Pain & Temperature - CH. 15

Question 1

Nociceptive pain

Answer 1

Physiologic response to heat, cold, vibration, stretch, or chemicals released from damaged cells that may cause tissue damage.

Question 2

Somatic nociceptive pain

Answer 2

Aching, throbbing, or dull pain arising from the skin, muscles, and joints that is usually discrete and intense

Question 3

Visceral nociceptive pain

Answer 3

Squeezing, cramping, dull, and deep pain originating in a bodily organ. Often poorly localized to the affected organ and commonly associated with referred pain

Question 4

Neuropathic pain

Answer 4

Increased sensitivity to painful stimuli and results from abnormal processing of pain information in the peripheral or central nervous system. It is generally the result of trauma or disease of nerves and is most often chronic. Does NOT active nociceptive receptors and does not follow a typical transmission pattern of impulse conduction

Question 5

Causes of neuropathic pain

Answer 5

Pressure on nerve
Physical injury to neuron
Chemical injury to neuron
Infection of neuron
Ischemia
Inflammation

Question 6

Neuritis

Answer 6

Inflammation of a nerve

Question 7

Neuralgia

Answer 7

Pain that follows the distribution of a nerve

Question 8

Radiculopathy

Answer 8

Pain or the loss of sensory and/or motor function as a result of impaired conduction in a spinal nerve or its roots

Question 9

Neuropathy

Answer 9

A disease or disorder of the PNS and/or CNS

Question 10

Peripheral neuropathy

Answer 10

Constant or intermittent burning, aching, or lancinating limb pain due to lesions or dysfunction of peripheral nerves

Question 11

Central neuropathy

Answer 11

Caused by lesion in CNS. Cord trauma, phantom limb

Question 12

Acute pain

Answer 12

Associated with acute tissue damage/trauma, inflammation, a surgical procedure, or a brief disease process. May be somatic (superficial), visceral (internal), or referred (present in an area distant from its origin). Can last from hours to weeks

Question 13

Protective mechanism of acute pain

Answer 13

Alerts an individual to a condition or experience that is immediately harmful to the body. Duration and intensity of pain diminish as tissue healing occurs

Question 14

Manifestations of acute pain

Answer 14

Fear & anxiety
Tachycardia, hypertension, fever, diaphoresis, dilated pupils, outward pain behaviors, elevated blood sugar levels, decreased gastric acid secretion and intestinal motility, and a general decrease in blood flow

Question 15

Chronic pain

Answer 15

Pain lasting well beyond the expected normal healing and may be intermittent or persistent. Chronic pain is a situation; state of existence and is often associated with chronic diseases. Usually defined as lasting at least 3-6 months or longer than expected for healing to take place.

Question 16

Chronic recurrent pain

Answer 16

Repeated and intense episodes of pain separated by pain-free periods

ex. migraine

Question 17

Chronic intractable benign pain

Answer 17

Continuous pain with varying levels of intensity

Question 18

Chronic progressive pain

Answer 18

Continuous pain that increases in intensity
ex. cancer pain

Question 19

Pain physiology

Answer 19

Involves transduction, transmission, modulation, and perception of the pain.
3 responsible portions of nervous system: afferent, CNS, efferent pathways

Question 20

Transduction

Answer 20

Conversion of a noxious thermal, mechanical, or chemical stimulus into a nerve impulse

Question 21

Specialized sensory (afferent) neurons

Answer 21

Responsible for the detection of a noxious thermal, mechanical, or chemical stimuli

Question 22

Nociceptor

Answer 22

Free nerve endings in skin, muscle, joint, arteries, and the viscera that respond to chemical, mechanical, and thermal stimuli. Responsible for the transduction of a noxious stimulus into a nerve impulse

Question 23

Afferent system

Answer 23

Responsible for transmission of a noxious stimulus to the spinothalamic tract in the CNS.

Question 24

Ad Fibers

Answer 24

Large myelinated fibers that have a low stimulation threshold and a fast conduction velocity

Question 25

Type 1 - Ad fibers

Answer 25

High-threshold mechanical nociceptors that respond to both chemical and mechanical stimuli

High threshold for thermal but will respond to lower temps with continued stimuli or in presence of tissue injury

Response for first or fast pain of a mechanical stimulus

Fast pain starts abruptly and ends when the stimulus is removed

Question 26

Type 2 - Ad fibers

Answer 26

Low-heat threshold and high mechanical threshold

Responsible for the conduction of fast pain in response to a noxious heat stimulus

Fibers release glutamate in the cord.

Question 27

Unmyelinated C fibers

Answer 27

Smallest of all peripheral nerve fibers and transmit slow-wave pain with slower onset and longer duration

Question 28

Chemical - unmyelinated C fibers

Answer 28

Tissue trauma, ischemia, inflammation releases chemicals
H+, K+, prostaglandins, leukotrienes, bradykinin, acetylcholine & serotonin

Question 29

Prostaglandin & chronic pain

Answer 29

Prostaglandins enhance sensitivity of pain endings but do NOT directly stimulate them

Question 30

What do C fibers release

Answer 30

Glutamate and substance P in the cord

Question 31

Substance P

Answer 31

Belongs to the peptide class of neurotransmitters, thus its name

Primary function appears to be signaling messages from nociceptors to the dorsal horn of the spinal cord.

Opiates, 5HT agonists, and NE agonists exert analgesic effect by acting on substance P nerve terminals to limit release of this pain-inducing peptide.