pain

Question 1

Nociceptive pain

Answer 1

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.

Question 2

Peripheral Neuropathic pain

Answer 2

aberrant somatosensory processes in peripheral nervous system
AIDS polyneuropathy and entrapment neuropathy)

Question 3

CNS Neuropathic pain

Answer 3

spinal cord injury and stroke

Question 4

Psychogenic pain

Answer 4

Pain that is truly experienced by the patient, but best explained by psychiatric disease.

Question 5

Idiopathic pain

Answer 5

Refers to pain for which no clear cause can

be identified be identified.

Question 6

Hyperalgesia

Answer 6

painful stimuli perceived as more painful

Question 7

Hyperpathia

Answer 7

all stimuli (noxious and innocuous) are more intense

Question 8

Allodynia

Answer 8

nonpainful stimuli are perceived as painful

Question 9

Dysesthesia

Answer 9

unpleasant sensations

Question 10

Spontaneous Pain

Answer 10

pain in the absence of a stimulus

Question 11

Description of Bone pain

Answer 11

aching gnawing deep aching, gnawing

Question 12

Description of Neuropathic pain

Answer 12

tingling, sharp, shooting, electric, burning

Question 13

Description of Visceral pain

Answer 13

deep, aching, colicky, squeezing

 hard to localize

Question 14

Ascending pain pathway - PRIMARY order neuron

Answer 14

First/PrimaryOrder Neuron
Primary afferent fibers
Convey sensation from periphery to spinal cord (Dorsal horn)

Question 15

Ascending pain pathway - SECONDARY order neuron

Answer 15

Secondary order neurons convey within CNS

- Spinal Thalamic Tract from Dorsal Horn to Thalamus

Question 16

Ascending pain pathwy - Third/Tertiary Order Neuron

Answer 16

Neurons in Thalmus and RC convey info to cortex
 Higher level Interpretation and action
Thalamus sends info to:
Cingulate gyrus
Somatosensory cortex
Limbic system

Question 17

Acute Pain - what sx & what is tx aimed at?

Answer 17

Assoc w/ autonomic sx:
• tachycardia, high BP, pallor, diaphoresis

Medical treatment aimed at Medical treatment aimed at underlying physical problem.
Usually self limited

Question 18

Chronic Pain - what sx & what is tx aimed at?

Answer 18

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

Question 19

Complex regional pain syndrome includes:

Answer 19

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.)

Question 20

Chronic Pain Syndromes

Answer 20

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

Question 21

Unrelieved pain issues leads to:

Answer 21

• Depression
• Poor socialization
• Sleep disturbance Sleep disturbance
• Decreased immune function
• Increased BP
• Impaired ambulation
• Increased health care costs