Pain Management

Question 1

Acute

Answer 1

“Pain that is usually temporary and results from something specific, such as a surgery, an injury, or an infection.”

Question 2

Chronic

Answer 2

“Pain that lasts beyond the term of an injury or painful stimulus. Can also refer to cancer pain, pain from a chronic or degenerative disease, and pain from an unidentified cause.”

Question 3

Referred

Answer 3

Pain felt at a site different from the location of the injured or diseased part of the body. Referred pain is due to the fact that nerve signals from several areas of the body may “feed” the same nerve pathway leading to the spinal cord and brain

Question 4

Nociceptors

Answer 4

Nerve endings activated by noxious stimuli.

Question 5

A-Delta

Answer 5

small, myelinated fibers. (A=acute)
Quick onset; short duration. Sharp/stabbing/prickling pains.
Located mainly superficially

Question 6

C Fibers

Answer 6

small, unmyelinated fibers. Slow onset, long lasting. Dull ache, tingling, burning pain. (C=chronic) Located in deeper structures

Question 7

A-Beta

Answer 7

larger, myelinated. FASTER than A-delta. Stretch, vibration and mechanoreceptors. In joints and skin

Question 8

Pain threshold

Answer 8

level of stimulation required to activate the pain perception transmission.
Everyone’s threshold is different and can be manipulated by electronic stimulation or feedback.

Question 9

Gate Theory

Answer 9

Since 1965
A-Beta fibers are nonnociceptive. Travel faster than A-Delta and C fibers. Therefore stimulus of A-Beta can block transmission of A-Delta and C closing the “gate” to the brain.
One reason why massage works and trigger point release works. Also used for TENS.

Question 10

Limbic System

Answer 10

Emotional center of the body. Regulates autonomic nervous system (ANS).

Question 11

Sympathetic Nervous System (SNS)

Answer 11

“Fight or Flight”. Located thoracic and upper lumbar spinal cord segments. Functions, increase CV, neuromuscular, respiratory, and neurologic function. Stimulated by fear, excitement, anger, pain, etc.

Question 12

Parasympathetic Nervous System (PNS)

Answer 12

Opposes the SNS. Located: midbrain, pons, medulla, and sacral spinal segments
Relaxation response.
Decreased CV, respiratory, neuromuscular and neurological responses.
Calming effects.

Question 13

Locus of Control

Answer 13

Ability to control life conditions and event

Question 14

Internal

Answer 14

Outcomes are self determined.

Question 15

External

Answer 15

Outcomes are determined by others.

Question 16

Malingerer

Answer 16

a patient that continues to c/o pain even after stimulus has been removed. “Lingers” in symptomatic form or may have fabricated the symptoms in the first place. Defined as “intentional production of false or grossly exaggerated physical…symptoms, motivated by external incentives such as avoiding military duty, avoiding work, financial compensation, evading criminal prosecution, or obtaining drugs.”

Question 17

Symptom Magnifier

Answer 17

“self-destructive, socially reinforced behavioral response pattern.” Patient focuses on symptoms and is unable to focus on rehab. Exaggerated reports of symptoms. Always 10/10.
**Be careful how you document either of these!!!

Question 18

Depression

Answer 18

“morbid sadness, dejection, or a sense of melancholy, distinguished from grief…”

Question 19

Dementia

Answer 19

Lack of intellect after age 18. Characterized by: progressive confusion, disorientation, memory loss, personality changes

Question 20

Alzheimer’s Disease

Answer 20

Degeneration of limbic system and neuronal synapses. Progressive from mild to moderate to severe. common causes of death: infection or falls. Medication available: Aricept.