Pain and Inflammation Flashcards

1
Q

Acute Pain

A
  • Frequently results from a disease, injury, or inflammation
  • Sudden onset
  • Short duration (<6months)
  • Resolves with Healing
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2
Q

Chronic Pain

A
  • Considered a disease
  • Persistent
  • Continues after healing
  • Resistant to majority fo medical treatments
  • Can be influenced by environment and psychological factors
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3
Q

Nociceptive Pain

A
  • Physiologic
  • “Normal” pain transmission
  • Tissue injury
  • Pharmacologic management: Nonopioids, opioids, local anesthetics
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4
Q

Neuropathic

A
  • Pathologic
  • Abnormal processing
  • Pharmacologic management: Adjuvant analgesics
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5
Q

Somatic Pain

A
  • Skin, bone, muscle, soft tissue
  • Well localized
  • Sharp, burning, gnawing, throbbing, cramping
  • Intermittent or constant
  • Acute or chronic
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6
Q

Inflammatory Pain (Inflammatory Joint Diseases)

A
  • Inflammatory joint diseases
  • Acute or chronic
  • Signs & symptoms: swelling, tenderness, deformities, limitation of motion
  • Treat with anti-inflammatory meds
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7
Q

Visceral Pain

A
  • Diffuse, not well localized
  • Nociceptor stimulation in abdominal or thoracic organs and tissues
  • Dull, aching, cramping
  • Referred
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8
Q

Neuropathic Pain

A
  • Injuries to peripheral pain receptors, nerves or CNS
  • Pain can arise from a stimulus that usually would not cause pain
  • Shooting, burning, stabbing
  • Difficult to treat
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9
Q

Nociceptive Pain Processes

A
  1. Transduction
    - Nociceptors
    - Inflammatory response
  2. Transmission
    - A-Delta and C Fibers
  3. Perception
    - Higher brain structure activation
  4. Modulation
    - Neurochemicals
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10
Q

Transduction

A
  • If above needed threshold, the neuron will depolarize and trigger action potential
  • Release of excitatory neurotransmitters and compounds
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11
Q

Transmission

A

Action potential
A-delta
- Glutamate
C fibers
- Substance P
Dorsal root ganglia
Spinal cord
Brain

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12
Q

A-delta fibers

A

Faster transmission
Lightly myelinated
Rapid reflex withdrawal

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13
Q

C fibers

A

Slow conduction
Unmyelinated
Poorly localized pain
Aching, burning

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14
Q

Glutamate

A

Binds to N-methyl-D-aspartate (NMDA) receptor
Promotes pain transmission
Secreted in spinal cord at A-delta nerve fiber endings

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15
Q

Substance P

A

Secreted at C nerve fiber endings
Opioids block at dorsal horn

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16
Q

Serotonin and Norepinephrine

A

Suppress nociceptive transmission

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17
Q

Perception

A

Higher brain structures are activated
Brain perceives pain

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18
Q

Modulation

A

Descending neuronal pathways
Inhibit pain transmission
- Endorphins
- Serotonin
- Norepinephrine

19
Q

Endogenous Analgesia System

A

Opioids can activate
Neuropeptides

20
Q

Neuropeptides

A

Endorphins
Enkephalins
Dynorphins

21
Q

Endorphins

A

Inhibit pain signal transmission
Induce euphoria

22
Q

Enkephalins

A

Inhibit Substance P release
Modulate pain perception

23
Q

Dynorphins

A

Produce analgesia

24
Q

Opioid Receptors

A

Mu Receptors
Kappa Recepotrs
Delta Receptors

25
Q

Mu Receptors

A

Analgesia
Respiratory Depression
Euphoria
Miosis
Reduced GI motility

26
Q

Kappa Receptors

A

Analgesia
Sedation
Respiratory Depression
Dysphoria
Miosis

27
Q

Delta Receptors

A

Analgesia

28
Q

Neuropathic Pain Transmission

A

Damage or dysfunction of the PNS or CNS
Abnormal processing of stimulus
Absence of tissue damage and inflammation
No useful purpose
Hyper excitable nerve endings

29
Q

Inflammation

A

Nonspecific localized reaction
Protective function

30
Q

Acute Inflammation

A

Less than 2 weeks
Protective function
Resolves after cause is removed

31
Q

Chronic Inflammation

A

Months to years
Not protective
Long-lasting or permanent tissue damage

32
Q
A
32
Q

Five Cardinal Signs of Inflammation

A

Redness
Warmth
Swelling
Pain
Loss of function

33
Q

Inflammatory Response Vascular Changes

A

Immediate vasoconstriction, then vasodilation
Increased vascular permeability

34
Q

Inflammatory Response Cellular Changes

A

Increased Leukocyte
Chemical Mediators

35
Q

Inflammatory Mediators

A

Bradykinin
Histamine
Prostaglandins

36
Q

Bradykinin

A
  • Vasodilation
  • Increased vascular permeanbility
  • Attract neautrophils
  • Associated with pain response
37
Q

Histamine

A
  • Mast Cells
  • Vasodilation
  • Increased capillary permeability
38
Q

Prostaglandins

A
  • Chemical mediators
  • Participate in inflammatory response
  • Cyclooxygenase (COX) enzymes -> metabolize arachidonic acid -> produce prostaglandins
  • Sensitize pain receptors
39
Q

COX-1 causes…

A
  • Decrease gastric acid secretion
  • Increased mucus production
  • Maintenance of renal perfusion
  • Maintenance of renal function
  • Vasodilation
  • Bronchodilation
  • Regulates plateleet aggregation
40
Q

COX-2 causes…

A
  • Vasodilation
  • Increased capillary permeability
  • Edema
  • Pain
  • Leukocytosis

Inflammtion

41
Q

Inhibiting COX-1 can cause…

A
  • Gastric erosion
  • Gastric ulceration
  • Bleeding tendencies
  • Renal impairment
  • Protects against MI and stroke
42
Q

Inhibiting COX-2 can
cause…

A
  • Renal impairment
  • Promotion of MI and stroke by suppressing vasodilation
43
Q

Systemic Effects of Inflammation

A

Fever, leukocytosis, malaise, anorexia, sepsis