pathophysiology of pain Flashcards

1
Q

pain receptors

A

nociceptors

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2
Q

types of primary afferent fibres

A

a delta fibres - myelinated , for fast sharp pain
c fibres - unmyelinated , chronic pain

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3
Q

what does primary hyperalgesia describe

A

increased responsiveness to heat add mechanical stimulus at the site of injury

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4
Q

visceral pain ?

A

pain originating from the internal organs

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5
Q

what type of stimuli are associated with visceral pain

A

distention and ischemia

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6
Q

what is chronic pain ?

A

pain without apparent biological value that persists beyond tissue healing ( >3 months )

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7
Q

what is the suggested theory behind the development of chronic pain ?

A

wind up phenomenon, repetitive stimulation off c fibres ( central sensitization)

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8
Q

what is secondary hyperalgesia ?

A

hypersensitivity to pain in an area that is distant to the primary site of injury

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9
Q

what receptors play a role in the maintenance of chronic pain ?

A

NMDA receptors

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10
Q

what are the classifications of chronic pain ?

A

1- inflammatory pain - tissue is damaged by trauma or infection
2- neuropathic pain - pathology of the nervous
3- dysfunctional pain - poorly localised pain not caused by inflammation or nerve damage

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11
Q

what are examples of neuropathic pain

A

phantom limb
carpal tunnel
peripheral neeuropathy
central neeuropathy

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12
Q

examples of dysfunctional pain

A

fibromyalgia
irritable bowl syndrome

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13
Q

7 types of neuropathic pain

A

lumbar radicular pain
trigeminal neuralgia
post herpetic pain
complex regional pain syndrome
phantom limb
diabetic neuropathy
central pain syndrome

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14
Q

what is the CP of neuropathic pain

A

may be described as tingling, burning ,stabbing or numb sensation
associated with spontaneous pain without any stimulus
may be associated with allodynia or hyperalgesia

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15
Q

what is allodynia

A

the feeling of pain from a non painful stimulus

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16
Q

what is the cause of complex regional pain syndrome

A

usually triggeredd by an injury

17
Q

what are thee different types off complex regional pain syndrome ?

A

CRPS I
CRPS II

18
Q

old names for CRPS ?

A

type 1 - reflex sympathetic dystrophy
type 2 - causalgia

19
Q

what is the difference between CRPS type 1 and 2 ?

A

type 1 - occurs after a minor fracture or injury to a limb without direct nerve injury
type 2 - after injury to a major peripheral nerve

20
Q

what are the presenting symptoms of complex regional pain syndrome ?

A

continuing pain
allodynia
hyperalgesia
autonomic changes - hyperhydrosis or changes iin temperature
trophic skin changes
motor abnormalities
neglect like syndrome
+ sympathetically maintained pain

21
Q

presentation of trigeminal neuralgia

A

neuropathic pain affecting the the eye, lips nose scalp or forehead
shooting sharp pain “electric shock like pain”
pain provoked by innoxious stimuli

22
Q

what disease is commonly associated with trigeminal neuralgia ?

A

multiple sclerosis

23
Q

what is thee cause off trigeminal neuralgia ?

A

due to microvascular loop compressing on the nerve

24
Q

what tumor is commonly associated with trigeminal neuralgia ?

A

tumor arachnoid cysts in the
cerebellar cerebellopontine angle

25
when is post herpetic neuralgia diagnosed ?
if the pain persists or arises at least three months after the skin lesions has healed
26
what is the commonest area associated with post herpetic neuralgia ?
thoracic dermatomes and the ophthalmic division of trigeminal nerve exhibiting allodynia and hyperalgesia
27
types of neoplastic plexopathy ?
cervical plexopathy brachial plexopathy lumbosacral pleexopathy
28
what is the pain syndrome associated with multiple myeloma
myeloma bone disease
29
which type of breast cancer is associated with the highest level of circulating TGF-B1 levels
HER-2 type
30
example of multidimensional pain scale ?
short form mcgill pain questionnaire