Pain assesment

Question 1

define pain

Answer 1

unpleasant sensory or emotional experience; associated w actual or potential tissue damage

Question 2

define analgesia

Answer 2

absense of awareness of pain w/o loss of consiusness

Question 3

define nociception

Answer 3

detection by NS of the potential for actual pain

Question 4

how nociception happens (where signals go)

Answer 4

axon fibers carry signals to thalamus in cerebral cortex

Question 5

difference between somatic and visceral pain

Answer 5

somatic= signals come from peripherary, localized to an area, deep (muscle/bone) or superficial
visceral= fibers transmit from body core, usu dull or ard to localize

Question 6

physiologic v pathologic pain

Answer 6

physiologic= little to no tissue damage (ex: pulling hand away from hot stove)
pathologic=tissue damage, inflammation, neuropathic pain (nerve injury), visceral/ somatic pain, idiopathic pain

Question 7

the pain pathway

Answer 7

noxious event -> nociceptors(transduction) ->transmission-> spinal cord(modulation) -> brain (perception)

Question 8

difference between alpha delta fibers and C-fibers

Answer 8

alpha-delta= thick, myelinated, conduct rapidly, responsible for sharp/fast localized pain, predominatley in skin
C-fibers=thin, unmyelinated, conduct slowly, slow/diffuse burning pain, pay persist after noxious stimulus is gone, redominatley in viscera

Question 9

example of chemical noxious stimuli

Answer 9

poisonous or destructive chemicals

Question 10

goal of pain managment in terms of chosing a course of therapy

Answer 10

target 2 or more receptors (multimodal therapy)

Question 11

define stoicism

Answer 11

animal is less likely to demonstrate painful behavior

Question 12

which are subjective, which are objective;

physiologic signs or behavioral signs?

Answer 12

physiologic= objective (quantitative) (HR, RR, etc.)
behavioral= subjective (qualitative)

Question 13

pain/stress leads to production of what from the immune system

Answer 13

cortisone and epinephrine from adrenal glands

Question 14

excessive cortisol leads to

Answer 14

catabolism (destructive metabolism/ tissue beakdown)
immunosuppresion
supresses healing, promotes inflamation

Question 15

untreated pain consequences on cardiovascular system

Answer 15

(epineprine release) tachycardia, hypertension, arrythmias

stim of A receptors-> peripheral vasoconstriction -> pale mm

Question 16

untreated pain consequences on pulmonary/resp system

Answer 16

tachypnea, hypoxemia (bc shallow breaths), pulmonary edema, hypertension, resp acid/base imbalance

Question 17

how untreated pain effects renal system

Answer 17

renal hypertension from cardiac system,

excessive cortisol-> protein breakdown -> release acids -> kidney problems

Question 18

untreated pain consequences on metabolic system

Answer 18

cachexia (extreme weight loss), neg. nitrogen balanace (causing decreased protein synthesis)

Question 19

what is wind-up pain, how is it caused

Answer 19

repeated chronic pain increases the excitability of spinal neurons, NMDA fibers (which are normally dormant) become pain pathways
less stimulation is required to produce pain

Question 20

define hypealgesia

Answer 20

less stimulus required to initiate pain

Question 21

define allodynia

Answer 21

pleasent or neutral nerve fibers become part of pain pathway

Question 22

should you match pain mgmt to anticipated pain o how the patient expresses pain

Answer 22

anticipated pain

Question 23

how long to give send home analgesics for soft tissue surgery like spay or neuter

Answer 23

3-4 days post op

Question 24

fo procedure that cause severe pain, like orthopedics, send home analgesics to last for how long

Answer 24

1 week post op