Pain Flashcards
Definition of Pain
Unpleasant sensory and emotional experience associated with actual or potential tissue damage
Types of Nociceptors
Mechanoceptors, thermoreceptors, chemical nociceptors, silent nociceptors
Can be unimodal or polymodal
Pain transmission
Nociceptors pick up painful stimuli, once threshold is reached an electrial signal is conducted to the spinal cord. Travels through spinothalamic tract before reaching the brain.
Spinothalamic tract pathways
Neospinothalamic tract - fast transmission, moves from receptor site to dorsal horn using myelinated A delta fibers and directly to the thalamus
Paleospinothalamic tract - continuous, moves from receptor site to spinal cord using unmyelinated C fibers, terminate throughout the brainstem.
Exhitatory mediators of Pain
Glutamate
Substance P
Prevention of Pain Transmission
Endorphins attach to opiate receptors inhibiting exhitatory release of substances
Gate Control Theory
A neural gate is present in the dorsal horn. Controlled by large and small fibers, opened once nociceptor info exceeds the inhibitory threshold, activating the pain pathway and allowing the brain to produce the conscious sensation of pain.
Reflex Arc
Strong stimulus causes the impulse to be transmitted down motor pathways to initiate response. At the same time the impulse is being transmitted to the cerebrum for interpretation.
Acute vs Chronic Pain
Acute: sudden, transient (up to 6 months), area is well defined, suffering decreases with time, relieve pain, eventually complete pain relief occurs.
Chronic: sudden or developed, prolonged, less easily to differentiate location, suffering increases over time, actions to modify the pain experience, complete pain relief is normally not possible.
Phantom Limb Pain
pain felt in the amputated limb
DOLOR
Description Onset Location Other signs and symptoms Relieving factors
QUESTT
Question the child Use pain rating scales Evaluate behaviour and psychological changes Secure patient's involvement Take cause of pain into account Take action and evaluate results
Abbreviated Injury Score (AIS)
injury is allocated a number from 1 to 6. 6 is unsurvivable
looks at specific areas of the body and gives them a score up to 75
Injury Severity Score
Sum of the three highest numbers of AIS squared
3 impacts involved in MVAs
vehicle collide with object
occupant collide with inside of car
organs collide with inside of occupant
