Pain Exam 3 Flashcards
Three portions of the nervous system are responsible for the sensation and perception of pain:
One is:
________ pathways – begin in the peripheral nervous system and travel to the spinal gate in the dorsal horn and then ascend to the centers in the central nervous system
Afferent
Three portions of the nervous system are responsible for the sensation and perception of pain:
One is:
____________ centers – located in the brain stem, midbrain, diencephalon and cerebral cortex
Interpretive
Three portions of the nervous system are responsible for the sensation and perception of pain:
One is:
________ pathways – descend from the central nervous system back to the dorsal horn of the spinal cord
Efferent
Pain transduction begins when tissue is _______ by exposure to chemical, mechanical or thermal noxious stimuli
______ fibers – rapidly transmit sharp, localized “fast” pain sensation – elicit the reflex withdrawal
__ fibers – slowly transmit dull, aching or burning sensations
damaged
A-delta
C fibers
All A-fibers are myelinated and the fastest
A-alpha (A-a): _______ A Fibers
A-delta: Smallest A fibers
C-fibers are unmyleniated fibers and are the ______
Largest
Smallest
Slowest
Pain ____________ is the conduction of pain impulses along the A-delta and C fibers into the dorsal horn and the spinal cord
transmission
Pain __________ is the conscious awareness of pain (occurs in the reticular and limbic systems and the cerebral cortex)
perception
Pain __________ involves many different mechanisms that increase or decrease the transmission of pain signals throughout the nervous system
modulation
Neuromodulators of pain include substances that
- Stimulate pain nociceptors (excitatory neuromodulators)
- Prostaglandins, bradykinins, lymphokines, substance P, glutamate, histamine
Suppress pain (inhibitory neuromodulators)
- GABA, endorphins
- Some substances excite peripheral nerves but inhibit central nerves: serotonin, norepinephrine
P
histamine
serotonin
There are three Types of Acute Pain:
One is:
_______ pain – superficial, arising from the skin- described as sharp, dull, aching or throbbing (well localized) (can be associated with nausea, vomiting and shock)
Somatic
There are three Types of Acute Pain:
One is:
________ pain – occurs in the organs, abdomen, or skeleton; radiating pain (poorly localized)
Visceral
________ pain – pain felt in an area removed or distant from its point of origin (can be acute or chronic)
Referred
Considered the thermostat center of the body
Hypothalamus
A significant rise in body temperature
Sweating is a compensatory mechanism
Temp > 37.6 C
Hyperthermia
Accidental or therapeutic decrease in body temperature below normal range.
Shivering and vasoconstriction occur
Leads to reduced perfusion, reduced blood flow and coagulation
Hypothermia
results from prolonged high core or environmental temperatures
Heat Exhaustion
A potentially lethal result of an overstressed thermoregulatory center
Can be caused by exertion and overexposure
Heat Stroke
Newborns produce heat through non shivering thermogenesis which is accomplished through the metabolism of brown fat
Heat loss controlled by
Drying infant
skin to skin
CM
Crying restlessness
Skin feels cool
Acrocyanosis may be present (Blue hands and feet)
Newborn Thermoregulation
Paint theories
___________ theory of pain (Descartes) – there are
specific pain receptors in the body that project to the
brain and that the intensity of pain is directly related
to the amount of associated tissue injury
_______ Theory – describes the role of impulse intensity and the repatterning of the central nervoussystem
___________ Theory – proposes that the brainproduces patterns of nerve impulses drawn fromvarious inputs, including genetic, psychologic andcognitive experiences
____ Control Theory – pain transmission is
modulated by a balance of impulses conducted to the
spinal cord
Specificity
Pattern
Neuromatrix
Gate
_____ pain - protective mechanism that alerts the individual to a condition or experience that is immediately harmful to the body and immobilizes the individual to take prompt action to relieve it
– Somatic pain – superficial, arising from the skin- described as sharp, dull, aching or throbbing (well localized) (can be associated with nausea, vomiting and shock)
– Visceral pain – occurs in the organs, abdomen, or skeleton; radiating pain (poorly localized)
– Referred pain – pain felt in an area removed
Acute Pain
______ pain – pain lasting for more than 12
weeks; well beyond the expected normal
healing time
– Sciatica – low back pain along the distribution of a lumbar nerve root
Chronic
_______ pain – pain experiences in an
amputated limb after the stump has completely healed
• Stump pain
– Acute nociceptive pain at site of amputation
• Phantom sensations
– Feelings other than pain in missing body part
• Telescoping
– Sensation that distal part of missing limb is gradually approaching limb stump
• Phantom limb pain
– Pain perceived as
Phantom
______ ____pain - In sickle cell anemia the sickled erythrocytes tend to plug the blood vessels, increasing the viscosity of the blood
Sickle Cell
______ pain - Cancer-associated pain can arise from a variety of direct and indirect mechanisms
– Direct pressure, obstruction, invasion of a sensitive structure, stretching of visceral surfaces, tissue destruction, infection and inflammation all cause pain
– Pain can occur at the site of the primary tumor or at a distant metastatic lesion
Caner Pain
