Pain Physiology

Question 1

Pain Def

Answer 1

unpleasant sensory and emotional experience from actual or potential tissue damage

Question 2

Eudynia Def

Answer 2

signal to body that it’s being damaged in some way that needs immediate attention.

Question 3

Nociceptive Pain Def

Answer 3

normal neural processing pain that occurs when free nerve endings are activated by tissue damage or inflammation

ex. somatic, deep visceral

Question 4

Neuropathic Pain Def

Answer 4

abnormal processing of stimuli from peripheral/CNS, thought to serve no useful purpose

Question 5

Nociception Def

Answer 5

encoding and processing of harmful stimuli

Question 6

Allodynia Def

Answer 6

pain resulting from a stimulus that does not normally cause pain

Question 7

Paresthsia Def

Answer 7

abnormal sensation, spontaneous or evoked

Question 8

Analgesia Def

Answer 8

absence of pain in response to stimuli that is normally painful

Question 9

Hypogesia Def

Answer 9

diminished pain to a normally painful stimul

Question 10

Hyperesthesia Def

Answer 10

excessive physical sensitivity

Question 11

Hypoesthesia Def

Answer 11

reduced physical sensitivity

Question 12

Pain Tolerance Def

Answer 12

total pain experience

maximum intensity/duration of pain that a person is willing to endure before they want something done about it.

Question 13

Pain Threshold Def

Answer 13

the point at which a stimulus is perceived as painful

Question 14

Differentiate between the following types of pain:

• cutaneous
• Deep somatic
• visceral(referred)
• phantom
• acute
• chronic

Answer 14

Cutaneous-
arises from superficial structures, sharp, bright pain, localized accurately
ex. paper cut

Deep Somatic-
deep body structures, more diffuse pain, periosteum, muscles, tendons, joints, blood vessels.
ex. sprained ankle

Visceral(referred)-
pain of internal organ that is perceived to originate from a distant area of the skin. low density of nociceptors in viscera,
visceral and somatic afferent neurons converge on same dorsal horn projection neurons making it difficult to identify origin of pain.
* referred pain- localized to the dermatome of embyological origin, ex: heart»>neck, shoulder, & arm

acute-
short duration, resolves when underlying pathological process has resolved. Alerts of actual or impending tissue damage.

Chronic-
pain that persists longer than reasonably expected after inciting event, is often resistant to medical treatments May continue for years and years
ex. migraine HA

Question 15

Managing Acute Pain

Answer 15

aggressively managed and pain meds provided before pain becomes severe.

Question 16

Phantom Limb Pain

Answer 16

neurologic pain following amputation

tingling, squeezing, heaviness, leading to burning, cramping, or shooting

Question 17

Trace the transmission of pain signals

Answer 17

Initial tissue injury, NT released (prostaglandins, ACH, substance P) from tissues, recognized by nociceptors, nociceptor travels to dorsal horn and synapes onto 2nd order neuro to the thalamus via spinothalamic tract (neo- alpha/delta fast fibers sharp pain, fast withdrawl OR paleo-C fibers slow dull pain), synapses to 3rd order neuro and communicates w/ somatosensory cortex where pain is differentiated.

neospinothalamic- can be localized well

paleospinothalamic- poorly localized slow pain

Question 18

4 physiologic processes associated w/ pain

Answer 18

Transduction - conversion of noxious stimulus into electric activity in peripheral terminals of nociceptors

Transmission- passage of AP from periphery along axons to central terminal of nociceptors in CNS

Modulation- alteration of sensory input

Perception- interpretation of the info to the brain, gives person the specified sensation

Question 19

Endogenous Analgesic Mechanisms & How they relate to pain transmission

Answer 19

3 endogenous opioids- enkephalins, endorphins, dynorphins

inhibit Ca2+ channels in dorsal root and inhibit post synaptic transmission of pain impulses