Pain 2 Flashcards
what is cutaneous pain?
pain in skin and superficial tissues that is well defined
what is somatic pain?
injury to ligaments, tendons, bones or blood vessels that is poorly localised
what is visceral pain?
from organs or body cavities that is very difficult to localise
what is referred pain?
pain in unaffected area of the body
how is referred pain caused?
convergence of visceral and somatic pain receptors converging on the same spinal cord nociceptor
what is a tension type headache?
pain radiating from neck, back, eyes etc which may be caused due to tension
what is a thunderclap headache?
most severe, sudden onset and may be caused by an underlying issue
what is a cluster headache?
attacks in clusters, potentially over long period, not life threatening
what is a hypnic headache?
occurs in elderly, at night and lasts up to 1 hour
what is a cold stimulus headache?
ingestion of cold food or drink, subsides spontaneously
what are the underlying issues that may cause thunderclap headaches?
hypertension, glaucoma, eye strain, fever, infections, tumours, head trauma
how can pain be quantified?
1-10 scale, validated questionnaires, physical symptoms
what are physical symptoms of pain?
pallor, sweating, tachycardia, vomiting, fainiting, restless
what are the features of pain over minutes or hours?
inflammation, hyperalgesia and allodynia
what are the features of pain over hours/weeks/months?
hyperalgesia/allodynia stops, tissue repairing occurs
what is hyperalgesia?
elevated pain response to stimuli that is usually less painful
what is allodynia?
tenderness in an area where even an innocuous sensation causes pain
what are the features of chronic pain?
no biologic cause, persists beyond course of illness, can occur at intervals
what is acute pain?
pain from tissue damage, infection or inflammation
what is nociceptive pain?
involving nociceptive receptors
what is neuropathic pain?
involving damage to neurones and no stimulus
what kind of diseases are related to neuropathic pain?
carpal tunnel or spinal cord injuries
how is activation of pain inflammation started?
inflammation causing release of pain mediators that cause stimulation of nerves
what are examples of pain mediators? how do they work?
bradykinin, prostaglandins, serotonin or histamine. sensitise nerve endings to less intense stimuli
what is peripheral sensation?
damage to the neurones causing spontaneous actiion potentials
how does peripheral sensitisation cause stimulation of further neurones?
backwards travel of action potentials causes sensory terminals to release neuropeptides that cause stimulation of other sensory terminals
what is central sensitisation?
prolonged activation of a neurones leading to strengthening of a synapse, leading to responses to innocuous stimuli
how might neuromas occur?
damage of an axon causing degeneration, however regrowth occurs causing inappropriate linkages between axons
what are symptoms of neuromas?
they cause shooting pains and hyperalgesia and allodynia
how can pain responses be modified?
endogenous analgesia system modified using endocannabanoid system, supplementation using drugs such as opioids and inhibitory connection between A beta and C fibres
