Orofacial Pain Flashcards
What is pain?
An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage
How are physical pain patients assessed?
PAIN scores (McGill)
How are emotional symptoms of patients pain assessed?
Pyschological scores (HAD)
Quality of life scores (OHIP)
What is involved in the feeling of pain?
- nociception
- peripheral nerve transmission
- spinal modulation
- central appreciated
What nerve is affected in a Bell’s Palsy?
Facial Nerve (VII)
- due to inflammation
What occurs in Bell’s Palsy?
- problems with salivation on affected side
- paralysis of muscles on affected side
- things sound very loud on affected side
Where does the trigeminal nerve nucleus lie?
From pons all the way to cervical spinal nerves
If a patient presents with numbness in the face, how might damage to cervical spine region cause this?
Pressing on trigeminal nerve nucleus
What different nerves affect the head & neck?
Somatic =
- V, VIIm IX, X & cervical 1-3
Autonomic =
- sympathetic
- parasympathetic
Do autonomic nerves carry pain information?
YES
Why does pain via an autonomic nerve cause more distress?
Travels via the basal ganglion of the brain
What do efferent autonomic nerves control in the face?
- sweating
- blood flow
What is the gate theory of nerve transmission ?
Spinal cord can modulate what information in terms of pain gets to the brain ** RESEARCH
What is descending facilitation?
What is descending inhibition?
How can learned pain be prevented?
- local anaesthetics
- analgesics
What is CRPS?
Chronic Regional Pain
- delocalised pain that spreads around anatomical boundaries
- bilateral
- gripping, tight, burning
How does CRPS present?
- colour change in overlying skin
- autonomic changes
- feeling of sweating & heat
What is nociceptive pain?
Caused by activity in neural pathways in response to potentially tissue-damaging stimuli
- damage in the tissues
What is neuropathic pain?
Initiated or caused by primary lesion or dysfunction in the nervous system
- damage to the structure of the nerve
What are examples of nociceptive pain?
- post-op pain
- arthritis
- sports injury
What are examples of neuropathic pain?
- postherpetic neuralgia
- trigeminal neuralgia
- CRPS
What is postherpetic neuralgia?
Once viral problem is cleared, the nerve is permanently damaged and inflamed which causes pain even though there is technically nothing wrong
What are signs/symptoms of neuropathic pain?
- constant burning/aching pain
- fixed location
- often a fixed intensity
- genetic predisposition (tends to get neuropathic pain elsewhere)
