S3L3: Classification of Pain Flashcards
Three dimensions
Refers to localization, intensity, duration, & the nature of
the pain (burning, sharp, shooting, superficial, etc.)
Sensory-discriminative
Three dimensions
Refers to the emotional response a person has to the pain
Motivation-affective
Three dimensions
Includes physiological manifestations of that emotional
response, including nausea
Motivation-affective
Three dimensions
Relates to how pain is interpreted in the context of past &
present experience, culture, & so forth
Cognitive-affective
Physiological Classification
Refers to response to an immediate noxious stimulus signaling
impending tissue damage
Nociceptive
Modified T/F
A. Nociceptive pain can be due to mechanical, thermal, or chemical insult to the area
B. It leads to protective withdrawal response & is beneficia
TT
Physiological classification
This type of pain ncreases sensory sensitivity after tissue damage thus discouraging use & further damage
Inflammatory pain
Modified T/F
A. Inflammatory pain allows for tissue repair
B. It is due to hypersensitivity due to peripheral injury, pathology, or other inflammatory process
TT
T/F
Inflammatory pain is generally beneficial as it encourages rest, but becomes counterproductive if severe or ongoing.
True
Physiological classification
This type of pain results from an abnormally functioning nervous system relaying pain signals unrelated or disproportionate to
tissue damage
Maladaptive pain
Modified T/F
A. Maldaptive pain represents altered neural processing
B. Decreased physical activity resulting from maladaptive
pain contribute to healing an recovery
TF
Decreased physical activity resulting from maladaptive pain does not contribute to healing & may exacerbate pain & lead to secondary problems
Which of the following conditions is NOT typically considered an example of maladaptive pain?
A) Tension headache
B) TMJ disorder
C) Fibromyalgia
D) Migraine headache
D) Migraine headache
Which condition is commonly regarded as an example of maladaptive pain?
A) Tension headache
B) TMJ disorder
C) Fibromyalgia
D) Inflammatory bowel syndrome (IBS)
E) A & D only
F) All of the above
F) All of the above
T/F
Characteristics of muscle pain include dull, deep, aching, cramping, & localized
F
Difficult to localize
Modified T/F
A.Muscle trigger points can refer pain to other sites
b. It can cause other Sx such as tinnitus, paresthesias, & blurry
vision
TT
Modified T/F
A. Trigger points may be idiopathic or associated with OA, RA, FM, TMJD, or chronic tension headaches
B. Widespread myofascial pain syndrome appears to
involve peripheral sensitization & central nociception
TF
Widespread myofascial pain syndrome appears to
involve** central sensitization & peripheral nociception**
Fast vs. Slow Pain
Nerves: A-delta
(myelinated)
Fast
Fast vs Slow pain
Nerves: C (unmyelinated)
Slow
Fast vs Slow pain
Stimulus: Pinprick, heat
Fast
Fast vs. Slow pain
Stimulus: Tissue damage
Slow
Fast vs Slow pain
Sensation: Sharp, pricking,
burning,
dermatomal
Fast
Fast vs. Slow pain
Sensation: Slow, dull, crawling,
sclerotomal
Slow
Fast vs. Slow pain
Diameter: 1-4 micrometer
Fast
Fast vs. Slow pain
Diameter: 0.1-1 micrometer
Slow
Fast vs. Slow pain
Conduction Velocity: 5-30 m/sec
Fast
Fast vs. Slow pain
Conduction velocity: 0.4-1.4 m/sec
Slow
Fast vs. Slow pain
Distribution: Body surface
Fast
Fast vs. Slow pain
Distribution: All tissue except
CNS
Slow
Fast vs. Slow pain
Reflex response: withdrawal
Fast
Fast vs. Slow pain
Reflex response: withdrawal: Muscle spasm, increased tone or muscle guarding
Slow
Fast vs. Slow pain
Biological Value: Avoidance of tissue
damage because
we withdraw the
area
Fast
Fast vs. Slow pain
Biological Value: Enforced rest
Slow
Fast vs. Slow pain
Effect Of Morphine: Very little
Fast
Fast vs. Slow pain
Effect Of Morphine: Supresses
Slow
Morphine is usually given to those patient who suffer from chronic pain because it affectsmthe C fibers
Fast vs. Slow pain
CNS Target: Thalamus, cortex
Fast
Fast vs. Slow pain
CNS Target: Limbic,
hypothalamic
Slow
Fast vs. Slow pain
Affective Response: No
Fast
Fast vs. Slow pain
Affective Response: Yes
Slow
Fast vs. Slow pain
Automatic signs: No
Fast
Fast vs. Slow pain
Automatic signs: Yes
Slow
Fast vs. Slow pain
Localized
Receptive Field: Yes
Fast
Fast vs. Slow pain
Localized
Receptive Field: No
Slow
Fast vs. Slow pain
Dorsal Horn
Connection: Laminae I & V
Fast
Fast vs. Slow pain
Dorsal Horn
Connection: Laminae II & III
Slow
Modified T/F
A. Peripheral Neurogenic Pain refers to mechanical or chemical change to the peripheral nerves
B. Vasomotor, sudomotor & trophic changes can occur
TT
Vasomotor, sudomotor & trophic changes can occur specifically in CAUSALGIA
T/F:
Usual symptoms of peripheral neurogenic pain are hypoesthesia, anesthesia, weakness, paresthesia, dysesthesia, & pain
True
Nerves can be a source of pain d/t []
(sensory innervation of nerve) & []
(sensitive to movement or stretch)
Nerves can be a source of pain d/t nervi nervorum
(sensory innervation of nerve) & neural connective tissue
(sensitive to movement or stretch)
T/F
Peripheral neurogenic pain can extend beyond the initial nerve injury through processes of peripheral sensitization & glial cells releasing growth factors & other substances acting on the immune system
True
True or False: Causalgia, characterized by severe aching pain in a limb resulting from a peripheral nerve injury, is rare, and severe cases can be referred to as Major Causalgia.
False
Causalgia, characterized by** severe burning pain in a limb**
Modified T/F
A. Central neurogenic pain refers to the injury of CNS such as stroke, TBI, MS or FM
B. Pain is burning, aching, lancing, pricking, or pressing
TT
Modified T/F
A. Hyperalgesia & allodynia should not coincide in central neurogenic pain
B. Central neurogenic pain involves descending facilitation
FT
Hyperalgesia & allodynia may coincide
Modified T/F
A. In central neurogenic pain, glia and astrocytes play a role in altering synaptic connections forming between General Somatic Afferents (GSA) and pain fibers.
B. Central neurogenic pain, often associated with conditions like fibromyalgia (FM), irritable bowel syndrome (IBS), post-traumatic stress disorder (PTSD), and burnout, involves dysregulation of the Hypothalamic-Pituitary-Adrenal (HPA) Axis.
TT
