Pain Physio (EB)

Question 1

Why do people withhold analgesia

Answer 1

difficulties in recognizing pain. Lacking of knowledge in the appropriate use of analgesics. Fear of drug side effects

Question 2

Why is it important to monitor the response to pain tx?

Answer 2

lots of consequences of pain

Question 3

What 2 combinations of things is pain?

Answer 3

nociception and perception

Question 4

What are the classic categorizations of pain (5)

Answer 4

disease Anatomy. General location Duration Intensity

Question 5

What is physiologic/nociceptive pain? (3)

Answer 5

early-warning physiological protective system Touching things too hot, cold, sharp

Question 6

What type of pain is essential for bodily integrity?

Answer 6

physiologic/nociceptive pain

Question 7

What are the 2 types of pathological/clinical pain?

Answer 7

inflammatory Neuropathic

Question 8

What type of pain is adaptive but still needs to be reduced?

Answer 8

inflammatory pain

Question 9

What type pain must be treated?

Answer 9

neuropathic pain

Question 10

What is the purpose of inflammatory pain?

Answer 10

assist in healing by discouraging physical contact or movement

Question 11

What pain is not protective at all, just maladaptive?

Answer 11

neuropathic pain

Question 12

What does neuropathic pain result from?

Answer 12

abnormal functioning of the NS

Question 13

What fibers participate in nociception?

Answer 13

A-delta C A-beta

Question 14

Pathway of nociception

Answer 14

transduction Transmission Modulation Projection Perception

Question 15

What is the transduction of pain?

Answer 15

detection of innocuous and noxious information

Question 16

What nerve fibers are responsible for “first pain” aka the pricking and sharp pain?

Answer 16

A-delta fibers

Question 17

What type of receptors are Adelta fiber nociceptors composed of?

Answer 17

75% of low-threshhold 25% of high-threshold

Question 18

What nociceptive fibers have a higher discharge rate?

Answer 18

A delta

Question 19

What nociceptive fibers have a high threshold?

Answer 19

C fiber

Question 20

What nociceptive fiber has a second/slow pain?

Answer 20

C fibers

Question 21

What fibers have to be activated for the perception of acute pain?

Answer 21

both the Adelta and C nociceptors

Question 22

What are the silent or sleeping nociceptors?

Answer 22

A delta and C fiber

Question 23

What activates the silent/sleeping nociceptiors?

Answer 23

inflammation NOT activated by tissue damaging events

Question 24

What stimulation are the silent/sleeping nociceptors very sensitive to?

Answer 24

mechanical

Question 25

What fibers pick up a low intensity pain stimulus? What is their threshold?

Answer 25

A beta fibers Low threshold

Question 26

What fibers pick up a high intensity pain stimulus? What is their threshold?

Answer 26

A delta and C fibers High threshold

Question 27

What is it when A beta fibers are more easily excitable?

Answer 27

allodynia

Question 28

What is it when A delta and C fibers are more easily excitable?

Answer 28

hyperalgesia

Question 29

What does peripheral sensitization result in?

Answer 29

hyperalgesia at the site of injury (primary hyperalgesia)

Question 30

What causes peripheral sensitization

Answer 30

inflammatory/sensitizing soup

Question 31

What is responsible for pain memory?

Answer 31

central sensitization

Question 32

What does central sensitization result in?

Answer 32

primary and secondary hyperalgesia and allodynia

Question 33

What is wind-up

Answer 33

temporal summation of sensory inputs in the spinal cord

Question 34

What drugs inhibit transduction of pain (4)

Answer 34

opioids Local anesthesia A2 agonists NSAIDs

Question 35

What drugs inhibit transmission of pain (1)

Answer 35

local anesthesia

Question 36

What drugs inhibit the perception of pain (5)

Answer 36

inhalants Sedatives Injectables Anesthesics NSAIDs

Question 37

What drugs inhibit the projection of pain (6)

Answer 37

inhalant anesthetics Injectable anesthetics Local anesthetics Opioids A2 agonists ketamine