Chapter 02 - Fundementals of Pain Management Flashcards
Q2-1: How does the International Association for the Study of Pain define pain?
A2-1: The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”
Q2-2: Identify variables that contribute to an individual’s experience of pain.
A 2-2: Pain is influenced by many variables that contribute to an individual’s experience of pain. The sex of an individual provides genetic and hormonal influence. Gender also adds numerous complex components that include an array of socially constructed roles and relationships, personality traits, attitudes, behaviors, values, relative power, and influence that society ascribes based on a differential basis. Other factors, such as age, physical health, mental health, emotional status, expectations, previous experiences, learned responses, and ethnic and cultural norms also impact the pain experience.
Q2-3: Discuss pain as a protective response.
A2-3: As a physiological response to our environment, pain is a protective response. Physiological pain serves to protect us from harmful experiences. This protective response is a rapid, reflexive, subconscious reaction. However, a less emergent painful annoyance may elicit a slower, conscious-level reaction. Without the protective pain response, the ability to maintain a healthy body would be seriously compromised.
Q2-4: Define pain threshold.
A2-4: Pain threshold is the point at which a stimulus begins to produce a sensation of pain. It is highly reproducible in the same individual and among different individuals.
Q2-5: Define pain tolerance.
A2-5: Pain tolerance is an individual’s reaction to a painful stimulus. A common experience of pain produces a highly variable reaction from one individual to another.
Q2-6: Define acute pain.
A2-6: Acute pain usually lasts for a few seconds to not more than six months, depending on the causative factors. It is generally caused by tissue damage from an injury or disease.
Q2-7: Define chronic pain.
A2-7: Chronic pain is long-term pain that persists for more than six months, with or without an identifiable cause. The longer an acute pain continues the more likely the pain will become a chronic pain experience.
Q2-8: Name the three broad classifications of pain.
A2-8: Pain is generally considered in three broad classifications: nociceptive pain, neuropathic pain, and pain disorders. Subclassifications exist within these broad categories.
Q2-9: Define nociceptors.
A2-9: Nerve fibers have specialized endings to detect and transmit information to the central nervous system. For pain, the receptor fibers are known as nociceptors. Nociceptors are unique because they are polymodal, meaning they respond to all types of stimuli: mechanical, thermal, and chemical.
Q2-10: Explain the difference between pain and nociception.
A2-10: Pain and nociception are not synonymous. Nociception is the body’s neurophysical detection of tissue trauma by nociceptors and the process of transmission of signals of the tissue injury within the nervous system. Nociception is not a conscious process. The process of nociception is influenced by an individual’s age, general health, and genetics. An individual must have conscious awareness to experience pain. Pain cannot exist apart from consciousness and cannot be objectively measured.
Q2-11: Define nociceptive pain.
A2-11: Nociceptive pain is caused by injury or disease in body tissues. Pain may be constant or intermittent and often escalates with movement.
Q2-12: Define somatic and visceral pain.
A2-12: Somatic nociceptive pain occurs on superficial structures such as skin and muscles and is caused by traumatic injuries. The resulting pain may be sharp, aching, or throbbing. Visceral nociceptive pain occurs in internal body cavities and is caused by compression, expansion, stretching, and/or infiltration of internal organs. It usually produces squeezing or gnawing sensations.
Q2-13: Define neuropathic pain.
A2-13: Neuropathic pain is caused by nerve tissue injury or dysfunction of the sensory nerves in central or peripheral nervous systems. There are numerous neuropathic pain types.
Q2-14: Define pain disorders with psychological factors.
A2-14: Pain disorders are related to mental or emotional problems that affect the experience of pain. Pain disorders with psychological factors are diagnosed after other causes of physical pain have been eliminated.
Q2-15: What physiological responses occur as a result of sympathetic nervous system activation?
A2-15: Heart rate and contractions increase, blood pressure increases, and pupils dilate. Bronchodilation and vasodilation of skeletal muscle arterioles occur along with vasoconstriction of mesenteric circulation.
