Pain

Question 1

Heath and pain aspects

Answer 1

Biological
Social
Psychological

Question 2

Pain

Answer 2

Unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.

Question 3

Nociception

Answer 3

The neuronal process of encoding noxious stimuli
(Can be checked)

Question 4

Nociceptive pain

Answer 4

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

Question 5

Neuropathic pain

Answer 5

Pain caused by lesion or disease of the somatosensory nervous system (hit the elbow —> hand “burns”)

Question 6

Loeser’s model of pain

Answer 6

Nociception (irritating nocioceptive fibers; injury / tissue damage)

Pain (unpleasant sensory and emotional experience)

Suffering (emotional response that includes fear, depression, anxiety, …)

Pain behaviour

Question 7

Pain characteristics

Answer 7

1- Pain changes through life and its impact is not the same for young vs elder people
2- Not everything is about drugs… pain management programmes

Question 8

Nocioception

Answer 8

Doesn’t really happen unless the patient is anaesthetised. We don’t feel anything, but HR does go up, patients start sweating,… even though we put patients to sleep, nociceptors still fire. There is however no feeling of pain, as we have to be conscious to feel pain. There is an emotional component to it

Question 9

Suffering

Answer 9

Pain doesn’t mean suffering. Suffering = emotional impact (ex: persistent pain, patient can no longer cope with it = suffering).

Question 10

Pain behaviour

Answer 10

When you actually change your way of acting in a day-to-day life due to pain. Ex: a person that stops seeing friends, family,… due to fear of pain.

Question 11

How is pain transmitted?

Answer 11

Receptors activated
Info travels to spine through somas in dorsal root ganglia)
Info arrives to brain (thalamus) —> to cortex
Descending pathway

Question 12

Why do we shout before feeling pain?

Answer 12

Because the electrical stimulus gets to the cortex, but in its way between thalamus and cortex is Broca’s area, related to language.

Question 13

Types of nerve fibers

Answer 13

A-beta fibres
- don’t transmit painful signals
- very rapid fibres
- transmit sensation (touch and vibration)

A-delta fibres
- some degree of myelination
- transmit signals DIRECTLY from the Nociceptors.

C fibres
- unmyelinated
- transmit less precise sensations from the area around the point of pain

Question 14

Pain —> fibers

Answer 14

• 1st, sharp, precise localized pain = delta fibres
• 2nd, diffuse expanded pain = C fibres

Question 15

Discrimination of pain

Answer 15

More/less pain depends on the amount of receptors activated (+ painful = higher firing rates, not more nerves firing)

Question 16

Dermatomes

Answer 16

Sensory areas of the body (also for all the viscera)

Question 17

Visceral pain dermatomes

Answer 17

Much more diffuse, overlap

Question 18

Gate theory explain why…

Answer 18

Touching painful area calms down the pain

Question 19

Gate theory

Answer 19

There are inhibitory interneurons in the spinal cord.

C fibres inhibit the inhibitory interneuron = potentiates painful signal.

A-beta fibres activates inhibitory interneuron —> inhibit 2nd neuron = painful signals to brain
(Still hurts, but it hurts less)