Week 6: Physiology and Classification of Pain Flashcards
(148 cards)
1
Q
Define
Pathophysiology
A
The study of the functional changes in the body that result from a disease or injury.
2
Q
Define
Nociceptive Pain
A
Pain caused by tissue damage, typically from injury or inflammation, involving the activation of nociceptors.
3
Q
Define
Somatic Pain
A
A type of nociceptive pain originating from the skin, muscles, bones, and joints, often well-localized and sharp.
4
Q
Define
Visceral Pain
A
A type of nociceptive pain arising from internal organs, often diffuse and hard to pinpoint.
5
Q
Define
Neuropathic Pain
A
Pain caused by damage or disease affecting the nervous system, often leading to chronic pain and abnormal pain processing.
6
Q
Define
Psychogenic (Somatoform) Pain
A
Pain that is real and persistent but has no identifiable physical cause, often related to psychological factors.
7
Q
Define
Afferent Pathway
A
The nerve pathway that transmits sensory information, such as pain signals, from the body to the central nervous system.
8
Q
Define
Efferent Pathways
A
Nerve pathways that carry signals away from the central nervous system to muscles, triggering a response.
9
Q
Define
Nociceptors
A
Sensory receptors that respond to potentially harmful stimuli by sending pain signals to the brain.
10
Q
Define
Transduction
A
The process of converting energy from a harmful stimulus into electrical signals in the nervous system.
11
Q
Define
Transmission
A
The process of pain signals traveling from the site of injury through the nervous system to the brain.
12
Q
Define
Perception
A
The conscious awareness of pain, involving various brain structures such as the somatosensory system and limbic system.
13
Q
Define
Modulation
A
The process by which pain signals are amplified or dampened as they travel through the nervous system.
14
Q
Define
Endogenous Opioids
A
Natural pain-relieving chemicals in the body, such as endorphins and enkephalins, that modulate pain.
15
Q
Define
Gate Theory
A
A theory that suggests pain signals can be modulated by a “gate” mechanism in the spinal cord, which can either amplify or inhibit pain perception.
16
Q
Define
A-delta Fibres
A
Fast-conducting nerve fibers responsible for transmitting sharp, well-localized pain.
17
Q
Define
C Fibres
A
Slow-conducting nerve fibers responsible for transmitting dull, diffuse, and aching pain.
18
Q
Define
A-beta Fibres
A
Large, myelinated nerve fibers that transmit non-painful stimuli and are involved in the inhibition of pain through the gate theory.
19
Q
Define
Neuropathic Pain Mechanisms
A
The processes by which damage to the peripheral or central nervous system leads to abnormal pain perception.
20
Q
Define
Peripheral Sensitisation
A
A mechanism in which damaged tissues release substances that increase the sensitivity of nociceptors, leading to heightened pain responses.
21
Q
Define
Acute Pain
A
Pain with a sudden onset, typically associated with injury or illness, lasting for a short period and generally subsiding as healing occurs.
22
Q
Define
Persistent Pain
A
Also known as chronic pain, it persists beyond the normal healing time, lasting for more than 3-6 months, and often lacks a clear cause.
23
Q
Define
Superficial Somatic Pain
A
Pain that originates from the skin, mucous membranes, or subcutaneous tissues, typically described as sharp or throbbing.
24
Q
Define
Deep Somatic Pain
A
Pain arising from muscles, bones, joints, tendons, or blood vessels, usually described as dull or aching.
25
# Define
Referred Pain
Pain perceived at a location other than the site of the painful stimulus, often due to the convergence of nerve signals.
26
# Define
Cancer Pain
Pain associated with cancer, which can be due to tumor progression, treatments, or physical limitations, often persistent but sometimes acute.
27
# Define
Breakthrough Pain
A sudden, intense flare-up of pain that occurs despite ongoing pain management, commonly seen in individuals with chronic conditions like cancer.
28
# Define
Intractable Pain
Severe, persistent pain that is resistant to standard medical treatment, often leading to significant physical and psychological distress.
29
# Define
Phantom Pain
Pain felt in a part of the body that has been amputated, thought to be related to the ongoing transmission of nerve impulses in the area.
30
# Define
Hyperalgesia
An increased sensitivity to pain, often occurring in the tissue surrounding an affected organ, making normally non-painful stimuli painful.
31
# Define
Opioid-Responsive Pain
Pain that can be effectively managed with opioid medications, commonly used for moderate to severe nociceptive pain.
32
# Define
Polyneuropathy
A condition involving damage to multiple peripheral nerves, which can lead to neuropathic pain and other neurological symptoms.
