Pain Flashcards
What are the three types of nociceptive pain?
Somatic, visceral, and referred pain
Define nociceptors.
Specialized sensory receptors for painful stimuli.
What is neuropathic pain?
Pain caused by damage to the nervous system.
Name two types of nerve fibers involved in pain transmission.
A-delta fibers and C fibers.
What role do A-delta fibers play in pain?
They transmit sharp, well-localized pain.
What role do C fibers play in pain?
They transmit dull, aching, and poorly localized pain
What is the pain threshold?
The point at which a stimulus is perceived as pain.
What is pain tolerance?
The maximum level of pain that a person is able to tolerate.
Define hyperalgesia.
Increased sensitivity to pain.
What is allodynia?
Pain due to a stimulus that does not normally provoke pain.
What is the Gate Control Theory of pain?
A theory suggesting that non-painful input closes the “gates” to painful input, preventing pain sensation from traveling to the central nervous system.
What are endorphins?
Natural painkillers produced by the body.
What is the role of opioids in pain management?
They bind to opioid receptors in the brain and spinal cord to reduce the perception of pain.
How do NSAIDs reduce pain?
By inhibiting cyclooxygenase (COX) enzymes and reducing prostaglandin production.
Describe the WHO analgesic ladder.
A stepwise approach to pain management: start with non-opioids, then mild opioids, and then strong opioids for increasing levels of pain.
What is nociceptive pain?
Pain from physical damage or potential damage to the body.
What is the difference between acute and chronic pain?
Acute pain is short-term and usually has a clear cause, while chronic pain persists for a long time and can be more complex.
What are some non-pharmacological interventions for pain management?
Physical therapy, acupuncture, cognitive-behavioral therapy, and relaxation techniques.
How does diabetes cause neuropathic pain?
Through hyperglycemia-induced nerve damage.
What is phantom limb pain?
Pain perceived in an amputated limb.
What causes trigeminal neuralgia?
Compression of the trigeminal nerve.
What is the FLACC scale used for?
Assessing pain in infants and young children based on their behavior.
Define central sensitization.
Increased sensitivity of neurons in the central nervous system to pain stimuli.
What is complex regional pain syndrome (CRPS)?
A chronic pain condition typically following an injury, characterized by severe pain, swelling, and changes in the skin.
What is the role of NMDA receptors in pain?
They are involved in central sensitization and the development of chronic pain.
What is anterolateral cordotomy?
A surgical procedure to cut pain-conducting pathways in the spinal cord to alleviate pain.
What is midline myelotomy?
A surgical procedure to relieve severe chronic pain by cutting the spinal cord pathways that transmit pain signals.
Name a common cause of lumbosacral radicular pain.
Herniated intervertebral disc.
What is postherpetic neuralgia?
Persistent nerve pain following a shingles infection.
What is the primary cause of chemotherapy-induced peripheral neuropathy?
Neurotoxicity from chemotherapy drugs.
How is pain assessed in non-verbal patients?
Using behavioral assessment tools like the FLACC scale.
What are some physiological symptoms of pain in infants?
Increased heart rate, blood pressure, and ventilatory rate; changes in skin color; sweating.
What are some behavioral responses to pain in infants?
Changes in facial expression, crying, body movements, and withdrawal of affected limbs.
What is central pain syndrome?
Pain caused by damage to the central nervous system.
Name some causes of central pain syndromes.
Stroke, multiple sclerosis, spinal cord injury, brain tumors, traumatic brain injury.
What is the consequence of hyperglycemia in diabetic neuropathy?
Degeneration of unmyelinated sensory neurons.
What are the typical symptoms of diabetic neuropathy?
Burning pain and loss of sensation in the feet and hands.
What are the clinical features of CRPS?
Ongoing pain, allodynia, hyperalgesia, edema, cutaneous blood flow, and sweating abnormalities.
How does nerve injury contribute to neuropathic pain?
Through the formation of neuromas and spontaneous action potentials.
