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CATA 348 > Pain > Flashcards

Pain Flashcards

1
Q

Pain is subjective or objective

A

Subjective sensation

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2
Q

Perception of pain is affected by what?

A

Past experiences and expectations

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3
Q

Can treatment change the perception of pain?

A

YES
Much of what we do to treat pain is to change perception of pain

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4
Q

Essential aspect of caring for the injured patient?

A

Control/management of pain

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5
Q

Selection of a therapeutic agent should be based on what?

A

On a sound understanding of its physical properties and physiological effects

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6
Q

3 types of pain

A

Acute pain
Chronic pain
Referred pain

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7
Q

Pain of sudden onset

A

Acute pain

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8
Q

Pain lasting for more than 6 months

A

Chronic pain

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9
Q

Pain that is perceived to be and area that seems to have little relation to the existing pathology

A

Referred pain

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10
Q

Example of referred pain (2)

A

Kehr’s sign
Myofascial trigger points

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11
Q

Pain that arises from actual or threatened damage to NON-NEURAL tissue and is due to the activation of nociceptors

A

Nociceptive pain

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12
Q

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

A

Neuropathic pain

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13
Q

Pain that arises from altered nociception despite no clear evidence of factual or threatened tissue damage
(causing the activation of peripheral nociceptors or evidence for disease or lesion of the somatosensory system causing the pain)

A

Nociplastic pain

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14
Q

A stimulus that is damaging or threatens damage to normal tissues
ex: heat

A

Noxious stimulus

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15
Q

The minimum intensity of a stimulus that is perceived as painful

A

Pain threshold

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16
Q

Is pain threshold variable to everyone?

A

Yes

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17
Q

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

A

Pain tolerance level

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18
Q

Irritating nerve roots and extending distally (from proximal to distal)

A

Radiating pain

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19
Q

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

A

Sclerotomic pain

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20
Q

What do we need in a pain measurement scale? (2)

A

Reliability and validity

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21
Q

Which scale has the most strengths and fewest weaknesses?

A

1-10 scale
1-4 = mild
5-6 = moderate
7-10 = severe

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22
Q

Which scale is consisted of a line to represent the extreme limits?

A

Visual analogue scale

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23
Q

With what tool do we detect change in pain? and what is a meaningful change?

A

The scale does it best
30% or 2 points or more on scale

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24
Q

What makes up a pain profile? (4)

A
  • Identify type of pain
  • Quantify intensity of pain
  • Evaluate the effect of the pain experience on patient’s level of function
  • Assess the psychosocial impact of pain
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25
Q

What tool is used to establish spatial properties of pain?

A

Pain chart

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26
Q

Blue in pain chart

A

Aching pain

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27
Q

Yellow in pain chart

A

Numbness or tingling

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28
Q

Red in pain chart

A

Burning pain

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29
Q

Green in pain chart

A

Cramping pain

30
Q

What tool is used to represent dimensions of the pain experience?

A

McGill Pain questionnaire

31
Q

What tool is used to assess functional impairment associated with pain?

A

Activity Pain indicators profile

32
Q

What is the most common acute pain profile used in sports medicine clinics?

A

Numeric pain scale

33
Q

3 goals in managing pain

A
  • To control/manage acute pain and protect from further injuries
  • Reducing pain is an essential part
  • Encourage body to heal through designed progressively increase functional capacity and RTP
34
Q

Name the 4 sensory receptors

A

Mechanoreceptors
Nociceptors
Proprioceptors
Thermoreceptors

35
Q

Which receptors are responsible for pain?

A

Nociceptors

36
Q

What type of cell is responsible for nociceptors?

A

Free nerve endings

37
Q

Transmit impulses from the sensory receptors toward the brain

A

Afferent nerve fibers

38
Q

Transmit impulses from the brain toward the periphery

A

Efferent nerve fibers

39
Q

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

A

Accommodation

40
Q

What do the first order neurons do?

A

Transmit impulses from the sensory receptors to the dorsal horn of the spinal cord

41
Q

4 different types of first order neurons (from fastest)

A

A alpha
A beta
A delta
C fibers

42
Q

Is it the fastest or the slowest fibers that have a large diameter afferents?

A

The fastest

43
Q

Which signal gets to the brain first?

A

Faster nerve = override the smaller ones

44
Q

What do the second order neurons do?

A

Carry sensory messages from the dorsal horn to the brain

45
Q

Second order afferent fibers are categorized as ___ or ___

A

wide dynamic range or nociceptive specific

46
Q

What do the third order neurons do?

A

Carry information to various brain centers where the input is integrated, interpreted and acted upon

47
Q

What is a chemical helpful for the synapse?

A

Neurotransmitters

48
Q

Neuron that transmits pain signals

A

Nociceptive neuron

49
Q

Injury to a cell causes the release of 2 things

A

Substance P
Prostaglandi

50
Q

How do we sensitize the nociceptors in and around the area of injury?

A

By lowering their depolarization threshold

51
Q

When threshold is lowered and pain is increased

A

Primary hyperalgesia

52
Q

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

A

Secondary hyperalgesia

53
Q

Which type of neurons transmits “fast pain”?

A

A delta

54
Q

A delta and C fibers transmit what sensations? (2)

A

Pain and temperature

55
Q

Where do A delta neurons originate from?

A

Receptors located in skin

56
Q

Where do C neurons originate from?

A

Both superficial tissue (skin) and deeper tissues (ligaments and muscle)

57
Q

Which type of neurons transmits “slow pain”?

A

C fibers

58
Q

3 mechanisms of pain control

A
  • Gate control theory
  • Descending mechanisms (central biasing)
  • Release of endogenous opioids (beta-endorphin)
59
Q

Explain the gate control theory

A

Concept that the signal transmitted is the signal passing through the fastest neurons being activated at the moment
So if the Abeta fibers are activated (2nd fastest) they override the message of pain from Adelta and C fibers

60
Q

Explain the descending pain control mechanism

A

Concept of blocking the gate to impulses carried along the Adelta and C afferent fibers at the dorsolateral tract

61
Q

Other name for descending pain control mechanism

A

Central biasing

62
Q

Explain central biasing

A

It is theorized that previous experiences, emotional influences, sensory perception, and other factors could influence transmission of pain message and perception of pain, focusing

63
Q

Slide 58 to 61

A

What

64
Q

Stimulation of Adelta and C fibers afferents can stimulate the release of what 2 things

A

Endogenous opioid:
B-endorphin
Dynorphin

65
Q

Role of the 2 endogenous opioid

A

Block the neurotransmitters that are transmitting the pain signals
They are inhibitors

66
Q

Therapeutic modalities can be used to (3)

A
  • stimulate large-diameter afferent fibers
  • decrease pain fiber transmission velocity
  • stimulate release of endogenous opioids through prolonged small diameter fiber stimulation with TENS
67
Q

Why is it more unpleasant to stimulate the smaller nerve fibers?

A

Because more current (electricity) is needed since they are located deeper

68
Q

Medically inactive substance that delivers desired response

A

Placebo

69
Q

What is the placebo effect?

A

Observable, measurable improvement of health not attributable to treatment

70
Q

What are the 4 take home messages?

A
  • Cannot ignore pain
  • No pain no gain true in conditioning but not rehabilitation
  • Cannot ignore placebo effect
  • Pain will change how you treat each athlete

CATA 348 (6 decks)

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