Analgesia: Physiology of Pain

Question 1

What is nociception?

Answer 1

the detection of actual or potential tissue injury (i.e. pain) by the CNS

Question 2

What are nociceptors?

Answer 2

the nerve cells involved in the detection of pain

Question 3

What are the 4 main steps of pain perception?

Answer 3

1. transduction
2. transmission
3. modulation
4. perception

Question 4

What is transduction?

Answer 4

transformation of stimuli read by peripheral A-delta and C-fibers

Question 5

What do A-Delta Fibers do? (2)

Answer 5

1. Sharp, localized pain

2. Feels the pain immediately

Question 6

What do C-Fibers do? (3)

Answer 6

1. Achy, throbbing pain
2. Hard to localized
3. Dull pain

Question 7

What is transmission?

Answer 7

conduction of sensory electrical impulse to the spinal cord

Question 8

What is modulation?

Answer 8

impulses from the peripheral nociceptors are received by the spinal cord neurons

Question 9

What is perception?

Answer 9

sensory impulse is transmitted to the brain, where it is processed and recognized as pain

Question 10

What makes it possible to use multiple drugs at the same time to control pain?

Answer 10

At each step of the pain pathway, different types of nociceptors are involved

Question 11

What is multimodal analgesia? (2)

Answer 11

1. using a combination of analgesic drugs

2. each with a different mechanism of action to control pain

Question 12

What is pain classified as? (2)

Answer 12

1. adaptive

2. maladaptive

Question 13

What is Adaptive Pain? (2)

Answer 13

1. the normal sensory response caused by tissue damage and inflammation
2. acute or chronic

Question 14

What is Maladaptive Pain?

Answer 14

results from physical changes that occur in the normal spinal cord and brain

Question 15

What causes Maladaptive Pain? (2)

Answer 15

1. Constant stimulation of nociceptors leads to physical changes
2. when adaptive pain is not managed appropriately

Question 16

What leads to amplified pain? (2)

Answer 16

1. Increased Nociceptor sensitivity

2. increase in the severity of the pain

Question 17

What can non-noxious stimuli cause that doesn’t normally happen? (2)

Answer 17

1. Increased nociceptor sensitivity that creates pain

2. simply touching an area near the site of injury or even one that is far away

Question 18

Definition of Hyperalgesia

Answer 18

increased sensitivity to noxious stimuli

Question 19

Definition of Allodynia

Answer 19

pain produced by non-noxious stimuli

Question 20

Definition of Windup

Answer 20

CNS hypersensitivity to noxious and non-noxious stimuli