Pain Flashcards

1
Q

What is nociception?

A

The sensory response to a noxious stimulus

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2
Q

What is pain?

A

The perception of nociceptive sensory information

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3
Q

What is congenital indifference to pain?

A

Congenital condition where a person is not responsive to pain

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4
Q

What are the two dimensions of pain?

A
  1. sensory-discrimination

2. motivation-affective

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5
Q

What is the sensory-discrimination part of pain?

A

perception of exteroceptive (external) or enteroceptive (internal)
noxious information and ‘localization’ of the site.

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6
Q

What is the motivation-affective aspect of pain?

A

emotional and sympathetic responses and associated (learning) behaviors

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7
Q

What are the three types of pain?

A
  1. Physical
  2. Inflammatory
  3. Neuropathic
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8
Q

What is the main part of the brain that is associated with the sensory-discriminatory part of pain?

A

Primary and secondary somatosensory cortices

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9
Q

What are the main part of the brain that is associated with the motivation-affective part of pain?

A

Frontal cortex
Limbic system
Brainstem areas

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10
Q

What are the three functions of the sensory-discriminative component of pain?

A
  1. location
  2. Intensity
  3. Modality
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11
Q

What are the two components of the emotional component of pain?

A

Negative impact on affect/mood

Chronic pain accompanied by depression

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12
Q

How fast is acute pain felt?

A

0.1 sec after initiation of stimulus (very fast)

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13
Q

What is the fiber type that conducts pain?

A

A-delta fibers

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14
Q

How adaptive is physiologic pain?

A

Very–as tissue heals, pain lessens

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15
Q

What is the initial type of pain sensations that are felt?

A

Sharp, prickling, electric sensation

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16
Q

What is pathologic pain?

A

Chronic pain

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17
Q

When does pathologic pain begin?

A

> 1 sec after the stimulus, then increases slowly

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18
Q

How can pathologic pain become maladaptive?

A

Persistence even without tissue damage

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19
Q

What type of fibers carry pathologic pain? Is this fast or slow conducting?

A

C fibers

Slow conducting

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20
Q

What are the sensations felt with pathologic pain?

A

Dull, throbbing, aching, nauseous senstion

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21
Q

What is the function for nociception? Inflammatory?

A
Nociception = warning
Inflammatory = promotes healing
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22
Q

What is dysfunctional pain?

A

Pain without understanding or the origin

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23
Q

What is neuropathic pain?

A

Pain d/t damage to nerves

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24
Q

What is the function of neuropathic pain?

A

It has no protective function

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25
Q

What are the two types of somatic pain? What is the quality of the pain for each? Well or not well localized?

A
Superficial pain (sharp, well localized)
Deep (dull, poorly localized)
26
Q

What are the fibers that carry superficial pain (initial and delayed)?

A

A delta intially, followed by C fibers for delayed

27
Q

Where is deep pain felt?

A

CT, bones, joints, muscles,

28
Q

What type of fibers carry visceral pain?

A

C fibers

29
Q

What type of pain follows a dermatomal distribution?

A

Visceral

30
Q

What are the four processes of pain processing?

A
  1. Transduction
  2. Transmission
  3. Modulation
  4. Perception
31
Q

What is transduction?

A

sensation taken in from receptors, transmitted

32
Q

What are the nociceptors for pain?

A

Free nerve endings

33
Q

Do pain neurons have a high or low threshold? Do they adapt slowly or fast?

A

High threshold

Slowly adapt

34
Q

What are the three stimuli that nociceptors respond to?

A

Mechanical (nociceptive)
Thermal
Chemical

35
Q

Free nerve endings that innervate the body go where (where are the cell bodies)? Face?

A
Body = spinal ganglia
Face = trigeminal ganglia
36
Q

What is the first process that occurs with damage?

A

Nociception via direct activation of:

  • open cation channels
  • Membrane depolarization
  • Generate action potential
37
Q

What is the major mediator of pain? Other two? (“inflammatory soup”) What do these do?

A

Bradykinin
5HT
Prostaglandin

These interact with primary afferent neurons near the site of pain to release other substances

38
Q

What is the MOA of substance P, which is released in response to a painful stimulus? (What is the effect on blood vessels, and on the immune system)?

A

Vasodilation and inflammation

Mast cell release of histamine

39
Q

What is the indirect sensitization of the peripheral nociceptive processing?

A

Lowered threshold of nociceptors

40
Q

What is peripheral sensitization?

A

Spreading of the action potential over other areas where membrane is at a resting state

41
Q

What does peripheral sensitization lead to? (4)

A
  1. Increased sensitivity
  2. Increased receptive field size
  3. Inflammatory mediators release
  4. Activation of silent nociceptors
42
Q

What are the silent nociceptors? What is their function?

A

nociceptors that only respond to the molecules secreted by other activated nociceptors

Expand the receptive field for the pain stimulus

43
Q

What is primary hyperalgesia?

A

Increase response to a stimulus that is normally painful

44
Q

What is allodynia?

A

Pain resulting from non-noxious stimulus

45
Q

What is the triple response of Lewis?

A

Erythema
Edema
Wheal

46
Q

What type of pain is nociceptive pain (physiologic or chronic)?

A

Physiologic

47
Q

Which has tissue damage, nociceptive pain or inflammatory pain?

A

Inflammatory pain

48
Q

Fibromyalgia or IBS is what type of pain? What causes it?

A

Dysfunctional pain

–no understandable lesion found

49
Q

Does neuropathic pain have a protective function?

A

No

50
Q

True or false: neuropathic pain is disproportionate to the intensity of nociceptor activation

A

True

51
Q

What are the receptors utilized for thermal stimuli?

A

TRP

52
Q

What is the axon reflex?

A

Activation of the sympathetic system in response to pain

53
Q

Activator of pain, or sensitizer: K

A

Acivator

54
Q

Activator of pain, or sensitizer: prostaglandins

A

Sensitizer

55
Q

Activator of pain, or sensitizer: hydrogen

A

Activator

56
Q

Activator of pain, or sensitizer: substance P

A

Activator

57
Q

Activator of pain, or sensitizer: leukotrienes

A

Sensitizer

58
Q

Activator of pain, or sensitizer: ATP

A

Sensitizer

59
Q

Activator of pain, or sensitizer: bradykinin

A

Activator

60
Q

What are the type of fibers that sense mechanical sensations (2)? Which has a high threshold, and which a low?

A
A-alpha = low threshold
A-delta = high threshold
61
Q

What is the type of fiber that senses heat, chemical, and other multimodal stimuli? Do theses have a high or low threshold? Fast or slow fibers?

A

C fibers
High threshold
Slow conduction