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PATHO/PHARM I > Pain > Flashcards

Pain Flashcards

Final Exam

1
Q

Pain

A

“whatever the experiencing person says it is, existing whenever he says it does.”

“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

Acute pain is what kind of pain?

A

Acute pain is protective and promotes withdrawal from painful stimuli, allows the injured part to heal, and teaches avoidance of painful stimuli.

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3
Q

What does acute pain promote? What does this allow for?

A

promotes withdrawal from painful stimuli, allows the injured part to heal, and teaches avoidance of painful stimuli.

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4
Q

Three parts of the nervous system responsible for the sensation, perception and response to pain:

A
  1. Afferent pathways
  2. Interpretive centers
  3. Efferent pathways
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5
Q

Nociception

A

The processing of potentially harmful (noxious) stimuli through a normally functioning nervous system is called nociception.

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6
Q

Nociceptor

A

Nociceptors, or pain receptors, are free nerve endings in the afferent peripheral nervous system.

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7
Q

When nociceptors are stimulated, what do they cause?

A

When they are stimulated, they cause nociceptive pain.

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8
Q

How are nociceptors distributed throughout the body?

A

Nociceptors are unevenly distributed throughout the body, so the relative sensitivity to pain differs according to their location

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9
Q

Nociceptors respond to different types of stimuli:

A
  1. Mechanical (pressure or distortion)
  2. Thermal (extreme temps)
  3. Chemical (acids or chemicals of inflammation, such as bradykinin, histamine, leukotrienes, or prostaglandins)
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10
Q

Four phases of nociception

A
  1. transduction,
  2. transmission,
  3. perception, and
  4. modulation
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11
Q

Pain transduction

A

begins when nociceptors are activated by a noxious stimulus,

causing ion channels (sodium, potassium, calcium) on nociceptors to open, creating electrical impulses that travel through axons of two primary types of nociceptors that are transmitted to the spinal cord, brainstem, thalamus, and cortex

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12
Q

What exactly happens when nociceptors are activated by noxious stimuli?

A

ion channels (sodium, potassium, calcium) on nociceptors to open, creating electrical impulses that travel through axons of two primary types of nociceptors that are transmitted to the spinal cord, brainstem, thalamus, and cortex

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13
Q

Two primary types of nociceptors

A
  1. A delta fibers
  2. C fibers
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14
Q

A-delta fibers

A

Aδ fibers are larger myelinated fibers that rapidly transmit sharp, well-localized “fast” pain sensations, such as intense heat or a pinprick to the skin.

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15
Q

C fibers where are they located?

A

are located in muscle, tendons, body organs, and in the skin.

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16
Q

C fibers

A

C fibers are the most numerous, are smaller and unmyelinated

They slowly transmit dull, aching, or burning sensations that are poorly localized and often constant.

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17
Q

Pain transmission

A

Pain transmission is the conduction of pain impulses along the Aδ and C fibers (primary-order neurons) into the dorsal horn of the spinal cord

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18
Q

Pain perception

A

Pain perception is the conscious awareness of pain, which occurs primarily in the reticular and limbic systems and the cerebral cortex.

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19
Q

Pain threshold

A

Pain threshold is defined as the lowest intensity of pain that a person can recognize.

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20
Q

How does intense pain in one location influence the threshold of another location?

A

Intense pain at one location may increase the threshold in another location.

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21
Q

Pain tolerance

A

Pain tolerance is defined as the greatest intensity of pain that a person can endure.

22
Q

How is pain tolerance influenced by exposure?

A

Pain tolerance generally decreases with repeated exposure to pain, fatigue, anger, boredom, apprehension, and sleep deprivation and may increase with alcohol consumption, persistent use of opioid medications, hypnosis, distracting activities, and strong beliefs or faith.

23
Q

Pain modulation

A

Pain modulation involves many different mechanisms that increase or decrease the transmission of pain signals throughout the nervous system.

24
Q

When does modulation occur?

A

Depending on the mechanism, modulation can occur before, during, or after pain is perceived.

