def. of terms describing pain Flashcards
acupuncture
the practice of inserting needles at certain points in the skin to achieve specific effects such as pain relief
adjunctive
additional therapy used together w. the 1* Tx
adjuvant
a drug that is administered for a purpose other than analgesia, but that has independent or additive pain-relieving effects; Tx that is given in addition to the 1*, main, or initial Tx
agonist
a drug that exerts its effect by binding to and activating specific receptors
algogenic
pain inducing
allodynia
pain caused by a stimulus that does not normally cause pain
analgesia
loss of sensitivity to a stimulus that would normally produce pain (noxious stimulus)
analgesic ceiling effect
the drug dosage beyond which no beneficial analgesic effect is observed
an analgesic ceiling effect is observed w both butorphanol AND buprenorphine
anesthesia
total or partial loss of sensation
antagonist
a drug that exerts its effects by competitively binding to receptors and Px the effects of agonists
central sensitization
sensitization of Nn in the spinal cord and brain d/t amplification and facilitation of synaptic transfer from the peripheral nociceptor to dorsal horn neurons in the spinal cord
is triggered in central neurons by intense nociceptor input into the spinal cord (activity dependent) and is sustained beyond the initiating stimulus by changes in the molecular machinery of the cell (transcription dependent)
activation of N-methyl-D-aspartic acid (NDMA) receptors play a key role in the development of central sensitization
distress
condition in which stress negatively affects biologic functions critical to the animal’s well-being
also: to cause pain of suffering, to make miserable
dysesthesia
abnormal sense of touch
epidural space
the space above the dura mater
injection into this are is commonly referred to as an epidural
hyperalgesia
an increased response to a stimulation that is normally painful (heightened sense of pain) at the site of injury or in surrounding undamaged tissue
stimulated nociceptors respond to noxious stimuli more vigorously and at a lower threshold
1* and 2* hyperalgesia…
primary hyperalgesia
increased sensitivity to a stimulus that is normally painful at the site localized to the area of tissue damage or inflammation
secondary hyperalgesia
increased sensitivity to a stimulus that is normally painful in uninjured or inflamed tissues in areas around and beyond the 1* site of tissue injury
caused by central sensitization
hyperesthesia
increased sensitivity to touch
hyperpathia
a painful syndrome characterized by an increased reaction to a stimulus, especially if it is repetitive
hypoalgesia
decreased sensitivity to a noxious stimulus
hypoesthesia
decreased sensitivity to touch
interventional pain management
an invasive procedure to Tx or manage pain through an injection of a drug or implantation of a drug delivery device
local anesthesia
the temporary loss of sensation in a defined part of the body w/o loss of consciousness
multi-modal analgesia
the use of multiple drugs w different mechanisms of action, which may act at different levels of the nociceptive pathways, to produce enhanced (additive, superadditive) analgesic effects
myofascial pain
a syndrome of focal pain in a muscle or related tissues, stiffness, muscle spasm, a decreased range of motion
nociception
the neural processes for encoding pain: transduction, conduction, and central nervous system processing of nerve signals generated by the stimulation of nociceptors
the physiologic process that leads to the perception of pain
noxious stimulus
a stimulus (chemical, thermal, mechanical, electrical) that produces pain and damages or threatens to damage normal tissues
opioid
a drug that is related naturally or synthetically to morphine
pain
an unpleasant sensory or emotional experience associated with actual or potential tissue damage or described in terms of such damage
the inability to communicate verbally does not negate the need for appropriate pain-relieving Tx
acute pain
pain that follows some bodily injury, disappears with healing, and tends to be self-limiting
adaptive pain
pain that contributes to survival by limiting or preventing contact w or movement of the injured part until healing is complete, thereby minimizing further damage
inflammatory pain is typically adaptive and decreases as the damage and inflammatory response resolve
breakthrough pain
a transient flare-up of pain in the chronic pain setting that can occur even when chronic pain is under control
cancer pain
pain that can be acute, chronic, or intermittent; is related to the disease itself or to the Tx
central pain
pain initiated or caused by dysfunction or a lesion in the CNS
chronic pain
pain that lasts several weeks to months and persists beyond the expected healing time when nonmalignant in origin
clinical pain
pain of inflammatory or neuropathic origin that is characterized by increased sensitivity to noxious (hyperalgesia) and non-noxious stimuli and a spread of hypersensitivity to uninjured tissue (2* hyperalgesia)
differs from physiologic pain by the presence of pathologic hypersensitivity
deep pain
pain that is present in “deep” anatomic structures (bone, muscle, tendon, ligament)
dysfunctional pain
amplification of nociceptive signaling in the absence of inflammation or neural lesions
first pain
the initial well-localized and generally brief pain produced by a noxious stimulus: produced by high-threshold nociceptors
inflammatory pain
pain as a result of tissue damage and the release or activation of local inflammatory mediators (PGs, hydrogen ion, histamine)
inflammatory pain typically decreases as the damage and inflammatory response resolve
intractable pain
