Pain Flashcards
Describe the PT’s goal for pain
Change the pt. perception of pain and restore function
3 Dimensions of Pain
- Sensory-discrimination (SENSORY)
- Motivational-affective (EMOTIONAL)
- Cognitive-evaluative (COGNITIVE)
Dimension of Pain: Location, magnitude, duration, quality
Sensory-discrimination
Dimension of Pain: Emotions, anxiety, depression
Motivational-affective
Dimension of Pain: post experience, possibility of outcomes, influenced by one’s culture and beliefs
Congitive-evaluative
Term: Increased sensitivity to noxious stimulus
Hyperalgesia
Term: Feeling of pain from a non-noxious stimulus
Allodynia
Describe the difference between primary and secondary pain
Primary - pain at the site of injury
Secondary - pain away from the site of injury, same as referred pain
Term: Increased responsiveness or decreased threshold of neurons
Sensitization
Describe the difference between peripheral and central sensitization
Peripheral = dysfunction in PNS, PRIMARY hyperalgesia/allodynia
Central = dysfunction in CNS, SECONDARY hyperalgesia/allodynia
Describe the basic concept of the Ascending Pain Pathways
3 order neuron system
1st order = primary afferent fibers (have two axons)
2nd order = spinothalamic tract
3rd order = thalamocortical neurons
Describe the difference between Alpha Delta/C fibers and Group 3/4 fibers
Alpha Delta and C fibers innverate the skin while Group 3/4 fibers innervate deep tissues (mm, joint, synovium, ligament, etc.)
Describe the difference between Alpha delta/G 3 pain and C/G 4 pain
Alpha beta/G 3 = fast, sharp pain from thermal or mechanical noxious stimulus; low-threshold
C/G 4 = slow, dull pain from thermal, mechanical or chemical noxious stimulus; high-threshold
Describe the difference between slow and fast pain
Fast: immediate sharp sensation and id of location; processed by lateral pain system (spinothalamic)
Slow: dull/burning/throbbing followed by sharp pain that is not easily localized; processed by medial pain system
Term: Sensory receptor that can transduce pain stimulus
Nociceptor
3 Types of pain processed by the PNS
Chemical, thermal, mechanical
Describe the noxious mechanical stimulus in the following tissue types
- Skin
- Visceral
- Joint
- Muscle
- cut, burn, stretch, pressure
- distension
- friction, pressure/compression, tension
- tear, stretch, ischemia
3 Peripheral Pain Mechanisms
- Uni/Polymodal neurons (indicates types of stimulus responded to)
- Receptors (ion channels and receptors)
- Chemical
2 Main functions of the Primary Afferent Neuron
- Transduction
- Transmission
Term: Detection of noxious or damaging stimuli
Transduction
Term: Passage of the resulting sensory input from peripheral terminals to spinal cord
Transmission
Describe why we can only have primary hyperalgesia/allodynia in the PNS
Because of the two main functions of the primary afferent
Can pain at location due to transduction but won’t transmit information to CNS due to damage
Term: Tissue damage resulting in release of chemicals
Inflammation
3 Sx of Inflammation
- Constant pain from normal stimuli
- Heat
- Edema