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NUR2229 oncology & palliative care > week 5 - pain concepts & assessments > Flashcards

week 5 - pain concepts & assessments Flashcards

1
Q

what are the 4 phases of the ascending pain pathway?

A
  1. complex transmission from periphery to dorsal root of spinal cord
  2. terminate in dorsal horn
  3. signals communicate w/ local interneurons
  4. neurons w/ long axons ascend to brain
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2
Q

what woud you use OPQRSTSUV for?

A

acute

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3
Q

what do C fibres transmit?

A

poorly localised, dull, aching pain

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4
Q

what level does modulation occur in the NS?

A

all lvls

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5
Q

can there be selective responses to stimuli in the descending pain pathway?

A

yes

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6
Q

what are 3 ways to describe neuropathic pain?

A
  1. shooting
  2. burning
  3. electric
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7
Q

define referred pain

A

pain felt in an area of the body distant from actual source

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8
Q

what is visceral pain often the result of?

A

stretching from inflammation or spasms of organ tissues

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9
Q

what are C fibres associated w/?

A

diffuse, dull, persistant pain

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10
Q

what is released during transduction?

A

chemcal mediators

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11
Q

what is the PAINAD scale for?

A

pain assessment in advanced dementia

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12
Q

what 4 things are involved in the perception of pain?

A
  1. reticular activating system (RAS)
  2. somatosensory system
  3. limbic system
  4. cortical structures
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13
Q

what would you use the numeric rating scale NRS for?

A

acute
children

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14
Q

what does persistant pain assessment =?

A

acute + other

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15
Q

what are 3 signs of inflammatory pain?

A
  1. redness
  2. swelling
  3. heat
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16
Q

what would you use the intitial pain assessment tool for?

A

acute

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17
Q

give 3 examples of what nociceptors detect

A
  1. heat
  2. pressure
  3. chemical irritants
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18
Q

what is allodynia?

A

condition in which normally non-painful stimuli is perceived as painful

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19
Q

what 3 chemical substances can be released during modulation?

A
  1. endogenous opioids
  2. serotonin
  3. NA
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20
Q

what stimuli are C fibres sensitive to?

A

mechanical
thermal
chemical

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21
Q

what is visceral pain?

A

originating from internal organs

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22
Q

what is another name for psychogenic pain?

A

somatoform

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23
Q

what is transduction?

A

when a noxious stimulus is detected by nocicepted > converted into electrical signals (AP)

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24
Q

what would you use the visual analogue scale VAS for?

A

acute

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25
Q

how long does pain need to last to be considered persistant?

A

> 3-6 months (arbitrary)

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26
Q

comment on

  1. vital signs
  2. pt activity
  3. pt mentioning of pain
  4. pain behaviour

for acute pain

A
  1. high BP, RR, HR
  2. restless/anxious
  3. reports pain
  4. exhibits pain behaviour
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27
Q

comment on the myelination, diameter & conduction speed of C fibres

A
  1. unmyelinated
  2. small
  3. slow-conducting
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28
Q
A
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29
Q

what is idiopathic pain?

A

pain w/ unknown/unclear underlying cause

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30
Q

what is inflammatory pain?

A

arising from activation of immune response, often due to tissue damage/infection

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31
Q

is the brief pain inventory BPI multidimensional & who what you use it for?

A

yes
persistent, children, elderly, CALD (culturally & linguistically diverse)

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32
Q

what 3 ways can the descending pain pathway be modulated?

A
  1. chemical substances
  2. gate theory
  3. actions
33
Q

what is referred pain due to?

A

shared nerve pathways

34
Q

what would you use the pain anxiety symptom scale PASS for?

A

persistent

35
Q

what is psychogenic pain?

A

primarily caused/influenced by psychological factors

36
Q

what would you use the pain catastrophising scale for?

A

persistent

37
Q

what would you use the verbal descripter/rating scale for?

A

acute

38
Q

what are the 4 elements of assessment for pain?

A
  1. patient self-report
  2. observation
  3. interview
  4. physical examination
39
Q

is the McGill pain questionnaire MPQ multidimensional & what would you use it for?

A

yes
persistent

40
Q

what would you use PQRST for?

A

acute

41
Q

what is breakthrough pain?

