Module 3 Flashcards
Define pain
Unpleasant sensory and emotional experience associated with actual or potential tissue damage
Pain vs nociception
Pain is subjective experience while nociception is the neural processes.
Long version:
- Pain is conscious experience resulting from brain activity in response to noxious stimuli and engages sensory, emotional, cognitive processes of brain
- Nociception is process by which info about noxious stimulus is conveyed to the brain: the total sum of neural activity that occurs prior to cognitive processes that enable humans to identify a sensation as pain
Is pain sensation implied with nociception?
No
A high-threshold sensory receptor of peripheral somatosensory nervous system that is capable of transduction and encoding noxious stimuli
Nociceptor
A stimulus that is damaging or threatens damage to normal tissues
Noxious stimulus
-algia
Localized pain without knowing cause: e.g. lumbalgia
Increase or decrease in pain: hyperalgesia or hypoalgesia
Antalgic/analgesic
Pertaining to reduction of perceived pain
Parenthesis
Abnormal sensation
Hypoesthesia
Decrease in sensitivity to stimulation, excluding special senses
Hypoalgesia
Decrease in pain in response to noxious stimulus
Anesthesia
Absence of all sensation
Analgesia
Absence of pain in response to stimulation which would be painful
Hyperesthesia
Increased sensitivity to stimulation, excluding special senses
Hyperalgesia
Increased pain from stimulus that provokes pain
Allodynia
Pain due to stimulus that does not provoke pain
Perception of pain is paradoxical in 3 respects
- Adaptiveness
- Lack of clear cortical representation
- Presence of descending pain control mechanisms
17th century philosopher that said mind and body were separate entities in a “mind-body” theory
Rene Descartes
Body is a machine governed by the mind/soul
Biomedical model
Assumption: each disease process results from unique underlying pathoanatomical/pathophysiological lesion
Biopsychosocial (BPS) model
Current understanding:
3 main components of painful experience
- biological
- psychological
- social
CIP
Congenital insensitivity to pain
Biological factors of the BPS model include:
A&P Neuroanatomy/neurophysiology Inflammatory processes Genetics Family history Age Sex Race Pre-existing medical conditions
Psychological component of BPS system include
Attitudes Beliefs Behaviors and coping strategies Perceptions Cognition/thought patterns Emotional state (depression, stress)
Social component of BPS model include
Previously learned info regarding health, disease and pain
Cultural background
Social/community support and interactions
Family influence and support
Financial influences
Workplace environment
What is the tissue state of nociceptive transient pain vs acute vs chronic pain?
Noci - normal
Acute - inflamed
Chronic - injury to nervous system
What is the physiologic change of nociceptive transient pain vs acute vs chronic pain?
Noci - normal
Acute - increased excitation or decreased inhibition of nociceptors
Chronic - cellular structural changes
What is the PNS plasticity change of nociceptive transient pain vs acute vs chronic pain?
Noci - no change
Acute - peripheral sensitization
Chronic - modification of pain afferents
What is the CNS plasticity change of nociceptive transient pain vs acute vs chronic pain?
Noci - no change
Acute - central sensitization
Chronic - retired networks/assemblies, circuits
What are the features of nociceptive transient pain vs acute vs chronic pain?
Noci - well localized pain. 1st pain perception (Aδ fibers) and 2nd pain (C fibers)
Acute - temporary increased pain sensitivity, hyperalgesia, allodynia
Chronic - prolonged increased pain sensitivity, hyperalgesia, allodynia
Aδ fibers and C fibers are associated with what?
Transient nociceptive 1st pain (Aδ fibers) and 2nd pain (C fibers)
What serves as early warning sign that alerts the brain to the presence of potentially tissue-damaging events?
Transient nociceptive pain
Nociceptive pain is divided into (3) types
Somatic
Visceral
Inflammatory - associated with process of tissue repair following tissue damage
Neuropathic pain is divided into (2) categories of pain
Neurogenic
Functional
Treatment of neuropathic pain depends on whether origin of pain is _____ or ______
Peripheral (e.g. diabetic neuropathy) or central (e.g. spinal cord injury)
Define functional neuropathic pain
Dysfunction of CNS that can enhance perception of pain through excitation of neural systems or through inhibition of endogenous pain modulation systems
E.g. fibromyalgia and post-stroke central pain syndrome
2 principles of pain measurement
- Pt is only authority to evaluate their pain
2. Pain should be evaluated in terms of impact on person as a whole
What are quantifiable components of pain? (5)
Pain intensity Physical capacity Spatial attributes Pain quality Psychological component
