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Health Psychology > Pain > Flashcards

Pain Flashcards

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1
Q

• Pain is protective
– Brings into consciousness the awareness of tissue damage
• Pain doesn’t feel protective
– It is accompanied by motivational and behavioral responses:
• Crying,Fear, Withdrawal

A

Physiology of Pain

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2
Q 
– Mechanical nociception
• Mechanical damage to body tissue
– Thermal nociception
• Damage due to temperature exposure
– Polymodal nociception
• General category
• Pain triggers chemical reactions from tissue damage
A

(pain perception) NOCICEPTION

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3
Q

conveys information about the senses to and from the brain[all motor nerves to skeletal muscles]

A

Somatic nervous system

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4
Q

convey info about the sense organs to the CNS

A

Afferent (sensory) neurons

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5
Q

convey info from CNS to muscles, organs, and glands

A

Efferent (motor) neurons

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6
Q

connect sensory to motor neurons

A

Interneurons

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7
Q

all motor nerves to smooth and cardiac muscles, galnds

A

autonomic system

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8
Q

Nociceptors in peripheral nerves first sense ____

A

injury

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9
Q

In response, release chemical messengers

which travel to spinal cord and brain ,____ neurons

A

afferent

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10
Q

Brain regions identify the site of the injury and

send messages back down spinal column, ____ neurons

A

efferent

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11
Q

• Leads to muscle contractions, helps block pain
• Changes in other bodily functions, such as
breathing

A

nociceptors

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12
Q
  • Acts in spinal cord

* Involved in the transmission of pain impulses from peripheral receptors to the CNS

A

Substance P

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13
Q
  • Acts in spinal cord
  • Amplifies pain signal transmitted from spinal cord to brain
  • Implicated in chronic pain
A

– Glutamate

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14
Q
  • Released by tissue damage

* Prolong the experience of pain by continued stimulation of nociceptors

A

Bradykinin & prostaglandins

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15
Q
  • Released by the immune system to signal the nervous system
  • Produce responses such as decreased activity, increased fatigue, increased pain sensitivity
  • May sensitize structures in the dorsal horn of the spinal cord to promote the development of chronic pain
A

Inflammatory cytokines

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16
Q

Head and neck pain is directly transmitted to

brain via the 12 ____ nerves

A

cranial

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17
Q

For the rest of the body, the peripheral nervous

system must send impulses to the brain via ___ ___

A

spinal cord

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18
Q

small, myelinated fibers that transmit sharp
pain
• Especially mechanical or thermal pain
• Regulate sensory aspects of pain by projecting onto areas of the
thalamus and sensory areas of the cortex

A

A-DELTA fibers

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19
Q

– large, myelinated fibers
• Conduct impulses 100x faster than C-fibers
• Easily stimulated

A

A-BETA fibers

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20
Q

– unmyelinated fibers transmit dull, aching pain
• >60% of all sensory afferents
• Require more stimulation
• Polymodal pain
• Regulate affective and motivational elements of pain by projecting onto thalamic, hypothalamic, and cortical areas

A

C-fibers

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21
Q
  • Primary & secondary somatosensory cortices
  • Anterior cingulated cortex (ACC)
  • Thalamus
  • Cerebellum
A

Brain areas involved in pain:

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22
Q

– The affective dimension of pain
– Feelings of unpleasantness and negative emotions
– Psychological and neural mechanismsinvolved
– Processed in the cerebral cortex are involved in
cognitive judgments about pain

A

Secondary Affect

23
Q

Electrical stimulation of a rat’s brain produced a

high level of analgesia

A

– The rat did not feel the pain of surgery
• Conclusion: The brain can control the amount of
pain experienced

24
Q

-substances like heroin or morphine,
but they are produced by the body
• These substances constitute an internal painregulation system

A

opioids

25
Q

– Produce peptides that project to the limbic system,

brain stem, & elsewhere

A

Beta-endorphins

26
Q

– Peptides that have widespread neuronal, endocrine, & CNS distributions

A

Proenkephalin

27
Q

– Found in the gut, the posterior pituitary, & the brain

A

Prodynorphins

28
Q

• Highly complex system (receptor sensitivity)
• Important in natural pain suppression
• Must be triggered
– Released by stress (Stress-Induced Analgesia)
• Suppress immune functioning
• Also implicated in cardiovascular control
• used for treating chronic pain

A

endogenous opioid peptides

29
Q

• Typically results from a specific injury
– Wound or broken limb
• Disappears when damaged tissue is repaired
• goes on for six months or less
• During there is an urgent search for relief

A

acute pain

30
Q 
– Typically begins with an acute episode
– Pain does not decrease with treatment
– Pain does not decrease as time passes
• Three types :
–  benign pain
– recurrent pain
–  progressive pain
A

chronic pain

31
Q 
– Persists more than 6 months
– Varies in severity
– Any number of muscle groups
– Relatively intractable to treatment
– Ex: Chronic low back pain & myofacial pain
A

Chronic benign pain

32
Q

– Intermittent episodes of acute pain
– Chronic because the condition lasts more than 6 months
– Ex: Migraine headaches & TMJMD

A

chronic recurrent pain

33
Q 
– Increases in severity over time
– Persists longer than 6 months
– Typically associated with malignancies or with 
degenerative disorders
– Ex: Rheumatoid arthritis & cancer
A

Chronic progressive pain

34
Q

Chronic pain may result from a predisposition to
respond to a bodily insult with a specified bodily
response

A

Prechronic pain – most crucial stage
– Time between acute and chronic pain
– Do you get better?
– Do you develop chronic pain?

35
Q
  • To soldiers, pain means, “I’m alive”

* To civilians it interrupts activities

A

Beecher’s study of WWII injuries

36
Q 
– Classical conditioning
• Dentist office, hospital
– Operant conditioning
• Rewards for pain behaviors may promote development of 
chronic pain
– Attention, sympathy, relief from normal responsibilities, 
disability compensation
– Secondary gains
– Personality
– Psychopathology
A

individual diff of experience of pain

37
Q

– Specific pain fibers and pain pathways exist, making the experience of pain virtually equal to the amount of tissue damage or injury
– Pain is a physical experience largely uninfluenced by psychological factors
– In reality, specificity is limited
– Pain is a complex, multidimensional phenomenon

A

Specificity Theory

38
Q

– Structures in the spinal cord act as a gate for the sensory input that the brain interprets as pain
• Increase pain (open gate)
• Decrease pain (close gate)
– Gate located in substantia gelatinosa in the dorsal horn
• A-delta, A-beta, and C fibers regulate the “gate”
– Central control trigger consists of nerve impulses that descend from the brain and regulate the “gate”
• Periaqueductal gray matter supports this theory
• Affected by beliefs & prior experience

A

Gate Control Theory

39
Q

– Extension of Gate Control Theory
– Stronger influence of the brain in pain perception
– The neuromatrix is a network of brain neurons that processes sensory information but can act even in the absence of sensory input (e.g., phantom limb)

A

Neuromatrix theory

40
Q
  • Rating scales
  • Large informal vocabulary
  • Questionnaires
A

Measuring Pain - Verbal Reports

41
Q

• Multidimensional Pain Inventory
– Pain characteristics, interference with lives and
functioning, mood

A

Measuring Pain: Self-report

42
Q

• Dysfunctional
– Higher pain, interference & distress, lower activity
• Interpersonally distressed
– Support persons not providing necessary support
• Adaptors
– Lower pain, interference & distress and higher functioning
• Repressors
– Report high pain & low activity but report low distress

A

Group patients into 4 categories for multidemensional pain inventory

43
Q

• Beck Depression Inventory (BDI)
– Chronic pain patients present with a different profile than do depressed patients without pain
• Symptom Checklist 90-Revised (SCL-90-R)
– Can differentiate between pain patients and people pretending to have pain

A

Measuring Pain: Standardized Tests

44
Q 
\_\_\_ \_\_\_\_are behaviors that arise as 
manifestations of chronic pain
– Distorted gait or posture
– Facial/audible expressions of distress
– Avoidance of activities
A

pain behaviors

45
Q

– Measures muscle tension

– Little relationship with self-report pain

A

Electromyography (EMG)

46
Q

Hyperventilation, blood flow in the temporal artery,
heart rate, hand surface temperature, surface
temperature, finger pulse volume, skin resistance level

A

Autonomic indices

47
Q

• Acute Pain
– Advantages: signals injury and promotes healing
– Disadvantages: it hurts!
– Advantages outweigh disadvantages

A

• Chronic Pain
– No Advantages
– Syndromes of pain based on symptoms

48
Q

– Recurrent attacks of pain that vary in intensity, frequency, & duration
• Symptoms: loss of appetite, nausea, vomiting, & exaggerated sensitivity to light and sound
• 30-50yrs of age

A

migraine headaches

49
Q

– Muscular in origin, accompanied by sustained
contractions of the muscles of the neck, shoulders, scalp, and face
– Includes mechanisms in CNS
• Symptoms: gradual onset; sensations of tightness; constriction or pressure; highly variable intensity, frequency,
and duration; dull, steady ache on both sides of head
– 40% of US population affected

A

Tension headaches

50
Q

– Severe headache that occurs in daily or nearly daily clusters
– Symptoms similar to migraines but much briefer, rarely last longer than 2 hours
– Localized on one side of the head; the eye on the other side often becomes bloodshot and waters
– Men > women at 10:1

A

Cluster Headache

51
Q

• Very common; 80% of people in US
• Most people recover
• Those who do not recover develop chronic pain
problems
• Substantial cost: > $90 billion a year
• Causes:
– Most frequent: injury or stress resulting in
musculoskeletal, ligament, and neurological in the lower back
– Infections, degenerative diseases, cancer, stress & psychosocial factors

A

Low Back Pain

52
Q

• Experience of chronic pain in the absence of a
body part
• Amputation removes the nerves that produce the impulses leading to the experience of pain but not the sensations
• Not limited to limbs, also found with breasts and teeth
• Severity and frequency varies
• Decreases over time
• Cause is debated but evidence supports the
Neuromatrix Theory

A

Phantom Limb Pain

53
Q

– Rheumatoid arthritis
• Autoimmune disease characterized by swelling & inflammation of joints, cartilage, bone, & tendons
• Can occur at any age & more frequent in women
– Osteoarthritis
• Progressive inflammation of joints; dull ache
• Most common form; especially among elderly

A

athiritis pain

Health Psychology (16 decks)

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