Pain Flashcards

1
Q

Define pain

A

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

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2
Q

Define immediate pain

A

Warns of imminent tissue damage - withdraw from source of injury

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3
Q

Define persisting pain

A

After immediate pain

Encourages us to immobilise the injured area, giving damage the best chance to heel

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4
Q

Define nociception

A

Describes neural processes involved in producing and the sensation of pain

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5
Q

Define nociceptive pathways

A

Transduction in the periphery, through transmission to the dorsal horn of the spinal cord, then on to the brain

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6
Q

What are the phases of pain

A

Phase 1 - instant

Phase 2 - acute

Phase 3 - chronic (abnormal)

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7
Q

Define acute pain

A

< 12 weeks duration

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8
Q

Define chronic pain

A

Continuous pain lasting > 12 weeks

Pain that persists beyond the tissue healing time

Chronic non-cancer pain vs chronic cancer pain

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9
Q

Define 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

Define neuropathic pain

A

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

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11
Q

Define nociplastic pain

A

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

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12
Q

Define allodynia

A

Pain due to a stimulus that does not normally provoke pain

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13
Q

Define dysesthesia

A

An unpleasant abnormal sensation whether spontaneous or evoked

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14
Q

Define hyperplasia

A

Increased pain from a stimulus that normally provokes pain

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15
Q

Define hypoalgesia

A

Diminished pain in response to a normally painful stimulus

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16
Q

What is the pain pathway

A

Peripheral receptor - detect relevant stimuli

1st order neuron - from the periphery to the ipsilateral spinal cord

2nd order neuron - which crosses to the contralateral cord and ascends to the thalamus, the systems integrative ‘relay station’

3rd order neuron - from thalamus to midbrain and higher cortical centres

17
Q

Define nociceptors

A

Free nerve endings of primarily afferent neurones

A delta fibres
C fibres

Found in any area of the body which can sense pain either externally and internally

18
Q

Where do cell bodies of nociceptors usually reside

A

Dorsal root ganglion (body)

Trigeminal ganglion (face/head/neck)

19
Q

Describe a-delta nerve fibre

Information carried
Myelin sheath
Diameter
Conduction speed m/s

A

Pain - mechanical and thermal

Myelinated

1-5micrometers

5-40m/s

20
Q

Describe C fibres

Information carried
Myelin sheath
Diameter
Conduction speed m/s

A

Pain - mechanical, thermal and chemical

Non-myelinated

0.2-1.5micrometers

0.5-2m/s

21
Q

Where is the degree of pain is judged

A

Insula

Contributes to subjective aspect of pain perception

22
Q

What can hyperactivity of the central nucleus of the amygdala cause

A

Pain-related emotional response

Anxiety-like behaviour

23
Q

What maintains reciprocal connections with other pain processing areas

A

Cingulate cortex

24
Q

What is the role of opioids in pain

A

a2-adrenoceptor agonists

Inhibit afferent nerve transmission (descending pain pathway)

3 types of opioid receptors which regulate the neurotransmission of pain signals

Can regulate pain within the spinal cord, brain stem and cortex

25
Q

Describe the descending pain pathway

A

Neuronal inhibition

Midbrain receives pain information sends information via the spinomescencephalic tract - processes nociceptive information and relays to the rostral ventral medulla

Send signals down spinal cord and activate endogenous opiate systems to supress pain