intense, constant, usually chronic pain that does not respond to any therapeutic medical intervention
maladaptive pain
pain that is uncoupled from a noxious stimulus or healing tissue and generally occurs in response to damage to the nervous system (neuropathic pain)
OR results from abnormal operation of the nervous system (dysfunctional pain)
is the expression of abnormal sensory processing and usually is persistent or recurrent; it is pain as disease
neuropathic pain
pain that originates from injury or involvement of the peripheral or central nervous system and is described as burning or shooting, possibly associated with motor, sensory, or autonomic deficits
nociceptive pain
the sensation associated with the detection of potentially tissue damaging noxious stimuli; this type of pain is protective
pathologic pain
a disease state that is caused by damage to the nervous system (neuropathic) or by its abnormal function (dysfunctional) and persists long after the healing process has occurred
perioperative pain
pain that is present or occurs during the period extending from the time of hospitalization for Sx to the time of discharge
second pain
delayed, diffuse and protracted, generally burning pain, that persists after the termination of the noxious stimulus
severe, acute painful events (trauma) and chronic and visceral pain are almost always characterized as second pain
superficial pain
pain that originates in “superficial” tissues (skin, subcutis)
visceral pain
pain that originates from the body cavities (abdominal, thoracic) and the brain
pain scales
visual, categoric, and numeric methods (instruments) used (by proxy) for diagnostic and therapeutic purposes to estimate the intensity of pain
pain threshold
the least amount of pain that an animal can recognize
pain tolerance level
the greatest level of pain that an individual can tolerate
paresthesia
a spontaneous or evoked abnormal sensation generally occurring in animals with neuropathic pain
pathologic pain
pain that has an exaggerated response much beyond its protective usefulness
is often associated with tissue injury incurred at the time of Sx or trauma
peripheral sensitization
injury and inflammation of tissue result in alterations of the chemical environment of the peripheral nerve terminal of nociceptors
injured or inflamed tissues release intracellular contents such as ATPs, K+, and H+, cytokines, chemokines, GFs, PGs
these factors act directly to activate (nociceptor activators) or to sensitize (nociceptor sensitizers) the terminal so that it becomes hypersensitive to subsequent stimuli
physiologic pain
pain that acts as a protective mechanism and that is initiated by high threshold receptors
well localized and transient
incites individuals to move away from the cause of potential tissue damage or to avoid movement or contact with external stimuli during a reparative phase
preemptive analgesia
a pharmacologic intervention performed before a noxious event (Sx) that is intended to minimize the impact of the stimulus by Px peripheral and/or central sensitization
preventative analgesia
analgesic Tx that is initiated before a procedure to reduce the consequences of nociceptive transmission initiated by the procedure
goal: to minimize sensitization induced by noxious perioperative stimuli including those arising before, during, and after the procedure
an analgesic therapy that is designed for the purpose of decreasing analgesic consumption relative to a placebo Tx or compared w no Tx and to produce an analgesic effect that extends for a period of time that outlasts the pharmacologic effect (more than 5.5 half-lives) for the drug in question
radiculopathy
irritation of or injury (compression, inflammation, tissue damage) to a nerve root
regional anesthesia
the loss of sensation in part of the body caused by interruption of the sensory Nn conducting impulses from that region of the body
sedation
CNS depression, mediated via the cerebral cortex, in which the individual is drowsy but arousable
somatic pain
pain that originates from damage to bones, joints, muscle, or skin and is described in human beings as localized, constant, sharp, aching, and throbbing
stress response
neuroendocrine-immune and behavioral response to actual or potential tissue damage
“fight or flight response”
subarachnoid space
the space above the pia mater and below the arachnoid mater, in which cerebrospinal fluid can be found
a subarachnoid injection is also referred to as a “spinal”
suffering
a state of emotional distress associated with events that threaten the biologic and/or psychosocial integrity of the individual
often accompanies severe pain but can occur in its absence; hence pain and suffering are phenomenologically distinct
sympathetic mediated pain
a syndrome in which there is abnormal sympathetic nervous system activity causing a severe debilitation that is often associated with tenderness to a light touch
trigger zone or point
hypersensitive area on the body surface where touch or pressure elicits a painful response
tolerance
a shortened duration and decreased intensity of the analgesic, euphoric, sedative and other CNS depressant effects, as well as considerable increase in the average dose required to achieve a given effect
tranquilization
a state of calmness, mediated through the reticular activating system, in which the individual is relaxed, awake, unaware or its surroundings, and potentially indifferent to minor pain
visceral pain
pain that arises from stretching, distension, or inflammation or the viscera
is described as deep, cramping, aching, or gnawing, without good localizaiton
wind-up
sensitization of nociceptors and peripheral and central pain pathways in response to a barrage of afferent nociceptive impulses resulting in expanded receptive fields and an increased rate of discharge
