pain Flashcards
Nociceptive pain
ongoing activation of pain-sensitive neural systems by tissue injury or inflammation.
Nociceptive processing involves ascending and descending pathways that either facilitate or modulate information about noxious stimuli.
Peripheral Neuropathic pain
aberrant somatosensory processes in peripheral nervous system
AIDS polyneuropathy and entrapment neuropathy)
CNS Neuropathic pain
spinal cord injury and stroke
Psychogenic pain
Pain that is truly experienced by the patient, but best explained by psychiatric disease.
Idiopathic pain
Refers to pain for which no clear cause can
be identified be identified.
Hyperalgesia
painful stimuli perceived as more painful
Hyperpathia
all stimuli (noxious and innocuous) are more intense
Allodynia
nonpainful stimuli are perceived as painful
Dysesthesia
unpleasant sensations
Spontaneous Pain
pain in the absence of a stimulus
Description of Bone pain
aching gnawing deep aching, gnawing
Description of Neuropathic pain
tingling, sharp, shooting, electric, burning
Description of Visceral pain
deep, aching, colicky, squeezing
hard to localize
Ascending pain pathway - PRIMARY order neuron
First/PrimaryOrder Neuron
Primary afferent fibers
Convey sensation from periphery to spinal cord (Dorsal horn)
Ascending pain pathway - SECONDARY order neuron
Secondary order neurons convey within CNS
- Spinal Thalamic Tract from Dorsal Horn to Thalamus
Ascending pain pathwy - Third/Tertiary Order Neuron
Neurons in Thalmus and RC convey info to cortex Higher level Interpretation and action Thalamus sends info to: Cingulate gyrus Somatosensory cortex Limbic system
Acute Pain - what sx & what is tx aimed at?
Assoc w/ autonomic sx:
• tachycardia, high BP, pallor, diaphoresis
Medical treatment aimed at Medical treatment aimed at underlying physical problem.
Usually self limited
Chronic Pain - what sx & what is tx aimed at?
Physical malfunction isn’t medically correctable
• Regular rating of pain intensity limited
Need to address:
• degree of suffering caused (depression,
anxiety and disruption in lifestyle)
Management aimed at symptom relief
Complex regional pain syndrome includes:
Causalgia (Severe burning pain in a limb caused by injury to a peripheral nerve.)
Reflex sympathetic dystrophy (pain (often “burning” type), tenderness, and swelling of an extremity associated with varying degrees of sweating, warmth and/or coolness, flushing, discoloration, and shiny skin.)
Chronic Pain Syndromes
No single/ Multiple mechanisms responsible for persistent pain after injury
peripheral sensitization
central sensitization
reorganization of afferent inputs
down regulation of common neurotransmitters
up regulation of novel substances
Unrelieved pain issues leads to:
- Depression
- Poor socialization
- Sleep disturbance Sleep disturbance
- Decreased immune function
- Increased BP
- Impaired ambulation
- Increased health care costs
