Head and Face Pain Introduction Flashcards
What are the factors affecting the perception of pain?
- Arousal - the reticular activating system
- Attention/Distraction - Frontal and Pariental Lobes of the R Hemisphere and the B.G./Midbrain
- Prior Experience - Temporal Lobe/Limbic
- Culture - Poor baby vs. suck it up
What are the two broad level classifications of pain?
- Physiological or Peripheral
2. Pathological or Central
What is the physiological or peripheral classification of pain?
Pain as a result of activation of peripheral nociceptors
What is the pathological or central classification of pain?
Pain as a result of functional changes within the CNS (Spinal Cord and Brain)
Define Allodynia
Non-noxious stimuli that induces pain
Define Hyperalgesia
Noxious stimuli that accentuates pain
Define Coping
Cognitive/limbic ability to deal with suffering
Define Catastrophizing
Downward spiral of suffering
What causes Nociception?
- Tissue Damage
- Infection
- Metabolic
- Nerve Compression
- CNS Plasticity
- Other
What types of tissue damage can cause nociception?
Trauma, inflammation, hypoxia, ischemia
What can pain cause?
- Sympathetic Activation
- Limbic Responses
- Motor Responses
- Cognitive Changes
What are the effects of pain induced sympathetic activation?
Increased IML activity
What are the effects of pain induced limbic responses?
Emotions, activation of the cingulate gyrus, amygdala, and/or autonomics
What are the effects of pain induced motor responses?
Antalgia, posturing, and balance changes
What are the effects of pain induced cognitive changes?
Focus, concentration, executive function, and others
Define Analgesia
Absence of pain in response to stimulation which would normally be painful
Define Dysesthesia
An unpleasant abnormal sensation, whether spontaneous or evoked
Define Paresthesia
An abnormal sensation, whenever spontaneous or evoked
Define Hyperesthesia
Increased sensitivity to stimulation, excluding the special senses
Define Hyperpathia
A painful syndrome characterized by an abnormally painful reaction to a stimulus, especially a repetitive stimulus, as well as an increased threshold
Define Hypoalgesia
Diminished pain in response to a normal painful stimulus
Define Hypesthesia
Decreased sensitivity to stimulation, excluding the special senses
What is the Melzack-Wall Pain Gate Theory with no input?
Closed
No input - inhibitory neuron prevents the projection neuron from sending signals to the brain.
What is the Melzack-Wall Pain Gate Theory with Normal Somatosensory input?
(Closed)
More LDA stimulation - both the inhibitory neuron and projection neuron are stimulated, but the inhibitory neuron prevents the projection neuron from sending signals to the brain
What is the Melzack-Wall Pain Gate Theory with Nociception?
Open
More SDA or only SDA stim, inactivates the inhibitory neuron, and the projection neuron sends signals to the brain informing it of pain.
What are the 3 factors of gate theory?
- SDA - opens the gate
- LDA - closes the gate
- Messages from the brain - modulation
How can messages from the brain modulate the pain gate?
Concentrating on the pain VS trying not to think about it
What physical conditions open the pain gate?
Extent of Injury
Inappropriate activity level
What emotional conditions open the pain gate?
Anxiety or Worry
Tension
Depression
What mental conditions open the pain gate?
Focusing on pain
Boredom
What physical conditions close the pain gate?
Medications Counter stimulation (massage)
What emotional conditions close the pain gate?
Positive emotions
Relaxation
Rest
What mental conditions close the pain gate?
Intense concentration or distraction
Involvement & interest in life activities
