Module 8 - Dissecting Pain Flashcards
1
Q
What purpose does pain serve?
A
Warns of:
- Tissue damage
- Injury
- Disease
2
Q
What might pain lead to?
A
- Poor health behaviours
- Loss employment/income
- Depression, fear, anxiety
- Social isolation
- Sleep disorders
- Marital/family dysfunction
3
Q
What is the Specificity Theory of Pain proposed by Descartes in 1664?
A
- Directly proportional to amount of tissue damage
- Signal sent from nerve, to spine, to motor nerve and brain
4
Q
What is the purely biomedical approach to pain?
A
- one-to-one correspondence to injury/disease
- focus on pharmacological, surgical, medical control pain
5
Q
What are some unfortunate practices in a purely biomedical approach to pain?
A
- Blaming patient
- Assuming psychiatric disorder
- Assume fake symptoms
6
Q
What is the Gate-Control Theory of Pain?
A
- Pain is NOT directly proportional to tissue damage
- Neural pain gate in spinal cord opens and closes to modulate pain signals
7
Q
What does the neural pain gate in the spinal cord that opens and closes to modulate pain signals to the brain involve?
A
- Inhibitor and Projector Neurons
8
Q
What do inhibitor and Projector Neurons respond to?
A
- Somatosensory input
9
Q
Where do inhibitor and projector neurons send signals?
A
- To the brain
10
Q
What kind of factors influence the opening and closing of the neural gate that modulates pain?
A
- Physical
- Emotional
- Cognitive
11
Q
What physical factors open the pain gate?
A
- Extent of injury
- Inappropriate activity level
- Incactivity
12
Q
What physical factors close the pain gate?
A
- Medication
- Counter stimulation (massage, heat)
13
Q
What emotional factors open the pain gate?
A
- Anxiety/Worry
- Tension
- Depression
- Relationship Problems
14
Q
What emotional factors close the pain gate?
A
- Positive emotions
- Relaxation
- Social Support
15
Q
What cognitive factors open the pain gate?
A
- Focus on pain
- Boredom
16
Q
What cognitive factors close the pain gate?
A
- Distraction
- Concentration
- Involvement/Interest in Activities
17
Q
Do objective findings have clinical significance on pain levels?
A
- NO
18
Q
What is neuropathic pain?
A
- Results from current/past disease/damage in peripheral nerves
- People experience pain in absence of noxious stimulus
19
Q
What is Neuralgia?
A
- Extremely painful syndrome in which patient experiences recurrent episodes of intense shooting or stabbing pain along a nerve
20
Q
What does neuralgia often follow?
A
- Infection
21
Q
What is Causalgia?
A
- Complex regional pain syndrome
22
Q
What does Causalgia involve?
A
- Recurrent episodes of severe burning pain
23
Q
What is Causalgia often triggered by? example
A
- Minor stimuli
- Ex. clothes resting on area
24
Q
What is Fibromyalgia?
A
- Disorder involving chronic widespread pain
- Heightened pain response to pressure in absence of tissue damage
25
What does fibromyalgia result from?
- Neurochemical imbalance (imflammatory pathway activation in brain)
26
What is Phantom LImb Pain?
- Pain experienced in an amputated limb
27
Explain the Neuromatrix Theory of Pain
- Neuromatrix distributed throughout brain
- Matrix can generate pain in absence of signals from sensory nerves
28
What is the body-self neuromatrix?
- widespread network of neurons that generate pattern that is felt as whole body processing a sense of self
29
Where is pain produced in the Neuromatrix Theory?
- Brain and Spinal Cord
30
Do cognitive and emotional factors affect the neuromatrix?
- YES
31
What factors are involved in the biopsychosocial model of pain?
- Biology
- Psychology
- Social Factors
32
What are the biology factors in the biopsychosocial model of pain?
- Injury
- Tissue Damage
- Nervous System
- Somatic Sensation
33
What are the psychology factors in the biopsychosocial model of pain?
- Sensory
- Cognitive
- Emotional Factors
34
What are the social factors in the biopsychosocial model of pain?
- Isolation
- Relationship health
- Social support
- Work Setting
35
How is pain defined?
- Unpleasant sensory and emotional experience associated with actual or potential tissue damage
36
Is pain objective?
- NO (subjective)
37
What is the Wong-Baker FACES Pain Rating Scale?
- Pain rating 0-10
38
What are the advantages of the self-report measures of pain?
- Serves important survival role
- Permits somewhat accurate accounts of experience
- Methodologically convenient
39
What are the limitations of a self-report measures of pain?
- Dependent on cognitive/communication competence
- Contextually drive; mood-dependent
-Selective; Reflect perceived best interests, social desirability
40
What are some non-verbal measures of pain?
- Facial/audible expression of distress
- Distortions in posture or gait
- Negative affect (mood, anxiety, depression)
- Avoidance of activity
41
What are the neonatal facial coding scale of pain?
- Brow lower
- Eye squeeze
- Squint
- Blink
- Flared Nostril
- Nose Wrinkler
- Nasolabila Furrow
- Cheek Raiser
- Open Lips
- Upper Lip Raiser
- Lip Corner Puller
- Horizontal Mouth Stretch
- Vertical Mouth Stretch
42
How to code for pain in mice?
- Orbital tightening
- Nose bulge
- Cheek bulge
- Ear position
43
What is organic pain?
- Pain that has clearly identifiable physiological cause
44
What is psychogenic pain?
- Pain resulting from psychological processes
45
What is the current recognition of all pain?
Involves both:
- Physiological factors
- Psychosocial factors
46
What does positive emotion do to pain?
- Reduce it
47
What does negative emotion do to pain?
- Worsen
48
Why are pain and stress intimately linked?
- Pain is stressful
- Stress can produce pain
49
What are the different ways of coping with pain?
- Maladaptive Coping
- Catastrophizing
- Adaptive Coping
- Acceptance
- Positive Reappraisal
50
What are the two types of maladaptive coping to pain?
- Destructive Thinking
- Helplessness
51
What are some catastrophizing ways of coping with pain?
- Frequent, magnified negative thoughts
- Magnification
- Rumination
- Helplessness
52
Expalin the appraisal model of pain catastrophizing
- Primary appraisal
- Secondary appraisal
53
Explain the primary appraisal of pain catastrophizing
- Focusing on/exaggerating threat value of pain
54
Explain the secondary appraisal of pain catastrophizing
- Appraisals of helplessness
- Inability to cope
55
What does catastrophizing increase with?
- Pain intensity
56
Explain adaptive coping of pain
- Relaxation
- Distraction
- Redefinition of pain (reappraisal)
- readiness to change, taking an active role
57
Explain acceptance coping of pain
- engage in activities despite the pain and disinclined to control or avoid the pain
58
What do people with high levels of pain acceptance pay less attention to?
- PAIN
59
What do people with high levels of pain acceptance have greater of?
- Self-Efficacy for daily tasks
- Function
60
What do people with high levels of pain acceptance use less of?
- Pain medication
61
What does positive reappraisal coping of pain attenuate?
- Feelings of pain
62
What does social support do for feelings of pain?
- Attenuates it
63
How are patients pain behaviours associated with social rewards they receive?
- Avoid disliked social activities or receive help/attention
64
What might solicitousness may lead to?
- More pain behaviours
65
Explain the communal coping model of pain catastrophizing
- Manage distress in social context
66
What does the caregiver provide in the communal coping model of pain catastrophizing?
- Proximity
- Support
- Empathy
- Assistance
67
What parts make up of the social communication model of pain?
- Person in pain & caregiver
- Trauma (physical or perceived)
- Interexchange
68
What influences impact people in pain and the caregiver of the social communication model of pain?
- Intrapersonal
- Interpersonal
69
Explain the exchanges that occur in the social communication model of pain
- Personal experience of pain
- Expression of pain
- Pain assessment
- Pain management
70
what does the social communication model place primacy on ?
- Interpersonal context of pain
71
how does the dynamic interplay between patient and caregiver influence pain?
- Continuously
72
What is social pain?
- Pain experienced as result of interpersonal rejection or loss
73
What is the neural system that supports both physical and social experiences of pain?
- Dorsal anterior cingulate cortex (dACC) and anterior insula (AI)
74
What component of the brain is associated with distress?
- Dorsal anterior cingulate cortex
75
What part of the brain is associated with regulating distress?
- Right ventral prefrontal cortex
76
Can Acetaminophin reduce social pain?
- YES
77
What are some clinical interventions for pain?
- Surgical intervention
- Chemical treatment
- Stimulation therapies
- Physical therapy & rehabilitation
78
What kind of chemical treatments are used to treat pain?
- Peripherally active analgesics
- Cnetral acting analgesics / opioids
- Local anesthetics
79
What are peripherally active analgesics?
- Acetaminophen
80
What are centrally acting analgesics?
- Morphine
81
What are local anesthetics?
- Noyocaine
82
What are stimulation therapies?
- Transcutaneous electrical nerve stimulation (TENS)
83
What is usually not enough to control pain, particularly chronic pain?
- Medical methods alone
84
Why are medical methods alone not usually enough for controlling chronic pain?
- PScyhosocial factors play important role
85
What are the goals of psychological treatments for pain including helping clients?
- Reduce frequency/intensity pain
- Improve emotional adjustment
- Increase social/physical activity
- Reduce analgesic drug use
86
What is the operant approach to controlling pain?
- Modifying consequences of behaviour
87
What does operant approach to pain control do aside from reducing reliance on pain medications?
- Promote 'well' behaviour
- Discourage pain behaviour
88
Is the operant approach to pain management succesful?
- Yes, but hard to sustain once reward removed
89
How does fear reduction work for pain management?
- Have individuals do things they think might experience pain from
90
Is fear reduction succesful for pain management?
- Reduced pain fear and catastrophizing
- Increase activity levels in individuals with chronic low back pain
91
Explain Progressive muscle relaxation
- Focusing attention on specific muscle groups while aternately tightening and relaxing muscles
92
Explain meditation
- Focus attention on meditation stimulus
- midfulness
- Become detached from feelings about pain
93
What biofeedback is used for relaxation pain management?
- Exert voluntary control over bodily functions (HR)
94
What does the cognitive method of pain management entail?
- Assessing/addressing pain-related belief and coping strategies
95
What coping strategies would you promote in the cognitive method of pain management?
- Distraction
- Nonpain Imagery
- Redefinition
96
Explain the distraction coping strategy for pain
- Focusing on a non-painful stimulus to divert attention
97
Explain nonpain imagery coping strategy of cognitive method for pain management
- Imagining a mental scene that is unrelated to or incompatible with the pain
98
Explain redefinition coping strategy of cognitive method for pain management
- REplacing unhelpful thoguhts with constructive/realistic ones
99
Has hypnosis been found to be effective?
- Treating acute/chronic pain
100
What are cognitive behavioural therapy and psychoanalysis helpful for?
- emotional difficulties
101
What underscores the importance of biopsychosocial approach to pain management?
- Chronic pain often requires a multidisciplinary approach to manage it
