Introduction to Pain Flashcards
an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage
pain
What is pain?
a warning of actual or potential tissue damage
T/F Pain is a combination of factors
T - mechanical, neurological, psychlogical, and sociological
T/F pain is a reliable indicator of location and severity of tissue damage
T AND F
it may be, but not always. In instances where it is not must address tissue damage and help patient understand their pain
increased responsiveness and reduced threshold of nociceptive neurons in the periphery to stimulation of receptor fields
Peripheral sensitization
Increased responsiveness of nociceptive neurons in CNS to normal or subthreshold afferent input
central sensitization
Both peripheral sensitization and central sensitization are indicative of…
pain that is out of proportion
Pain is a _________, activated by an individual’s specific pain ____________
multiple system output
neural signature
The neural signature is activated whenever the brain ___________
perceives a threat
What pain scale quantifies pain but doesn’t do a good job of showing us location or limited function?
visual analog and numeric scales
What are some methods of assessing pain?
body diagrams,
daily activity/pain logs
open-ended interviews
physical examination and testing
respond to intense mechanical stimulation and heat or cold
a-delta afferent neurons
short duration, sharp, stabbing or pricking sensation
a-delta
small and myelinated
a-delta
consists of 20% of pain afferents
a-delta
these neurons are NOT blocked by opioids
a-delta
longer duration, dull, throbbing, aching, burning, tingling, diffusely localized, accompanied by sweating, increased heart rate and blood pressure, and nausea
c-afferent
small unmyelinated
c-afferent
consists of 80% of pain afferents
c-afferent
CAN be blocked by opioid medication
c-afferent
Neuron responsible for proprioception
a-alpha
non-painful sensation related to vibration, stretching, and mechanical pressure
a-beta
Larger and myelinated neruons
a-alpha and a-beta
Where is the pain located if it is sharp/pricking/vibrating and easily located?
superficial at the skin
Where is the pain located if it is dull/achy/heavy and more difficult to localize?
musculoskeletal
Where is the pain located if it is aching in quality and frequently referred superficially?
visceral
elicited by activation of nociceptive tissues in the body in the absence of tissue damage
transient pain
goes away without treatment. Ex. touching something hot and moving away quickly
If actual tissue damage occurs, relatively short duration pain with defined etiology. May be localized and have a reflex mechanism initiated for protection from damage
acute
longer duration, often persisting longer than typical for a condition
chronic/persistent
often inadequate response to appropriate care and associated with more emotional reactions
what type of pain has a clear stimulus-response relationship with the initial injury?
Nociceptive
What type of pain has a burning or lancinating quality?
neuropathic
what kind of pain is usually accompanied by signs or symptoms of neurological dysfunction, such as paresthesias, itching, anesthesia, weakness?
neuropathic
radicular vs referred pain
T/F Only nociceptive pain can be both acute or chronic
F Both nociceptive and neuropathic pain can be acute and become chronic
Pain that travels along the path of a nerve is called
radicular pain
pain that occurs away from the origin/source of pain is called
referred pain
may be acute or chronic
specific pain receptors transmit signals to a pain center in the brain and that’s how they perceive pain
specificty theory
people feel pain when a specific pattern of neural activity occurs regardless of what neurons are activated
pattern theory
_______ control pain by binding to specific opioid receptors
opiopeptins - endorphins, enkephalins, dynorphins
The ___________ releases opiopeptins in times of emotional stress and results in a raised pain threshold.
may be an explanation for how acupuncture can cause pain relief of pre-existing pain.
endogenous opioid system
T/F For persistent pain it may be necessary to use an integrated multidisciplinary form of treatment
T
psychological and physiological therapies, physical agents, and exercise.
