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control > L29 - knowing pain > Flashcards

L29 - knowing pain Flashcards

1
Q

location of insular cortex

A

below the lateral sulcus

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2
Q

pain - primary somatosensory cortex

A

tells us amplitude and location of pain

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3
Q

pain - amygdala

A

emotionally affected area (fearfulness / anxiety)

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4
Q

pain - hippocampus

A

memory of pain

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5
Q

pain - anterior cingulate cortex

A

tension pain

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6
Q

pain - brainstem

A

autonomic functions of body (heart rate, bp)

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7
Q

pain - pre-frontal cortex

A

modulates pain

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8
Q

pain definition

A

“An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.”

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9
Q

autonomic descriptions of pain

A

heart rate increasing
can’t sleep
blood pressure increasing

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10
Q

visceral descriptions of pain

A

sickening, nauseating

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11
Q

how does pain travel

A

spinothalamic tract

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12
Q

what happens to pain when emotions are tightened

A

increases

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13
Q

how can you become less sensitive to pain

A
  • gate control theory of pain

- descending inhibitory fibres

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14
Q

pain fibres

A

C fibres

small, slower fibres

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15
Q

mechanoreceptor fibres

A

A-delta fibres
slightly longer
sharp, quick pain associated with reflexes

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16
Q

gate control theory of pain

A
  • inhibitory neurones present at dorsal horn
  • when touch fibres are activated, later A-beta fibres, interneurones are activated
  • release of opioids in the synapse
  • depolarisation
  • reducing C-fibre input
  • hence, touch, reduces pain
17
Q

TENS machine

A

electrical devices often used in labour - stimulates mechanoreceptors and touch fibres, reducing pain

18
Q

descending inhibitory fibres

A
  • the midbrain consists of periaqueductal grey matter
  • rich in opioid receptors
  • enhances descending inhibitory pathways and reduces pain
19
Q

key neurotransmitters in descending pathway

A

noradrenaline (fight of flight)

serotonin (mood determiner)

20
Q

what are serotonin re-uptake inhibitors used for

A

depression and pain

21
Q

nociceptive pain

A

pain due to tissue damage and inflammation

22
Q

neuropathic pain

A

spontaneous pain initiated or caused by a primary lesion or dysfunction in the CNS or PNS

23
Q

examples of neuropathic pain

A

trigeminal neuralgia (jaw claudication), phantom pain, diabetic neuropathy

24
Q

features of neuropathic pain

A
  • accompanied by positive or negative phenomena
  • often constant - not reduced by rest
  • associated with severe comorbidity and poor QOL
25
Q

treatment for nociceptive pain

A
  • rest
  • exercise
  • allow repair
  • usually responds to pain killers
  • normal WHO ladder - paracetamol, NSAIS, weak opioids
26
Q

example of nociceptive pain

A

arthritis

27
Q

treatment for neuropathic pain

A
  • neuropathic pain killers
  • gabapentin, pregabalin, amitriptyline
  • spinal cord stimulation
  • often doesn’t respond to pain killers
28
Q

acute pain

A
  • usually nociceptive

- associated with trauma or injury

29
Q

chronic pain

A

pain that persists past abnormal duration of tissue healing

30
Q

hyperalgesia

A

worsening of pain with opioids

31
Q

measuring pain

A

nociceptive input (pain pathway) + biopsychosocial phenomena

32
Q

nociceptive mete

A

VAS numeric pain distress scale

33
Q

reasons why pain killers may not worl

A
  • biopsychosocial aspects
  • tolerance
  • misdiagnosis
  • incorrect dose
34
Q

ACT

A

acceptance and commitment therapy

  • trying to develop a rich, full and meaningful life
  • learning skills to deal with difficult thoughts and feelings
35
Q

spinal cord stimulation

A

Delivery of energy to the spinal cord through electrodes in the epidural space

  • SCS works by delivering small electrical pulses to the pain sensing pathways of the spinal cord, effectively altering the pain signals traveling to the brain.
  • SCS is typically prescribed for the treatment of pain of the back, trunk, or limbs

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