Pain Flashcards

1
Q

What is pain

A

An unpleasant sensory and emotional
experience associated with actual or potential
tissue damage, or described
in terms of such damage

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2
Q

What pain do we feel on a daily basis

A

Acute (nociceptive) pain

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3
Q

What characterises ‘normal pain’

A

Only elicited when intense/noxious stimuli
threaten to damage normal tissue - INDUCED

  • Has an adaptive/biologically useful role:
    Serves as a protective function
  • Characterised by a high threshold and
    a limited duration
  • Afferents: Aδ and C-fibres
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4
Q

What fibres create a sharp stabbing pain

A

A delta

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5
Q

What fibres are responsible for a dull aching (2nd) pain

A

C fibres

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6
Q

What are the features of nociceptor endings

A

Free nerve endings
High threshold of activation
Respond to intense (noxious) stimuli usually associated with pain
-A delta: noxious mechanical/heat
-C fibres: polymodal
Carry several types of receptor proteins - responsive to different noxious stimuli
Display sensitisation

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7
Q

Where does the 2nd order sensory neurone project into in the spinothalamic pathway

A

Antero-lateral funiculus (white matter)

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8
Q

Where does the 2nd order neurone give off little colateral branches

A

Medulla (2)
Pons (2)
Midbrain (2)

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9
Q

How do we feel pain in our teeth

A

Free nerve endings in dentine of the tooth send axons via trigeminal nerve to spinal nucleus up to thalamus and then to sensory cortex

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10
Q

What receptors are found in pain pathways

A

Nociceptors

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11
Q

What are the names of the pain pathways

A

Spinothalamic
Anterior (ventral) trigemino-thalamic

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12
Q

Where in the brain do pain signals go

A

Primary sensory cortex
Subcortical areas

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13
Q

What are the advantages of pain

A
  • Location
  • Pain quality – sharp stabbing, dull ache
  • Pain intensity
  • Frequency / duration
  • Provoking / relieving events
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14
Q

What are referred pains

A

These are perceived in one part of the
body, but the pathology is elsewhere
Pain tends to refer from an internal
organ to a superficial area e.g. skin

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15
Q

What causes referred pain

A

Referral due to a convergence of
inputs in the CNS
Pains tend to be referred to sites of
common embryological origin

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16
Q

Where can referred heart pain be felt

A

Left chest, shoulder and heart

17
Q

What factors affect a persons pain perception

A

Tissue damage
Genetic
Molecular
Cellular
Anatomical
Physiological
Psychological
Social

18
Q

What external factors can affect pain tolerance

A

Psychological
-sex
-age
-cognitive level
-culture

Situational
-expectation
-control
-relevance

Emotional
-fear
-anger
-frustration

19
Q

What can block the pain signals

A

Inhibitory Interneurons stimulated by things such as rubbing a burn

20
Q

What is the supraspinal loop

A

Group of cells which relay information back down from the PAG to meddula and to spinal chord inhibiting second order neurones or reduce receptor activity
Reduced feeling of pain

21
Q

What 5 pillars are associated with tissue damage

A

heat
redness
swelling
pain
loss of function

22
Q

What is the triple response to mild trauma

A

Wheal
Red reaction
Flare

23
Q

What causes the wheal

A

Release of bradykinin

24
Q

What causes the dilation of blood vessels and what response is this

A

CGRP dilates blood vessels causing a flare

25
Q

What relieving actions can be taken against the triple response

A

Restrict blood supply, pressure + cold water
Minimise effect of mast cell degranulation: anti-histamine

26
Q

What is released following tissue damage to stimulate activation of mast cells and capillaries

A

Substance P and CGRP