Week 6 Pain Flashcards
Pain by origin
Superficial- skin or subcutaneous (burns and abrasions)
Visceral- deep internal (abdominal, cranium, thorax) not well localized,
Can be called tight, pressure, crampy pain
Somatic- ligaments, tendons, nerves, blood vessels and bone. Localized, achy or tender. Think fracture or sprain, arthritis, bone cancer
Radiating- pain spreads from origin like heartburn
Referred- pain distant from origin site like heart attack
Phantom- missing limb
Psychogenic- pain exists from origin with no known cause.
Nociceptive pain
(Cause)
Nociceptors stimulated- caused by noxious thermal, chemical, or mechanical stimuli
(Visceral & somatic)
Described as aching commonly
Neuropathic pain
(Causes)
Complex and often chronic pain, arising from injury to one or more nerves.
Repeated pain signal w/o stimuli
Described as burning, numbness, itching, prickling pain,
Origin- stroke, diabetes, tumor, amputation, viral infection.
Duration of pain
Acute- varies in intensity and lasts up to 6 months.
Chronic- persistent 3 to 6 month or longer. May experience periods of remission and exacerbation.
Fall more often, disturbed sleep and appetite, and ADLs
Intractable- chronic and resistance to relief. Approach with multiple methods of pain relief
Quality of Pain
Quality- sharp or dull, aching, throbbing, stabbing, burning, ripping, searing, or tingling
Periodicity- episodic, intermittent, or constant
Intensity- mild, distracting, moderate, severe, or intolerable
Unrelieved pain systemic effects
(Endocrine)
Endocrine- excessive release of hormones (ADH, cortisol, GH, glucagon)
Insulin and testosterone decrease.
This all leads to macronutrients catabolism, and inflammatory response results in weight loss, tachycardia, fever, increased respiratory rate and death
Unrelieved pain
Cardiovascular
Leads to hyper-coagulation and increase heart rate, blood pressure, cardiac workload, and oxygen demand. May lead to unstable angina(chest pain), intracoronary thrombosis(clots in heart vessels), and myocardial ischemia and infraction (heart attack)
Un relieved pain
Musculoskeletal system
Impaired muscle function, fatigue, immobility.
Impaired ADL’s
Unrelieved pain
Respiratory system
Shallow breathing, to reduce movement to thoracic and abdominal regions. This is called “splinting” increases inhaling and exhaling pressures.
Can lead to pneumonia and atelectasis as well under-ventilation and respiratory acidosis
Unrelieved pain
Genitourinary system
Release of excessive amounts of catecholamines, aldosterone, ADH, cortisol, angiotensin 2, and prostaglandins.
Lead to decreased urinary output, retention, fluid overload, hypokalemia, hypertension, and increased cardiac output
Unrelieved pain
Gastrointestinal system
Intestinal secretions and smooth muscle tone increase, and gastric emptying and motility decrease.
Pain Physiology
Transduction- activation of nociceptors by stimuli
Transmission- conduction of pain message to spinal cord
Pain perception- recognizing and defining pain in cortex
Pain modulation- changing pain perception