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Physical Agents > Chapter 6: Pain Modulation > Flashcards

Chapter 6: Pain Modulation Flashcards

1
Q

what is pain

A

unpleasant sensory and emotional experience that is associated with actual or potential tissue damage
-duality based on physiological or psychological experience

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2
Q

function of pain

A
  • warning for withdrawal
  • alerts that something is wrong
  • protective function (spasm)
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3
Q

goals pain treatment

A
  • resolve underlying pathology causing pain
  • modify pt perception of pain to allow participation
  • allow pt to maximize functional abilities
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4
Q

categories of pain: nociceptive (somatic)

A
  • activation of nociceptors found in most body tissue
  • respond to mechanical and chemical stimuli
  • found in skin, joint, mucles
  • caused by injury, disease, surgical intervention
  • “normal pain”
  • treated with electrophysical agents (EPA)
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5
Q

categories of pain: nociceptive (visceral)

A

activation of nociceptors found in viscera

  • referred
  • diffuse and poorly localized
  • specificity: not all viscera are sensative to pain
  • EPA not effective
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6
Q

categories of Pain: neuropathic

A

Peripheral: disease associated with peripheral nerves (EPA treated)

  • Central: due to pathological functioning of CNS
  • -often delayed as in stroke, MS, parkinson’s disease
  • -seldom treated EPAs
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7
Q

Categories: psychogenic

A

non organic source

-assocaited with emotional, cognitive, behavioral responses

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8
Q

carcinogenic pain

A
  • caused by cancerous pathology

- EPA not effective

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9
Q

types of pain

A
  • acute
  • chronic
  • referred
  • radicular
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10
Q

acute

A

-perception of pain is combination of unpleasant sensations with emotional and psychological reactions, but in response to noxious stimulus provocted by acute injury

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11
Q

acute pain

A
  • tmie limited
  • mediated through rapidly conducting pathways
  • assocaited with increased sympathetic nervous system activity
  • intensity: related to extent of tissue damage
  • location: well organized and defined
  • duration: as long as noxious stimulus persists
  • serves protective function
  • may impair function
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12
Q

treatment acute

A
  • facilitate resolution of underlying disorder
  • reduce inflammation
  • modify transmission of pain from periphery to CNS
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13
Q

chronic pain

A

continuous, long term pain

-more than 12 weeks

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14
Q

chronic pain

A

duration: several months or years
symptoms: simliar to original symptoms
history of many treatment failures
-history many medications tried
-continued use of analgesics and tranquilizers despite no long term effects
-intensirty: unbearable or incapacitating
-often seeking right treatment to cure pain

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15
Q

chronic pain psychosocial changes

A
  • ex
  • depression
  • disturbed sleep
  • decreased energy
  • altered moods
  • etc
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16
Q

chronic pain result of

A

result form changes in sympathetic NS, adrenal activity, reduced production of endogenous opioids, or sensitization of primary afferents
-increased sensitivity to both noxious (hyperalgesia) and non-noxious (allodynia) stimuli

17
Q

hyperalgesia

A

increase in perception of pain due to stimulus thought to be painful before, but is more painful now

18
Q

allodynia

A

-pain response when a stimulus which was previously none painful is now presented as painful

19
Q

referred pain

A

felt at location distant from its source

  • from nerve to area of innervation
  • from one area to another derived from same dermatome
  • from one area to another derived from same embrionic segment
  • peripheral nerve pathways from different areas converge on same area of spinal cord
  • =synapse with same second order neurons to ascend to cerebral cortex
20
Q

example referred pain

A
  • pain referred from diaphragm to tip of shoulder-both areas initially develop in the neck region during embryonic development
  • both have efferent innervation from phrenic nerve
  • both have afferent innervation to second to forth level of C-spine
21
Q

radicular pain

A
  • originating from irritated nerve root

- follows dermatomal reference

22
Q

danger alarm system

A
  • transduction-danger receptros
  • peripheral transmission
  • modulation
  • central transmission
  • perception
  • pain control theories
23
Q

transduction

A
  • sensors: danger receptors:
  • in walls and at ends of neurons
  • convey info to spinal cord
  • can be specialized:
  • mechanical
  • chemical
  • temp
24
Q

how does it work

A
  • respond to stimuli by opening, allow (+) particles in, sets off action potential
  • chemicals can open or shut: pain medication closes sensor (no transmission to spinal cord), bee sting opens receptor
  • recycled every few days, environment determines number and type of sensor
25
Q

sensors rate of production

A
  • generally stable

- can change sensitivity of neuron if change rate of sensor receptor

26
Q

nociceptor

A
  • responds to all manner stimuli

- enough activated (opened), a danger message sent to spinal cord

27
Q

nociceptor def:

A
  • free nerve endings involved in danger detection
  • in skin=cutaneous danger
  • in tendons and joints=somatic danger
  • in body organs=visceral danger
  • have high activation threshold, pain threshold vs tolerance
28
Q

nociception

A

perception of danger

29
Q

peripheral transmission

A

-afferent nerve pathway

30
Q

perpheral nerve afferent fibers

A
  • A beta fibers: 6-12 um diameter myelinated transmit impulses at >30 m/sec
  • A delta fibers-

Physical Agents (2 decks)

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