Week 10: Pain Management

Question 1

consequences of untreated pain

Answer 1

catabolism
wasting
immune system suppression
inflammation
delayed wound healing
anesthetic risk/increased dose
patient suffering

Question 2

neuroendocrine/catabolic wasting

Answer 2

ACTH release
elevated cortisol, norepinephrine, epinephrine
decreased insulin

Question 3

sympathetic stimulation can result in cardiac arrhythmias

Answer 3

vasoconstriction
increased myocardial work
increased myocardial oxygen consumption

Question 4

nocioception

Answer 4

detection of nervous system for potential or actual tissue injury

Question 5

physiological pain

Answer 5

ouch pain
little or no tissue injury
protective response

Question 6

pathologic pain

Answer 6

follows tissue injury

acute or chronic

Question 7

visceral pain

Answer 7

originates from organs

Question 8

somatic pain

Answer 8

originates from musculoskeletal system
superficial pain-skin
deep pain-muscle, bone, joint

Question 9

hyperalgesia

Answer 9

hypersensitivity to painful or even normally non panful stimuli

Question 10

secondary hyperalgesia

Answer 10

CNS hypersensitivity
wind up
further away from site of injure
spinal cord neuron stimulation
modulated by NDMA receptors

Question 11

pain pathway

Answer 11

transduction
transmission
modulation
perception

Question 12

transduction

Answer 12

electrical signals

inhibited by NSAIDs, local anesthetics, opioids

Question 13

transmission

Answer 13

spinal cord

reduced by local anesthetics and alpha 2 agonists

Question 14

modulation

Answer 14

neurotransmitters

influenced by local anesthetics, alpha 2 agonists, opioids, NSAIDs, tricyclic antidepressants, selective serotonin, reuptake inhibitors, NDMA receptor agonists

Question 15

percdption

Answer 15

brain

alpha 2 agonist
opiods

Question 16

pain and stress response

Answer 16

fight or flight response

chronic pain=chronic stress

Question 17

behavior response to pain

Answer 17

young=less tolerant
cattle=stoic
large breed more stoic than toys
cats hide
dogs seek comfort
her animals separate themselves

Question 18

physical evidence of pain

Answer 18

change in gait
change in level of activity
reluctance to lie down/shifting
reluctance to move
posture changes (hunched)
vocalization
facial expression (tongue flick, eye roll, glazed expression, dilated pupils)

Question 19

pain assessment tools

Answer 19

verbal rating scale
simple descriptive scale
numeric rating scale
visual analogue scales

Question 20

opioid receptors

Answer 20

mu=brain
kappa=brain/spinal cord
delta
sigma