Lecture 1: intro to pain Flashcards
1
Q
true or false: pain is a perception
A
true
2
Q
true or false: pain is not an emotion
A
false: it is
3
Q
true or false: pain is a strong motivator of behavior
A
true
4
Q
does pain have effects on psychological health and well being
A
true
5
Q
true or false: pain is more psychological than other sensations ort disease states
A
true
6
Q
true or false:L the linkl between injury and pain is strong
A
falser: it is weak
7
Q
true or false: pain can be ,agnified by what we think
A
true
8
Q
true or falseL psychiological modulation has a huge effect
A
true
9
Q
true or false: soldiers are more tolerant to pain
A
technically from the study yes, but there were other factors that were not evaluated
10
Q
what is the #1 reason to visit healthcare
A
pain
11
Q
what is the #1 concern of patients with chronic disease
A
pain
12
Q
can pain kill us:
A
-does nit directly
-people with chronic pain have shorter life spans
-morbidity: suffering not dying
13
Q
pain is a more …. …. of mankind than …. itself
A
pain is a more terrible lord of mankind than death itself
14
Q
top 10 reasons to visit a doc
A
- Cough
- Back pain
- Abdominal pain
- Sore throat
- Dermatitis (itch)
- Fever
- Headache
- Leg pain
- Respiratory
10.Fatigue
15
Q
true or false: pain is ubiquitous
A
true
16
Q
prevalence of chronic pain
A
-1/20 would have chronic pain rn
-50% of us will experience chronic pain in our lifetime
17
Q
what is the epidemiologist bathtib?
A
-flow of the water is the incidence: so how much new cases of smth over a period of time and the flow says how fucked you are
-the prevalence is the tub so it is how many people have smth
-the vapor released is the recovery
-the water that gets out is the deaths
18
Q
backpain and the NHS in 1 year
A
-16 500 000 HAVE BACK PAIN
-3000 000-7 000 000 ARE CONSULTING A DOCTOR
-1 600 000 have a prescription for their backpain or they are being treated
-100 000 are at an hospital; because of that
-24 00 get surgery
19
Q
what is the prevalence of pain in kids
A
between 3%-10% but we are still unsure because different studies study different stuff
20
Q
true or false there is mor arthritis than high blood pressure
A
wrong there is more high blood pressure
21
Q
true or false: women have a higher prevalence of pain than men
A
true: more back pain, arthritis, migrane, crohns disease
men have more diabetes
22
Q
true or false: for men the longer you live the more likely you are to get pain
A
false after 70-74 it kinda decreases because probs men that were likely to get pain are dead
-it is true for women tho they do be suffering
23
Q
does the level of education that you have affect the amount of pain that you have
A
yup
-the more educated the less pain that you have
-probs due to less physical jobs for academics, a good socioeconomic status means less stress and less pain
-better insurance too means better treatments
24
Q
prevalence of pain by body part
A
-Lower bacl: 18%
-knee: 16%
-head: 15%
-leg 14%
-shoulder 9%
-neck and hip 8%
-hand 6%
-upper back: 5%
25
why is there the most pain in the lower back?
-works the most so we compensate with it a lot
-the gravity puts lots of pressure on the lower vertebrae
26
what are the 4 categories of burden of pain
-functional activity
sleep disturbance
work, household chores
leisure activities
energy
-social consequences
marital and family relations
intimacy
social isolation
-socio-economic consequences
healthcare cost
disability
lost productivity
-emotional functioning
irritable
angry
anxious
depressed
27
what is the most debilitating pain for complex activity like showering
lower back and knee pain
28
global burden of disease: true or false: cancer is the #1
false it is pain ex:
back pain
oth MSK
neck pain
headache
29
what does comorbidity means
if you have one condition, how likelyu you are of getting another
30
patients with peripheral neuropathic pain experience which symptoms in levels from the most popular to least
-difficulty sleeping
-lack of energy
-drowsiness
-concentration difficulties
-depression
-anxiety
poor appetite
31
patients with peripheral neuropathic pain experience which symptoms in levels from the most popular to least
-difficulty sleeping
-lack of energy
-drowsiness
-concentration difficulties
-depression
-anxiety
poor appetitetrue or
32
true or false: people with chronic pain are more likely to be at suicide risk
true
33
true or false: you will die faster if you have chronic pain
true
34
true or false: the cost of pain outweighs of cancer and the us defense
true
35
pain is abrahamic religions
-pain as a punishment for sin
ex: eve and the garden of eden, now it is painful to give birth
-pain as redemption like jesus on the cross
-pain as personal atonement
36
where does the word pain come from
-greel: peona which is like a punishment
-proto indo eurtopean: sadness/douleur
37
pain in philosophy
1. Aristotle (384-322 BCE): pain is an emotion,
in the heart
2. Galen (130-201): pain is a sensation,
in the brain
3. Avicenna (980-1037): pain is an independent
sensation from touch/temperature
4. Descartes (1596-1650): there exists a
“pain pathway” from the body to the brain
38
theodicy
-the vindication of divine goodness and providence in view of the existence of evil
basically is god is supposed to be good. why is there pain?
