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Physiology Prac Cns > Pain > Flashcards

Pain Flashcards

1
Q

Definition of Pain

A

Unpleasant sensory or emotional experience associated with actual or potential tissue damage.

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2
Q

Protective roles of pain: List four.

A
  1. Warns of a problem or threat.\n2. Prevents further damage by reflex guarding.\n3. Promotes rest for healing.\n4. Encourages seeking treatment.
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3
Q

Pain transduction by nociceptors: Mechanism

A
  1. Stimulation of pain receptors opens specific transduction channels.\n2. Na+ and Ca2+ inflow occurs, leading to depolarization (DP).\n3. Damaged tissues release proteolytic enzymes, K+, histamine, serotonin, ATP, bradykinin, and prostaglandins (PGs), which sensitize pain receptors.
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4
Q

Mechanical pain receptors: Ion channel

A

Mechanical stimuli open degenerin channels in pain receptors.

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5
Q

Thermal pain receptors: Channels

A
  1. Extreme heat opens TRPV channels.\n2. Extreme cold opens Anktm channels.
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6
Q

Chemical pain receptors: Example and mechanism

A

Example: HCL in peptic ulcers opens Acid-Sensing Ion Channels (ASIC).

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7
Q

Polymodal pain receptors

A

These receptors respond to all types of stimuli (mechanical, thermal, chemical).

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8
Q

Adaptation of pain receptors

A

Pain receptors are either slowly adapting or non-adapting.

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9
Q

Distribution of pain receptors: More sites

A

Pain receptors are more abundant in skin, periosteum, arterial walls, and joints.

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10
Q

Distribution of pain receptors: Less sites

A

Pain receptors are less abundant in deep tissues and internal viscera.

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11
Q

Sites without pain receptors

A

Pain receptors are absent in liver parenchyma, lung alveoli, brain, and bones.

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12
Q

Types of pain by site

A
  1. Cutaneous pain (superficial).\n2. Deep pain (musculoskeletal).\n3. Visceral pain (organs).\n4. Neuropathic pain (nerves).
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13
Q

Types of pain by quality

A
  1. Fast (acute) pain.\n2. Slow (chronic) pain.
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14
Q

Fast pain pathway

A

Neospinothalamic pathway.

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15
Q

Slow pain pathway

A

Paleospinothalamic pathway.

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16
Q

Neurotransmitter for fast pain

A

Glutamate.

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17
Q

Neurotransmitter for slow pain

A

Substance-P.

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18
Q

Characteristics of fast pain

A
  1. Sharp, pricking, and well-localized.\n2. Travels via Aδ fibers (myelinated).\n3. Perceived quickly in sensory cortex and thalamus.
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19
Q

Characteristics of slow pain

A
  1. Dull, burning, poorly localized.\n2. Travels via C-fibers (unmyelinated).\n3. Perceived in the thalamus and limbic system (emotional aspect).
20
Q

Perception of fast pain

A

Occurs in the lateral part of the thalamus and somatic sensory area I. Provides information about location and intensity.

21
Q

Perception of slow pain

A

Occurs in the medial part of the thalamus and the limbic cortex (especially the cingulate gyrus). Responsible for emotional reactions to pain.

22
Q

Reactions to fast pain

A
  1. Motor: Withdrawal reflex to remove the injured part.\n2. Autonomic: ↑HR and ↑BP.\n3. Emotional: Screaming and anxiety.
23
Q

Reactions to slow pain

A
  1. Motor: Guarding rigidity (e.g., inflamed appendix).\n2. Autonomic: ↓HR and ↓BP, nausea, vomiting, sweating.\n3. Emotional: Depression.
24
Q

Why is cutaneous pain accurately localized?

A
  1. High density of pain receptors in skin.\n2. Fast fibers reach the sensory cortex.\n3. Touch and vision assist in localization.
25
Q

Deep pain: Definition

A

Musculoskeletal pain originating from muscles, tendons, ligaments, joints, and periosteum of bones.

26
Q

Deep pain: Causes

A
  1. Inflammation.\n2. Mechanical trauma.\n3. Ischemia.
27
Q

Ischemic pain: Cause and mechanism

A

Cause: Narrowing or compression of an artery → ischemia.\nMechanism: Accumulation of metabolites and release of proteolytic enzymes.

28
Q

Visceral pain: Key features

A
  1. Diffuse (poorly localized) because of sparse pain receptors in viscera.\n2. Carried by C-fibers (slow dull pain).
29
Q

Visceral pain: Causes

A
  1. Ischemia → ↑ H+, K+, bradykinin, PGs.\n2. Inflammation.\n3. Irritation (e.g., HCL in peptic ulcers).\n4. Overdistension of hollow viscera (e.g., bladder).\n5. Spasm of hollow viscera (e.g., gut, ureters).
30
Q

Referred pain: Definition

A

Pain felt at a site other than the injured one, usually on the skin surface.

31
Q

Dermatomal rule for referred pain

A

Pain is referred to a structure that developed from the same dermatome as the pain-producing organ.

32
Q

Mechanism of referred pain: Convergence-projection theory

A
  1. Afferent pain fibers from the organ and skin converge on the same spinal cord neuron.\n2. Brain misinterprets the pain as coming from the skin due to better cortical representation of the skin.
33
Q

Mechanism of referred pain: Facilitation theory

A
  1. Viscus afferents give collaterals to spinal cord cells.\n2. These cells receive pain signals from the skin, leading to facilitation and misinterpretation.
34
Q

Examples of referred pain: Cardiac pain

A

Referred to the left shoulder, left arm, root of the neck, lower jaw, and epigastrium.

35
Q

Examples of referred pain: Gall bladder pain

A

Referred to the right shoulder, tip of the right scapula, and epigastrium.

36
Q

Examples of referred pain: Gastric pain

A

Referred to the area between the xiphoid process and umbilicus.

37
Q

Examples of referred pain: Pancreatic pain

A

Referred to the back.

38
Q

Examples of referred pain: Renal pain

A

Referred to the flank, inguinal region (groin), and testicles (in males).

39
Q

Examples of referred pain: Appendicular pain

A

Referred to the area around the umbilicus.

40
Q

Examples of referred pain: Ovarian pain

A

Referred to the umbilicus.

41
Q

Examples of referred pain: Testicular pain

A

Referred to the pelvis and abdomen.

42
Q

Examples of referred pain: Diaphragmatic pain

A

Referred to the shoulder.

43
Q

Headache: Types and causes

A

Headache can originate from tension, vascular problems (e.g., migraines), or referred pain from deeper structures.

44
Q

Pain testing method: Procedure

A
  1. Use an object with sharp and dull ends (e.g., safety pin).\n2. Apply stimuli randomly and perpendicularly to the skin.\n3. Ask the patient to indicate sharp/dull.\n4. Avoid rapid application to prevent impulse summation.
45
Q

Pain testing: Areas of the body

A

All areas of the body should be tested systematically.

46
Q

Sterilization of instruments after pain testing

A

The testing instrument must be sterilized or disposed of after use.

Physiology Prac Cns (5 decks)

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