Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CM Clinical Symposia > Pain > Flashcards

Pain Flashcards

1
Q

Nocicpetion

A

Sensory process that provides the signals that trigger pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pain

A

Feeling/perception of irritating, sore, stinging, aching, throbbing, miserable/unbearable sensations from a part of the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Congenital analgesia

A

Don’t sweat, feel no internal/external pain, large scars

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Nociceptors found in

A

Periphery as simple free nerve endings, terminate as naked, unmyelinated endings in dermis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Normal sensory receptors found in

A

Cell body in dorsal root ganglion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Tissue damage and inflammation leads to

A

Release of substances (prostaglandins, bradykinin, histamine) - sensitise peripheral nocicpetors and induce hyperalgesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Types of nociceptor

A

Transduction of nociceptive stimuli occur at free endings of unmyelinated ‘C’ fibres and thinly myelinated ‘Ad’ fibres

Polymodal/only respond to 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Physiological basis of nociceptive pain

A

Activation of peripheral nociceptors, transmission of impulses via A-delta and C sensory afferents to DH, projection to brain via ascending pathways > avoidance, emotion, withdrawal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Transcutaneous nerve recording in human (microneurography)

A
  1. Thermal stimuli applied to receptive field of cutaneous thermoreceptor and nociceptor
  2. Record afferent firing to response to incremental temperatures
  3. Graph plotting afferent firing frequency vs temp
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Dissociated sensory loss/Brown-Sequard syndrome

A

Unilateral spinal lesion, loss of touch, pressure, vibration and proprioception on same side below lesion, pain opposite side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Phantom pain

A

Pain and touch sensations with no sensory inputs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Endogenous analgesia/pain modulation

A

Sensory inputs without pain sensations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Hyperalgesia

A

Increased pain, tissue that has already been damaged/inflamed is extra sensitive (a reduced threshold for pain, increased intensity of painful stimuli, spontaneous pain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Allodynia

A

Touch-evoked pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Acute pain

A

Trauma/injury, resolves with healing of underlying injury, protective function, assists wound repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Chronic pain

A

Persists beyond normal time of healing, 3-6 months beyond onset, tissue damage, not protective, considerable suffering

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Nociceptive pain

A

Tissue damage and painful stimuli, regulated by opioidergic system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Chronic nociceptive pain

A

Persists > neuropathic and mixed pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Benefits of acute pain

A

Trauma response, protective (avoid further damage)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Adverse acute pain

A

Humanitarian, CV stress, resp compromise, hypercoagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Factors associated with changes in pain perception

A

Anxiety, depressed, gender, circadian variation, climate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

WHO analgesia ladder

A

1 - morphine, fentanyl, hydromorphone, buprenorphine, methadone
2 - Codeine, dihydrocodeine, tramadol
3 - aspirin, NSAIDs, COX-2-inhibitor, acetaminophen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Opioids

A
  • Presynaptically pain signal transmission

- Postsynaptic membrane hyperpolarised, decreasing probably of AP generation

24
Q

Non-opioid analegsics - NSAIDS

A
  • Act peripherally
  • Act on nociceptive pain
  • Inhibit cyclooxygenase, prostaglandin synthesis decreases
25
Q

Side effects of NSAIDs

A

GI irritation/bleeding, renal toxicity, CV (cox-2)

26
Q

Non-opioid analegsics - paracetamol

A
  • Acts centrally
  • Analgesic and antipyretic effects
  • No anti-inflammatory action
  • Inhibition of central prostaglandin synthesis
27
Q

Paracetamol side effects

A

Toxic liver damage

28
Q

Examples of weak opiods

A

Tramadol and codeine

29
Q

Examples of strong opiods

A

Morphine and oxycodone

30
Q

Efficacy of opiods

A

Nociceptive pain, less effective in chronic, partially in neuropathic pain

31
Q

Mode of action of opiods

A

Activate endogenous analgesic system, stimulate receptors in limbic system eliminated subjective feeling of pain, affect descending pathways that module pain perception, reduce ascending pain signal transmission in spinal cord

32
Q

Side effects of opioids

A

Nausea, vomiting, constipation, dizziness/vertigo, somnolence, dry skin, pruritus, resp depression

33
Q

Best early warning sign of respiratory depression

A

Progressive sedation

34
Q

Renal failure and opioids

A

Don’t use morphine/codeine - sedative metabolites accumulate, Fentanyl or Oxycodone are okay

35
Q

Epidural analgesia

A

Directly into epidural space, catheter placed

36
Q

Uses of epidural analgesia

A
  • Postoperatively (thoracic, abdominal, groin/perineal, lower limb surgery)
  • Labour pain
  • Chronic pain
37
Q

Benefits of epidural analgesia

A
  • High quality pain relief
  • Improved pulmonary function
  • Reduced sepsis and chest infection
  • Reduced cardiac morbidity
  • Reduced vascular graft failure
  • Reduced incidence of DVT
38
Q

Epidural space

A

Potential space between dura and vertebral canal wall - connective tissue, fat and blood vessels and nerve roots and tissue in folds

39
Q

Morphine

A

Regular immediate release (4 hourly), allow access for breakthrough pain

40
Q

Celiac plexus block used for

A

Pancreatic carcinoma and upper abdominal neoplasia

41
Q

Spinal opiods

A

Act at dorsal horn, lipophobic morphine reaches brainstem, lipophilic fentanyl remains segmentally localised (subarachnoid space)

42
Q

Neuropathic pain

A

Spontaneous pain and hypersensitivity to pain in associated with damage to/lesion of NS

43
Q

Causes of neuropathic pain

A
  • Post herpetic neuralgia
  • Painful diabetic neuropathy
  • Trigeminal neuralgia
  • Pain after CVA
  • Post traumatic/post operative
44
Q

Dysaesthesias

A

Unpleasant abnormal sensations ‘ants crawling on the skin’

45
Q

Neuropathic pain prevalence

A

2-4% population

46
Q

McGill Pain Questionnaire (MPQ)

A

78 ranked descriptors, time consuming but well validated

47
Q

Drug therapy for neuropathic pain

A
  • NSAIDs (poor)
  • Antidepressants
  • Anticonvulsants
  • Opioids
  • Membrane stabilising drugs
  • Topical drugs
48
Q

Antidepressants efficacy (tri-cyclic agents)

A

Neuropathic pain, complex regional pain syndrome, tension headache (serotonin uptake inhibitors ineffective)

49
Q

Antidepressants mode of action

A

Inhibit neuronal reuptake of noradrenaline and serotonin (5-HT)

50
Q

Side effects of antidepressants

A

Constipation, dry mouth, somnolence, abnormalities in heart rate/rhythm, insomnia, increased appetite

51
Q

Anticonvulsants efficacy

A

Neuropathic pain

52
Q

Anticonvulsants mode of action

A
  • Gabapentin (binds to presynaptic voltage-dependent Ca channels)
  • Pregabalin (interacts with special N-type Ca channels)
  • Carbamazepine (blocks Na and Ca channels)
53
Q

Anticonvulsant side effects

A

Sedation, dizziness, ataxia, peripheral oedema, nausea, weight gain

54
Q

Carbamazepine, phenytoin

A

Na+ channel blockers > dizziness, sedation, rashes, liver damage

55
Q

Valproate, clonazepam

A

GABA agonist

56
Q

Loeser conceptualised pain

A

Four dimensions - pain behaviours, suffering, pain, nociception

CM Clinical Symposia (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions