Pain System 1 Flashcards
What is pain according to the International Association for the Study of Pain (IASP)?
“An unpleasant SENSORY AND EMOTIONAL experience associated with ACTUAL OR POTENTIAL tissue damage, or described in terms of such damage.”
nociception
physiological processing of tissue damaging information
Why does pain exist in our biology?
protective mechanism to prevent tissue injury and permit recovery from injury
hyperalgesia
heightened pain (e.g. when damaged tissue is exposed to noxious stimulus)
TRUE or FALSE: a sunburn is an example of allodynia
FALSE: hyperalgesia
Draw and label allodynia and hyperalgesia on a pain sensation vs stimulus intensity graph.
slide 5
allodynia
pain arising from gentle touch (painful response to a stimulus that would not normally be painful)
TRUE or FALSE: allodynia is paradoxical pain
TRUE
What are the 2 components of pain perception?
- somatosensory component
- affective component
Describe the 2 responses of musculoskeletal and other mild pain.
- initial response to tissue damage sensed by free nerve endings (pricking pain = first pain)
- secondary response is ongoing pain caused by release inflammatory soup at site of lesion (burning/diffuse pain = second pain)
What fiber transmits first pain
sensory A-delta fibers
What fiber transmits second pain?
C fibers
What is another name for nociceptive pain?
deep pain
What is deep pain treated with?
opioids
Describe deep pain,
deep ACHING pain, felt as deep to the body surface, poorly localized
What is deep pain initiated by?
major trauma (postop pain, injury, or childbirth)
What does neuropathic pain result from?
nerve injury or infection
TRUE or FALSE: neuropathic pain is normally treated with opioids
FALSE: neuropathic pain responds POORLY to opioids
What is used to treat neuropathic pain?
antidepressants, cannabinoids, anticonvulsant
Which anticonvulsants can be used to treat neuropathic pain?
pregabalin and gabapentin
Is neuropathic pain stimulus dependent?
no, it is spontaneous and stimulus-independent
What is neuropathic pain characterized by?
allodynia, hyperalgesia, causalgia, and spontaneous (stimulus-independent) pain
classify the following as good or bad pain:
- musculoskeletal pain
- deep pain
- neuropathic pain
good pain: musculoskeletal and deep
bad pain: neuropathic
Which afferent fibers are non-pain fibers?
A-alpha and A-beta
What is the level of myelination and condution for A-alpha and A-beta fibers?
myelinated; rapidly conducting
What kind of information is transmitted via A-alpha and A-beta fibers?
touch, pressure, muscle afferent information
What is the level of myelination and conduction for A-delta fibers? What kind of information is transmitted?
- thinly myelinated; slow conduction
- carry first pain
What kind of receptors are associated with A-delta fibers?
high-threshold mechanoreceptors (mechanical nociceptors)
Where do A-delta fibers terminate?
in spinal lamina I (marginal zone) and lamina II and lamina V
(lamina I, II, V)
What is the level of myelination and conduction in C fibers? What kind of information is transmitted?
- unmyelinated; very slow conduction
- carry second pain
What are the 2 main types of C fibers?
peptidergic and isolectin B4 Positive (IB4+)