Pain assesment Flashcards
define pain
unpleasant sensory or emotional experience; associated w actual or potential tissue damage
define analgesia
absense of awareness of pain w/o loss of consiusness
define nociception
detection by NS of the potential for actual pain
how nociception happens (where signals go)
axon fibers carry signals to thalamus in cerebral cortex
difference between somatic and visceral pain
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
physiologic v pathologic pain
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
the pain pathway
noxious event -> nociceptors(transduction) ->transmission-> spinal cord(modulation) -> brain (perception)
difference between alpha delta fibers and C-fibers
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
example of chemical noxious stimuli
poisonous or destructive chemicals
goal of pain managment in terms of chosing a course of therapy
target 2 or more receptors (multimodal therapy)
define stoicism
animal is less likely to demonstrate painful behavior
which are subjective, which are objective;
physiologic signs or behavioral signs?
physiologic= objective (quantitative) (HR, RR, etc.) behavioral= subjective (qualitative)
pain/stress leads to production of what from the immune system
cortisone and epinephrine from adrenal glands
excessive cortisol leads to
catabolism (destructive metabolism/ tissue beakdown)
immunosuppresion
supresses healing, promotes inflamation
untreated pain consequences on cardiovascular system
(epineprine release) tachycardia, hypertension, arrythmias
stim of A receptors-> peripheral vasoconstriction -> pale mm
untreated pain consequences on pulmonary/resp system
tachypnea, hypoxemia (bc shallow breaths), pulmonary edema, hypertension, resp acid/base imbalance
how untreated pain effects renal system
renal hypertension from cardiac system,
excessive cortisol-> protein breakdown -> release acids -> kidney problems
untreated pain consequences on metabolic system
cachexia (extreme weight loss), neg. nitrogen balanace (causing decreased protein synthesis)
what is wind-up pain, how is it caused
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
define hypealgesia
less stimulus required to initiate pain
define allodynia
pleasent or neutral nerve fibers become part of pain pathway
should you match pain mgmt to anticipated pain o how the patient expresses pain
anticipated pain
how long to give send home analgesics for soft tissue surgery like spay or neuter
3-4 days post op
fo procedure that cause severe pain, like orthopedics, send home analgesics to last for how long
1 week post op
