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Pain Flashcards

1
Q

What is pain?

A

localised unpleasant bodily sensation

complex sensations cause mild to severe physical discomfort and emotional distress typiaclly from injury or disease

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2
Q

What is pain’s goal?

A

Protect from world- is a survival skill

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3
Q

Pain insensitivity

A

Congenital analgesia: defective gene that is involved in transmission of nociceptive

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4
Q

Experience of pain is…

A

individualised and subjective
situational
cultural

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5
Q

How do we measure pain?

A
  • verbal reports
  • self-report scale
  • mcgill pain questionnaire
  • multi-dimensional pain inventory (interference with daily activities)
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6
Q

How does pain manifest?

A

burn, ache, throb, stabbing

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7
Q

How do we behave in pain?

A

Facial and audible expressions

Distortions of posture and gait

Negative affect > bad mood

Avoidance of activity

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8
Q

Physio measures of pain

A

Muscle tension

skin temp is hotter

heart rate increases

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9
Q

Acute pain

A

brief, signals to avoid further injury

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10
Q

Chronic pain

A

over months or years, no reason why

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11
Q

Pre-chronic pain

A

btw acute and chronic

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12
Q

Chronic recurrent pain

A

alternating episodes of pain and no pain

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13
Q

Nociceptive pain

A

Caused by the activation of nociceptors (pain receptors) in response to tissue injury or inflammation.

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14
Q

Anatomy of nociception

A

Perception > modulation > motor reflexes > transmission > transduction

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15
Q

What are nociceptors?

A

detect signals from damaged tissue or threat of damage and indirectly respond to chemicals released from damaged tissue

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16
Q

How are nociceptors activated?

A

temp
mechanical (strain or stretch)
chemical (pH change)

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17
Q

what are the four types of nociceptors?

A
  • skin: mechno, thermal, chemical, polymodal
  • joint: mechano, polymodal, silent
  • visceral (internal organs) : mechano, thermal, chemical, SILENT
  • silent
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18
Q

How do nociceptors work exactly?

A

Muscle spasms and lactic acid

Histamine (inflamates area)

Globulin and protein kinases, Arachidonic acid

Nerve growth after injury

Substance P

Neurotransmitter

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19
Q

What is transduction

A

is the process by which noxious stimuli (mechanical, thermal, or chemical) are converted into electrical signals by nociceptors. This electrical signal, known as an action potential, is then transmitted to the spinal cord for further processing.

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20
Q

Transduction Nerve Fibres

A

A-alpha > proorioception > myelinated > big and fast

A-beta > touch > myelinated > medium and slow > Closed pain gate

A-delta > mechano and thermal pain > myelinated > thin and very slow > open gate

C > mechano, thermal and chem pain > non-myelinated > extremely thin and slow > open gate

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21
Q

What are the three main pathways for pain in the transmisson

A
  • Neospinohalamic tract (immediate awareness of pain and where)
  • Paleospinothalamic tract (emotional and visceral response)
  • Archispinothalamic pathway (automatic response to pain)
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22
Q

How does perception work?

A

signal travels up spinal chord to reticular formation and thalamus

alpha and delta signall are relayed to somatosenory cortex

23
Q

Types of pain

A

Somatic (body)
Visceral
Thalamic
Neuropathic
Psychosomatic
Referred
Phantom

24
Q

Somatic pain

A

cutabeous, superficial or peripheral
- prickling pain: neospinothalamic
- burn and soreness: paleospinothalamic and archispinothalamic

deep pain: signaled via paleospinothalamic and archispinothalamic tracts

25
Visceral pain
signaled via paleospinothalamic and archispinothalamic tracts often not localised to the site of its cause (heart attack but pain in shoulder)
26
Thalamic pain
damaged thalamus from stroke or occulsion- painful but no sensory loss
27
psychosomatic pain
anguish, anxiety, crying, depression, etc.
28
phantom pain
no actual nociceptor, sensory roots destroyed, complete break of the spinal chord
29
What are the potential cause of phantom pain?
- remaining cut ends of nerves which grow into nodules called neuromas - overactive spinal neurons - abnormal flow of signals through somatosensory cortex - burst-firing neurons in the thalamus
30
Neuropathic pain
sharp and shooting pain that is persistent controlled by anti-flammatory drugs no treatment in come cases (diabetes, AIDS, cancer)
31
What are the causes of neuropathic pain?
- once the nerve is damaged, sustained activation of nocieptors - CNS neuronal hyperexcitability
32
Referred pain
Painful sensation at a site other than injured one
33
Potential causes of referred pain
- axons carry pain information from the viscera to the spinal cord - within the spinal cord there is convergence of the information on the same nocineurons
34
Gate Theory
structures in the spinal cord act as a gate that can open and close, modulating the sensory input that the brain interprets as pain
35
How do signals from periphery open and close gates?
EX. rubbing injuries: activates afferent touch neurons or A-b fibers. These occupy the same pathway through the spianl cord and thus interfere with afferent pain signals
36
Gate control trigger
nerve impulses that descend from the brain and influence the gate mechanism (distraction, relaxation, adrenaline rush, etc.)
37
Strengths of Gate control theory
helps explain injury without pain or emotions psych factors are central to the expereince of pain
38
Weaknesses of Gate control theory
cannot explain chronic pain or phantom limb
39
Neuromatrix
We have networks of neurons that form our felt representations of our unified physical selves genetically determined but can be modified by expereince
40
Neurisignatures
Where characteristic patterns of activation are stored (pain) and can be reactivated without sensory input
41
When can we treat pain?
At any point in the process
42
Ibuprofen and acetaminophen
target chemicals at the site to dampen nociotive signals
43
Local anesthetics
block transmission and transduction to spinal cord
44
Spinal blocking agents
block transmission up to spinal cord
45
stimulation-produced analgesia
electrical stimualtion of brain stem blocks pain signals
46
opiates
blocks at brain stem
47
acupuncture
stimulates release of endogenous opioids
48
acetaminophen
blunts social pain too and reduces empathy for others
49
surgical interventions
repair source of pain or later nervous system to alleviate pain
50
limitations of surgery
may not repair tissue, pain may find new pathways, potential for additional damage, expensive and invasive
51
analgesia
inability to feel pain
52
stress induced analgesia
endogenous opioids blunt pain
53
stress induced hyperanalgesia
overactive amygdala
54
hypnoanalgesia
the use of hypnotic suggestion to relieve pain

PSY333 (7 decks)

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