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Passive Care Final (563) > Pain and Control > Flashcards

Pain and Control Flashcards

1
Q

What are the fives stages of response to terminal illness as demonstrated in the Kubler-Ross model?

A

1 denial 2 anger 3 bargaining 4 depression 5 acceptance

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2
Q

The Kubler-Ross death and dying model can be applied to most grief or depression including illness and injury, but which type of injury is it not as applicable to?

A

Athletic injury

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3
Q

What is the cognitive appraisal model?

A

Response to injury depends on individual’s understanding of the injury (no stages or order)

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4
Q

Is depression following injury common among athletes?

A

No (refer to cognitive appraisal model)

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5
Q

What is the most common use of therapeutic modalities?

A

Reduce pain levels

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6
Q

What is transduction?

A

Process of changing energy of nociception into electrical action potential in the neuron

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7
Q

Which proprioceptors detect change in muscle length and spindle tension?

A

Golgi tendon organs (GTOs)

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8
Q

Which mechanoreceptors also detect change in joint position?

A

Pacinian corpuscles

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9
Q

Which mechanoreceptors sense pressure and touch?

A

Meissner’s corpuscles

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10
Q

Which mechanoreceptors sense skin stretch and pressure?

A

Merkle cells

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11
Q

What two things determine the velocity of nerve transmission?

A

Diameter of the nerve and degree of myelination

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12
Q

What are the unmyelinated pain fibers? Myelinated?

A 
Unmyelinated = C fibers
Myelinated = A-delta
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13
Q

Which first order afferent fibers are associated with only touch and vibration and NOT pain?

A

A-beta

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14
Q

What is the relationship between nerve fiber diameter and speed?

A

Increased diameter = increased speed

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15
Q

Which type of fibers are the fastest?

A

A-beta (greater diameter)

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16
Q

Which are faster: C fibers or A-delta fibers?

A

A-delta (due to myelination and increased diameter)

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17
Q

What is the location of C fibers?

A

Muscle, skin

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18
Q

What is the location of A-beta and A-delta fibers?

A

Skin

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19
Q

Which fibers have warm and cold receptors and are found in hair follicles?

A

A-delta

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20
Q

What are the smallest peripheral nerve fibers associated with pain?

A

C fibers

21
Q

Where does the first order neuron of the pain pathway synapse?

A

Dorsal horn of spinal cord

22
Q

What are the most important parts of the thalamus for pain transmission?

A

VPL and VPM

23
Q

Where are the cell bodies of the third order neurons in the path pathway located?

A

Thalamus

24
Q

Where do ascending pain fibers from just the head and face synapse in the thalamus?

A

VPM

25
Q

Where do ascending pain fibers from the body synapse in the thalamus?

A

VPL

26
Q

Where does localization and discrimination of pain transmission occur in the cortex?

A

Postcentral gyrus

27
Q

What area of the brain is important for regulating emotional, autonomic, and endocrine responses to pain?

A

Limbic system

28
Q

Ice treatment is an example of what kind of pain modulation?

A

Peripheral pain modulation

29
Q

How does peripheral pain modulation work?

A

Desensitizes peripheral nociceptors and increases threshold making fewer pain impulses transmitted to the spinal cord

30
Q

What is the gate theory of pain?

A

Non-painful stimulus can block transmission of noxious stimulus

31
Q

What specific location in the spinal cord acts as a “switch operator” in the gate theory?

A

Substantia gelatinosa

32
Q

Which endogenous pain killer is present in the substantial gelatinosa?

A

Enkephalins

33
Q

Why does shaking your hand after hitting it with a hammer help reduce your pain?

A

Stimulation of A-beta fibers to cause inhibitory interneurons to be stimulated to block pain transmission

34
Q

Which modulation provides sensory feedback at a non painful level to stimulate A-beta fibers to reduce pain?

A

TENS

35
Q

What specific location is targeted during motor pain modulation?

A

Reticular formation and pituitary gland

36
Q

What are the types of central pain modulation?

A

Motor and noxious pain modulation

37
Q

What specific location is targeted during noxious pain modulation?

A

Periaqueductal gray (PAG) and raphe nucleus

38
Q

The descending endogenous opiate system (DEOS) is involved in which form pain modulation?

A

Motor (central) pain modulation

39
Q

Cryotherapy stimulates what fibers in an effort for noxious pain modulation?

A

C fibers

40
Q

What is another name for nerve block pain modulation?

A

Wedensky’s inhibition

41
Q

What is Wedenski’s inhibition?

A

When stimulation encroaches on the refractory period of the sensory nerve and causes inhibition by continual stimulation

42
Q

Which types of modalities are associated with nerve block pain modulation?

A

Russian stimulation, interferential current

43
Q

What is exercise induced hypoalgesia?

A

Decreased pain sensation during physical activity

44
Q

When was EIH first noticed?

A

During Civil War and WWI when solider felt less pain during battle than in safety of a hospital

45
Q

What is the scientific reason behind exercise induced hypoalgesia?

A

Increased endogenous opioids (endorphins) and catecholamines (epinephrine and norepinephrine)

46
Q

Why is EIH an important thing to consider with patients?

A

Patients who are athletes could be seriously injured by not feel the intensity of their pain during a game

47
Q

Is EIH more prevalent with aerobic or anaerobic exercise?

A

Aerobic

48
Q

What are the 3 components of neuromuscular control that should be addressed in a rehabilitation plan?

A

1 consciously controlled muscle contraction
2 reflex responses
3 complex movement patterns

49
Q

How can a knee injury lead to muscle issues?

A

Stretch receptors in joint capsule with joint effusion send signals to CNS leading to reflex inhibition of VMO

Passive Care Final (563) (11 decks)

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