Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Applied Biochemistry > Orofacial Pain > Flashcards

Orofacial Pain Flashcards

1
Q

Structures in the oral cavity and maxillofacial region (11)

A
  • Teeth
  • Gingiva
  • Mucosa
  • Salivary glands
  • Muscles
  • Bone
  • Ligaments
  • Tendons
  • Blood and lymphatic vessels
  • Taste buds (special sensory)
  • Nerves (motor and sensory)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

— is the most prevalent pain in the facial region.

A

Toothache (odontalgia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

–% reported a history of toothache in the previous 6-month period.

A

12 to 14

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Not all pains are the —.
Not all toothaches are the —.
And not all toothaches are in fact toothaches (i.e., odontalgia).

A

sam same

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Odontogenic (2)

A
  • Pulpal

* Periodontal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Non-Odontogenic (7)

A
  • Sinus/nasal
  • Myofascial
  • Neurovascular
  • Neuropathic
  • Cardiogenic (rare)
  • Systemic (rare)
  • Idiopathic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Other forms of orofacial pain (5)

A
  • Mucosal Pain
  • Temporomandibular Disorders
  • Orofacial Neuropathic Pain
  • Neurovascular Pain (Headaches)
  • Sleep Disorders* (not really pain)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

TMJ
• Prevalence
 General population – F:M /
 Patient population – F:M /

A

6: 4

7. 5:1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

TMJ
• Bimodal distribution
 More prevalent in

A

younger adults & older adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

• TMD involving joint sounds
 35% have — TM joint sounds
 3.6-7.0% — TM joint sound

A

asymptomatic

symptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

TMJ
• Fluctuating, remitting, self-limiting
 — uncommon

A

progression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

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

A

pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why do we feel pain?

A

Instills protective behavior

but if unabated, pain can be harmful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Principles of pain (3)

A

• It is always subjective.
• It may or may not be tied to a stimulus.
• It is always a consequence of an emotional
experience and psychological state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do we experience pain (usually)? (5)

A

• Environmental stimulus (thermal, mechanical, chemical, polymodal)
• Receptor activation
• Generation of action potential
• Transmission through primary afferent to dorsal horn (trigeminal spinal track nucleus)
• Projection from dorsal horn/TSTN to brain for perception and interpretation
 Pain location, intensity, reflexes, and meaning (supraspinal structures)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q 
“--- is not pain until it reaches and is processed by
higher centers (supraspinal structures)"
A

Nociception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Descending Pathway (2)

A

Spinal

Supraspinal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Spinal (2)

A
  • Endogenous opioid signaling.

* Non-opioid inhibitory neurotransmitters.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

• Non-opioid inhibitory neurotransmitters. (4)

A

 Serotonin
 Noradrenaline
 GABA
 Glycine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Supraspinal

A
  • Influenced by psychological factors.
  • Neurons from the cortex and amygdala.
  • Periaqueductal gray & rostroventral medulla
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Pain Modulation

A

Dynamic process – can occur at multiple levels

of the ascending and descending pathways.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

modulation (3)

A

supraspinal
spinal
peripheral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Neuronal Sensitization

• Arises when

A

neurotransmitters are left to linger in the synapse.

- Due to failure(s) in diffusion, enzymatic destruction, reuptake.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Neuronal Sensitization

• Prolonging the effect on the

A

post-synaptic neuron

25
Q

Neuronal Sensitization

• Allows subthreshold input to

A

recruit a response

26
Q

Neuronal Sensitization

• — discharge.

A

Spontaneous

27
Q

Neuronal Sensitization

• Increased size of

A

receptive field

28
Q

Normal input

 Increased responsiveness of

A

nociceptive neurons

29
Q

Subthreshold input

Recruitment of a

A

response

30
Q

Peripheral sensitization

Nociceptive neurons at — of receptive field

A

periphery

31
Q

peripheral sensitization

• Increased responsiveness of

A

nociceptive neurons

32
Q

peripheral sensitization

• Reduced threshold to

A

stimulation

33
Q

• Reduced threshold to stimulation.

