Pain: Clinician Flashcards

1
Q

def. of pain

A

unpleasant subj. experience primarily assoc. with tissue damage or dercribed in terms of tissue damage

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2
Q

what is candian prevalence of chronic pain

A

29%

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3
Q

where do pain treatment disparities stem from

A
  1. healthcare system
  2. culture diffs
  3. clinician/patient interaction
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4
Q

def. of disease

A

specific clinical entity assoc. with disturbed function or structure of body

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5
Q

def. of illness

A

conception of sickness including

  1. symptoms
  2. interpretation
  3. expression of Sx
  4. coping behavs
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6
Q

4 aspects of biopsychosocial model

A
  1. sick role
  2. illness behavs.
  3. distress
  4. physical probs
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7
Q

what are psych aspects of pain

A
  1. basic cog. processes (attn., coping)
  2. social experiences
  3. pain behaviors
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8
Q

6 predisposing factors to chronic pain

A
  1. abuse
  2. marital discord
  3. fam. violence
  4. emot. trauma
  5. fam. members with chronic pain
  6. stress exposure
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9
Q

def. of chronic pain

A

> 6 months and beyond the normal healing time for an injury. Autonomic and reflex changes improve with time, but psych aspects tend to augment

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10
Q

what is main difference between chronic pain and chronic pain syndrome

A

sadness, hopelessness, social isolation, failed treatments, many doctors, demoralization

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11
Q

red flags for dev. of chronic pain disorder (6)

A
  1. intense and prolonged pain beyond that expected
  2. spreading and new pains
  3. failure to respond to treatments
  4. dev. of PTSD
  5. work difficulties
  6. inability of employer to give modified work
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12
Q

what is nociceptive pain

A

pain that is the result of the normal operation of the pain system and arises from injury

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13
Q

what is neuropathic pain

A

pain that arises from primary injury or dysfunction and nervous system reulting from injury to nerves, PNS or CNS

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14
Q

what can explain ritual pain tolerance

A
  1. endorphins
  2. altered mind states
  3. both
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15
Q

what are alpha and theta waves

A

alpha - normal 8-13 cyc/sec waves seen in everyday life

theta - 4-7 /sec waves seen in light sleep, deep thinking, and ritual pain experience

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16
Q

3 ways that hyponsis supresses pain

A
  1. splitting consciousness
  2. activation spinal cord descending pathways to block pain
  3. altering the meaning of pain
17
Q

what is a placebo

A

ineffective treatment believed to be effective

18
Q

3 things placebo can fix

A
  1. bronchospasm
  2. pain
  3. posture tremors
19
Q

2 main types of MRI

A
  1. evoked responses in brain areas

2. correlated activity between brain areas (functional connectivity)

20
Q

what does structural imagin find in pain

A

reduced grey matter volume in in cingulate and insular cortex

21
Q

what is anterior ACC involved in

A

subjective pain perception

22
Q

what is found in expert meditators

A

reduced pain unpleasantness and enhanced activity in the anterior insula and cingulate cotrex

23
Q

2 therapies that can increase grey matter

A
  1. CBT

2. decreased pain catastrophizing

24
Q

what is found in MRI in hypnosis people

A

greater functional connectivity between hemis on dorsolateral prefrontal cortex

25
Q

what is placebo effect correlated with

A

increased white matter integrity

26
Q

what are non-dermatomal somatosensory deficits

A

appear after traumatic injuries and are associated with bad prognosis for pain