Test 1 Flashcards
acute pain lasts LESS than 3-6 months and is usually associated with ____
nociceptive
nociceptive is either somatic or visceral
define pain
an unpleasant sensory AND emotional experience with actual OR potential tissue damage OR described in terms of such damage
nociceptive is either __ or __
somatic or visceral
chronic pain tends to be non-____
non-nociceptive
non-nociceptive is either neuropathic or idiopathic (psychogenic)
non-nociceptive is either __ or __
non-nociceptive is either neuropathic or idiopathic (psychogenic)
Somatic pain is well localized, sharp in nature, and generally hurts at the point or area of stimulus. Somatic pain is carried by __ fibers
type A fibers
Visceral pain is diffuse and can be referred to another area, dull, achy, vague. Probably carried by type __ fibers
C
Neuropathic pain is like when you hit your funny bone, it’s a shock. It’s __
abnormal
Idiopathic pain has no apparent cause, may be psychological aka ___
idiopathic aka psychogenic
define algesia
increased sensitivity to pain, the pain threshold is decreased
algae are VERY sensitive to pain
define algogenic
pain producing
OWWgogenic
define allodynia
a usually nonharmful stimulus that is perceived as painful
an aloe plant is usually harmless, but if you’ve never seen one before you might think it would be painful
define analgesia
the absence of pain in the presence of a normally painful stimulus
define dysethesia
an unpleasant painful abnormal sensation, whether evoked or spontaneous
the opposite of good anesthesia is dysethesia
define hyperalgesia
a hyper response to pain
define neuralgia
pain in the distribution or region covered by a peripheral nerve
define neuropathy
an abnormal disturbance in the function of a nerve
neuro-path
define paresthesia
an abnormal sensation, whether spontaneous or evoked
your patients will get a “pair of thesias” when you brush their nerve roots with your epidural catheter
somatic nociceptive pain is defined by four processes
transduction, transmission, perception, and modulation
define transduction
the TRANSFORMATION of a stimulus into an action potential
define transmission
the PROCESS by which an action potential is conducted from the periphery to the CNS
define perception
involves the signal being RECOGNIZED by various areas of the brain
define modulation
ALTERATION of afferent activity, either SUPPRESS or ENHANCE
Which two fibers are the primary afferents involved in transduction?
myelinated A-delta and non-myelinated C fibers
A/c
How fast are myelinated A-delta fibers?
6-30 meters / second
Delta airplane fly between 6-30 meters per second
how fast are non-myelinated C fibers?
1/2 - 2 meters per second
Don’t forget that the __ neuron ascends several spinal segments before it synapses with the secondary neuron, which then crosses to the other side of the spinal cord and ascends to the thalamus
Primary
The synapse between primary afferents and secondary neurons is primarily in Lamina of Rexed 1, 2, and __
5
Wide dynamic range neurons receive input from both nociceptive (A-delta and C) AS WELL AS non-nociceptive (A-beta) neurons cause ___
central sensitization or chronic neuropathic pain.
anterolateral pathway of the spinothalamic tract ascends to the __
lateral thalamus
somatic nociceptive pain is defined by four processes
transduction, transmission, perception, and modulation
define transduction
the TRANSFORMATION of a stimulus into an action potential
define transmission
the PROCESS by which an action potential is conducted from the periphery to the CNS
define perception
involves the signal being RECOGNIZED by various areas of the brain
define modulation
ALTERATION of efferent activity, either SUPPRESS or ENHANCE
Which two fibers are the primary afferents involved in transduction?
myelinated A-delta and non-myelinated C fibers
A/c
How fast are myelinated A-delta fibers?
6-30 meters / second
Delta airplane fly between 6-30 meters per second
how fast are non-myelinated C fibers?
1/2 - 2 meters per second
Don’t forget that the __ neuron ascends several spinal segments before it crosses to the other side of the spinal cord and ascends to the thalamus
secondary
The synapse between primary afferents and secondary neurons is primarily in Lamina of Rexed 1, 2, and __
5
Wide dynamic range neurons receive input from both nociceptive (A-delta and C) AS WELL AS non-nociceptive (A-beta) neurons cause ___
central sensitization or chronic neuropathic pain.
anterolateral pathway of the spinothalamic tract ascends to the __
lateral thalamus
Modulation =
descending
Pain modulation is enhanced in the presence of __
central sensitization
remember, modulation can be either suppression or enhancement, so sensitization plays right along with that.
endogenous opioids such as endorphins, dynorphins, and enkephalins are ___
inhibitory
what are the two excitatory neurotransmitters?
substance P and glutamate
what is the special receptor for glutamate?
NMDA
where ketamine works
what are the five inhibitory neurotransmitters?
glycine, GABA, enkephalin, serotonin, and norepinephrine
GGESN
