Pain Management Flashcards
purpose of pain management
allows more comfy life
improves sleep, appetite
quicker recovery
dec risk for pneumonia and DVT
dec depression and anxiety
what is pain
unpleasant sensory and emotional exp
assoc c actual or potential tissue damage
usual signs in OI that points to pain
grimacing/frowning
holding the injured site
loss of function
purpose of holding injured site in response to pain
to protect
to soothe or massage area
what is nociception
neural process of encoding noxious stim
tissue injury and damage is present
what is the difference of pain vs nociception
nociception: neural process alone; no facial expressions or signs of pain
pain: emotion showing; (+) signs
discuss the pathophysiology of pain
- noxious stim causes release of prostaglandins that trigger PNS
- transduction: conversion of noxious to nerve impulse
- A delta and C fibers receive impulse
- goes to DRG; 1st order neuron
- impulse goes to dorsal horn of SC; 2nd order neuron
- decussates to other side and goes up to spinothalamic tract
- synapse to thalamus; 3rd order neuron
- thalamocortical projections send to sensorimotor cortex - limbic - frontal - ANS
discuss A-beta fibers
large, myelinated and fast
stim by mechanoreceptors - touch
rubbing and massaging to dec pain
discuss A-delta fibers
medium, myelinated and intermediate speed
stim by noxious - sharp pain
hand over burning candle
discuss C fibers
small, unmyelinated and slow
stim by noxious - burning and aching (secondary pain)
after burning candle mag ache - long term pain
factors that influence pain perception
beliefs
psychological factos
cultural factors
other illnesses
coping strategies
social factors
spiritual factors
discuss GCT
A-delta and C fibers sends to brain - gate opens = pain
stim A-beta = close gate = no pain
discuss acute pain
3 mo or less
can progress to chronic if untreated
discuss chronic pain
more than 3 mo
persistent pain despite healed injury - basta healed chronic na kahit less than 3 mo
more diff to manage
discuss cancer pain
progressive if untreated - metastases = more pain
often chronic
discuss non-cancer pain
acute but can be chronic
post-surgery, degenerative conditions, nerve compression or no obvious cause
discuss nociceptive mechanism
protective in nature from tissue injury
physiological pain
sharp, throbbing and aching - localized
discuss neuropathic mechanism
somatosensory or pathological pain - not protective
tissue injury may no be obvious - damage to nervous system
shooting, burning, pins and needles - radiating
causes of neuropathic pain
trauma
cancer
amputation
disease states
trigeminal neuralgia
common
on LE, UE and face
post-herpetic neuralgia
chickenpox stays in nerve - becomes herpes
causes lesions on nerve - follows nerve pattern
very painful
peripheral and entrapment nueropathy
CTS, sciatica
arachnoiditis
inflammation and infection of the arachnoid matter
severe HA
brachial plexus avulsion
athletes - severe pain in UE
