Pain Pathophysiology Flashcards
__ is defined as “An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.”
pain
Over __ million people in the US live with chronic pain
100
__ million Americans will experience acute pain due to injury or surgery in one year
25
The estimated economic burden of pain is greater than __ billion US dollars annually
500
Five distinct steps of pain processing?
TCTMP
T - transduction C - conduction T - transmission M - modulation P - perception
__ is the stimulation oof specialized nerve fiber receptors known as nociceptors that are found in somatic or visceral locations
transduction
__ are activated and sensitized by mechanical, thermal, and chemical stimuli due to the release and activation of cytokines and chemokines.
nociceptors
___ is activation of the nociceptors leading to conversion of the chemical signal into and electrical signal (action potential)
conduction
Which nerve fibers are large-diameter, sparsely myelinated and evoke sharp and well localized pain?
A-delta or C-polymodal?
A-delta
Which nerve fibers are small diameter, ummyelinated and evoke aching and poorly localized pain?
A-delta or C-polymodal?
C-polymodal
__ is afferent nociceptive nerve fibers synapse in the laminae of the dorsal horn in the spinal cord?
transmission
Which step of pain processing involves voltage gated sodium channels?
conduction
Which step of pain processing involves N-type voltage gated calcium channels?
transmission
Transmission signals reach the brain through ascending spinal cord pathways with the __ acting as the relay station within the brain
thalamus
Transmission:
The electrical signal is converted back into a chemical signal by releasing __ and __ regulated by N-type voltage gated calcium channels
glutamate, substance P
Modulation:
Glutamate or substance P can make pain signals ___ intense.
a. less
b. more
b. more
Sensation of pain varies in individuals due to ___
modulation
Modulation:
The pain signal can b e inhibited by descending pathways that consists of:
- enkephalins/beta endorphins
- GABA
- norepinephrine
- serotonin
- NMDA
Which fibers are myelinated for fast conduction?
A or C
A
C are non-myelinated, associated with dull pain
What part of brain responsible for emotional dimension of pain perception?
frontal cortex
Which part of brain responsible for location and intensity of pain perception?
somatosensory cortex
__ pain is also known as pathophysiologic pain.
maladaptive
different from nociceptive pain
Neuropathic pain, IBS, and neuropathic pain produce __ pain
maladaptive
Acute pain is duration less than ___ days
30
Acute pain is usually nociceptive
a. true
b. false
a. true
Chronic pain is categorized into __ vs __ pain
cancer, non-cancer
Vitamin B12 and TSH tests are associated with chronic or acute pain?
chronic
What pain assessment is used in pediatrics?
FLACC
What pain assessment is used in ICU pts?
CPOT
