Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

I & P Year 1 > Understanding Pain > Flashcards

Understanding Pain Flashcards

1
Q

What is chronic pain?

A

experiencing pain for 3 months of the year or more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How many adults experience pain?

What % of these are adult women and men?

A

14 million

37% adult women and 31% adult men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

In which groups is chronic pain more prevalent?

A

Older people and low income households

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How many times more likely are those experiencing pain going to visit the GP?

A

5 times more likely to visit the GP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What consequences can severe pain lead to?

What percentage of those with severe pain develop these consequences?

A

clinical anxiety and depression

69% of those with the most severe pain have these features

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What % of adults reported pain in the last 12 months?

What % report more than 1 site of pain?

A

87% of adults reported 1 pain in the last 12 months

75% reported more than 1 site of pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the consequence of having more pain sites?

A

More disability and distress

It is not simple cause and effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does the number of pain sites change with age?

What is this linked to?

A

it changes little after 20 years

There are links with maternal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why is pain not an extraordinary experience?

A

It is a common day-to-day experience and a fundamental characteristic of living

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is congenital analgesia?

A

When someone cannot experience pain and register that their body is damaged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does congenital analgesia lead to in childhood?

A

Increased amount of injury and physical health problems

Bones do not heal properly after being broken as children start becoming active far too early after injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the IASP definition of pain?

A

An unpleasant and emotional experience associated with actual or potential tissue damage, or described in terms of such damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is meant by “potential tissue damage” is identifying the source of pain?

A

The root cause of pain may not be able to be found

There may be no detectable reason in a physical examination to describe why someone may be in pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the alternative definition of pain?

A

Pain is what the patient says it is and exists when s/he says it does

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is detection of the intensity of pain linked to the alternative definition?

A

You cannot detect the intensity of pain and must go off the patient’s definition of where/how intense the pain is

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why is pain difficult to diagnose?

A

People build up their own internal representations of pain so it is a subjective experience

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the 5 constructs used to assess pain?

A
  1. physiological - nocioception
  2. sensory
  3. affective
  4. cognitive
  5. behavioural
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is meant by nocioception as a construct?

A

The physiological responses to threat

It can be measured but it is quite invasive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is meant by sensory as a construct?

A

The quality and the intensity of the pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is meant by affective as a construct?

A

This is the unpleasantness of the pain and how it affects someone’s mood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is meant by cognitive as a construct?

A

Expectations of pain and models of pain that are built up on previous experiences of pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is meant by behaviour as a construct?

A

How the individual vocalises their pain, how it affects their posture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are typical pain behaviours?

A
  1. facial expressions
  2. para-vocalisation - “ouch”
  3. complaints
  4. rubbing/holding/guarding
  5. posture changes
  6. reduced behavioural repertoire
  7. taking pain relief
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How is pain assessed using the pain thermometer?

A

The patient rates how bad their pain is on a scale of 1 to 10

This is repeated on a number of different occasions to see what factors changed their experience of pain

25
Q

What is significant about the appearance of the pain thermometer?

A

It is a fixed point rating scale with vertical orientation

26
Q

What are visual analogue scales in pain rating?

A

They are 100 mm long and a line that reaches from “no pain” to “extremely painful”

27
Q

How are visual analogue scales used to rate pain?

A

The patient marks the severity of their pain on the scale

The distance from the start is measured to give a numerical value for the severity of the pain

28
Q

Why are visual analogue scales preferred to the pain thermometer?

A

Scale of 0-100 rather than 0-10

this gives more reliability and reflects differences in people’s subjective experience to pain as it gives more precision in the way they communicate their experience

29
Q

How does the McGill pain questionnaire work?

A

The patient picks out words that describes their current experience of pain

They colour in the body area affected

The pain rating index comes from summation of their pain descriptors

30
Q

What are the descriptors in the McGill pain questionnaire?

A
  1. sensory
  2. affective
  3. evaluative
  4. temporal (how much pain varies)
31
Q

What is the standardised paediatric pain assessment?

A

Faces pain scale

The child picks a face or level between the faces that resembles how the pain makes them feel

32
Q

Why is the faces pain scale reliable?

A

It is standardised

33
Q

What was Descartes concept of the pain pathway?

