Pain Flashcards
Relay impulses that are poorly localized, burning and persistent
ex: MI, stepping on a nail.
C Fibers
An unpleasant, subjective and emotional experience associated with actual or potential tissue damage
- whatever the experiencing person says it is, existing whenever they say it does
- it is not the responsibility of patients to prove they are experiencing this, it is a nurses Responsibility to accept their report
Pain
Inhibition of the pain impulse is the fourth and last phase of the nociceptive process
Modulation
- what affects pain expression
- some believe its natural to be demonstrative about pain
- others tend to be more introverted
Culture
Absence of identifiable physical or psychological cause or pain perceived as excessive for the extent of an organic pathological condition
- chronic pain
- CPRS
Idiopathic Pain
Pain at the actual site of the tumor or distant to the site
Referred pain
Pain that occurs sporadically over an extended period of time
- episodes last for hours, days or weeks
- pain R/T sickle cell disease
- migraine headaches
Episodic pain
level of pain a person is willing to accept
Pain tolerance
the point at which a person feels pain
-everyone is different
Pain threshold
substances that increase pain transmission and cause an inflammatory response
-neurotransmitters involved in pain response
substance P
prostraglandins
bradykinin
histamine
substances that decrease pain transmission and produce analgesia
serotonin
endorphins
arises from damage to or inflammation of tissue other than of peripheral CNS
- usually throbbing, aching, localized pain
- responds to opioids and non opioids
- somatic(muscle) and visceral(organ)
- surgical incision that is dull, throbbing and aching
nociceptive pain
a state of adaptation that is manifested by a drug class specific withdrawal syndrome produced by abrupt cessation and rapid dose reduction, decreased B/P
physical dependence
contributes to venous thrombus formation
- damage to vessel wall
- alterations in blood flow
- alterations n blood constitutes
Virchow’s triad
arises from abnormal or damages pain nerves -responds to adjuvant meds -phantom limb pain below spinal cord injury diabetic neuropathy -burning shooting or electric like
neuropathic pain
a person with chronic pain will seek numerous health care providers to alleviate pain
pseudoaddiction
identifies the location and intensity of pain
somatosensory cortex
web of hand between thumb and index finger
-influences nerve pathways to the face and head
acupressure
mental and physical freedom from tension or stress that provides individuals a sense of self control
- meditation, yoga, zen, guided imagery
- only teach when patient is not distracted by discomfort
relaxation
- sensation of pain extending from initial site to another body part
- pain feels traveled down and along body
- intermittent or constant
ex: low back pain from ruptured disk
radiating pain
no pain receptors
- perception of pain in unaffected area
- sensory neurons into same spinal cord segment from area of pain
- pain in part of body separate source of pain and assumes characteristics
referred pain
- pain resulting from stimulation of skin
- short duration
- localized
- usually sharp sensation
ex: needle stick, small cut, laceration
superficial or cutaneous
resulting from stimulation internal organs
- diffuse/radiates different directions
- duration varies-last longer in superficial
- pain is sharp dull or unique to organ involved
- ex: crushing sensation, burning sensation
deep or visceral
primarily limbic system determines how a person feels about pain
association cortex
somatic and visceral free nerve endings of thinly mylinated and unmyelinated fibers
-react to tissue injury but many also be excited by endogenous chemical substances
nociceptors
lasts longer than 6 months
- constant or recurring with a mild to severe intensity
- does not always have an identifiable cause which can lead to personal suffering
- usually non life threatening
chronic pain
affective cognitive behavioral spiritual and social dementions
-peripheral neuropathy, arthritis, low back pain, myofascial pain, headache
chronic pain
protective and has an identifiable cause
- short duration
- limited tissue damage and emotional response
- SNS(flight/fight) tachycardia, anxiety, sweating, muscle tension
acute pain/transient
complete pain relief is not always achievable but reducing pain to a tolerable level is realistic
-assess location, severity, and quality
what is the physiological process of nociceptive pain?
- transduction
2 transmission - perception
- modulation
inhibition of pain/release of inhibitory neurotransmitters
- ways to decrease pain with nonpharmocologics
- release endogenous opioids work to hinder pain and help produce an analgesic effect
modulation
the patients experience of pain
-the point the person is aware of the pain
perception
conversion of stimulus into electrical energy
-begins in periphery when pain producing stimulus sends an impulse across nerve fiber initiating action potential
transduction
thermal, chemical, and mechanical are stimulus causing pain
sending of impulse across a sensory pain nerve fiber(nociceptor)
-where pain impulse begins
transmission
sends sharp localized and distinct sensations that specify the source of pain and its intensity
ex: stepping on a nail
A Fibers
what controls the rhythm of the sleep wake cycle?
suprachiasmatic nucleus nerve cells in the hypothalamus
excessive sleeping without obvious cause
hypersomnolence
measures eye movement muscle tone changes and brain electrical activity during at least 4 napping opportunities spread throughout the day
multiple sleep latency test
These neuroregulators are generated from the breakdown of phospholipids cell membranes and is thought to increase sensitivity to pain
Prostaglandins
This new regulator is released from plasma that leaks from surrounding blood vessels at the site of tissue injury. It binds to receptors on peripheral nerves increasing pain stimuli. Binds to cells that cause a chain reaction producing prostaglandins
Bradykinin
Found in pain neurons of the dorsal horn. Needed to transmit pain impulses from the periphery to higher brain centers. Causes vasodilation and edema
Substance P
Produced by mast cells causing capillary dilation and increases capillary permeability
Histamine
Released from the brainstem and dorsal horn to inhibit pain transmission
Serotonin
What are some associated symptoms of chronic pain
Fatigue insomnia anorexia weight loss apathy hopelessness and anger
What is PQRST in relation to pain assessment
Palliative or provocative factors: what makes pain better what makes your pain worse.
Quality: how do you describe your pain
Region or radiation: show me where you hurt. does is stay there or does it spread someone else
Severity: on a scale of 1 to 10 how bad is your pain now. What is the worst pain you have had in the last 24 hours. What is the average pain you have had in the past 24 hours.
Timing: is your pain constant intermittent or both and when did it start.
