deck_2464937 Flashcards
Old French name of pain?
peine
Latin name of pain?
poena, “punishment, penalty”
Greek name of pain?
Greek “ποινη” (poine), generally “price paid,” “penalty, ” “punishment.”
Unpleasant sensory and emotional experience associated with actual or potential tissue damage
PAIN
It is both a sensation and an emotion as it is accompanied by anxiety and the urge to escape or terminate the feeling.
PAIN
The ability to experience pain is essential for ??
protection from injury.
Insensitivity to pain is associated ?
with risk of tissue damage due to undiscovered injury.
The International Association for the Study of Pain advocates that
Relief from pain should be recognized as a human rightChronic pain should be considered a disease in its own rightPain medicine should have the full status of a specialty
fivers that transmit pain impulses?
A-delta (Aδ)and C fibers
fibers transmit light touch ?
A-beta (Aβ)
A peripheral nerve consists of the axons of three different types of neurons:
primary sensory afferents, motor neurons, and sympa- thetic postganglionic neurons
The cell bodies of pri- mary sensory afferents are located in the?
dorsal root ganglia in the vertebral foramina
primary afferent axon has two branches:
one projects centrally into the spinal cord and the other projects peripherally to innervate tissues
The largest-diameter afferent fibbers?
A-beta (Aβ),
respond maximally to light touch and/or moving stimuli; they are present primarily in nerves that innervate the skin
A-beta (Aβ),
In normal individuals, the activity of these fibers does not produce pain
A-beta (Aβ),
he small-diameter myelinated
A-delta (Aδ)
unmyelinated axons
(C fiber)
primary afferent nociceptors (pain receptors
(C fiber) , A-delta (Aδ)
is a non-associative learning process in which repeated administrations of a stimulus results in the progressive amplification of a response
Sensitization
Inflammatory mediators?
bradyki- nin, nerve-growth factor, some prostaglandins, and leukotrienes
Sensitization occurs at the level of the peripheral nerve terminal
(peripheral sen- sitization)
Sensitization at the level of the dorsal horn of the spinal cord
(central sensitization).
Peripheral sensitization occurs in?
damaged or inflamed tissues
generated by nociceptors during inflammation, enhances the excitability of nerve cells in the dorsal horn of the spinal cord
(central sensitization).
increased pain intensity in response to the same noxious stimulus; e.g. moderate pressure causes severe pain?
hyperalgesia
are normally relatively insensitive to nox- ious mechanical and thermal stimuli?
Viscera
Aδ and C fiber afferents innervating vis- cera are completely insensitive in normal , However, in the presence of inflammatory mediators, these afferents become sensitive to mechanical stimuli
silent nociceptors
It is a potent vasodilator, degranulates mast cells, is a chemoattractant for leukocytes, and increases the production and release of inflammatory mediators
substance P, an 11-amino-acid peptide
spinal neurons are most often activated by inputs from the?
skin
spatial displacement of pain sensation from the site of the injury that produces it is known as?
referred pain.
Five categories: Classification of Pain
Duration and severityAnatomical locationBody system involvedCauseTemporal characteristics
pain that is of recent onset and resolves quickly
Acute
pain that lasts a long time; pain that extends beyond the expected period do healing
Chronic
pathways for pain?
ALST
The suggestion that pain will worsen following administration of an inert substance can increase its perceived intensity
the nocebo effect).
because of opiod receptor in the pathway, some may experience diminish pain by?
