Pain

Question 1

what is the new definition of pain

Answer 1

an unplainsant sensory and emotional experience associated with or resembling that associated with actual or potential tissue damage

Question 2

what are the 6 carasterics of definition of pain

Answer 2

• pain is always a personal experience that is influence by biological, psychological and social factors
• pain and nociceptor are different phenomena. pain cannot be inferred solely from activity in sensory neuron
• through their life experience, indivdual learn the concept of pain
  -a person’s report of an experience as pain should be respect
• verbal description is only one of several behaviors to express pain: inability to communicate does not negate the possibility that a human experience pain

Question 3

pain is a

Answer 3

subjective sensation and composed of a variety of human discomforts

Question 4

perfeception of pain is modified how

Answer 4

by past experience and expectations

Question 5

slection of a therapeutic agent should be based on

Answer 5

a sound understanding of its physical properties and physiologic effects

Question 6

what is acute pain

Answer 6

pain of suddent onset

Question 7

what is chronic pain

Answer 7

pain lastinf for mnore than 6 month

Question 8

what is refered pain

Answer 8

pain that is perceived to be in an area that seems to have little relation to the existing pathology
Kehr’s Sign
Myofascial trigger points

Question 9

what is nociceptive pain

Answer 9

Pain that arises from actual or threatened damage to non-neural tissue and is due to the activation of nociceptors.

Question 10

what is neuropathic pain

Answer 10

Pain caused by a lesion or disease of the somatosensory nervous system.

Question 11

what is nociplastic pain

Answer 11

Pain that arises from altered nociception despite no clear evidence of actual or threatened tissue damage

Question 12

what nociplastic pain cause

Answer 12

Causing the activation of peripheral nociceptors or evidence for disease or lesion of the somatosensory system causing the pain.

Question 13

what is a noxious stimulus

Answer 13

A stimulus that is damaging or threatens damage to normal tissues.

Question 14

what is pain threshold

Answer 14

The minimum intensity of a stimulus that is perceived as painful.

Question 15

what is the pain tolerance level

Answer 15

The maximum intensity of a pain-producing stimulus that a subject is willing to accept in a given situation.

Question 16

what are the 2 type of pain

Answer 16

radiating and sclerotmic pain

Question 17

what is sclerotomic pain

Answer 17

associated with a segment of bone innervated by a spinal segment that is a
deep somatic pain

gnawing, aching, sharp

Question 18

after common cold what is the most common reason for health care visit

Answer 18

pain

Question 19

provenance of chronic pain range from

Answer 19

8% to 60%

Question 20

pain can be measure how

Answer 20

by asking if the pain change, interfere, increase, decrease with the following
Pain intensity
Pain quality
Pain location
Pain behaviour
Pain interference
Depression
Sleep quality
Alcohol and drug use

Question 21

what is pain intensity and how can it be describe

Answer 21

Is the magnitude or severity of perceived pain
Current versus usual pain
by using visual analogue scale, 1-10 scale

Question 22

what does the scale does best for describing the pain

Answer 22

indicate the change in pain
30% change is meaningful (2 points or more on scale)

Question 23

what to do when we do a pain profile

Answer 23

Pain profiles
Identify type of pain
Quantify intensity of pain
Evaluate the effect of the pain experience on patients’ level of function
Assess the psychosocial impact of pain

Question 24

utility of pain chart

Answer 24

establish spatial properties of pain
Patient colors pictures in areas that correspond to pain
(blue = aching pain, yellow =numbness or tingling, red = burning pain, green =cramping pain)

Question 25

which questionnaire can be use to represent dimension of the pain experience

Answer 25

Mcgill pain questionnaire

Question 26

what can be used to asses functional impairment associated with pain

Answer 26

self-reported tool

Question 27

what does the self-reported tool do

Answer 27

Measures the frequency of certain behaviors such as housework, recreation and social activities that produce pain

Question 28

what is the most common acute pain profil used in sport medicine clinic

Answer 28

numeric pain scale

Question 29

goal in managing pain

Answer 29

To control / manage acute pain and protect patient from further injury while encouraging progressive exercise in a supervised environment. Reducing pain is an essential part of treatmen t Encourage body to heal through exercise designed to progressively increase functional capacity and to return the patient to work, recreational and other activities as swiftly and safely as possible

