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Processes of Human Diseases 1 > Week 5: Pain > Flashcards

Week 5: Pain Flashcards

1
Q

Is pain a subjective or objective experience?

A

Subjective

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2
Q

The PHYSIOLOGIC mechanisms involved in the pain phenomenon are termed ______.

A

nociception

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3
Q

Free nerve endings are called what?

A

Nociceptors

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4
Q

What are the four stages of physiology of pain? (Nociception can be divided into what four stages)

A

Transduction, transmission, perception, modulation

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5
Q

Transduction

A

Process of converting painful stimuli to neuronal action potentials at the sensory receptors.
- Pain begins in periphery when free nerve endings called nociceptors are stimulated

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6
Q

Transmission

A

Refers to the movement of action potentials along neurons that make their way from peripheral receptor to the spinal cord and then centrally to the brain.

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7
Q

When does perception occur?

A

Occurs when the brain receives pain signals and interprets them as painful.

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8
Q

Modulation

A

Complex mechanism whereby synaptic transmission of pain signals is altered

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9
Q

Transduction: Where can nociceptors be found?

A

Skin, muscle, connective tissue, circulatory system, abdominal, pelvic and thoracic viscera.

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10
Q

Transduction: What are some important chemical mediators of pain?

A

K+, H+, Lactate, histamine, serotonin, bradykinins, acetylcholine, substance P and prostaglandins.

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11
Q

What are very common prostaglandin inhibitors? Describe briefly the role of prostaglandings in relation to pain threshold.

A

Aspirin and Non-steroidal anti-inflammatory drugs (NSAIDS).
- Prostaglandins formed when cells are damaged, then an enzyme breaks down multiple times to form prostaglandin, therefore the sensitization by prostaglandins lowers the pain threshold, causing pain when normally it would not.

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12
Q

Transduction: What are the primary sensory fibers included in the transmission of nociceptive impulses?

A
  • Aδ and C fibers
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13
Q

Transduction: Describe Aδ fibers?

A
  • Large, myelinated
  • Thermal, mechanical stimuli
  • Fast traveling
    -** Sharp, stinging, cutting, pinching, **
  • Amount 10%
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14
Q

Transduction: Describe C fibers?

A
  • Unmyelinated
  • Polymodal (mechanical, thermal, chemical)
  • Slower travelling
  • ** Dull, burning, aching ***
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15
Q

Transuction: Afferent vs Efferent Neurons

A

Afferent neurons carries information from skin and other organs to CNS (brain, spinal cord)
Efferent carry motor information away from the central nervous system to the muscles and glands of the body.

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16
Q

Transduction: Sensory afferent pain fibers enter the spinal cord by way of ______

A

Posterior nerve roots

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17
Q

Transduction: Cells bodies of pain neuron are located where?

A

Dorsal root ganglion

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18
Q

Pain perception can be described in what two terms?

A

Pain threshold and pain tolerance

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19
Q

Pain threshold

A

Level of painful stimulation required to be perceived

20
Q

Pain tolerance

A

Degree of pain that one is willing to bear before seeking relief

21
Q

Describe some ways people express pain

A

Pacing, jaw clenching, facial grimacing, muscle guarding, crying moaning, groaning

22
Q

Describe the difference between physiologic and pathologic pain

A

Physiologic: touching Hot stove

Pathologic: characterized by an amplified response to normally innocuous stimuli, and an amplified response to acute pain. Pathological pain has long been described as the result of dysfunctional neuronal activity.

23
Q

T or F
Pain is a symptom of an underlying problem rather than a primary disorders

A

True

24
Q

When pain is classified in accordance to duration, it is either ______ or _______

A

Acute or chronic

25
Q

Signs and symptoms of someone with acute pain

A
  • Elevated respiratory rate, heart rate and blood pressure, as well as pallor, sweating (diaphoresis) and nausea
26
Q

How do persons experiencing acute pain express it? *

A

Pacing, grimacing, crying, moaning
* risk of becoming dependent on pain meds is minimal.

27
Q

What is the most common cause of acute pain?

A

Headache

28
Q

Chronic pain can be considered chronic if it lasts for several months (around 6). What are two probable mechanisms for chronic pain?

A

Peripheral sensitization and central sensitization

29
Q

Peripheral sensitization

A

Reduction in pain threshold and an amplification in responsiveness of nociceptors when primary sensory neurons are exposed to inflammatory mediators

30
Q

Central sensitization (Give an example)

A
  • Increased sense of pain with things that should not be causing you so much pain.
  • When neurons in dorsal horn are affected by central senisitzation they develop increased spontaneous activity and reduction in threshold
  • Fibromyalgia is the best example. Body becomes sensitized due to psychological factors such as stress, sleep problems and fatigue.
31
Q

T or F
Chronic pain symptoms are often more psychological

A

True

32
Q

What is fibromyalgia?

A
  • Often triggered by psychological stress
  • Chronic pain syndrome, where women are more affected then men with chronic widespread affecting all four extremeties, sleep disturbances and fatigue.
  • Relates to individuals with excessive trauma and endocrine disorders
33
Q

Describe hyperalgesia and allodynia

A

Hyperalgesia: Extreme sensitivity to pain
Allodynia: Pain to stimulus that usually doesnt cause pain

34
Q

Describe 3 other types of chronic pain?

A

neuropathic, ischemic and reffered pain

35
Q

Which of the following can result in nerve injury?
(SATA)
1. Surgery
2. Tumour growth
3. Metastasis
4. Radiation therapy
5. Chemotherapy
6. Elevated blood glucose
7. Viral infections

A

ALL

36
Q

Clinical manifestations of neuropathic pain

A
  • Allodynia
  • Hyperalgesia
  • Atrophy of affected extremity
  • Coldness in affected area
  • Dystrophic changes
  • Hair loss
  • Shiny appearance of skin
37
Q

If you have hair loss, shiny appearence of skin and coldness in an affected area, what type of pain are you most likely to have? (reffered, neuropathic, ishemic)

A

Neuropathic

38
Q

Pain resulting from sudden or profound loss of blood flow to tissue main result in ____

A

Ischemic pain

39
Q

Ischemic pain is described as _____

A

Aching, burning, or prickling (paresthesia)

40
Q

If you have ischemic pain of cardiac origin, where will pain originate and radiate to?

A

Origin is visceral and radiates to arm or jaw

41
Q

Symptoms of ischemic pain

A

Deep, aching, diffuse and pressing

42
Q

____ ischemia is usually associated with thrombus or embolus.
(Chronic or acute)

A

Acute.
- Can be dissolved or removed

43
Q

Referred pain may be perceived at some distance from the area of tissue injury, but generally felt _____

a. with slightly less intensity
b. on the same side of the body
c. within the same dermatome
d. within 10 to 15 cm area

A

C. Within the same dermatomee

44
Q

Substance P

A

A neurotransmitter and a modulator of pain perception by altering cellular signaling pathways

44
Q

What are physiological responses to pain?

A
  • Increase gastric secretions
  • Decrease gastrointestinal motility
  • Increase circulating blood glucose
  • Hypomotility of bladder and ureters
  • Blood shifts from superficial vessels to striated muscles, heart, lungs, brain
  • Bronchioles dilate to increase oxygenation

Processes of Human Diseases 1 (18 decks)

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