Types of pain (3.1 Part A) Flashcards
What is involved in the Pain involves sensory pathway and may trigger psychological, autonomic and motor effect
- Stimulus, Nociceptors
- Transduction, conduction, transmission, Perception, Modulation
- Affective - Distress – psychological
- Autonomic – tachycardia, hypertension, respiratory distress
- Motor
What is involved in the Pain can be classified according to duration, location and site of referral
- Visceral vs Somatic Pain
- Nociceptive vs Neuropathic Pain
- Acute vs Chronic Pain –> Deep vs Superficial
- Referred Pain, Phantom Pain
- Hyperalgesia, Analgesia
Describe the origin of pain and suffering? Define nociception
nociception: sensory nervous system’s response to certain harmful or potentially harmful stimuli.
What is the difference between nociception and pain?
NOCICEPTION
- Normal response to noxious stimuli
- Including reflexes between the suprathreshold
- Protect body from pain
PAIN
- Only perceived when suprathreshold for the nociceptors to reach an action potential
- Initiate the pain pathway is reached
- Acute pain protective but chronic no benefit
Describe nociceptors
- Sensory receptors
Two main types
> A-delta fibers –> rapid and sharp
> C-fibers –> slow and dull
Location: Skin, viscera, muscles, joints and meninges
- Detect harmful or noxious stimuli
Stimuli: mechanical, thermal, chemical –> pressure, touch, temperature, proprioception
–> Transmits electrical signal to CNS
For Nocicepetive Pain;
A) What is it
B) Where are nociceptors found?
C) What are the types
D) How to treat?
E) What is the mechanism of nociceptive pain
A)
- Detection of noxious stimuli by nociceptors (unlike neuropathic pain which may not require stimuli)
B)
- Found in all parts of body –> high concentrations in skin, lining of gut, capsule of kidney
C)
- Can be acute or chronic
- Two main types include somatic and visceral pain
D)
- Analgesic and anti-inflammatory medications
E)
- Stimuli –> Nociceptors –> Transduction –> autonomic ganglion –> conduction to spinal cord –> transmission brain –> perception of pain
For Neuropathic pain;
A) What causes it
B) what is Allodynia and Hyperalgesia
C) How is it classifed
D) What are some examples
E) How to treat
A)
- Injury to nerve in the pain pathway in nervous system
- Alteration in the process and modulation pain –> psychological factors
- Persistent and chronic pain –> worsens by psychological factros
B)
- Allodynia: Painful responses to a stimulus that is not normally painful
- Hyperalgesia: Increased excitability and sensitivity to pain –> heightened responses to a normally painful stimulus (eg arthritic pain)
C)
- Classified as either peripheral or central neuropathic pain
D)
- Classified as either central or peripheral neuropathic pain
D)
- Phantom limb pain (central neuropathic pain)
- Diabetic neuropathy (peripheral neuropathic pain)
E)
- Complex, antidepressants, opoids or some NSAIDs
What is phantom limb pain (central neuropathic pain)?
- Vivid perception that a limb that has been removed / amputated is still present and functioning
- Often feel that the phantom limb is distorted or shorter than the original limb
Sensations felt
- Tickling, irritation
- Cramps
- Shooting, piercing, or stabbing pain
- Numbness
- Pleasure
Wha is acute pain?
- Protective mechanism to alert individual of potential harmful tissue damage
- Sudden onset, relief when stimulus removed
- Transient /short duration –> seconds to days, up to 3 months
- Associated with stimulation of ANS – mainly sympathetic –> increased heart rate and blood pressure, pupil dilation (fight or flight responses)
- Anxiety
- Acute pain arises from cutaneous, deep somatic or visceral –> called somatic, visceral or referred pain
What is chronic pain?
- Persistent pain, lasting for more than 3-6 months
- Unlike acute pain, chronic pain serves no purpose and poorly understood –> cause suffering
- Ongoing or intermittent
- Absence of autonomic responses due to physiological adaption over prolong period
- Associated with significant psychologic responses
- Persistent inflammation and pain link to neuropathic pain
- Increased irritability, depression, social isolation, decreased sleep and libido
What is the difference between visceral and somatic pain?
Visceral pain
- Location: visceral tissues, internal organs
- Stimuli: pain and pressure
- Sensation: diffused, dull, aching pain which is poorly defned
Somatic pain
- Location: superficial arises from skin, deep arises from bones, joints, muscles, tendons and blood vessels
- Stimuli: Touch, pressure, temperature, pain, proprioception
- Sensation: sharp, burning (superficial), sharp radiating pain (deep)
What is referred pain?
- A pain that is perceived at a site which is different from the site of injury or origin of pain
- Innervated by same spinal segment
- Somatic and visceral afferents neurons converge on the same dorsal horn projection in spinal cord
What is pain threshold and pain tolerance?
- Pain is subjective
- Threshold –> lowest intensity of pain recognised by individual
- Tolerance –> duration or intensity individual can endure
- Pain tolerance decrease with repeated exposure to stimuli
- But increase with alcohol consumption and prolonged opioid medications
