Pain Management Flashcards
pain influenced by many factors (4)
1) affective ex/ fatigue 2) behavioral ex/ age 3) cognitive ex/ alert, not alert 4) physiological sensory ex/ neuro function, genes
pains serves as what
an injury prevention mechanism
what is nociception
how pain is transferred/processed
-processing painful stimuli
transduction
impulses travel along afferent (sensory) nerve fibers
a-delta
sharp, localized pain after injury
c-fibers
- slow conducting
- dull, poorly localized pain after injury
- first vs. second
impulses travel via the ____
spinothalmic tract
what is the most important pathway for pain sensation
spinal dorsal horn
impulse route
A-delta & c-fibers -> dorsal root -> spinal dorsal horn -> spinothalmic tract -> brain stem -> thalamus
neurotransmitters:
-all cellular damage results in release of (3)
1) prostaglandins (increase feeling of pain)
2) substance P (causes increase pain too)
3) serotonin (decrease pain)
neurotransmitters produce a ____ _____ inflammatory response
pain-sensitizing
perception: once the impulse reaches the cerebral cortex, the brain interprets the quality of pain based on what 3 things
1) past experiences
2) knowledge
3) culture
perception is?
personal awareness
modulation
to control / regulate it
once the brain perceives pain, it releases endogenous opioids to produce ____
analgesia
- serotonin
- norepinephrine
gate control theory: _____ acts as a gate
dorsal horn
how does dorsal horn acts as a gate for pain?
- CLOSE to prevent nociceptive impulses from reaching the brain
- OPEN to allow impulses to be transmitted to the brain
what fibers open the gate?
a-delta & c-fibers
what fibers close the gate?
alpha & beta fibers
whats the significance of the gate theory
provides ideas for pain relief emphasizing multiple dimensions of pain
- sensory
- emotional
- behavioral
- cognitive
5 types of pain
1) acute
2) persistant (chronic)
3) cancer
4) nociceptive
5) neuropathic
acute pain
usually less than 6 months -with injury or disease -associated w/ anxiety / fear -typically increases with: wound care ambulation coughing deep breathing
persistant (chronic) pain
- longer than 6 months
- assoc. w/ depression, frustration, fear
- cause may be unidentifiable (idiopathic)
nociceptive pain
somatic, visceral
