Pain Flashcards
What is pain
Unpleasant sensory and emotional experience, asssoc with actual tissue damage or described in terms of such damage
What are the 4 process in physiology of pain
Transduction
Transmission
Modulation
Perception
What is transduction
Translation of noxious stimulus into electrical activity at the peripheral nociceptors
What is transmission
Propagation of pain signal as nerve impulses through nervous system
What is modulation
Hindering of pain transmission in the nervous system e.g. inhibitory neurotransmitters like endogenous opioids
What is perception
Conscious experience of pain
What are nociceptors
Specific primary sensory afferent neurones normally activated by intense noxious stimuli e.g. mechanical, thermal, chemical
What are the function of nociceptors
First order neurones that relay info to 2nd order neurones
Where do second order neurones ascend from
Spinal cord in the anterolateral system ( terminates in the thalamus (
What are the subtypes of nociceptors
Delta fibres
C fibres
What are delta fibres
Mechanical / thermal nociceptors, thinly myelinated
Medicare fast and first pain, SHARP
What are C fibres
Unmyelinated, response to all noxious stimuli
Mediate second or slow
Achy, dull pain
What are classifications of Paul
Nociceptive pain, inflammatory, pathological, neuropathic / dysfunctional
What is nociceptive pain
Normal Response to injury of tissue by noxious
Function is a early warming physiological protective system to detect and avoid
What is inflammatory pain
Caused by activation of immune system by tissue injury or infection
Discourages physical contact with affected pain and discourages moment
What are the two types of pathological pain
Neuropathic and dysfunctional
What is neuropathic pain
Caused by damage of neural tissue
Can be burning, shutting, numbness, pin and needles
What is dysfunctional pain
No identifiable damage or inflammation
Can pathological pain be treated with analgesics
NO
Features of mechanical back pain
Presents age: 20-55
Lumbosacrol region, bum and thighs
Features of nerve root pain
Unilateral leg pain
Radiates to foot or toes
Numbness or Paraesthesia in same distribution
What are serious spinal pathology
Cauda equina syndrome
Acute flaccid foot
Risk factors for serious spinal pathology
Severe night pain Cancer Systemic steroids, premature menopause, DMARDS Tb/ IV drug abuse / HIV Unexplained weight loss Widespread neurological changes Structural deformity
What is cauda equina syndrome
Saddle anaesthesia ( anus, perineum, genitals)
Difficultly with micturition
Loss of anal sphincter tone or faecal incontinence
Widespread or progressive motor weakness in the leg or gait disturbance