Pain Modulation
ACUTE OR CHRONIC?Needle prick, venipuncture (seconds)
ACUTE PAIN
ACUTE OR CHRONICFinger trapped on a car door when it is closed (seconds to minutes)
ACUTE PAIN
ACUTE OR CHRONIC?Migraine (minutes to hours)
ACUTE PAIN
ACUTE OR CHRONIC?Angina pectoris (seconds to minutes)
ACUTE PAIN
ACUTE OR CHRONIC? Labor pains (hours)
ACUTE PAIN
ACUTE OR CHRONIC?Dysmenorrhea (days)
ACUTE PAIN
ACUTE OR CHRONIC?Postoperative pain (days)
ACUTE PAIN
ACUTE OR CHRONIC?Osteoarthritis
CHRONIC PAIN
ACUTE OR CHRONIC?Headache from a brain tumor
CHRONIC PAIN
ACUTE OR CHRONIC?Frozen shoulder / adhesive capsulitis
CHRONIC PAIN
ACUTE OR CHRONIC?Diabetic neuropathy
CHRONIC PAIN
ACUTE OR CHRONIC?Cancer pain
CHRONIC PAIN
ACUTE OR CHRONIC?Postherpetic neuralgia
CHRONIC PAIN
TRUE OR FALSE?Subjective perception of pain is the same from person to person, and within the same person depending on the context
FALSE Subjective perception of pain is different from person to person, and within the same person depending on the context
TRUE OR FALSE?A person’s self-report is the most reliable measure of pain, with health professionals tending to underestimate severity.
TRUEA person’s self-report is the most reliable measure of pain, with health professionals tending to underestimate severity.
Ruptured cerebral aneurysm leading to subarachnoid hemorrhage what kind of headache?
“thunderclap” headache“Worst headache of your life”
In nonverbal patients : what do you Observe for specific behaviours about pain?
GrimacingGuardingCrying – babies feel pain but lack the language to report it
pain arising from a perturbation of the body
Somatogenic
– pain arising from a perturbation of the mind
Psychogenic
Diagnosis usually made when all physical / organic causes have been ruled out
Psychogenic
due to stimulation of peripheral nerve fibers that respond only to stimuli approaching or exceeding harmful intensity (TYPE OF SOMATOGENIC PAIN?)
Nociceptive
caused by damage or disease affecting the nervous system(TYPE OF SOMATOGENIC PAIN?)
Neuropathic
Examples of Thermal Nociceptive Pain
FrostbiteFirst degree and second degree burnsSipping a hot cup of Starbucks coffeeHolding a piece of dry iceA baby placed in a container with boiling water
Examples of Mechanical Nociceptive Pain
FractureA bump on the headA liver abscess distending the Glisson’s capsuleAn open woundDog bite
Examples of Chemical Nociceptive Pain
Alcohol on an open woundAcid thrown on the faceMuriatic acid ingestion
involves the skin (superficial), joints, muscles, tendon and ligaments (deep)usually sharp, well-defined and easy to localize
Somatic pain
usually dull, vague and difficult to localizeInvolves the internal organs
Visceral pain
nociception from a visceral organ is sensed to be coming from an area distant from the site of the stimulus
Referred pain
pain perceived to be from a part of the body that has been lost or from which the brain no longer receives signals
Phantom Pain
A type of neuropathic pain
Phantom Pain
A common experience of amputees
Phantom Pain
Local anaesthetic injection into the nerves of the stump may relieve the pain
Phantom Pain
Excitement of sport causes?
Episodic Analgesia
During war causes what to pain?
Episodic Analgesia
typically has an unusual burning, tingling, or electric shock–like quality and may be triggered by very light touch
Neuropathic pain
a greatly exaggerated pain sensation to innocuous or mild nociceptive stimuli
Hyperpathia
Hyperpathia also characteristic of what kind of pain?
neuropathic pain
very lightest moving stimulus evokes exquisite pain
allodynia
Damaged primary afferent nociceptors acquire adrenergic sensitivity and can be activated by stimulation of the sympathetic outflow. This constellation of spontaneous pain and signs of sympathetic dysfunction following injury has been termed
complex regional pain syndrome (CRPS)
(CRPS)
complex regional pain syndrome (
(CRPS). When this occurs after an identifiable nerve injury, it is termed
CRPS type II
CRPS type II (also known as
posttraumatic neuralgia or, if severe, causalgia).
what kind of (CRPS) with clinical picture appears without obvious nerve injury, it is termed ?
CRPS type I
CRPS type I (also known as
reflex sympathetic dystrophy
the most com- mon emotional disturbance in patients with chronic pain,
depression
useful screening device for depression?
Beck Depression Inventory
