pain

Question 1

what is pain?

Answer 1

an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage

Question 2

is there always tissue damage with pain?

Answer 2

no there may or may not have tissue damage

Question 3

T/F: there are pain receptors in the body

Answer 3

false the correct terms are nocicpetors

Question 4

which fiber type conduct pain?

Answer 4

a and c fibers

Question 5

what are c fibers?

Answer 5

they are unmyelinated fibers, create longer lasting and slower pain normally a day or 2 later

Question 6

what are a fibers?

Answer 6

thinly myelinated create initial pain

Question 7

what do tissues do?

Answer 7

they tell you what is going on

Question 8

what makes the final decision?

Answer 8

the brain

Question 9

which fibers are nociceptive?

Answer 9

C and A delta fibers

Question 10

what do nociceptive fibers do?

Answer 10

free nerve endings that convey pain, temperature, and crude touch

Question 11

which fibers are non nociceptive?

Answer 11

A beta fibers

Question 12

what do non nociceptive fibers do?

Answer 12

touch, pressure, and vibration (fake pain)

Question 13

what are the three ways for the nervous system to be stimulated?

Answer 13

1. mechanically
2. thermally
3. chemically

Question 14

T/F: the amount of pain and the severity of an injury do not always correlate with each other

Answer 14

true
ex) painless battle wounds, painless nail in head, and phantom limb pain

Question 15

what is one of the most common reasons people seek care from physical therapists?

Answer 15

pain

Question 16

when does pain normally resolve for acute tissue injury and infection?

Answer 16

48-72 hours

Question 17

T/F: pain isn’t subjective and not always real

Answer 17

False pain is always subjective and always real

Question 18

what are some contextual factors contributing to the experience of pain?

Answer 18

biological, physical, psychological, occupational, social, cultural, and environmental factors

Question 19

how do we feel pain?

Answer 19

through ascending pathways

Question 20

describe the ascending pathway

Answer 20

injury to body
release of cytokines
PGs stimulate C fibers and A delta fibers
C fibers and A delta fibers carry the nociceptive information to the ipsilateral dorsal horn of the spinal cord
at the same time information from surrounding levels are also sensing information that needs to be regulated

Question 21

where do first order neurons synapse?

Answer 21

on the substantia gelatinosa

Question 22

first order neurons activates substance P which activates what?

Answer 22

second order neurons which project to the spinothalamic tract

Question 23

what is sensed in the anterior spinothalamic tract?

Answer 23

crude touch

Question 24

what is sensed in the lateral spinothalamic tract?

Answer 24

pain and temperature

Question 25

where do second order neurons ascends through?

Answer 25

spinal cord and the brain stem and projects to the thalamus

Question 26

what happens in the thalamus?

Answer 26

the second order neuron will synapse on third order neuron

Question 27

what does the third order neuron project on?

Answer 27

to the primary somatosensory cortex on the left side of the brain

Question 28

what do the ascending pathways do what?

Answer 28

detect pain

Question 29

what do the descending pathways do?

Answer 29

control pain

Question 30

where is nociceptive information sent to?

Answer 30

dorsal horn

Question 31

do non noxious stimulus get sent to the brain?

Answer 31

no

Question 32

T/F: interneurons are mainly inhibitory

Answer 32

true

Question 33

how are touch fibers (A beta fibers) activated?

Answer 33

with light touch, pressure, or vibration

Question 34

touch receptors send action potentials into where and give off what?

Answer 34

posterior grey horn and give off collateral neurons which synapse on interneurons

Question 35

what do interneurons release?

Answer 35

gamma aminobutyric acid (GABA)

Question 36

what does GABA inhibit?

Answer 36

activity at substantia gelatinosa (which inhibits substance P)

Question 37

what is pain inhibition also known as?

Answer 37

the gate control theory

Question 38

during the descending analgesic pathway activation of a delta and c fibers produce what?

Answer 38

stimulation of hypothalamus, thalamus, cortex, and amygdala that causes a projection of the periaqueductal grey matter and stimulation of the lotus

Question 39

projections down to substantia gelatinosa of the dorsal horn when releases?

Answer 39

NE and serotonin to interneurons in dorsal horn

Question 40

what do interneurons release?

Answer 40

enkephalins, endorphins, and dynorphins which inhibit substantia gelatinosa resulting in decreased pain

Question 41

what is acute pain?

Answer 41

a natural sensation that warns of possible injury

Question 42

what is chronic pain?

Answer 42

defined as pain lasting more than 3 months. serves no benefits, cognitive and emotional factors have a critical influence on pain perception

Question 43

how does central sensitization (allodynia) play a huge role in chronic pain?

Answer 43

with persistent nociception via C fibers, permanent neuroplastic changes are likely to occur, after constant barrage from C fibers, the interneuron may die due to high levels of amino acids. decreased ability to modulate nociception and the pain experience, now everything gets projected to the brain including light touch which may now be painful

Question 44

what can allodynia result in?

Answer 44

in spreading pain or mirror pain from abnormal synapsing in spinal cord

Question 45

sensory maps are genetically determined and sculpted based on?

Answer 45

movement and exercising it

Question 46

what is smudging?

Answer 46

not using a body part therefore losing it

Question 47

what are central changes that occur with/are caused by pain?

Answer 47

homunculus become blurry enlarged map difficulty with L vs R discrimination

Question 48

what is central processing of persistent pain?

Answer 48

when the brain starts questioning its map, threat level of nervous system goes up and can cause pain or increase pain for a prolonged period of time. this smudging of map causes a ramp ip phenomena of nervous system because the brain wants to know more

Question 49

how does a stressful situation affect pain and the development of chronic pain?

Answer 49

if you hurt yourself in a high stress environment, you are 8X more likely to develop chronic pain ex) surgery, car accident, work, abuse

Question 50

how do sport situations affect pain and the development of chronic pain?

Answer 50

kids who play contact sports in life experience less pain in life ex) learn injury and pain is normal

Question 51

How does pain work in the brain and ask if it is being threatened?

Answer 51

potentially novice-give information is sent up to the brain via ascending system and the brain processes this via the neuromatric and asks "am I in danger"

Question 52

what happens if the brain thinks it is in danger?

Answer 52

it wants to know more information known as facilitation

Question 53

what happens if the brain doesn't think it is in danger?

Answer 53

it concludes no threat and we see inhibition

Question 54

what is occurring when we experience pain and the fight or flight response is active?

Answer 54

adrenocorticotropic hormone (ACTH) is released from pituitary gland to stimulate the adrenal glands to produce adrenaline. cortisol helps to mobilize glucose reserves but can leave you feeling sore, tired, sensitive, and fatigued

Question 55

how does cortisol affect the immune system?

Answer 55

chronic conditions including stress- 3 immune chemicals seem to be very active. nerves become more sensitive to immune system

Question 56

what are some effects of long term pain?

Answer 56

fatigue, insomnia, and hypervigilance