Topic 2 - Pain Theories & Clinical Reasoning Models Flashcards
T/F - If tissues are not a source of pain, they can then be a source of nociception.
False - If tissues are not a source of pain, they can NOT TECHNICALLY be a source of nociception.
___________ are the source of nociception and _______ stimuli are what they detect.
Nociceptors
Noxious
Tissue damage leads to ____ damage.
Cell
Cell damage neurochemicals initiate an ____________ (noxious) and immune response. __________ nociceptors are sensitized and there is _______ hyperalgesia in the immediate area of injury.
Inflammatory
Peripheral
Primary
Neurochemicals from cell damage reach the spinal cord in _____ and lymph. _______ nociceptors are sensitized and there is _________ hyperalgesia and/or allodynia in areas surrounding or distant from the area of injury.
Blood
Central
Secondary
What are the 2 types of hyperalgesia associated with different mechanisms?
1) Primary Hyperalgesia
2) Secondary Hyperalgesia
Area of increased excitability of nociceptors at the site of the insult or injury. Common after skin injury, but may also develop following insults to joints, muscle or viscera.
Primary Hyperalgesia
T/F - Secondary hyperalgesia is largely attributed to an increase in the excitability of peripheral nociceptors.
False - PRIMARY hyperalgesia is largely attributed to an increase in the excitability of peripheral nociceptors.
Area of increased sensitivity surrounding the site of injury, and often at sites distant from the injury (particularly when joints and especially the viscera are involved).
Secondary Hyperalgesia
T/F - With visceral insult, sensations are referred or perceived to arise from overlying structures, most notably skin.
True
Myocardial oxygen deficiency (aka. angina) involves pain being referred to the ________, down the ____ arm, and occasionally up to the jaw.
Shoulder
Left Arm
T/F - Primary hyperalgesia is associated with changes in the excitability of neurons in the CNS, including the spinal cord and supra-spinal sites in the brain.
False - SECONDARY hyperalgesia is associated with changes in the excitability of neurons in the CNS, including the spinal cord and supra-spinal sites in the brain.
If one’s ankle gets broken, the entire limb may show increased ___________ to touch, heat, cold, and the person will feel malaise, fatigued, and overall agitated… the entire limb from the above example has now turned into a huge ___________ “source”.
Sensitivity
Nociceptive
T/F - One definite and exclusive source of nociception without other systemic effects is theoretically possible.
True
There are now good grounds to believe that in some cases of __________ pain states, central nociceptive sensitization in the spinal cord has become __________.
Persistent (x2)
A physical feeling from contact with the body. The ability to feel something physically.
Sensation
T/F - Perception is a mental process (e.g. seeing, hearing, smelling) resulting from immediate external stimulation of a sense organ.
False - SENSATION is a mental process (e.g. seeing, hearing, smelling) resulting from immediate external stimulation of a sense organ.
Relating to sensation or to the senses. Conveying nerve impulses from the sense organs.
Sensory
The state of being or process of becoming aware of something through the senses. Awareness of the elements of the environment through physical sensation.
Perception
_________ can be described as:
- Physiological process
- Information about the physical world via our sensory receptors
- Involves specialized neurons that respond to specific types of stimuli
- Sensory information is detected by a sensory receptor
- Transduction is a characteristic
Sensation
__________ can be described as:
- Psychological process
- Process by which sensations are organized and interpreted
- Differ from person to person based on the individual’s memory, emotions, expectations and learning
Perception
Conversion from sensory stimulus energy to action potential.
Transduction
T/F - Sensation cannot occur without perception.
False - Sensation CAN occur without perception.
Perceptions built from sensory input. There is no context to the experience
Bottom-Up
Interpretation of sensations influenced by what we know, have experienced, and are what we think. There is context to the experience.
Top-Down
What type of perception is being described below?
“Someone jabbed you with a needle, but you don’t know they did it. You feel pain in your arm.”
Bottom-Up
What type of perception is being described below?
“Someone jabbed you with a blood filled needle in a dark alley, and you know they did it. You feel no pain in your arm because you are freaked out and scared for your life.”
Top-Down
Features of __________ that may be present with a pain experience include:
- Belief
- Memory
- Fear
- Hope
- Imagination
Perception
