Exam 1 Study Guide Flashcards
What causes peripheral sensitization?
- result of injury
- peripheral nerves (esp nociceptors) can become sensitized
- have a lower threshold for pain
With peripheral sensitization, where is the area of sensitization?
Site of initial injury
How does central sensitization occur?
- Low threshold mechanoreceptors plastically adapt
- create new neural pathways directly to pain centers of the brain
Because of central sensitization, what happens from innocuous stimuli?
- triggers a pain response by the CNS
- otherwise wouldn’t be considered painful to the average person
What are the clinical syndromes where central sensitization is a contributor?
- RA
- OA
- TMD
- FM
- HA
Central sensitization: RA
Miscellaneous MSK pain
Central sensitization: OA
Neuropathic
Central sensitization: TMD
CRPS
Central sensitization: FM
Post-surgical pain
Central sensitization: HA
- visceral pain
- hypersensitivity
What results in the best outcomes with chronic pain pts?
- Pt education about the neurophysiology of pain
- Better than anatomical explanation
Main types of pain
- nociceptive
- inflammatory
- neuropathic
What are the 5 critical factors for quality pain mgmt?
- Prompt recognition and tx of pain
- Include pt and caregiver in pain mgmt planning
- Provide multimodal therapy
- Frequently adjust tx as needed (reassess!)
- Monitor outcomes using national performance instruments
WHO analgesic ladder for mgmt of chronic pain (steps)
- Non-opioids for mild pain (NSAID)
- Weak opioids for mod pain
- Strong opioids for mod to severe pain
Common side effects of opioids
- constipation
- nausea, vomiting
- delirium
- respiratory depression
- sedation
- allergy
- hyperalgesia/allodynia
- myoclonus
- pruritis
