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Neuroscience, Behavior and Social Sciences > Introduction to Pain > Flashcards

Introduction to Pain Flashcards

1
Q

Definition of pain

A

Unpleasant sensory, emotional experience linked with actual/potential tissue damage or described in terms of such damage

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2
Q

Definition of placebo effect

A

Patient believes in an effective treatment and expects a reduction in symptoms

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3
Q

Definition of hidden treatment

A

Drug administered by a computer

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4
Q

Definition of active treatment

A

Drug administered visibly by a healthcare professional

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5
Q

Definition of nociceptive pain

A

Pain that arises due to physical damage

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6
Q

Definition of inflammatory pain

A

Pain experienced in an immune response

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7
Q

Definition of neuropathic pain

A

Caused by damage to somatosensory system

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8
Q

Definition of dysfunctional pain

A

Chronic pain

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9
Q

Definition of allodynia

A

Pain threshold lowered so stimuli that don’t normally cause pain do

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10
Q

Definition of hyperalgesia

A

Increased responsiveness => exaggerated/prolonged pain

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11
Q

Describe the incorrect specificity theory

A

Intensity of pain directly related to amount of associated tissue injury

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12
Q

What is pain

A

Unpleasant sensory and emotional experience associated with actual/potential tissue damage or or described in terms of such damage

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13
Q

Describe the role of nociceptors in pain sensation

A

Noxious stimuli detected by nociceptor receptors

Electrical energy only generated if threshold exceeded

Larger the change in voltage => increased frequency of AP generated

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14
Q

Describe the ascending pathway of pain

-which pathway is involved

A

Spinothalamic, spinoreticular

Peripheral nociceptors send impulse down sensory afferent

Synapse with 2nd order neurone in dorsal horn

Decussation from dorsal horn=>ventral contralateral horn. Ascends up spinothalamic/spinoreticular

Synapses with 3rd order neurone in thalamus => cerebral cortex

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15
Q

What type of pain is associated with each pain ascending pathway

A

Spinothalamic
-discriminative fast pain

Spinoreticular
-arousal and unpleasant dull pain

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16
Q

How is pain processed in the spinal cord

A

Different sensory afferents terminate in different regions of the DH

Pain in regions I and II

17
Q

Describe the incorrect pain matrix theory and processing in the brain

A

Areas in the brain responsible for processing nociceptive inputs and generating pain sensation

18
Q

What are the 3 main opioids released in the brain

What are the receptors for these opioids

A

Specific opiate receptor (u, s, k) in brain tissue

  • endorphins
  • dynorphins
  • enkaphalins
19
Q

Describe the descending pain modulatory system

A

Periaqueductal gray in midbrain produces analgesia when electrically stimulated

Fibres descend from PAG =>on seretonergic neurones in RVM medulla

RVM => inhibition/facilitation of nociceptive processing

20
Q

What are the 3 weaknesses of specificity

A

Does not account for pain without damage
Does not account for damage without pain
Psychological factors not considered

21
Q

Describe the Gate Control Theory of Pain

A

When inhibitory neurone activated by more sensory pain signal => pain signal not sent to transmission cell => brain

When inhibitory neurone inhibited by more pain => pain signal sent to transmission cell => brain

22
Q

What 2 fibres are involved in

  • pain
  • somatosensation
A

Pain

  • Ad
  • C

Somatosensation

  • Aa
  • Ab
23
Q

What 3 factors regulate the gate

A

Activity in pain fibres
Activity in other peripheral fibres
Descending pathways, psychology and attention to pain

24
Q

What are the 3 components of pain

Describe them

A

Sensory discrimination
-sense of intensity, location and duration

Affective motivational
-unpleasant and desire to escape it

Cognitive component
-involving judgements, beliefs, memories, perception of environment

25
Q

How would you treat pain

-4 methods

A

Combination of treatments

  • physical therapy
  • psychological approaches (CBT)
  • relaxation, hypnosis
  • placebo
26
Q

What is the placebo effect

A

Psychosociobiological phenomenon, patient believes in an effective treatment => expects reduction in symptoms

27
Q

What are the 2 possible mechanisms of placebo action

  • psychosocial
  • biochemical
A

Psychosocial

  • conscious cognitions of belief and improvement (verbal suggestions can be enough)
  • unconscious conditioning with drug

Biochemical
-cascade of biochemical events in the brain following administration

28
Q

Describe the open and hidden effect in treatment

What were the effects of both treatments

A

Hidden treatment

  • drug administered by computer
  • smaller reduction in pain (actual effect)

Open treatment

  • drug administered visibly by doctor
  • greater reduction in pain (actual+placebo effect)
29
Q

What are the 2 types of adaptive and maladaptive pai

A

Adaptive

  • Nociceptive
  • Inflammatory

Maladaptive

  • Neuropathic
  • Dysfunctional
30
Q

Why do we need to be sensitive to pain

What is the problem with being hypersensitive

A

Sensitivity allows us to detect potentially harmful stimuli

Hypersensitivity => pain that provides no benefit

31
Q

What are the effects of both types of pain hypersensitivity

  • allodynia
  • hyperalgesia
A

Allodynia
-threshold lowered so stimuli that normally don’t cause pain do

Hyperalgesia
-increased responsiveness => exaggerated/prolonged pain

32
Q

Describe the 2 mechanisms in pain hypersensitivity

  • peripheral sensitisation
  • central sensitisation
A

Peripheral sensitisation

  • decreased threshold, increased responsiveness of peripheral nociceptors
  • as a result of inflammatory chemicals (prostaglandins)

Central sensitisation

  • increased neurone excitability in CNS
  • triggered by an activity burst in nociceptors => alters synaptic connection strength in SC
33
Q

What are the 2 subtypes of pain

  • duration
  • conduction speed
  • treatment
A

Acute/nociceptive

  • strong noxious stimulus activates nociceptors
  • short duration
  • fast nerve conduction
  • analgesia

Chronic

  • pain that lasts past normal healing time (3-6+months)
  • slow nerve conduction
  • more behavioural than drug treatments
34
Q

Describe the effects of catastrophizing pain

A

Adding more negative emotions to pain signals

=> pain is harder to control, less likely to recover as fast

35
Q

What are the psychological trains of thought that are needed for pain relief

A

Perceiving evaluation as complete
Feeling the received explanation for treatment
Believing that treatment improved daily activity

Neuroscience, Behavior and Social Sciences (50 decks)

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