A

intense episodes of pain that breakthrough regular pain management regiment

42
Q

what is modulation in the pain pathway?

3 sentences

A

signals from brain travelling downwards

amplification/dampening of pain system

release of chemical substances

43
Q

what are 2 endogenous opioids?

A
  1. encephalins
  2. endorphins
44
Q

define neuropathic pain

A

results from damage/dysfunction of the NS inc. nerves

45
Q

is visceral pain challenging to localise?

A

yes

46
Q

can neuropathic pain be chronic?

A

yes

47
Q

comment on:
1. vital signs
2. skin
3. pupils
4. pt activity
5. pt mentioning of pain
6. pain behaviour

for chronic pain

A
  1. normal
  2. dry/warm
  3. normal/dilated
  4. depressed/withdrawn
  5. dowsn’t mention pain unless asked
  6. often absent
48
Q

what is analgesia?

A

relief from pain, often through meds/interventions that block pain signals or alter pain perception

49
Q

what are A-delta fibres associated w/?

A

acute pain

50
Q

what do A-delta fibres transmit?

A

well-localised, sharp pain

51
Q

why does phantom pain occur?

A

brain’s attempt to interpret signals from nerves that used to supply missing body part

52
Q

define pain

A

unpleasant sensory & emotional experience associated w/ actual or potential tissue damage

protective mechanism

53
Q

what does the paediatric FLACC scale stand for?

A

face
legs
activity
cry
consolability

54
Q

what is the descending pain pathway?

A

brain > spinal dorsal horn

55
Q

what is hyperalgesia?

A

increased sensitivity to painful stimuli

56
Q

define nociceptive pain

A

pain caused by activation of nociceptors

localised, well-defined

57
Q

does chronic pain have sympathetic or parasympathetic NS responses?

A

parasympathetic

58
Q

what phase are A-delta & C fibres used?

A

injury site > spinal cord (transmission)

59
Q

comment on the myelination, diameter & conduction speed of A-delta fibres

A
  1. thinly
  2. large
  3. fast-conducting
60
Q

is neuropathic pain easy to treat?

A

can be challenging

61
Q

what would you use the neuropathic/nociceptive discrimination DN4 scale for?

A

persistent

62
Q

what would you use the faces pain scale for?

A

children

63
Q

what are 3 ways to describe visceral pain?

A
  1. dull
  2. deep
  3. vague
64
Q

what are the 4 steps in the nociceptive pain response?

A
  1. transduction
  2. transmission
  3. perception
  4. modulation
65
Q

what is phantom pain?

A

percieved in a part of the body that has been amputated

66
Q

is acute pain a parasympathetic or sympathetic NS response?

A

sympathetic

67
Q

what did persistant pain used to be called?

A

chronic

68
Q

what does PQRST stand for?

A

provocation/palliation
quality/quantity
region/radiation
severity
timing

69
Q

what are the 3 phases of transmission?

A
  1. injury site > spinal cord
  2. spinal cord > brain stem & thalamus
  3. thalamus > cortex
70
Q

what stimuli are A-delta fibres sensitive to?

A

mechanical
thermal

71
Q

what are nociceptors?

A

specialised sensory receptors that respond to harmful stimuli

72
Q

what does OPQRSTUV stand for?

A

onset
provocation/palliation
quality
region/radiation
severity
treatment
understanding
impact
values

73
Q

what are 3 possible causes of psychogenic pain?

A
  1. stress
  2. anxiety
  3. depression
74
Q

what is chronic pain?

A

persists for an extended period, beyond tissue healing time

significant impact on person’s quality of life

75
Q

what is acute pain?

A

sudden, usually related to a specific injury/illness

warning sign, short duration

related to tissue injury

76
Q

what are the 2 primary types of nerve fibres responsible for transmitting pain signals to the CNS?

A
  1. A-delta fibers
  2. C fibers
77
Q

what are 7 chemical mediators in pain?

“BOdySHoP Pain’S”

A
  1. bradykinins
  2. others
  3. substance P
  4. histamine
  5. potassium
  6. prostaglandins
  7. serotonin
78
Q

what is perception in the pain pathway?

A

conscious experience of pain

NUR2229 oncology & palliative care (14 decks)

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