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MSK 1 > Unit 3 Week 9 Pain > Flashcards

Unit 3 Week 9 Pain Flashcards

1
Q

what is the biopsychosocial perspective of pain?

A

pain is not a factor of just one part of a person, it is a component of interplay between sensory information, emotion and context

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2
Q

what is the mature organism model?

A

behavior is adapted for survival
sample the environment, scrutinize the input and then respond
pain perception = sensory; altered thoughts = cognitive; altered feelings = affective - all alter behavior and physiology

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3
Q

what is the fear-avoiding model?

A

perception of threat effects personal affect
high threat = priority to pain control = negative affect
low threat = priority to valued life goals = positive affect

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4
Q

what is pain catastrophizing?

A

the tendency to explain pain experience in more exaggerated terms than the average person
increases pain through altered attention, anticipation, and emotional response

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5
Q

what is the pain catastrophizing scale?

A

rumination - attention
magnification - exaggeration
helplessness - low self efficacy

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6
Q

what is occurring with chronic stress?

A

cortisol inhibits the hypothalamus and pituitary; over time the overused gland becomes less effective
lower cortisol levels impair the ability to control inflammation (immunosuppression); reduced growth factors in brain; and decreased function and size of the hippocampus (memory and mood)

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7
Q

what are the three cortical changes in response to pain?

A

size: body representation grows
laterality recognition: difficulty differentiating left from right
smudge: representation blurs

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8
Q

what is the cartesian model of pain?

A

a bottom up view of pain
pain is a direct result of tissue damage and the brain is a passive recipient of the pain signal

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9
Q

what is the specificity theory?

A

specific pain nerves, pathways, and brain center for pain

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10
Q

what is the pattern theory?

A

generic nerves respond to pain sensation with uniquely coded impulse
the frequency and intensity of the nerve signal is what creates the sensation of pain

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11
Q

what is the neuromatrix theory of pain?

A

the brain and spinal cord are what produce pain, not tissue damage
various parts of the central nervous system work together to produce pain
genetically determined and environmentally shaped
nociception + threat = pain

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12
Q

true/false: pain presentation is the same in both the acute and chronic phases.

A

true

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13
Q

what is nociceptive pain?

A

due to activation of nociceptors (inflammation, mechanical irritant, injury)
attributable to pathophysiology

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14
Q

how does nociceptive pain present?

A

localized and appropriate to injury
responds to aggravating and alleviating
intermittent and sharp with movement/provocation
constant due ache to throb at rest

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15
Q

what is nociplastic pain?

A

due to disturbance in central pain processing (increased excitability and decreased inhibition)
amplification of neural signaling in the CNS that elicits pain hypersensitivity

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16
Q

what is a nervous system “wind up”?

A

inhibition of descending inhibitory pain pathways which then skews excitatory and inhibitory inputs that contribute to the intensity of pain
changes pain thresholds and contributes to radiating of pain

17
Q

what is neuropathic pain?

A

due to lesion or disease of the somatosensory system

18
Q

how does neuropathic pain present?

A

referred in dermatomal or cutaneous distribution
history of nerve injury or disease
provocation with tests that load neural tissue

19
Q

what is central sensitization?

A

disproportionate or diffused pain

20
Q

what is allodynia?

A

painful response to a normally non-painful stimuli

21
Q

what is hyperalgesia?

A

the amplification of the sensation of pain

22
Q

what is assessed in a biopsychosocial assessment?

A

type of pain
somatic factors
cognitive factors
emotional factors
behavioral factors
social factors
motivation

23
Q

how would you assess the quantity of pain?

A

visual analog scale
numeric pain rating scale

24
Q

how would you assess the quality of pain?

A

patient characteristics
location
frequency/duration
time of day
activity and rest response

25
Q

what psychosocial issues are related to central sensitization?

A

fear avoiding behaviors
pain catastrophizing
depression

26
Q

what is 2-point discrimination?

A

the measure of sensory thresholds of receptive field
there will be a diminished ability in persistent pain states due to cortical changes

27
Q

what is graphesthesia?

A

the ability to recognize a common symbol as it is drawn on the skin

28
Q

what is sensation localization>

A

the ability to identify where the body is being touched

29
Q

what should you promote when communicating your findings of a pain assessment?

A

safety

30
Q

what should you avoid when communicating your findings of a pain assessment?

A

fear inducing words
(pathoanatomy)

31
Q

what are the characteristics of fibromyalgia?

A

chronic widespread pain
fatigue and sleep alternations
cognitive dysfunction
hypersensitivity to external stimuli
somatic symptoms
psychiatric disorders

32
Q

what is it hard to diagnose fibromyalgia?

A

lack of biomarkers

33
Q

what is the hypothesized etiology of fibromyalgia?

A

interplay of peripheral and central mechanisms causing changes in nociceptive functions
nociplastic pain condition

34
Q

what is the pathogenesis of fibromyalgia?

A

genetics
negative/stressful life events
peripheral injury/disease

35
Q

what are the 4 pillars of fibromyalgia treatment?

A

patient education
fitness
pharmacology
psychotherapy

36
Q

what are the parameters of exercise for patients with fibromyalgia?

A

short sessions initially (3-5 min)
use RPE scale to measure tolerance
increase duration in small increments (sec-min)
“no pain, no gain” does not apply
goal: 30 min/day

37
Q

what mode of exercise should be used with patients with fibromyalgia?

A

low-moderate aerobic exercise, flexibility exercises, and strength training
aquatic therapy

MSK 1 (10 decks)

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