A

Primary hyperalgesia

34
Q

Hyperalgesia

A

An increased pain experience in

response to a painful stimulus

35
Q

Central sensitization

Nociceptive neurons in the

A

central nervous system

36
Q

central sensitization

Increased responsiveness to

A

normal/subthreshold afferent input

37
Q

• Increased responsiveness to normal/subthreshold afferent input. (2)

A

 Primary and secondary hyperalgesia

 Allodynia

38
Q

central sensitization

• May also result from dysfunctional

A

endogenous pain control

39
Q

Allodynia

A

Pain resulting from a stimulus
that does not normally
provoke pain.

40
Q

Revised Gate Control Theory

A

• Myelinated (fast) non-nociceptive afferent fiber can activate
inhibitory interneurons modulating nociceptive transmission.
• Reason you instinctively wave, hold, clench your fingers when they
burn.
• Reason why T.E.N.S. helps relieve pain .

41
Q

Diffuse noxious inhibitor control

A

• The threshold for nociception can be raised when another noxious
stimulus is provoked in another area.

42
Q

Placebo effect

A
  • Psychological

* Leads to release of endogenous analgesic substances.

43
Q

Different ways to categorize different pains (3)

A
  • Neurophysiology
  • Structures involved
  • Timing
44
Q

Nociceptive pain (2)

A

• Pain resulting from damage or threatened
damage to non-neural tissue
• Activation of nociceptors.

45
Q

Neuropathic pain (1)

A

• Pain resulting from the presence of a lesion or

disease of the somatosensory nervous system.

46
Q

Nociplastic pain (4)

A

• New concept.
• Pain that arises from altered nociception.
• Does not satisfy the definitions of nociceptive
or neuropathic pain.
• It is possible for a patient to present with
nociceptive and nociplastic pain at the same
time.

47
Q

types of pain (2)

A

acute

chronic

48
Q

Acute Pain
• Pain with close temporal relationship to a (3)
• Tends to respond to treatment in a — dose-dependent fashion

A

stimulus, injury, or disease

linear

49
Q

Chronic Pain
• Pain that has lasted
• Does not typically respond to treatment in a — dose-dependent fashion.
• Presence of other/multiple ongoing pains is a predictor for transition from
• More influence of — factors.
• More – to treat.

A 
>3 months
linear
acute to chronic
psychosocial
difficult
50
Q

Most Common Disorders (4)

A
  • Anxiety
  • Major depression
  • Personality disorders
  • Pain distress
51
Q

Coping Mechanisms (5)

A
  • Internal locus of control
  • Perceived control
  • Catastrophic thinking
  • Hypervigilance
  • Fear avoidance
52
Q

Assessment (3)

A 
• Pain intensity
• Pain distress
• Pain-related interference
 Functional limitation, disability
• Oral Habits
53
Q

Homotopic Pain

A

• Site = Source

Treat site of pain, effective

54
Q

Heterotopic pain

A

• Site ≠ Source

Treat site of pain, ineffective

55
Q
  1. Central Pain
A
  • Source is central but perceived peripherally

* Example: Brain tumor (brain does not have nociceptors)

56
Q
  1. Projected pain
A
  • Pain follows same nerve distribution as primary source
  • Dermatome or motor distribution
  • Hyperalgesia may be present
  • Example: Post-herpetic neuralgia
57
Q
  1. Referred Pain
A

• Pain in different nerve than primary source and is spontaneous (non-provoked)
• Sensitization of interneurons – central sensitization
• Not aggravated by palpation
• Does not respond to anesthesia at site of pain –must block source of pain
• Does not typically cross midline (only if generated at midline)
• Can refers upward: cervical to trigeminal, mandibular to maxillary
• Example: Mandibular molar affected, but perceived at maxillary molar
Same nerve root

58
Q

Evaluation of Pain (6)

A
  1. What kind of pain are they experiencing and describing?
  2. Why are they in pain? What is the cause/source?
  3. Where is the site of pain? How does it relate to the cause/source?
  4. Is the pain acute or chronic?
  5. Are there any other contributing factors? Inflammation/Psychosocial?
  6. How can we modulate their pain?
59
Q

Pain Management

A

Understand why the patient is in pain (MOST IMPORTANT)
• Treat source(s) and cause(s) of the pain
Determine what type of treatment goal is appropriate and achievable
• Curative intent
• Palliative intent
 Limit tissue damage
 Get patient through adaptive phase
 Manage chronic pain
 More aggressive care if palliative care is ineffective to control symptoms
or of there is significantly decreased quality of life.
Multidisciplinary approach may be necessary

Applied Biochemistry (52 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions