Part 1 Flashcards
Gate pain theory
model for TENS
Who developed it?
Melzack & Wall’s Theory (1969’s) and revised in 1983
Noxious stimuli
modified both by activity within the spinal cord and by descending influences from the brain
feed-forward and feedback loops between
between the CNS & PNS.
Substantia gelatinosa in the spinal cord
acts as a “gate” to control access to the pain pathways.
ACUTE PAIN
Lasting less than 6 months Most often associated with new inflammatory conditions Unpleasant sensory perceptual, emotional, and mental experience provoked by acute disease or injury with autonomic, psychological, & behavioral responses.
RONIC PAIN
Lasting longer than 6 months Persistent pain that lasts beyond the expected time frame for tissue healing For fast healing tissues
PHANTOM PAIN
Pain originating from the damaged or amputated body part
REFERRED PAIN
Pain felt at a site other than origin Example: pain from the pancreas or stomach which is felt in the back
ORGANIC PAIN
Refers to any pain resulting from a disorder, abnormality or chemical imbalance in an organ system, Has a traceable and identifiable distribution specific to an organic system.
NON-ORGANIC PAIN –
Has no identifiable physical cause, meaning that it usually stems from psychological factors.
VISUAL ANALOGUE SCALE -VAS ADVANTAGES
Easily administered Requires little to no training or equipment
DISADVANTAGES
Due the subjectivity of rating pain, one patient may sense pain as more severe than another therefore not a highly reliable, objective tool for measurement.
Body Diagram ADVANTAGES
Good reliability Can be scored as organic – in accordance with anatomical patterns of pain Can be scored as non-organic – not in accordance with anatomical pain patterns
Body Diagram DISADVANTAGES
More time consuming to fill out Requires patient instruction More difficult to objectively analyze
McGill Pain Questionnaire –MPQ) Consists of 3 parts
Body diagram Pain intensity rating List of words used to describe the quality of pain
PAIN QUESTIONAIRES ADVANTAGES
Provides a lot of information
PAIN QUESTIONAIRES DISADVANTAGES
Lengthy May be culturally inappropriate due to inability to understand the descriptive words
Pain Disability Index
self report and Quality of Life
DOCUMENTATION OF PAIN ADVANTAGES
Help to determine the impact of the pain on a persons ability to perform normal daily tasks and functions
DOCUMENTATION OF PAIN DISADVANTAGES
Can be culturally inappropriate Time consuming to score and administer
Anxiety
An emotional state consisting of uneasy feelings of anticipation or dread of a real or imagined danger or uncomfortable situation
The 2 main techniques for managing problematic behavior are:
Relationship building Good communication
YOU” STATEMENTS
Beginning a statement with “YOU” can make communication difficult & even create a sense of hostility between patient and care-giver
I” STATEMENTS
Beginning a statement with “I” helps to diffuse an emotional charged conversation & remove any sense of blame.
Active Listening
The active listener is: Empathetic - Listens completely and objectively without jumping to conclusions or assumptions Non-judgmental - Does not interpret Encourages appropriate disclosure
Reflection Emotion
Technique 1: Acknowledgement Verbally label the emotion in a way that the patient feels heard & validated Example - It sounds like you are very frustrated, Mr.. Jones.
Migraine
extremely bad headache: a recurrent, throbbing, very painful headache, often affecting one side of the head and sometimes accompanied by vomiting or by distinct warning signs, including visual disturbances
What is Pelvic floor dysfunction?
Non- neurogenic, uncoordinated behavior of the pelvic floor musculature Muscles of the pelvic floor are weak or tight
Clinical Conditions
Urinary incontinence Fecal Incontinence Pelvic organ prolapse Defecatory dysfunction: trouble emptying the bowels Sexual dysfunction Chronic pain (vulvodynia
