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Regional > Pain PPT McDizzels > Flashcards

Pain PPT McDizzels Flashcards

Josh's guide to McDizzles riveting lecture on pain!!!!!!!! drop your socks grab your cocks you in for a ride!!!!!!!!!!

1
Q

Fun Fact

Benedictus de Spinoza stated “pain is a localized form of ________”

A

sorrow

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2
Q

3 psychosocial factors that influence pain?

A
  • intRApersonal (occurs within self)
  • intERpersonal (Occurs between individuals)
  • Social
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3
Q

where does pain Happen?

A

“brain”

pain isn’t pain until it gets to the brain

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4
Q

With the gate theory what happens when the gate is open?

A

pain

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5
Q

With the gate theory what happens when the gate is closed?

A

no pain

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6
Q

In relation to the DH (dorsal horn) NT (neurotransmitters):

what is found in large calls?

A

Excitatory amino acids (glutamate and aspartate)

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7
Q

In relation to the DH (dorsal horn) NT (neurotransmitters):

What do small cells contain?

A
  • FRAP (fluoride-resistant acid phosphatase
  • sP
  • VIP (Vasoactive intestinal polypeptide)
  • Somatistatin
  • CCK (cholecystokinin)
  • GRP (gastrin-releasing peptide
  • CGRP (calcitonin-gene-related peptide
  • ENK (leuenkephalin)
  • DYN (dynorphin)
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8
Q

What are the 3 primary pathways to the brain? (ascending tract)

A
  • Spinothalamic tract (STT)
  • Spinoreticular tract (SRT)
  • Spinomesencephalic tract (SMT)
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9
Q

Acute pain is a __________ experience!

A

multdimensional

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10
Q

Somatic events of acute pain are termed in:

A
  • space, time, intensity
  • motivational-emotional mechanisms
  • Aversive behavior (avoiding behavior)
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11
Q

Psychological components or acute pain are?

A
  • sensory-discriminative
  • motivational-affective
  • cognitive-evaluative
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12
Q 
Visceral Structures (pain):
what type of fibers involved
A

C-afferent fibers
A-delta fibers

(visCerAl)

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13
Q 
Visceral Structures (pain):
when do the C-afferent and A-delta fibers get activated? (what causes this type of pain)
A

-disease
-inflammation
-isometric contraction
-ischemia
-rapid distention
(remember these are organs- thus when you get appendicitis you hurt from the inflammation stretching, ischemia etc)

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14
Q 
Visceral Structures (pain):
C-afferent and A-delta fibers are activated by what?
A

noxious stimuli

alogenic substances

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15
Q 
Visceral Structures (pain):
the C-afferent fibers and A-delta fibers act as what???/
A

transducers

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16
Q 
Visceral Structures (pain):
the C-fibers and A-delta fibers are conducted to the \_\_\_\_ \_\_\_\_\_\_ or \_\_\_\_\_\_\_\_
A

dorsal horn
or
medulla

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17
Q 
Visceral Structures (pain):
The C-fibers and A-delta fibers are conducted to the dorsal horn and medulla, and are influenced by what?
A

intensity
duration
microenviroment

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18
Q

What are 2 ways to decrease pain?

A
  • augmentation

- inhibition

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19
Q

what is inhibition

A
  • counterirritation

- -rubbing, vibration, more sophisticated methods

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20
Q

what is augmentation?

A
  • sensation by repeated noxious stimuli

- lowering the threshold by alogenic substances

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21
Q

What opens the Gate after nerve injury?

A

decreased inhibition

increased excitation

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22
Q

what the reduction in inhibitory postsynaptic currents the consequence of (r/t peripheral nerve injury related pain)

A

decreased GABA responsiveness

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23
Q

what causes the decreased GABA release and consequent reduced inhibition? (r/t teh gate theory)

A

apoptosis

24
Q

Neuropathic Pain:

is a ____________ disease

A

neurodegenerative diseas

25
Q

Neuropathic Pain:

what type of treatment can about the neuropathic pain?

A

neuroprotective
and
disease-modifying theraoy

26
Q

what are the goals of an organized program for pain management?

A

educate pts
reduce incidence and severity of pain
enhance pt comfort and satisfaction
reduce post-op complications

27
Q

what are the principles or treatment for pain?

