Apex- Misc: Pain Flashcards
Pain from a stimulus that does not normally produce pain
example
Allodynia
Fibromyalgia
ALL things cause pain
A stimulus expected to produce pain
example
Algogenic
surgical incision
No pain sensed when met with a painful stimulus
example
Analgesia
opioid analgesics to relieve kidney stone pain
Abnormal and unplesant sense of touch
example
Dysethesia
Dys= abnormal/dysfunctional
burning senssation from diabetic neuropathy
Exaggerated pain response to a painful stimulus
example
hyperalgesia
opioid-induced hyperalgesia (remi)
Pain localized to a dermatome
example
Neuralgia
Herpes zoster (shingles)
Impaired nerve function
example
neuropathy
silent MI from diabetic neuropathy
Abnormal sensation described as pins and needles
example
Parasthesia
P = Pins
nerve stimulation during regional anesthesia
Burning sensation from diabetic neuropathy is classified as:
A. Neuralgia
B. Neuropathy
C. Dysesthesia
D. Paresthesia
C. Dysethesia
abdormal or unpleasant sense of touch
neuralgia is pain localized to a dermatome (herpes zoster)
neuroapthy is impaired nerve function (silent MI from diabeti neuropathy)
parasthesia is abnormal sensation described as pins and needles (nerve stim during regional)
i guess neuropathy just describes the imapred nerve function but the actual sensation being felt is dysethesia = altered/abnormal/unplesant
Explain how SSRIs and SNRIs can treat chronic pain
Okay so pain modulation occurs in the spinal cord
> with central sensitization, the efficacy of the descending inhibitory pain pathway is impaired
> the descending inhibitory pain pathway uses** norepi and serotonin **as inhibitory transmitters
okay so
1. SSRIs prevent reuptake of serotonin - more available
2. SNRIs prevent the reuptake of norepi - more available
more inhibitory neurotransmitters available to treat chronic pain
Where does pain modulation occur?
in the spinal cord
Names for type 1 and type 2 complex regional pain syndromes
what is the key distinction between the two?
- Reflex sympathetic dystrophy
- Causalgia
Type 2 is always preceeded by nerve injury
Type 1 is not
(Causualgia = CAUSED by nerve injury)
Which CRPS is ALWAYS preceeded by a nerve injury, type 1 or type 2?
Type 2
Type 1 = Reflex sympathetic dystrophy
Type 2 = CAUSALGIA - nerve pain CAUSES the issue
What is characterized by neuropathic pain with autonomic involvement?
Complex regional pain syndrome
Match the following regional blocks: thoracic paravertebral, celiac plexus, superior hypogastric plexus block:
- for breast surgery, thoracotomy, and rib fractures
- -for cancer pain of the pelvic organs
- for caner pain of the upper abdomen
Thoracic paravertebral = breast surgery, thoracotomy, rib fxs
Superior hypogastric plexus = cancer pain of the pelvic organs
Celiac plexus block = cancer pain of the upper abdomen
What kind of block is used for postdural puncture headaches?
Sphenopalantine
T/F: the optic nerve is enveloped by the meningeal sheath and is bathed in CSF
True
3 risk factors for complex regional pain syndrome
- female (cait)
- previous trauma (cait)
- previous surgery (cait)
neuropathic pain with autonomic invovlement
T/F: the paravertebral space is a potential space
local anesthetic deposited here targets what?
True
the ventral ramus of the spinal nerve as it exits the vertebral foramen
What kind of block can be used for cancer pain of the pelvic organs
superior hypogastric plexus block
urterus, ovaries, prostate, descending colon
label
sphenopalantine ganglion
What type of block can cause contralateral amaurosis
Retrobulbar
amaurosis = blindness
LA injected itno the optic sheath can migrate towards the optic chiasm, where it can anesthetize CN2 and 3 on the oppsite side of the block