What is the typical distribution of pain in diabetic neuropathy?
Stocking and glove distribution in the distal extremities.
How does neuropathic pain differ from nociceptive pain?
Neuropathic pain arises from nerve damage, while nociceptive pain comes from tissue damage.
What role does the sympathetic nervous system play in some CRPS cases?
Sympathetic blockade can alleviate pain, indicating involvement of sympathetic nerves.
What are the treatment steps in the WHO analgesic ladder?
Step 1: non-opioid analgesics, Step 2: weak opioids, Step 3: strong opioids, Step 4: invasive techniques.
What is the significance of the “wind-up” phenomenon in pain?
It describes the progressive increase in pain intensity with repeated stimulation.
What is disinhibition in the context of pain?
Reduction in the normal inhibitory influence on central nervous system neurons, contributing to pain sensitization.
What factors can influence pain perception in older adults?
Chronic diseases and individual variability in pain response.
What are the main goals of pain management in nursing?
Alleviate pain, improve function, and enhance quality of life.
How does chronic pain affect the economy?
Significant healthcare costs, employment-related costs, and welfare payments.
What is the importance of assessing pain in paediatric patients?
To provide adequate pain control and improve outcomes for infants and young children.
How does injury to the spinothalamic tract affect pain perception?
It can lead to central pain syndromes with intense and chronic pain sensations.
Explain the role of NMDA receptors in the development of chronic pain.
NMDA receptors contribute to central sensitization by increasing the excitability of neurons in the central nervous system, leading to persistent pain.
What mechanisms underlie the enhanced responsiveness of second-order neurons in neuropathic pain?
Changes in neuron excitability and reduced inhibition from endogenous pain control circuits contribute to central sensitization.
Describe the changes in neural pathways during central sensitization.
Central sensitization involves increased activity in second-order neurons and reduced inhibitory input, leading to heightened pain perception.
How does the FLACC scale quantify pain in preverbal children?
By scoring behaviors in five categories (Face, Legs, Activity, Cry, Consolability) from 0 to 2, with a total score ranging from 0 (no pain) to 10 (severe pain).
Discuss the use of multi-agent therapy in pain management.
Combining different types of analgesics, such as opioids, NSAIDs, and adjuvant agents, can enhance pain relief and target various pain mechanisms.
What is the significance of cutting the axons of spinothalamic tract neurons in pain management surgeries?
It aims to disrupt pain signal transmission, providing relief from severe, chronic pain, particularly of visceral origin.
What are the potential complications of a midline myelotomy?
Accurate lesion placement is critical; complications may include loss of other sensory functions and potential damage to the spinal cord.
How do local anaesthetic blocks alleviate CRPS pain?
By blocking sympathetic ganglia or adrenergic receptors, reducing pain signaling and providing relief.
What physiological changes occur in the sympathetic nervous system during CRPS?
Intact nociceptors become sensitive to noradrenaline, causing spontaneous activity and heightened responses to stimuli.
Describe the impact of hyperglycemia on sensory neurons in diabetic neuropathy.
Hyperglycemia causes degeneration of unmyelinated axons and ischemia-induced damage to blood vessels supplying peripheral nerves.
How does a neuroma contribute to pain following nerve injury?
Neuromas generate spontaneous action potentials and are highly sensitive to mechanical stimuli, leading to ongoing pain.
Explain the phenomenon of referred pain.
Pain perceived at a location other than the site of the painful stimulus, often due to the convergence of nerve fibers in the spinal cord.
What are the clinical features of trigeminal neuralgia, and what causes it?
Severe, sharp facial pain triggered by light touch, caused by compression of the trigeminal nerve.
How does central pain syndrome differ from peripheral neuropathic pain?
Central pain syndrome originates from damage to the central nervous system, while peripheral neuropathic pain results from damage to peripheral nerves.
What factors contribute to the variability of pain responses in older adults?
Chronic diseases, age-related changes in pain perception, and individual variability in pain threshold and tolerance.