25
Q

Two types of pathways of modulation:

A
  1. Diffuse noxious inhibitory control (DNIC)
  2. Expectancy-related cortical activation
26
Q

Diffuse noxious inhibitory control (DNIC) involves what?

A

is an inhibitory pain system that involves a spinal-medullary-spinal pathway.

27
Q

Diffuse noxious inhibitory control (DNIC):

A

Pain is relieved when two noxious or painful stimuli occur at the same time from different sites (pain inhibiting pain).

28
Q

Expectancy-related cortical activation- two types

A
  1. Placebo effect (beneficial expectations)
  2. Nocibo effect (adverse expectations)
29
Q

Expectancy-related cortical activation

A

can exert control over analgesic systems to attenuate or intensify pain.

In other words, cognitive expectations can cause real, measurable physiologic effects that share some of the same descending pain pathways as the pain modulatory systems.

30
Q

How long does acute pain last?

A

Acute pain is transient, usually lasting seconds to days, sometimes up to 3 months.

31
Q

How does acute pain begin, how is it relieved?

A

It begins suddenly and is relieved after the chemical mediators (usually related to inflammation) that stimulate pain receptors are removed.

32
Q

Acute pain arises from what structures?

A

Acute pain arises from cutaneous, deep somatic, or visceral structures

33
Q

Acute pain can be classified as:

A
  1. Somatic
  2. Visceral
  3. Referred
34
Q

Somatic pain arises from where?

A

Somatic pain arises from the skin (i.e., from an abrasion or a laceration), joints (pain from arthritis or injured tendons), and muscles (strain from overuse or muscle injury).

35
Q

Somatic pain is what kind of pain?

A

It is either sharp and well localized (especially fast pain carried by Aδ fibers) or dull, aching, throbbing, and poorly localized, as seen in polymodal C fiber transmissions.

36
Q

Visceral pain- how is it transmitted?

A

Visceral pain is transmitted by C fibers

37
Q

Visceral pain

A

refers to pain in internal organs and the lining of body cavities;

38
Q

Visceral pain is what kind of pain?

A

it tends to be poorly localized with an aching, gnawing, throbbing, or intermittent cramping quality.

39
Q

How does visceral pain spread?

A

Visceral pain often radiates (spreads away from the actual site of the pain) or is referred.

40
Q

Referred pain

A

Referred pain is felt in an area removed or distant from its point of origin—the area of referred pain is supplied by the same spinal segment as the actual site of pain.

41
Q

How is referred pain?

A

Referred pain can be chronic or acute

42
Q

Why does referred pain occur?

A

Impulses from many cutaneous and visceral neurons converge on the same ascending neuron, and the brain cannot distinguish between the different sources of pain.

43
Q

Why is painful sensations experienced at the referred site instead of the site of origin?

A

Because the skin has more receptors, the painful sensation is experienced at the referred site instead of at the site of origin.

44
Q

Chronic or persistent pain

A

defined as lasting for more than 3 to 6 months in adults and is pain lasting well beyond the expected normal healing time.

45
Q

What is the purpose of chronic pain?

A

Chronic or persistent pain serves no purpose

46
Q

How is chronic pain experienced?

A

It may be ongoing (e.g., low back pain) or intermittent (e.g., migraine headaches).

47
Q

Neuropathic pain

A

is chronic pain initiated or caused by a primary lesion or dysfunction in the nervous system and leads to long-term changes in pain pathway structures (neuroplasticity) and abnormal processing of sensory information.

48
Q

How does amplification of neuropathic pain occur?

A

There is amplification of pain without stimulation by injury or inflammation.

49
Q

What is neuropathic pain described as?

A

Neuropathic pain is often described as burning, shooting, shocklike, or tingling.

50
Q

Two classifications of neuropathic pain:

A
  1. Peripheral neuropathic pain
  2. Central neuropathic pain
51
Q

Peripheral neuropathic pain is caused by what?

A

is caused by peripheral nerve lesions.

52
Q

Central neuropathic pain is caused by what?

A

Central neuropathic pain is caused by a lesion or dysfunction in the brain or spinal cord.

PATHO/PHARM I (28 decks)

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