Question 30

afferent nerve fiver transmit impulse where

Answer 30

from sensory receptor toward the brain

Question 31

efferent nerve fiber transmit impulse where

Answer 31

motor neuron transmit impulse from the brain toward periphery

Question 32

what pain accomodation means

Answer 32

Decline in generator potential and the reduction of frequency that occur with prolonged stimulus or with frequently repeated stimuli

Question 33

what are the 4 type of first order neutrons

Answer 33

A-alpha, A-beta, A-S, C

Question 34

which first order neutron has large diameter and which one have small diameter

Answer 34

large: A-alpha and A-beta small: A-s, C

Question 35

wide dynamic range second order afferent neutron receive input from

Answer 35

A-beta, A-s, C

Question 36

nociceptive specific second order afferent response only to what and receive input only from

Answer 36

noxious stimulation and only from a-s, C

Question 37

for information to pass between neutron what need to happen

Answer 37

, a transmitter substance must be released from one neuron terminal - enter the synaptic cleft - and attach to a receptor site on the next neuron This was thought to occur due to chemicals called neurotransmitters

Question 38

norepinephrine inhibit pain where

Answer 38

between 1st and 2nd order neutron

Question 39

serotin is active where

Answer 39

in descending pathway

Question 40

substance P is secrete from

Answer 40

small-diameter primary afferent neutron

Question 41

enkephalin is active where

Answer 41

oppose active in descending pathway

Question 42

b-endorphin is active where

Answer 42

opiod endogenous to CNS

Question 43

what transmit pain signal

Answer 43

nociceptive neuron

Question 44

injury to cell cause release of

Answer 44

substance P and prostaglandi

Question 45

role of nociception

Answer 45

Sensitize the nociceptors in and around the area of injury by lowering their depolarization threshold Enhancing pain response

Question 46

substance P is a transmitter substance btw

Answer 46

1st and 2nd order afferent fibers

Question 47

what is primary hyperalgesia

Answer 47

when threshold is lowered and pain increase

Question 48

what is secondary hyperalgesia

Answer 48

Over several hours if there is continual dispersal of chemicals there is an increase of size of the painful area

Question 49

which fibre transmit sensation of pain and temperature

Answer 49

As, C

Question 50

which fiber transmit acute pain and why

Answer 50

As neurons originate from receptors located in skin and transmit “fast pain”

Question 51

which fiber transmit chronic pain

Answer 51

C neurons originate from both superficial tissue (skin) and deeper tissue (ligaments and muscle) and transmit “slow pain”

Question 52

which fiber transmit chronic pain

Answer 52

C neurons originate from both superficial tissue (skin) and deeper tissue (ligaments and muscle) and transmit “slow pain”

Question 53

what are the mechanism of pain

Answer 53

gate control theory descending mechanism release of endogenous opioid (B-endorphin)

Question 54

explain the gate control theory

Answer 54

Information from ascending Ab afferents and (pain messages) carried along As and C afferent fibers enter the dorsal horn Impulses stimulate the substantia gelatinosa at dorsal horn of the spinal cord inhibiting synaptic transmission in As & C fiber afferent pathways Sensory information coming from Ab fibers is transmitted to higher centers in brain Pain message" carried along As & C fibers is not transmitted to second-order neurons and never reaches sensory centers

Question 55

explain descending pain control mechanism

Answer 55

see schema

Question 56

interneront in descending pain control release what

Answer 56

enkephalin into dorsal horn which inhibit the synaptic transmission of impulse to second order afferent neutron

Question 57

what is release from hypothalamus from stimulation of As and C afferent

Answer 57

B-endorphin

Question 58

what is release from periaqueductal grey from stimulation of As and C afferent

Answer 58

dynorphin

Question 59

therapeutic modalities can be used to

Answer 59

Stimulate release of endogenous opioids through prolonged small diameter fiber stimulation with TENS

Question 60

what is the placebo

Answer 60

Medically inactive substance that delivers desired response Placebo effect – observable, measureable improvement of health not attributable to treatment