these are even painful to make Flashcards
what is pain
anything the patient says it is, wherever the patient says it is, whenever the patient says it is
harmful effects of unrelieved acute pain on the endocrine and metabolic system
wt loss ^ HR ^ RR shock glucose intolerance hyperglycemia fluid overload hypertension urinary retension
harmful effects of unrelieved acute pain on the cardiovascular system
HTN
unstable angina
MI
DVT
harmful effects of unrelieved acute pain on the on respiratory system
atelectasis
pneumonia
harmful effects of unrelieved acute pain on the renal and urologic system
constipation
anorexia
paralytic ileus
harmful effects of unrelieved acute pain on the musculoskeletal system
immobility
weakness and fatigue
harmful effects of unrelieved acute pain on the neurologic system
confusion
impaired ability to think, reason, and make decisons
harmful effects of unrelieved acute pain on the immune system
infection
what is the physiologic dimension of pain
genetic, anatomic and physical determinants of pain influence how painful stimuli are processed, recognized and described
what is the affective dimension of pain
emotional responses to pain include anger, fear, depression and anxiety
negative symptoms may interfere with quality of life
what is the cognitive dimension of pain
beliefs, attitudes, memories, and meaining attributed to pain influence the ways in which a person responds to pain
behavioral dimensions of pain
observable actions
sociocultural dimension of pain
age and gender influence
families
culture affects pain expression, medication use, coping methods
what is suffering
suffering is a state of distress associated with loss and a profound sense of insecurity
what is nociception
the physiologic process by which information about tissue damage is communicated to the CNS
what is the main idea of transduction
involves the conversion of a noxious mechanical, thermal. or chemical stimulus into a an electrical signal called an action potential
what chemicals are released from noxious stimuli and cell damage
prostaglandins, bradykinin, serotonin, substance p, histamine
what cells are involved in transduction
mast cells and macrophages
what types of neurons is the action potential sent from in transduction
from myelinated A fibers and unmyelinated C fibers
what is peripheral sensitization
the increased sensibility to nociception following an initial wound or noxious stimuli
what enzyme plays an important role in peripheral sensitization
cyclooxygenase
how do you stop pain at the transduction level
drugs that stabilize the neuronal membrane and inactive peripheral sodium channels inhibit production of the nerve impulse
Why did the cookie cry
because his mom was a wafer soo long!
what is transmission
is the process by which pain signals are relayed from the periphery to the spinal cord and then to the brain
where do the primary afferent fibers terminated when transmitting
in the dorsal horns
what does the dorsal horn do
it integrates and modulates the periphery
what are the three segments of transmission
1- transmission along the peripheral nerve fibers to spinal cord
2- dorsal horn processing
3- transmission to the thalamus and the cerebral cortex
what are dermatones
are areas on the skin that are innervated primarily by a single spinal cord segment
what is central sensitization
is increased sensitization and hyperexcitability of neurons in the CNS
what is allodynia
the epxerience of significant pain from touch or tactile stimulation in and around the area of tissue or nureve injury
what can untreated acute pain lead to
acute pain can lead to chronic pain through the process of central sensitization
what is neuroplasticity
the process that allow neurons in the brain to compensate for injury and adjust their responses to new situations or changes in their environment
what does central sensitization of the dorsal horn result in
1 hyperalgesia
2 painful responses to normally innocuous stimuli
3 prolonged pain after the original noxious stimuli ends
4 the extension of tenderness or increased pain sensitivity outside of an area of injury to include uninjured tissue
what is referred pain
location of pain reported by the person with an injury or a disease involving visceral organs
how do fibers from the dorsal horn enter the brain
through the spinothalamic tract and the spinoreticular tract
what are some ways to target pain in the transmission stage
opioid analgesics
what is perception
occurs when pain is recognized, defined, and assigned meaning by the individual experiencing the pain
what is the reticular activating system responsible for in the perception stage of pain
for warning the individual to attend to the pain stimulus
what is the somatosensory system responsible for
responsible for localization and characterization of pain
what is the limbic system responsible for in the perception stage of pain
for emotional and behavior responses to pain
what is the cortical structure responsible for in the perception stage of pain
crucial to constructing the meaning of pain
what is modulation
involves the activation of descending pathways that exert inhibitory or facilitatory effects on the transmission of pain
what type of drugs exert their effects on modulation of pain
antidepressants
what is nociceptive pain
normal processing of stimulus that damages normal tissue or has the potential to do so if prolonged
what is neuropathic pain
abnormal processing of sensory input by the peripheral or central nervous system
what is the treatment of nociceptive pain
typically a nonopioid or an opioid
what is the treatment of neuropathic pain
typically includes adjuvant analgesic
what causes nocicpetive pain
damage to the somatic or visceral tissue
characteristics of superficial pain
sharp burning prickly
characteristics of deep pain
deep aching throbbing
what causes viceral nociceptive pain
activation of nociceptors in the internal organs and body cavities- respond to inflammation, stretching, and ischemia
what are the signs and symptoms of neuropathic pain
described as numbing, hot, burning, shooting, stabbing, sharp, or electric shock-like
it is sudden intense, short lived or lingering
what are common causes of neuropathic pain
trauma, inflammation, metabolic disease, alcoholism, infections of the nervous system, tumors, toxins, and neurologic diseases
what is differentation pain
pain that results from loss of afferent input secondary to either peripheral nerve injury or CNS injury
what is sympathetically maintained pain
pain that is associated with dysregulation of the autonomic nervous system
what cause central neuropathic pain
is caused by CNS lesions or dysfunction
onset of acute pain
sudden
onset of chronic pain
gradual or sudden
duration of acute pain
less than 3 months or as long as natural healing to occur
what is the duration of chronic pain
longer than 3 months- may start as an acute injury but continues past normal time for recovery
cause of acute pain
generally can identify a precipitating event- surgery or illness or trauma
cause of chronic pain
may not be known, original cause of pain may differ from mechanisms that maintain pain
course of acute pain
decrease over time and goes away as recovery occurs
course of chronic pain
typically pain does not go away
periods of remission and exacerbation
typical physical and behavioral manifestations of acute pain
may vary but can reflect sympathetic nervous system activation - ^ HR, RR, BP - diaphoresis - pallor anxiety agitation confusion urinary retention
typical physical and behavior manifestations of chronic pain
predominantly behavioral manifestations - flat affect decreased physical activity fatigue withdrawal from social interaction
what is breakthrough pain
pain in patients who have a baseline of pain that is mild to moderate but fairly controlled
what is end- of - dose failure
pain that occurs before the expected duration of specific analgesic
why did the bicycle fall over
because it was two tired
what is sciatica
pain that follows the course of the sciatic nerve- it may originate from muscles or joints around the back or from compression or damage to the sciatic nerve
