medicine, Freie Universität Berlin, 3German Federal Institute for Risk Assessment (BfR), 4Unit of Physiology, Pathophysiology and Experimental Endocrinology, Department of Biomedical Sciences, University of Veterinary Medicine

JoVE 57046


 Behavior

Wrist and Hand Examination

JoVE 10242

Source: Robert E. Sallis, MD. Kaiser Permanente, Fontana, California, USA

The wrist is a complex joint made up of 8 carpal bones and their numerous articulations and ligaments. Overlying the wrist are the tendons and muscles of the hand and fingers. The hand is made up of 5 metacarpal bones, and the tendons that run to the hand overlie these bones. Finally, the fingers consist of 14 phalanges with their articulations held together by collateral ligaments and volar plates. Common mechanisms of both acute and chronic wrist injury include impact, weight bearing (which can occur in gymnastics), twisting, and throwing. Osteoarthritis of the hand commonly affects distal interphalangeal (DIP) and proximal interphalangeal (PIP) joints, while rheumatoid arthritis (RA) is seen in the metacarpophalangeal (MCP) and PIP joints. It is important to compare the injured wrist or hand to the uninvolved side. Key aspects of the wrist and hand exam include inspection, palpation for tenderness or deformity, testing the range of motion (ROM) and strength, neurovascular assessment, ligaments and tendon testing, and the special tests.


 Physical Examinations III

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache

1Headache & Orofacial Pain Effort (H.O.P.E.), Biological & Materials Sciences Department, University of Michigan School of Dentistry, 2Michigan Center for Oral Health Research (MCOHR), University of Michigan School of Dentistry, 3Translational Neuroimaging Laboratory, Molecular & Behavioral Neuroscience Institute, University of Michigan, 4PET Physics Section, Division of Nuclear Medicine, Radiology Department, University of Michigan, 53DLab, University of Michigan, 6Department of Obstetrics and Gynecology, University of Michigan

JoVE 50682


 Medicine

Ethanol-Induced Cervical Sympathetic Ganglion Block Applications for Promoting Canine Inferior Alveolar Nerve Regeneration Using an Artificial Nerve

1Department of Dental Anesthesia, Nippon Dental University Hospital at Tokyo, 2Department of Dental Anesthesiology, Nippon Dental University School of Life Dentistry at Tokyo, 3Department of Bioartificial Organs, Institute for Frontier Medical Science, Kyoto University

Video Coming Soon

JoVE 58039


 JoVE In-Press

Shoulder Exam II

JoVE 10185

Source: Robert E. Sallis, MD. Kaiser Permanente, Fontana, California, USA

The shoulder exam continues by checking the strength of the rotator cuff muscles and biceps tendons. The rotator cuff muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) act as compressors, holding the humeral head in place against the glenoid. Injury and degeneration of the rotator cuff tendons are the most common sources of shoulder pain. The strength testing of the rotator muscle is performed by testing motions against resistance applied by the examiner. Pain with these resisted motions suggests tendonitis; weakness suggests a rotator cuff tear. The strength tested is followed by tests for impingement syndrome, shoulder instability, and labrum injury. It is important to test both of the shoulders and compare between the sides. The opposite shoulder should be used as the standard to evaluate the injured shoulder, provided it has not been injured as well.


 Physical Examinations III

Description of a Novel, Surgically Implanted Neuromodulatory Technique Known As Bilateral Epidural Prefrontal Cortical Stimulation (Epcs) for Treatment-Resistant Depression (TRD)

1Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 2Department of Neurosciences, Medical University of South Carolina, 3Ralph H. Johnson VA Medical Center, 4Department of Psychiatry and Behavioral Sciences, Stanford University, 5American University of Beirut Medical Center

Video Coming Soon

JoVE 56043


 JoVE In-Press

Lower Back Exam

JoVE 10177

Source: Robert E. Sallis, MD. Kaiser Permanente, Fontana, California, USA

The back is the most common source of pain in the body. Examination of the back can be a challenge due to its numerous structures, including the bones, discs, ligaments, nerves, and muscles-all of which can generate pain. Sometimes, the location of the pain can be suggestive of etiology. The essential components of the lower back exam include inspection and palpation for signs of deformity and inflammation, evaluation of the range of motion (ROM) of the back, testing the strength of the muscles innervated by the nerves exiting in the lumbar-sacral spine, neurological evaluation, and special tests (including the Stork test and Patrick's test).


 Physical Examinations III

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