6. PAIN MANAGEMENT

Question 1

what is pain

Answer 1

=unpleasant sensory and emotional experience associated with, or resembling that associated with actual or potential tissue damage.
-unpleasant feeling,
-protection from harm
>nociception, nociceptor

Question 2

nociception neural processes of

Answer 2

encoding noxious stimuli

Question 3

nociception is physiological perception of

Answer 3

pain

Question 4

nociception does not require

Answer 4

consciousness and can continue unabated during general anesthesia if techniques that interrupt or inhibit transduction, transmission, and modulation of nociceptive stimuli are not included

Question 5

nociceptor sensory receptor that

Answer 5

generate action potential (nerve impulse) and sends signals that cause perception of pain in response to potentially damaging stimulus

Question 6

nociceptors - different nociceptors respond to different stimuli:

Answer 6

1. mechanoreceptors: pressure and strech
2. thermoreceptors: heat and cold
3. chemoreceptors: inflammatory mediators (H+, K+, prostaglandins)

Question 7

neuron includes

Answer 7

-dendrite
-nucleus
-axon
-cell body
-myelin sheath
-node of ranvier
-schwann cell
-axon terminal

Question 8

nociceptive impulses are transmitted in

Answer 8

Adelta and C fibers
> Adelta -small myelinated fibers: fast, sharp pin
> C - smallest unmyelinated fibers : slow dull pain

Question 9

transduction of noxious stimulus(any damage of tissue) > primary afferent nociceptor > transmission >

Answer 9

modulation > thalamus > thalamocortical projections > cortex > PERCEPTION

-modulation=changing - change signal to stronger or action let signal to main brain at all

Question 10

modulation of pain in

Answer 10

spinal cord, many receptors and mediators modulate information passing to brain

Question 11

modulation of pain excitatory transmitters

Answer 11

=prostaglandins > propagate pain impulse

Question 12

modulation of pain inhibitory transmitters

Answer 12

=endorphins, epinephrine, norepinephrine, GABA > reduce painful stimuli

Question 13

gate theory small fibers and large fibers >

Answer 13

pain

Question 14

hyperalgesia increased sensitivity to

Answer 14

pain, which may be caused by damage to nociceptors or peripheral nerves or lack of inhibitory transmitter

Question 15

primary hyperalgesia (kipuaistin lisääntyminen suoraan tulehtuneessa tai vahingoittuneella alueella) describes pain that occurs

Answer 15

directly in damaged tissues

Question 16

secondary hyperalgesia (Kipuaistimuksen lisääntyminen tapahtuu alueilla, jotka ympäröivät vahingoittunutta aluetta mutta eivät ole itse suoraan vahingoittuneet) describes pain sensitivity that occurs in

Answer 16

surrounding undamaged tissues

Question 17

hyperalgesia is

Answer 17

opioid -induced

Question 18

allodynia (tilaa, jossa normaalisti kivuttomat ärsykkeet aiheuttavat kipua) pain due to

Answer 18

stimulus that does not usually provoke pain

Question 19

tactile allodynia pain caused by

Answer 19

touch

Question 20

mechanical allodynia caused by

Answer 20

movement across skin

Question 21

thermal (temperature-related) allodynia caused by

Answer 21

heat or cold that is not extreme enough to cause damage to your tissues

Question 22

movement allodynia pain triggered by

Answer 22

normal movement of joints or muscles

Question 23

nociceptive pain: acute response to

Answer 23

tissue damage that resolves in period of days

Question 24

nociceptive pain: chronic pain lasts for

Answer 24

longer period of time, classically associated with chronic inflammatory disease or degenerative condition or following nerve injury or damage
>degenerative joint disease
>stomatitis
>intervertebral pathology

Question 25

somatic pain: superficial somatic pain in

Answer 25

-skin, subcutaneous tissue -well localized, sharp, burnin -burns, wound, contusions

Question 26

somatic pain: deep somatic pain

Answer 26

-muscles, joints, bones, fascia -localized or diffuse -dull, spastic -arthritis, tendonitis etc

Question 27

visceral pain-pain that results from

Answer 27

activation of nociceptors of thoracic, pelvic or abdominal organs (viscera)

Question 28

visceral pain-nociceptive fibers together with

Answer 28

autonomic nervous system

Question 29

postoperative pain form of

Answer 29

acute pain due to surgical trauma > inflammatory component >tissue irritation from extravascular blood >peripheral and central sensitization

Question 29

visceral pain etiology

Answer 29

-distention(strech) -ischemia -inflammation -not so sensitive to cutting or burning

Question 30

neuropathic pain that develops following injury to

Answer 30

peripheral nerves and central nervous system (spinal cord, brainstem, brain) > accompanied by hyperalgesia and allodynia to both inflammatory and normally non-painful stimuli >spontaneous action potential >in humans common as postamputation pain: limbs, tail, eye

Question 31

phantom pain perceptions that individual experiences relating to

Answer 31

limb or organ that is not physically part of body anymore >develops after amputation of limb, eye, testicles, tail, mastectomy > pain formed from injured nerve endings at stump site >pain prior amputation increases risk of phantom pain

Question 32

consequences of pain-cardiovascular system

Answer 32

-tachycardia -hypertension -increased myocardial oxygen requirements -cardiac arrhythmias -coagulation

Question 33

consequences of pain-respiratory system

Answer 33

-hyperventilation -atelectasis -pulmonary edema

Question 34

consequences of pain-central nervous system

Answer 34

-affected behaviour -depression -aggression -dilated pupils -sleep disturbances

Question 35

consequences of pain-GIT

Answer 35

-delayed gastric emptying -ileus -nausea -vomiting -loss of appetite

Question 36

consequences of pain-urinary system

Answer 36

-oliguria -urinary retention -postanesthetic kidney failure

Question 37

consequences of pain-immune system

Answer 37

-pro-inflammatory cytokines increase -anti-inflammatory cytokines decrease -unfections decrease -spread of cancer increase

Question 38

pain assessment

Answer 38

1-5

Question 39

perception of pain perceptual phenomenon requires

Answer 39

conscious being =kivun havaitseminen ja kokeminen

Question 40

perception of pain always includes

Answer 40

suffering

Question 41

assessment to chronic pain

Answer 41

-general mobility-ease of movement, fluidity of movement -performing activities - playing, hunting, jumping, using litter-box -eating, drinking -grooming -resting.observing, relaxing -social activities involving people and other pets -temperament

Question 42

parts of perception of pain

Answer 42

-sensory factors: injury, inactivity, body mechanics -cognitive factors: focus on pain, changes in behavioral patterns -emotional factors: depression, agression, anxiety, stress

Question 43

multimodal analgesia is most

Answer 43

effective and due to low doses of any single drug, provides less side effects