Module 3

Question 1

Define pain

Answer 1

Unpleasant sensory and emotional experience associated with actual or potential tissue damage

Question 2

Pain vs nociception

Answer 2

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

Question 3

Is pain sensation implied with nociception?

Answer 3

No

Question 4

A high-threshold sensory receptor of peripheral somatosensory nervous system that is capable of transduction and encoding noxious stimuli

Answer 4

Nociceptor

Question 5

A stimulus that is damaging or threatens damage to normal tissues

Answer 5

Noxious stimulus

Question 6

-algia

Answer 6

Localized pain without knowing cause: e.g. lumbalgia

Increase or decrease in pain: hyperalgesia or hypoalgesia

Question 7

Antalgic/analgesic

Answer 7

Pertaining to reduction of perceived pain

Question 8

Parenthesis

Answer 8

Abnormal sensation

Question 9

Hypoesthesia

Answer 9

Decrease in sensitivity to stimulation, excluding special senses

Question 10

Hypoalgesia

Answer 10

Decrease in pain in response to noxious stimulus

Question 11

Anesthesia

Answer 11

Absence of all sensation

Question 12

Analgesia

Answer 12

Absence of pain in response to stimulation which would be painful

Question 13

Hyperesthesia

Answer 13

Increased sensitivity to stimulation, excluding special senses

Question 14

Hyperalgesia

Answer 14

Increased pain from stimulus that provokes pain

Question 15

Allodynia

Answer 15

Pain due to stimulus that does not provoke pain

Question 16

Perception of pain is paradoxical in 3 respects

Answer 16

• Adaptiveness
• Lack of clear cortical representation
• Presence of descending pain control mechanisms

Question 17

17th century philosopher that said mind and body were separate entities in a “mind-body” theory

Answer 17

Rene Descartes

Body is a machine governed by the mind/soul

Question 18

Biomedical model

Answer 18

Assumption: each disease process results from unique underlying pathoanatomical/pathophysiological lesion

Question 19

Biopsychosocial (BPS) model

Answer 19

Current understanding:

3 main components of painful experience

• biological
• psychological
• social

Question 20

CIP

Answer 20

Congenital insensitivity to pain

Question 21

Biological factors of the BPS model include:

Answer 21

A&P
Neuroanatomy/neurophysiology
Inflammatory processes
Genetics
Family history
Age
Sex
Race
Pre-existing medical conditions

Question 22

Psychological component of BPS system include

Answer 22

Attitudes
Beliefs
Behaviors and coping strategies
Perceptions
Cognition/thought patterns
Emotional state (depression, stress)

Question 23

Social component of BPS model include

Answer 23

Previously learned info regarding health, disease and pain
Cultural background
Social/community support and interactions
Family influence and support
Financial influences
Workplace environment

Question 24

What is the tissue state of nociceptive transient pain vs acute vs chronic pain?

Answer 24

Noci - normal
Acute - inflamed
Chronic - injury to nervous system

Question 25

What is the physiologic change of nociceptive transient pain vs acute vs chronic pain?

Answer 25

Noci - normal Acute - increased excitation or decreased inhibition of nociceptors Chronic - cellular structural changes

Question 26

What is the PNS plasticity change of nociceptive transient pain vs acute vs chronic pain?

Answer 26

Noci - no change Acute - peripheral sensitization Chronic - modification of pain afferents

Question 27

What is the CNS plasticity change of nociceptive transient pain vs acute vs chronic pain?

Answer 27

Noci - no change Acute - central sensitization Chronic - retired networks/assemblies, circuits

Question 28

What are the features of nociceptive transient pain vs acute vs chronic pain?

Answer 28

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

Question 29

Aδ fibers and C fibers are associated with what?

Answer 29

Transient nociceptive 1st pain (Aδ fibers) and 2nd pain (C fibers)

Question 30

What serves as early warning sign that alerts the brain to the presence of potentially tissue-damaging events?

Answer 30

Transient nociceptive pain

Question 31

Nociceptive pain is divided into (3) types

Answer 31

Somatic Visceral Inflammatory - associated with process of tissue repair following tissue damage

Question 32

Neuropathic pain is divided into (2) categories of pain

Answer 32

Neurogenic | Functional

Question 33

Treatment of neuropathic pain depends on whether origin of pain is _____ or ______

Answer 33

Peripheral (e.g. diabetic neuropathy) or central (e.g. spinal cord injury)

Question 34

Define functional neuropathic pain

Answer 34

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

Question 35

2 principles of pain measurement

Answer 35

1. Pt is only authority to evaluate their pain | 2. Pain should be evaluated in terms of impact on person as a whole

Question 36

What are quantifiable components of pain? (5)

Answer 36

``` Pain intensity Physical capacity Spatial attributes Pain quality Psychological component ```