Ch. 34 Comfort & Pain

Question 1

How are nociceptors activated?

Answer 1

1 Histamines released. 2 Lactic acid accumulates in injured tissues

Question 2

What substances also stimulate nociceptors?

Answer 2

Bradykinin, Prostaglandins, & Substance P

Question 3

Bradykinin stars working on injured area before brain responds by

Answer 3

Vasodilator, > capillary permeability + constricts smooth muscle. Releases histamine=starts inflammation

Question 4

Prostaglandins

Answer 4

Send additional pain stimuli to brain

Question 5

Substance P

Answer 5

sensitizes receptors on nerves to feel pain and > firing rate

Question 6

Serotonin

Answer 6

stimulates smooth muscles, inhibits gastric secretion, & produces vasoconstriction

Question 7

Prostaglindins, Substance P, & Serotonin are

Answer 7

Neurotransmitters

Question 8

Transduction

Answer 8

The conversion of painful stimuli into electrical impulses that travel from the periphery to the spinal cord at the dorsal horn

Question 9

Transmission

Answer 9

The pathway the stimulus takes to higher brain sensory centers

Question 10

The two afferent pain receptor fibers

Answer 10

A-delta- fibers & C- fibers

Question 11

Difference btn 2 pain receptor fibers

Answer 11

A- 𝛿 fibers are fast-conducting & transmit acute, localized pain (reflex). C-fibers convey diffuse, visceral pain that’s “burning/aching”

Question 12

Pain threshold

Answer 12

When a pain is percieved

Question 13

Modulation

Answer 13

pain is inhibited

Question 14

Neuromodulators

Answer 14

Naturally present opioid compounds (morphine like chemical compounds)

Question 15

Name 2 opioid neuromodulators

Answer 15

Endorphins, enkephalins

Question 16

Endorphins

Answer 16

Analgesic + euphoria

Question 17

Which endorphin has the most potent analgesic effect?

Answer 17

Dynorphin

Question 18

Enkephalins

Answer 18

Less potent than endorphins. Reduces pain sensation by inhibiting the release of substance P from the terminals of the afferent neurons

Question 19

Gate Control Theory

Answer 19

Only a limited amount of sensory information can be perceived at any moment

Question 20

Remission

Answer 20

Disease is present but no pain rn

Question 21

Exacerbation

Answer 21

symptoms reappear

Question 22

Cutaneous pain

Answer 22

skin or subcutaneous tissue pain

Question 23

Somatic pain

Answer 23

deep tissue pain

Question 24

Visceral pain

Answer 24

Poorly localized

Question 25

Gaurding

Answer 25

Reflexive action to prevent trauma to the underlying structures. Tenses their abdomen

Question 26

Reffered Pain

Answer 26

Pain in area distant from actual injury

Question 27

Neuropathic Pain

Answer 27

Disease affecting PNS or CNS

Question 28

Allodynia

Answer 28

Pain that occurs after a weak or nonpainful stimului

Question 29

Intractable

Answer 29

When pain is resistant to therapy and persists depsite interventions

Question 30

Psychogenic pain

Answer 30

A physical cause for the pain cannot be IDed

Question 31

Complex Regional Pain Syndrome

Answer 31

Partially injured peripheral nerve. Burning, severe, diffuse, & persistent & elicited by minimal movement. Continues after stimulation ceases

Question 32

Posttherpetic neuralgia

Answer 32

Follows an acute CNS infection like herpes zoster (shingles)

Question 33

Trigeminal Pain

Answer 33

paroxysms of lightening-like stabs of intense pain in trigeminal nerve

Question 34

Patient- Controlled Analgesia system

Answer 34

infusion pump w prefilled prescribed opioid analgesic

Question 35

Medication on Demand (MOD)

Answer 35

Device is an oral PCA device attached to an IV pole and requires the patient to wear a wristband that allows a drawer to open on the IV (locks out intervals)

Question 36

Continuous Subcutaneous Infusion

Answer 36

Opioid consistently administered (hospice + palliative care)

Question 37

When is epidural pain management contraindicated?

Answer 37

No informed consent, takes anticoagulants, infection, allergic to opioids or local anesthetics, history of NSAID