A
  • assessment requires rapport
  • unreleived pain has negative effects
  • all pain will not be eliminated
  • prevention is better than treatment
  • communication problems requuire special attention
  • unexpected intense pain raises suspicion
28
Q

what are controllable factors of pain

A
  • HR
  • Preload
  • Afterload
29
Q

Pain treatment:

the approach must be what?

A
  • collaborative and interdisciplinary
  • individual and proactive
  • assessment intense
  • formal and structured
30
Q

what is involved in the pain assessment?

A
  • Pt self report
  • numerical or visual analog scale
  • cognitive appropriate tools
31
Q

Pyschological responses to pain include what?

A
  • fear
  • anxiety
  • unpleasent uneasy feelings
  • communication issues
32
Q

What is known about communication issues and pain?

A
  • 70% hospitalized pts did not discuss pain
  • negative social connotations
  • insignificant compared to others
  • > 66% do not mention pain until severe
33
Q

What are some adjunct treatments for pain management?

A
  • cognitive behavior techniques
  • systemic opioids or NSAIDs
  • PCA
  • Epidural analgesia
  • INTERMTANT NEURAL BLOCKADE
  • PHYSICAL AGENTS
  • TENS
34
Q

Contraindications for epidural

A
  • Pt refusal (thats for you jake)
  • coagulopathy
  • infection at injection site
  • uncorrected hypovolemia
35
Q

Epidural complications

A
  • Hypotension
  • total spinal
  • Local toxicity
  • Headache
  • Local site pain
  • Zebras (also the red panda)
36
Q

Continuous epidural analgesia dose, meds, rate etc. (this is just Mcd’s way)

A

10mL 0.25% bupivicaine (2.5mg/ml=25mg)
100 mcgs fentanyl
8 ml PF NS
After this loading dose maintain rate at 3-5 ml/hr

37
Q

ITA advantages

A

excellent analgesia
no sympathetic block
ambulatory pt

38
Q

ITA (with or without anesthetic) meds and doses

A

25 mcgs fentanyl

100-150 mcgs (0.2-0.3 ml) astromorph

39
Q

What is the combined tech??? “the best of both worlds”

A

Perform ITA

place epidural catheter for later use if needed

40
Q

Chronic pain:

is prolonged pain for how long?

A

> 6 months

41
Q

Chronic pain: is can be _____ or _______ pain?

A

persistent
or intermittent
(eg. low back pain VS migraines)

42
Q

Chronic pain:

what happens to endorphins?

A

May have decreased amount

43
Q

Chronic pain:

may have a predominance of ____ neuron stimulation

A

C

44
Q

Chronic pain:

due to adaptation what will happen to physical signs?

A

may be normal!

45
Q

Chronic pain:

what are 9 syndromes that cause chronic pain?

A 
Neuralgias
Causalgia
Complex regional pain syndrome (RSD)
hyperesthesias
Myofacial pain syndromes
Hemiagnosia
phantom leg pain
Back d/o
Herpes zoster
46
Q

Chronic pain:

what are 3 chronic back d/o

A

Low back pain
Spinal stenosis
Lumbar radiculopathy

47
Q

Music and the experience of pain:

what are the therapeutic use of music?

A

reduces pain
reduces anxiety
Reduces medication use
Improves pleasantness of recall

48
Q

Accupunture dates back to when

A

1500 B.C.

49
Q

Accupunture is the balance of what?

A

Yin

yang

50
Q

What is yin and yang?

A

Yin- female, cold, death
Yang- Male, warm, Life
(i love how the non-round eyes associate women with cold and death, they are smarter than we though more than just math)

51
Q

Accupunture

there are >____ points along the “meridians”

A

360

52
Q

Accupunture probably works on what?

A

gate control

53
Q

Hypnosis and the experience of pain:

what are some misconceptions?

A 
loss of consciousness
weakening of the will
giving away secrets
loosing control to the therapist
inability to dehypnotize
54
Q

Hypnosis and the experience of pain:

phases of Hypnosis!

A

I) induction
II) deepening and maintenance
III) utilization
IV) Termination

55
Q

Hypnosis and the experience of pain:

induction techniques

A

closed eyes deep breathing
progressive relaxation
eye fixation

Regional (24 decks)

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