A

It is a sensory experience and is reflex like

Peripheral receptors for pain lead to the brain

If pain is detected, the limb is moved away from the cause of the pain

34
Q

What is Melzack and Wall’s pain theory?

A

Gate control theory

When the gate is open there is pain

When the gate is closed, the pain reduces

35
Q

What is the analogy behind the gate control theory?

A

Modulation of pain happens around the level of the spinal cord

If there is a gate at the level of the spinal cord, it is opened in intense pain

This stimulates the C fibres (pain fibres)

36
Q

In which 2 ways can the gate in the gate control theory be closed?

A
  1. stimulation of beta fibres

2. expectations/physiological processes that occur in your head

37
Q

How does rubbing the elbow help with pain?

A

The beta fibres are touch/vibration fibres

This motion stimulates beta fibres to close the gate

sensory receptors are close to the pain receptors

38
Q

What are bottom-up processes and how are they driven?

A

They are processes that organise incoming information

They are sensory driven

39
Q

What are top-down processes and how are they driven?

A

They are processes that determine perception in ambiguous settings

They are driven by knowledge, experience and expectations

40
Q

What is transcutaneous electrical nerve stimulation (TENS) used for?

A

Small battery is placed in pocket and 2 small electrodes are placed close to the area of pain

This stimulates large nerve fibres to try and close the gate

41
Q

What conditions is TENS used for?

What is the clinical evidence?

A
  1. postoperative pain
  2. osteoarthritisn
  3. chronic musculoskeletal pain

Clinical evidence is not very good

42
Q

What are the advances in the gate control theory?

A
  1. pain as a perception
  2. individual as active
  3. individual variability expected
  4. multiple causes of pain
43
Q

What are the problems with gate control theory?

A
  1. there is no physical evidence of the gate

2. it still assumes an organic basis for pain

44
Q

What is phantom-limb pain?

A

Phantom sensations experienced by almost all amputees

This pain is real, normal and occurs in the same position as the lost limb

45
Q

How does phantom-limb pain change with progression?

A

It persists but the vividness often diminishes

46
Q

How many amputees experience phantom-limb pain?

A

80%

It is often stronger than other senses

47
Q

What are changes in phantom-limb pain linked to?

A

Changes in mood, behaviour and environment

48
Q

What method is used to reduce phantom pain of paraplegia?

A

Virtual walking

The patient, who has no use of their legs, legs are hidden from view

The patient watches themselves walking in a in a mirror and this information is fed to the brain

49
Q

How does pain in the legs change in paraplegia after using virtual walking?

A

15 days of virtual walking for 10 min/day

It addresses a motor output leading to sensory feedback mismatch

It changes the rating of pain and the areas un which pain appears

50
Q

How does overall pain change after the virtual walking task?

A

Duration of pain relief increases

Pre-task pain decreases

51
Q

What 3 characteristics make up what is painful?

A
  1. pain thresholds

sensation, perception, tolerance, encouraged/motivated tolerance

  1. pain duration

phasic, acute or chronic

  1. pain quality

superficial, deep, referred

52
Q

What are the cultural differences in pain treatment?

A

Pain is subjective and differs between people

In some cultures it is more normal to express pain and talk about it

53
Q

What is the positive Western cultural response to pain?

A

the stoical patient

they do not complain about pain or share their experiences

54
Q

How is relative anaesthesia used to cope with acute pain?

A

It doesn’t change the intensity of the pain

It reduces the unpleasantness of the level of pain

55
Q

What type of therapy is used to manage pain?

A

Cognitive-behavioural therapy is used in pain management

56
Q

How does chronic pain threaten identity?

A
  1. it takes over so the patient feels trapped
  2. the changes their sense of body (makes them feel older)
  3. pain relief becomes their primary goal in life
57
Q

What are the stages in the self-maintaining cycle of pain?

A
  1. pain
  2. anxiety
  3. tension and sleeplessness
  4. irritability
  5. decreased pain tolerance

the cycle repeats and causes psychological distress

58
Q

How are multidisciplinary clinics used to treat chronic pain?

A
  1. practical advice, physiotherapy and psychological interventions
  2. less reliance on medical controls
  3. allows for social and family support

I & P Year 1 (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions