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Anesthesiology Round 2!!! > Pain > Flashcards

Pain Flashcards

1
Q

Allodynia meaning?

A

Perception of a nonnoxious stimulus as pain

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2
Q

Anesthesia meaning?

A

Abscence of all sensation

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3
Q

Anesthesia dolorosa meaning?

A

Pain in an area that lacks sensation

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4
Q

Dysesthesia

A

Unpleasent or abnormal sensation with or without a stimulus

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5
Q

Hyperesthesia

A

Increased response to mild stimulation

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6
Q

Hyperpathia

A

Hyperesthesia, allodynia, hyperalgesia

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7
Q

Hyperalgesia

A

Increased response to noxious stimulation

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8
Q

Hypesthesia

A

Reduced cutaneous senation

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9
Q

Neuralgia

A

Pain inthe distribution of a nerve or a group of nerves

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10
Q

Paresthesia

A

Abnormal sensation percieved without an apparent stimulus

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11
Q

Radiculopathy

A

Functional abnormality of one or more nerve roots

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12
Q

Acute pain causes:

A
  • Injury
  • Disease process
  • Abnormal function of muscle or viscera
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13
Q

When pain fails to resolve because of either abnormal healing or inadequate treatment, it becomes…

A

Chronic

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14
Q

Superficial pain recieves input from:

A

Skin, subcutaneous tissues and mucous membranes

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15
Q

Deep pain recieves input from:

A

Muscles, tendons, joints or bones

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16
Q

True visceral pain typical location and type?-

A
  • Midline, dull and diffuse
  • Associated with abnormal sympathetic and parasympathetic activity
    -> nausea, vomiting, sweating and changes in BP and HR
17
Q

Parietal pain

A
  • Sharp, stabbing pain
18
Q

Chronic pain

A

Attenuated or absent neuroendocrine stress responses and have prominent sleep and affective disturbances

Can be neuropathic or nociceptive

19
Q

Persistent postsurgical pain

A

Chronic pain continuing beyond the typical healing period of 1-2 months

20
Q

Inflammatory pain examples:

A

Appendictis, rheumatoid arthritis, inflammatory bowel disease, herpes zoster

21
Q

Inflammatory pain mediators:

A

cytokines, TNF, acids, lipids, mast cells, ATP, vasoactive amines

22
Q

Types of nociceptors:

A
  • Mechanonociceptors - pinch and pinprick
  • Silent nociceptors - inflammation
  • Polymodal mechanoheat nociceptors - excessive pressure, heat, noxious substances (bradykinin, histamine, seratonin, H+, K+, prostaglandins, caspaicin, adenosine triphosphate)
23
Q

Nociceptive _ fibres from the esophagus, larynx and trachea travel with the ______ nerve to enter the ______ in the brainstem

A

C
vagus
nucleus solitarius

24
Q

Describe neurons structures in the pain pathway:

A
  • Primary afferent neurons are found in the dorsal root ganglia and contain an axon which bifurcates (one to the peripheral tissues and one to the dorsal horn)
  • Second order neurons are found in the dorsal horn and cross the midline to reach the thalamus (in the contralateral spinothalamic tract)
25
Q

Which are the main pain fibers?

A

Aδ (pain, temperature, touch), 2-5m diameter, 12-30 ms-1 conduction speed
(myelinated and fast)

C (dorsal root), pain, temprature, mechanoreceptors, reflex responses, 0.4-1.2m fibre diameter, 0.5-2ms-1 conduction speed

26
Q

Excitatory neurotransmitters modulating pain:

A

Substance P, calcitonin gene-related peptide, glutamate, aspartate, ATP

27
Q

Main excitatory pain neurotransmitters and their location:

A
  • Glutamate - main CNS NT
  • Substance P - DRG
    Calcitonin gene-related peptide - DRG
27
Q

Inhibitory neurotransmitters modulating pain:

A

Somatostatin, acetylcholine, enkephalins, B-endorphin, norepinephrine, adenosine, serotonin, GABA, glycine

28
Q

Opiois drugs classification:

A

Full agonists - morphine, heroine, methadone, meperidine, codeine, fentanyl

Partial agonists - buprenorphine

Mixed agonists/ antagonists - butorphanol, nalbuphine, pantazocine

Full antagonists - Naloxone, naltrexone, methylnaltrexone

29
Q

Non-opioid classification:

A

Salicylates
- Acetylsalicyclic acid (aspirin)

P-aminophenols
- Acetominophen

Proprionic acids
- Ibuprofen
- Naproxen

Indoles
- Indomethacin

COX-2 inhibitors:
- Celecoxib

30
Q

Antidepressants are used for _______
Examples

A

Neuropathic pain
Escitalopram, Bupropion, Citalopram

31
Q

ARDS diagnosis:

A

PaO2/FiO2 <300mmHg

Anesthesiology Round 2!!! (30 decks)

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