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cata 348 > Pain > Flashcards

Pain Flashcards

1
Q

what is the new definition of pain

A

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

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2
Q

what are the 6 carasterics of definition of pain

A
  • 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
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3
Q

pain is a

A

subjective sensation and composed of a variety of human discomforts

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4
Q

perfeception of pain is modified how

A

by past experience and expectations

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5
Q

slection of a therapeutic agent should be based on

A

a sound understanding of its physical properties and physiologic effects

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6
Q

what is acute pain

A

pain of suddent onset

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7
Q

what is chronic pain

A

pain lastinf for mnore than 6 month

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8
Q

what is refered pain

A

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

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9
Q

what is nociceptive pain

A

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

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10
Q

what is neuropathic pain

A

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

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11
Q

what is nociplastic pain

A

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

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12
Q

what nociplastic pain cause

A

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

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13
Q

what is a noxious stimulus

A

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

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14
Q

what is pain threshold

A

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

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15
Q

what is the pain tolerance level

A

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

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16
Q

what are the 2 type of pain

A

radiating and sclerotmic pain

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17
Q

what is sclerotomic pain

A

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

gnawing, aching, sharp

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18
Q

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

A

pain

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19
Q

provenance of chronic pain range from

A

8% to 60%

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20
Q

pain can be measure how

A

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

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21
Q

what is pain intensity and how can it be describe

A

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

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22
Q

what does the scale does best for describing the pain

A

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

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23
Q

what to do when we do a pain profile

A

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

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24
Q

utility of pain chart

A

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)

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25
Q

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

A

Mcgill pain questionnaire

26
Q

what can be used to asses functional impairment associated with pain

A

self-reported tool

27
Q

what does the self-reported tool do

A

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

28
Q

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

A

numeric pain scale

29
Q

goal in managing pain

A

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

30
Q

afferent nerve fiver transmit impulse where

A

from sensory receptor toward the brain

31
Q

efferent nerve fiber transmit impulse where

A

motor neuron transmit impulse from the brain toward periphery

32
Q

what pain accomodation means

A

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

33
Q

what are the 4 type of first order neutrons

A

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

34
Q

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

A

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

35
Q

wide dynamic range second order afferent neutron receive input from

A

A-beta, A-s, C

36
Q

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

A

noxious stimulation and only from a-s, C

37
Q

for information to pass between neutron what need to happen

A

, 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

38
Q

norepinephrine inhibit pain where

A

between 1st and 2nd order neutron

39
Q

serotin is active where

A

in descending pathway

40
Q

substance P is secrete from

A

small-diameter primary afferent neutron

41
Q

enkephalin is active where

A

oppose active in descending pathway

42
Q

b-endorphin is active where

A

opiod endogenous to CNS

43
Q

what transmit pain signal

A

nociceptive neuron

44
Q

injury to cell cause release of

A

substance P and prostaglandi

45
Q

role of nociception

A

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

46
Q

substance P is a transmitter substance btw

A

1st and 2nd order afferent fibers

47
Q

what is primary hyperalgesia

A

when threshold is lowered and pain increase

48
Q

what is secondary hyperalgesia

A

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

49
Q

which fibre transmit sensation of pain and temperature

A

As, C

50
Q

which fiber transmit acute pain and why

A

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

51
Q

which fiber transmit chronic pain

A

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

52
Q

which fiber transmit chronic pain

A

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

53
Q

what are the mechanism of pain

A

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

54
Q

explain the gate control theory

A

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

55
Q

explain descending pain control mechanism

A

see schema

56
Q

interneront in descending pain control release what

A

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

57
Q

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

A

B-endorphin

58
Q

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

A

dynorphin

59
Q

therapeutic modalities can be used to

A

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

60
Q

what is the placebo

A

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

cata 348 (7 decks)

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