Pain Pathophysiology

Question 1

__ is defined as “An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.”

Answer 1

pain

Question 2

Over __ million people in the US live with chronic pain

Answer 2

100

Question 3

__ million Americans will experience acute pain due to injury or surgery in one year

Answer 3

25

Question 4

The estimated economic burden of pain is greater than __ billion US dollars annually

Answer 4

500

Question 5

Five distinct steps of pain processing?

TCTMP

Answer 5

T - transduction
C - conduction
T - transmission
M - modulation
P - perception

Question 6

__ is the stimulation oof specialized nerve fiber receptors known as nociceptors that are found in somatic or visceral locations

Answer 6

transduction

Question 7

__ are activated and sensitized by mechanical, thermal, and chemical stimuli due to the release and activation of cytokines and chemokines.

Answer 7

nociceptors

Question 8

___ is activation of the nociceptors leading to conversion of the chemical signal into and electrical signal (action potential)

Answer 8

conduction

Question 9

Which nerve fibers are large-diameter, sparsely myelinated and evoke sharp and well localized pain?

A-delta or C-polymodal?

Answer 9

A-delta

Question 10

Which nerve fibers are small diameter, ummyelinated and evoke aching and poorly localized pain?

A-delta or C-polymodal?

Answer 10

C-polymodal

Question 11

__ is afferent nociceptive nerve fibers synapse in the laminae of the dorsal horn in the spinal cord?

Answer 11

transmission

Question 12

Which step of pain processing involves voltage gated sodium channels?

Answer 12

conduction

Question 13

Which step of pain processing involves N-type voltage gated calcium channels?

Answer 13

transmission

Question 14

Transmission signals reach the brain through ascending spinal cord pathways with the __ acting as the relay station within the brain

Answer 14

thalamus

Question 15

Transmission:

The electrical signal is converted back into a chemical signal by releasing __ and __ regulated by N-type voltage gated calcium channels

Answer 15

glutamate, substance P

Question 16

Modulation:

Glutamate or substance P can make pain signals ___ intense.

a. less
b. more

Answer 16

b. more

Question 17

Sensation of pain varies in individuals due to ___

Answer 17

modulation

Question 18

Modulation:

The pain signal can b e inhibited by descending pathways that consists of:

Answer 18

• enkephalins/beta endorphins
• GABA
• norepinephrine
• serotonin
• NMDA

Question 19

Which fibers are myelinated for fast conduction?

A or C

Answer 19

A

C are non-myelinated, associated with dull pain

Question 20

What part of brain responsible for emotional dimension of pain perception?

Answer 20

frontal cortex

Question 21

Which part of brain responsible for location and intensity of pain perception?

Answer 21

somatosensory cortex

Question 22

__ pain is also known as pathophysiologic pain.

Answer 22

maladaptive

different from nociceptive pain

Question 23

Neuropathic pain, IBS, and neuropathic pain produce __ pain

Answer 23

maladaptive

Question 24

Acute pain is duration less than ___ days

Answer 24

30

Question 25

Acute pain is usually nociceptive

a. true
b. false

Answer 25

a. true

Question 26

Chronic pain is categorized into __ vs __ pain

Answer 26

cancer, non-cancer

Question 27

Vitamin B12 and TSH tests are associated with chronic or acute pain?

Answer 27

chronic

Question 28

What pain assessment is used in pediatrics?

Answer 28

FLACC

Question 29

What pain assessment is used in ICU pts?

Answer 29

CPOT