Pain Physio (EB) Flashcards
Why do people withhold analgesia
difficulties in recognizing pain. Lacking of knowledge in the appropriate use of analgesics. Fear of drug side effects
Why is it important to monitor the response to pain tx?
lots of consequences of pain
What 2 combinations of things is pain?
nociception and perception
What are the classic categorizations of pain (5)
disease Anatomy. General location Duration Intensity
What is physiologic/nociceptive pain? (3)
early-warning physiological protective system Touching things too hot, cold, sharp
What type of pain is essential for bodily integrity?
physiologic/nociceptive pain
What are the 2 types of pathological/clinical pain?
inflammatory Neuropathic
What type of pain is adaptive but still needs to be reduced?
inflammatory pain
What type pain must be treated?
neuropathic pain
What is the purpose of inflammatory pain?
assist in healing by discouraging physical contact or movement
What pain is not protective at all, just maladaptive?
neuropathic pain
What does neuropathic pain result from?
abnormal functioning of the NS
What fibers participate in nociception?
A-delta C A-beta
Pathway of nociception
transduction Transmission Modulation Projection Perception
What is the transduction of pain?
detection of innocuous and noxious information
What nerve fibers are responsible for “first pain” aka the pricking and sharp pain?
A-delta fibers
What type of receptors are Adelta fiber nociceptors composed of?
75% of low-threshhold 25% of high-threshold
What nociceptive fibers have a higher discharge rate?
A delta
What nociceptive fibers have a high threshold?
C fiber
What nociceptive fiber has a second/slow pain?
C fibers
What fibers have to be activated for the perception of acute pain?
both the Adelta and C nociceptors
What are the silent or sleeping nociceptors?
A delta and C fiber
What activates the silent/sleeping nociceptiors?
inflammation NOT activated by tissue damaging events
What stimulation are the silent/sleeping nociceptors very sensitive to?
mechanical
What fibers pick up a low intensity pain stimulus? What is their threshold?
A beta fibers Low threshold
What fibers pick up a high intensity pain stimulus? What is their threshold?
A delta and C fibers High threshold
What is it when A beta fibers are more easily excitable?
allodynia
What is it when A delta and C fibers are more easily excitable?
hyperalgesia
What does peripheral sensitization result in?
hyperalgesia at the site of injury (primary hyperalgesia)
What causes peripheral sensitization
inflammatory/sensitizing soup
What is responsible for pain memory?
central sensitization
What does central sensitization result in?
primary and secondary hyperalgesia and allodynia
What is wind-up
temporal summation of sensory inputs in the spinal cord
What drugs inhibit transduction of pain (4)
opioids Local anesthesia A2 agonists NSAIDs
What drugs inhibit transmission of pain (1)
local anesthesia
What drugs inhibit the perception of pain (5)
inhalants Sedatives Injectables Anesthesics NSAIDs
What drugs inhibit the projection of pain (6)
inhalant anesthetics Injectable anesthetics Local anesthetics Opioids A2 agonists ketamine
