Pain Flashcards
Pain that an individual may continue to experience even when no damaging or threatening stimulus is present
Chronic pain
Pain that is caused by the irritation of nerves and nerve roots and can radiate down an extremity
Radiating pain
Pain associated with a myocardial infarction that is felt in the left arm is defined as:
Referred pain
________ nerve fibers transmit impulses from sensory receptors toward the brain, and ______ nerve fibers transmit impulses from the brain toward the periphery.
Afferent; efferent
Current findings indicate that specific nerve endings called ______ respond to all painful stimuli.
Nociceptors
Nociceptors give rise to types of first order nerve fibers called:
C fibers and A-delta fibers
____ fibers are small, unmyelinated, and transmit pain sensations described as dull, throbbing, aching, burning, tingling, or tapping.
C fibers
____ fibers are fast, myelinated, and transmit pain sensations described as sharp, stabbing, or pricking.
A-delta fibers
A hyperactive response of the SNS that fails to turn off in response to an acute injury can increase the severity of pain, which may lead to __________syndrome.
Complex regional pain
Theory that states severity of pain is controlled by the balance of excitatory and inhibitory inputs to T cells in the substantia gelatinosa of the spinal cord.
Gate Control Theory
The theory that pain is modulated at peripheral, spinal cord, and cortical levels by endogenous neurotransmitters that bind to the same receptors of exogenous opioids.
Endogenous Opioid System
Pain lasting 0 to 6 months’ duration for which an underlying pathology can be defined
and occurs as a direct result of actual or potential tissue injury due to a wound, disease process, or invasive procedure.
Acute Pain
Pain that arises as a direct result of a lesion or disease affecting nerves. This type of pain typically has a burning or lancinating quality and is accompanied by other signs or symptoms of neurological dysfunction.
Neuropathic Pain
Pain that does not serve a protective purpose
Dysfunctional Pain
These scales access pain severity by asking the patient to indicate the present level of pain on a drawn line or to rate the pain numerically on a scale such as 0-10.
Visual Analog and Numerical Scales
These control pain by modifying inflammatory mediators at the periphery, altering pain transmission from the periphery to the cortex, or altering the central perception of pain
Pharmacological Approaches
Neurons that projects to the thalamus, tactile sensation, aching pain.
Anterospinothalamic Tract (AST)
Pain transmitting neurons that originate in the spinal cord and carry impulses up to the thalamus; Afferent
Spinothalamic Tracts (ST)
Neurons that project to medial thalamus; sharp pain; Afferent
Lateral Spinothalamic Tract (LST)
Make connections within the spinal cord and synapse with afferent neurons projecting toward the cortex.
These are important in nociceptive transmission because they integrate information from nociceptive and non-nociceptive primary afferent fibers, other local T cells, and other supraspinal sites (like the cortex and brain stem).
Transmission cells (T cells)
Pain relief by the administration of drugs into the epidural or subarachnoid space of the spinal cord.
Primary advantage is that the drugs bypass the blood brain barrier, and that high concentrations reach the spinal cord at sites of nociceptive transmission.
Spinal Analgesia
Relieve pain from both the inflammatory and non-inflammatory sources.
Long term complications = usually GI irritation and bleeding.
Nonsteriodal Antiinflammatory Drugs (NSAIDs)
Based on biopsychosocial model of pain and cognitive-behavioral principles of treatment.
Designed to treat patients with chronic pain, they aim to restore patients’ independence and overall quality of life.
Coordinate team approach is one of the most crucial elements of these programs.
Comprehensive Pain Management Programs
Pain from stimulus that is not normally painful like touching the skin.
Allodynia
Increased sensitivity to pain.
Ex. Phantom Limb Pain
Hyperalgesia
Chronic pain after trauma, possible damage to central or peripheral nervous system.
The cause of pain is unknown.
Complex Regional Pain Syndrome (CRPS)
The system composed of the autonomic and somatic nervous system.
Peripheral Nervous System (PNS)
The system composed of the brain and spinal cord.
Central Nervous System (CNS)
This system is responsible for the ‘fight or flight’ response to the heart, lungs, and muscles.
Helps with survival.
Sympathetic Nervous System (SNS)