39
what is utilitarism and who proposed it
you should decide on the ethical permissiveness based on the pain and the pleasure that smth brings
-if there is more pleasure than pain that is brought then it is fine
-Jeremy Bentham
40
the principle of utility
-recognizes the fundamental role of pain and pleasure in human life'
-approves or disapproves of an action on the basis that the amount of pain or pleasure brought about (consequences)
-equated the good with the pleasurable and the evil with pain
-asserts that pleasure and pain are capable of quantification and hence of measure
41
duolism
mind and bodyu are seperate
42
monis
mind is an output of the body aka the brain
43
what was an evidence of duolism
phantom pain
44
pain and the problem of other minds
basically i might exist, you might exist and there is no way that you can prove to me that you actually exist
-same thing with pain, i know someone has pain but I could never feel it from another person and to know how bad it is
45
pain and animal rights: animal liberation and who proposed it
the funamental interest that entitle a being to equal consideration is the capacity for suffering and or enjoyment or happiness
Peter Singer
46
what is the declatatiojn of mtl?
-declaration that access to pain management is a fundamental human right
Article 1. The right of all people to have access to pain management without discrimination.
Article 2. The right of people in pain to acknowledgment of their pain and to be informed about
how it can be assessed and managed.
Article 3. The right of all people with pain to have access to appropriate assessment and
treatment of the pain by adequately trained health care professionals.
47
opiod consumption by country
-canada is number one followed by switzerland and Germany
48
what is the difference between industrialized countries and less industrialized
industrialized countries give wayyy more opiods
49
what is the name ofd the frida kalo painting
the broken column
50
what is the first definition of pain
an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage
51
why is masochism such a slay
-either people find it pleasnt in right moments
-or people get their rocks off when there is pain involved in sex
52
xamples of non-unpleasnt pain
-spicy food
-tattoos
-exercise
-scratching an itch
53
second definition of pain
an unpleasnt sensory and emotional experience associated with actual or potential tissue damage or described in terms of damage
-ex: when you press a large knife on the arm, it could hurt before the skin breaks
54
what was wrong with the second def of pain
-it does not account for neuropathic pain which is damage to the nerves, not tissue
-does not account that the longer you are in pain, the more you feel it
-it says as if pain can be a lot of touch and like that past a certain threshold it will hurt which is wrong
-it also does not account that pain != the state of someone, the pain depends on the person
55
what is pain? aka 3 things
-sensation?
like vision
is pain just a high intensity touch
stimulus/response mismatch
sensitization vs habituation
-emotioj like sadness
-drive state like
thirst
that which can't be ignored
it compels action
ex: hunger and tiredness
56
true or false: pain could trump all the other drive state
it could
57
true or false: there are good pain stimulus and bad pain stimulus
true
-some placed in the body don't care about certain stimuli ex: if the colon is burned, you won't feel it because the colon does not care about receiving burning pain there
58
what is the new def of pain
an unpleasant sensory and emotional experience associated with or resembling that associated with actual or potential tissue damage
59
true or false: all analgesia is anesthesia
false
all anesthesia is analgesia
Analgesia is the relief of pain without the loss of consciousness or sensation using analgesics (e.g., Aspirin, Carprofen, etc.). Anesthesia is the loss of physical sensation with or without loss of consciousness using anesthetics
60
pain and nociception are the same
no
nociception is basically the workings of nervous system and how it leads to the sensation of pain
61
true or false, we feel physical and emotional pain the same
false
-social rejection causes inflammation
-social suffering activates brain pain matrix
-acetaminophen reduces social pain and fear of death
62
true or false: pain can be constructed in the brain
true
63
the thermal grill illusion
-2 sets of cold and warm water in tubes qui sont repeated and it os not painful when you touch either because there is nociception when you only touch one but when you touch more than one it hurts af
64
Fordyce behavioral model of pain
nociception cause pain, pain causes suffering and suffering leads to pain behavior
65
what are the 3 lengths of pain
-acute pain (seconds to minutes)
-tonic pain (hours to weeks)
-chronic pain (weeks to years)
66
why acute pain
-to protect our bodies aka avoid tissue damage or minimize tissue damage
-teaching signal; it can show physical limitations like when you jump off of smth too high will indeed hurt
67
why tonic pain
-to rest and recover, so that we don't do a harsh movement ex: casts with broken bones
-to "punish certain movements"
68
why chronic pain?
