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Neuro PT > Pain > Flashcards

Pain Flashcards

1
Q

A sign that causes an excessive discharge of stimuli

A

Pain

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2
Q

Pain is both a

A

sensation and emotion

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3
Q

When can pain transmission occur?

A

When one has an intact spinothalamic system

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4
Q

A gate that receives pain stimuli from receptors

A

Substantia Gelatinosa

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5
Q

Transmitters of pain (excitatory)

A

Substance P
Calcium
Enzymes: Histamine
Prostaglandins

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6
Q

Inhibitory neurotransmitters of pain

A

Serotonin
GABA
Opioid peptides
Endorphins
Enkephalin
Dynorphin

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7
Q

What inhibitory neurotransmitter inhibits at the dorsal horn?

A

Opioid peptides

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8
Q

Pain pathway and interconnections

A

Receptors
Substantia Gelatinosa
Spinothalamic tract
Lateral/Anterior White mater
Tegmentum
VPL
Primary sensory area

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9
Q

subserve
the emotional aspect
of pain at the level of the brainstem

A

Spinoreticular pathway

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10
Q

Spinoreticular pathway

A

Pain to reticular fromation
To midbrain and pons tegmentum
to the hypothalamus
to the amygdala

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11
Q

Where is the Periaqueductal Gray (PAG) located?

A

gray matter of the tegmentum of the brainstem

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12
Q

What does the PAG do?

A

Regulates substantia gelatinosa; decides how much the substantia gelatinosa opens

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13
Q

What lobe is the core of emotions?

A

Limbic

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14
Q

Where is the Substantia Gelatinosa located?

A

Dorsal Spinal Cord

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15
Q

What does increased pain do to the RAS?

A

Activates RAS in the RF found in MB & Pons to activate the cortex resulting in alertness.

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16
Q

Central Modulation of Pain Perception acts on

A

Dorsal horn of the SC

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17
Q

What can the central modulation of pain do?

A

can enhance or inhibit pain depending on the emotional framework

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18
Q

Subserved by diffuse projections of pain fibers to the limbic and frontal lobes

A

Affective motivational aspect of pain

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19
Q

What does the affective motivational aspect of pain do?

A

It is the main factor of how pain is perceived by the brain

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20
Q

What neurotransmitter brings pain stimuli across the SGR?

A

Substance P

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21
Q

Pain from skin, bone, organs, ligaments, and muscles

A

Nociceptive pain

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22
Q

Pain from the dysfunction of the nervous system

A

Neuropathic pain

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23
Q

Protective role of nociceptive pain

A

Elicits reflex and behavioral responses that keep tissue damage to a minimum

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24
Q

Pain that originates or comes from cutaneous nociceptors

A

Somatic pain

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25
Q

Pain that originates or comes from nociceptors found in hollow organs

A

Visceral pain

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26
Q

Neuropathic pain may be

A

central or peripheral

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27
Q

pain that
occurs without identifiable nerve or tissue damage.

A

Central sensitization or dysfunctional pain

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28
Q

Duration of Central sensitization or dysfunctional pain

A

long-lasting duration

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29
Q

Scope of dysfunctional pain

A

Extends beyond the receptive field (widespread)

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30
Q

Examples of dysfunctional pain

A

Fibromyalgia
Irritable bowel syndrome

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31
Q

Types of nociceptive pain

A

ischemic
inflammatory
traumatic
metabolic
toxic

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32
Q

A type of nociceptive pain that results from lack of blood flow to the cells

A

Ischemic

33
Q

A type of nociceptive pain that results from infections

A

Inflammatory

34
Q

A type of nociceptive pain that is caused by external forces

A

Traumatic

35
Q

An example of this type of pain is uric acid that creates gouts.

A

Metabolic

36
Q

Examples of central neuropathic pain

A

Stroke
Tumor
Demyelinating diseases

37
Q

How much pain does nociceptive pain inflict?

A

Proportionate to the stimulus.

38
Q

How much pain does neurologic pain inflict?

A

Disproportionate to the stimuli

39
Q

PNS Lesions

A

Diabetic neuropathy
Phantom limb pain
Trigeminal neuralgia
LBP
Carpal tunnel syndrome

40
Q

CNS Lesions

A

Lesions in the VPL
Stroke
Myelopathic pain due to MS

41
Q

Type of pain present in neuropathic pain

A

Burning
Shooting
Stabbing
Vice-like
Electric shock-like

42
Q

A neuropathic pain that comes and goes

A

Paroxysmal

43
Q

A neuropathic pain that does not need any noxious stimuli

A

Spontaneous

44
Q

A neuropathic pain that is tolerable

A

Paresthesia

45
Q

A neuropathic pain that is no longer tolerable

A

Dysesthesia

46
Q

Onset of neuropathic pain

A

Immediate or delayed

47
Q

Pain stimulus in neuropathic pain

A

Allodynia
Hyperalgesia
Hyperpathia

48
Q

Clinical features associated with neuropathic pain

A

Insomnia
Anxiety
Depression
Weight loss
Decreased quality of life

49
Q

Burning, shock-like pain

A

Spontaneous pain

50
Q

Abnormal, unpleasant sensations

A

Dysesthesia

51
Q

Abnormal, not unpleasant sensation

A

Paresthesia

52
Q

Painful response to a non-painful
stimulus

A

Allodynia

53
Q

Heightened response to a painful
stimulus

A

Hyperalgesia

54
Q

Delayed, explosive pain to a painful
stimulus

A

Hyperpathia

55
Q

decreased sensitivity & a raised
threshold to painful stimuli

A

Hypoalgesia

56
Q

3 General Mechanisms of Neuropathic Pain

A

Ectopic focus
Peripheral and General Sensitization
Loss of Local and Central Inhibition

57
Q

damage in the CNS or PNS that will
fire by itself with pain stimuli

A

Ectopic focus

58
Q

Does neuropathic pain need noxious stimuli?

A

No

59
Q

Why does neuropathic pain still illicit pain despite not having any stimulus?

A

Spontaneous firing of axons at once

60
Q

Regenerating sprouts

A

Neuromas

61
Q

What do neuromas express

A

Na+ channels

62
Q

What does damage in the PNS do?

A

Enhances pain; makes receptors very sensitive to stimulus

63
Q

Where is diabetic neuropathy more common?

A

Lower extremities than upper extremities

64
Q

Viral infection of the peripheral nn that presents with sharp burning pain in the involved dermatome

A

Herpes Zoster

65
Q

Inadequate relief of herpes zoster may lead to

A

Post herpetic neuralgia

66
Q

An injury in the msk system that gets worse with time

A

Complex Regional Pain syndrome

67
Q

Complex regional pain syndrome often result in

A

impairment of motor function

68
Q

Conditions that lead to CRPS

A

reflex sympathetic dystrophy
causalgia
shoulder hand syndrome
acute bone atrophy
post-traumatic OP

69
Q

refers to burning pain

A

causalgia

70
Q

local treatments to neuropathic pain

A

thermotherapy, electrotherapy, anesthesia, capsaicin

71
Q

what nerve block treatments are there for neuropathic pain?

A

peripheral nerve, roots, plexus; sympathetic ganglia

72
Q

Anti-convulsant for neuropathic pain

A

Caramazepine
Gabapentine
Pregabalin
Valporic Acid
Lamotrigine

73
Q

Opioids for neuropathic pain

A

Oxycodone
Tramadol

74
Q

Topical prep for neuropathic pain

A

Capsaicin
Lidocaine 5%

75
Q

Anti-depressants for neuropathic pain

A

TCAs - lines
SSRIs - tines
SNRI - xines

76
Q

make you tell the px that the
pain will get better

A

Placebo

77
Q

tell the patient that they will
feel more pain

A

Nocebo

78
Q

aware that they are given the drug

A

Open analgesic

79
Q

not aware that they are given the
drug

A

Hidden analgesic

Neuro PT (12 decks)

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