Pain

Question 1

What is pain?

Answer 1

An aversive sensation and feeling associated with actual or potential tissue damage

Question 2

What are some negative effects of pain and stress?

Answer 2

Decreased pulmonary function, decreased immune function, increased coagulation, increased cardiovascular

Question 3

What are the 4 categoris of pre-emptive pain?

Answer 3

No pain
Mild pain
Moderate pain
Severe pain

Question 4

What are the three different types of pain?

Answer 4

Somatic
Visceral
Neuropathic

Question 5

Describe somatic pain

Answer 5

Originates from damage to bones, joints, muscle, or skin

Localized, constant, sharp pain

Question 6

Describe visceral pain

Answer 6

Arises from the stretching, disetention, or inflammation of viscera
Deep, aching pain with no localization

Question 7

Describe neuropathic pain

Answer 7

Originates from injury or involvement of the PNS or CNS

Burning or shooting pain

Question 8

What are the 5 steps in pain sensation

Answer 8

Transduction 
Transmission
Modulation
Projection 
Perception

Question 9

Transduction occurs where? What are some drugs that can interrupt transduction?

Answer 9

Occurs at the tissue level

NSAIDs, Local anesthetics, or opioids

Question 10

What are the two different types of nociceptors involved in transduction?

Answer 10

Alpha nociceptors: Low or high threshold, polymodal or single stimuli. Discharge at rates higher than C-fibers
C fiber nociceptors: all high threshold and polymodal. Slower onset of pain

Question 11

After transduction comes _____ which goes to the ____

Answer 11

Transmission

Dorsal root ganglion

Question 12

What are some drugs that can block transmission?

Answer 12

Local anesthetics, alpha-2 agonists

Question 13

In modulation, synpase with neurons in _____

Answer 13

dorsal horn of the spinal cord

Question 14

What drugs can be used to block modulation?

Answer 14

Opiods, a-2 agonists, NMDA antagonists, NSAIDs, anticonvulsants, local anesthetics

Question 15

What is the main tract involved in projection?

Answer 15

Spinothalamic tract

Question 16

What is the final step?

Answer 16

Perception; integration, processing, and recognition of sensory information occurs in multiple areas

Question 17

What does the reticular activating system mediate?

Answer 17

Motor, automatic, and endocrine response

Question 18

Periaqueductal gray area transfers area to ____ and serves a role ______

Answer 18

thalamus/hypothalamus

Relay for descending facilitative/inhibitory modulation

Question 19

Thalamus transfers information to _____

Answer 19

cerebral cortex and limbic system

Question 20

What are the three components of the thalamus and what do they controll?

Answer 20

Amygdala: fear, anxiety
Cingulate gyrus: emotion
Hippocampus: memory

Question 21

What is our main goal of pre-emptive pain management?

Answer 21

To decrease peripheral and central sensitization “wind-up”

Question 22

What is a limitation of the Glasgow composite measure pain scale?

Answer 22

Only made for dogs
Does not consider prior demeanor
No assessment for level of sedation

Question 23

At what level on the Glasgow composite measure pain scale would you rethink treatment?

Answer 23

6/24 or 5/20

Question 24

CSU acute pain scale is advantageous because

Answer 24

It is user friendly and has pictures that add visual cues

Also has a section for cats

Question 25

T/F Little Skipper scored at 2.5 on the CSU acute pain scale so we should reassess analgesic plan

Answer 25

TRUE; if it’s above 1.5

Question 26

What is a key we can use to evaluate pain in horses?

Answer 26

The equine pain face

Question 27

T/F As needed analgesia is a common technique veterinarians use

Answer 27

FALSE; this is actually a pretty horrible thing you sick monster