2 things
-there is no reason wht we have chronic pain, it is a pathology
it is like a broken alarm that is always on
-it makes us hypervigilant
69
which condiation leads to insensitivity to pain
The human pincussion
-congenital insensitivity to pain with anhidrosis which is an hereditary sensory neuropathy type IV
70
true or false people who have insensitity to pain have long life spans
false they have short life spans
71
what is the most common death cause of people that have pain insensitivity
infection (sepsis) from broken bones
72
pain and the lumping and splitting problem
-maybe pain is just one type of pain which means that all results are the same
-maybe there are 3 different types of pain, so gotta do more studies and then the results can't apply
ex: cancer
73
what is usually the time point where acute pain becomes chronic pain
3 months
74
what are the 2 tyoes of pain (time points)
-acute
ex: injury, post op
-chronic
75
what are the 4 types of pain (from the pain etiologies pt 1
-nociceptive
-neuropathic (cns or peripheral)
-visceral
-mixed
76
example of mociceptive pain
-inflammatory pain like osteoarthrisis and rheumathoid arthrisis
77
examples of neuropathic pain
-cns
post stroke
MS
spinal cord injury
migraine
HIV neuropathic pain
-PNS
post herpetic neuralgia
diabetic neuropathy
78
examples of visceral pain
-internal organ
-pancreatitis
-IBS
79
examples of mixed pain
-lower back
-cancer
-fibromyalgy
80
NOCICEPTIVE PAIN: PAIN ETIOLOGIES
-no nervous system lesion or inflammation
-stimulus dependant pain
-evoked by high intensity/noxious stimuli
81
pain etiologies pt 2: types of pain
-nociceptive pain
-inflammatory pain
-dysfunctional pain
-neuropathic pain
82
inflammatory pain: pain etiologies pt
-active inflammation
-spontaneous and stimulus dependant
-sensory amplification ex: when you have an inflamed finger, it'll hurt even when we don't touch it it'll hurt
-evoked by low and high intensity stimuli
83
what was the old name of dysfunctional pain
idiopathic pain
84
dysfunctional pain pain etiologies
-no known structural nervous system lesion or active peripheral inflammation
-spontaneous and stimulus dependant pain
-sensory amplification
-evoked by low and high intensity
-present with lack of stimulus
ex: fibromyalgia and IBS
-noci plastic is the new name
85
neuropathic pain: pain etiology part 2
-nervous system lesion or disease
-marked neuroimmune response
-spontaneous and stimulus dependent
-sensory amplification
-evoked by low and high intensity stimuli
86
types of pain location like separation
-superficial pain: skin near the surface
-deep pian: muscle, joint and bone
-visceral (referred)
-neuropathic pain
-phantom pain
87
why do we say that visceral pain is referred
-most of the time when you have stomach pain, it is possible that the pain is neuropathic
-pain in the internal organs like the bladder often feels like the pain is in the skin around the bladder
88
say what is the type of pain : pain due to a lesion or a dysfunction of the nervous system; you feel the pain in the tissue that the nerve is innervating
neuropathic pain
89
what type of pain is phantom limb pain
neuro pathic
pain is located in space where the limb was aka in the brain
90
what are the symptonms of pain disorders
-spontaneous pain: continuous or paroxysmal
-evoked pain
paresthesia/dysesthesia
-numbness
-paradoxal thermal sensations
-after sensations
91
spontaneous pain
-most common type of pain
-pain comes from where the location hurts
-it is coming from the inside by itself
-you don't need to touch it, move it, it hurts on its won
92
evoked pain: pain hypersensitivity
-smth must provoke it aka touch it in order to huert
-allodynia
-hyperalgesia
-static vs dynamic
-activity evoked aka you walk on ur injury
93
what is aloodynia
-heat
-cold
-mechanical
-vibration
-non noxious->noxious
94
what is hyperalgesia
-heat
-cold
-mechanical
-vibration
-painful into like super painful
95
true or false: the physiology of static and dynamic pain is the same
nope apparently they could be different
96
what is paresthesia
funny feeling
97
what is dysesthesia
unpleasant funny feeling
98
what are paradoxal thermal sensations
-you feel cold when touch is warm
99
ex of aloodynia and hyperalgesia
people that have a sun burn
100
describe the curve for hyperalgesia and allodynia vs normal pain response
,,,,,
101
relative frequency of signs and sympotoms of chronic pain
-deep pain
-ongoing pain
-evoked pain
-activity evoked pain
-cold evoked pain
102
at is the type of evoked pain that we study the moist
touch evoked pain
103
what is the most common tyope of dysesthesia
tingling
104
difference between sign and symptom
-symptom is what the patient complains of
-sign is what a clinician can observe
105
true or false: anxiety and chronic pain go hand in and
true
106
What did pain cause to the squids
-made them more cautious
-to remind u that you are injured and they were more cautious
-they were careful to not do anything dangerous so they were hypervigilant
107
functional activity consequences
-functional activity
sleep disturbance
work, household chores
leisure activities
energy
108
social consequences
-social consequences
marital and family relations
intimacy
social isolation
109
socio economic consequences
socio-economic consequences
healthcare cost
disability
lost productivity
110
emotional functioning consequences
-emotional functioning
irritable
angry
anxious
depressed
111
Aristotle
1. Aristotle (384-322 BCE): pain is an emotion,
in the heart
112
Galen
2. Galen (130-201): pain is a sensation,
in the brain
113
Avicenna
3. Avicenna (980-1037): pain is an independent
sensation from touch/temperature
114
Descartes
4. Descartes (1596-1650): there exists a
“pain pathway” from the body to the brain
