Pain Exam 2 Flashcards
what is pain
pain is a complex experience
patient needs to explain they are in pain
what is acute pain
protective pain
promotes withdrawal from painful stimuli, allows injured parts to heal, and teaches avoidance
no longer than 3 MONTHS
EX. when ulis was limping he had acute pain he was being careful on foot to not injure it more
Nociception
process of impulses traveling to brain and back from brain to pain
afferent pathways, interpretive centers, efferent pathways
afferent pathways
begin in peripheral nervous system, impulses travel into our spinal gait and ascend to cortex of brain
interpretive centers
cortical and subcortical areas of brain, brainstem, midbrain, and cerebral cortex - parts of anatomy that interpret sensations from afferent pathway saying —> hey this is pain, this is hurting
efferent pathways
take the message from the interpretive centers, backdown into the CNS and back out to peripheral nervous system and elicit a physical/mental response to pain
what are nociceptors
pain receptors
free nerve endings in afferent peripheral nervous system that when stimulated call something nociceptive pain
order of physiology of pain (nociception)
transduction –> transmission –> perception –> modulation
transduction
painful stimuli converted to action potentials (electrical currents) at the sensory receptor
happens along A-delta fibers and C fibers
-substances/chemical mediators released as a result of DIRECT injury and inflammation
prostaglandin
important mediator that when activated LOWERS THE PAIN threshold
-when circulating makes people feel pain more easily
A-delta nerve fibers
myelinated - RAPID transmission of pain
pain is sharp, stinging, cutting, and pinching
localized
-stimulated/used when you cut yourself or poke with knife
C-fibers nerve fibers
unmyelinated - SLOW transmission of pain
pain is dull, burning, aching
poorly localized - stretching pain
EX. primarily in muscles, tendons, organs
transmission
process where ACTION POTENTIALS move from peripheral receptors to the spinal cord and then the brain
a-delta and c fibers are responsible for this transmission
perception
brain then receives these signals and interprets them as painful
modulation
synaptic transmission of pain signals in altered
gate control
if one can inhibit the nerve impulse BEFORE it reaches the thalamus/cortex, one can decrease PERCEPTION OF PAIN
what are the signs and symptoms of inflammation produced by
chemical mediators
- they are present in the plasma and activated by tissue injury
what are prostaglandins
a chemical mediator that promote inflammation, pain, and fever
- they protect the lining of the stomach from the effects of acid
- promote blood clotting by activating platelets
- affect kidney function –> dilate blood vessels that lead to the kidneys
what is chronic pain
lasting for more than 3-6 months
serves no purpose
often no ANS response - we do not see vital sign changes
Neuropathic pain
arises from direct injury to the nerves
stimulus within the CNS
what is referred pain
pain is felt at a DISTANCE form from the actual pathology - brain is unable to distinguish