33
# Define
NMDA Receptors
A type of receptor in the central nervous system involved in pain transmission and modulation, particularly in persistent pain states.
34
# Define
Diaphoresis
Excessive sweating, often a symptom of acute pain or sympathetic nervous system activation.
35
# What is
The study of the functional changes in the body that result from a disease or injury.
Pathophysiology
36
# What is
Pain caused by tissue damage, typically from injury or inflammation, involving the activation of nociceptors.
Nociceptive Pain
37
# What is
A type of nociceptive pain originating from the skin, muscles, bones, and joints, often well-localized and sharp.
Somatic Pain
38
# What is
A type of nociceptive pain arising from internal organs, often diffuse and hard to pinpoint.
Visceral Pain
39
# What is
Pain caused by damage or disease affecting the nervous system, often leading to chronic pain and abnormal pain processing.
Neuropathic Pain
40
# What is
Pain that is real and persistent but has no identifiable physical cause, often related to psychological factors.
Psychogenic (Somatoform) Pain
41
# What is
The nerve pathway that transmits sensory information, such as pain signals, from the body to the central nervous system.
Afferent Pathway
42
# What is
Nerve pathways that carry signals away from the central nervous system to muscles, triggering a response.
Efferent Pathways
43
# What is
Sensory receptors that respond to potentially harmful stimuli by sending pain signals to the brain.
Nociceptors
44
# What is
The process of converting energy from a harmful stimulus into electrical signals in the nervous system.
Transduction
45
# What is
The process of pain signals traveling from the site of injury through the nervous system to the brain.
Transmission
46
# What is
The conscious awareness of pain, involving various brain structures such as the somatosensory system and limbic system.
Perception
47
# What is
The process by which pain signals are amplified or dampened as they travel through the nervous system.
Modulation
48
# What is
Natural pain-relieving chemicals in the body, such as endorphins and enkephalins, that modulate pain.
Endogenous Opioids
49
# What is
A theory that suggests pain signals can be modulated by a "gate" mechanism in the spinal cord, which can either amplify or inhibit pain perception.
Gate Theory
50
# What is
Fast-conducting nerve fibers responsible for transmitting sharp, well-localized pain.
A-delta Fibres
51
# What is
Slow-conducting nerve fibers responsible for transmitting dull, diffuse, and aching pain.
C Fibres
52
# What is
Large, myelinated nerve fibers that transmit non-painful stimuli and are involved in the inhibition of pain through the gate theory.
A-beta Fibres
53
# What is
The processes by which damage to the peripheral or central nervous system leads to abnormal pain perception.
Neuropathic Pain Mechanisms
54
# What is
A mechanism in which damaged tissues release substances that increase the sensitivity of nociceptors, leading to heightened pain responses.
Peripheral Sensitisation
55
# What is
Pain with a sudden onset, typically associated with injury or illness, lasting for a short period and generally subsiding as healing occurs.
Acute Pain
56
# What is
Also known as chronic pain, it persists beyond the normal healing time, lasting for more than 3-6 months, and often lacks a clear cause.
Persistent Pain
57
# What is
Pain that originates from the skin, mucous membranes, or subcutaneous tissues, typically described as sharp or throbbing.
Superficial Somatic Pain
58
# What is
Pain arising from muscles, bones, joints, tendons, or blood vessels, usually described as dull or aching.
Deep Somatic Pain
59
# What is
Pain perceived at a location other than the site of the painful stimulus, often due to the convergence of nerve signals.
Referred Pain
60
# What is
Pain associated with cancer, which can be due to tumor progression, treatments, or physical limitations, often persistent but sometimes acute.
Cancer Pain
61
# What is
A sudden, intense flare-up of pain that occurs despite ongoing pain management, commonly seen in individuals with chronic conditions like cancer.
Breakthrough Pain
62
# What is
Severe, persistent pain that is resistant to standard medical treatment, often leading to significant physical and psychological distress.
Intractable Pain
63
# What is
Pain felt in a part of the body that has been amputated, thought to be related to the ongoing transmission of nerve impulses in the area.
Phantom Pain
64
# What is
An increased sensitivity to pain, often occurring in the tissue surrounding an affected organ, making normally non-painful stimuli painful.
Hyperalgesia
65
# What is
Pain that can be effectively managed with opioid medications, commonly used for moderate to severe nociceptive pain.
Opioid-Responsive Pain
66
# What is
A condition involving damage to multiple peripheral nerves, which can lead to neuropathic pain and other neurological symptoms.
Polyneuropathy
67
# What is
A type of receptor in the central nervous system involved in pain transmission and modulation, particularly in persistent pain states.
NMDA Receptors
68
# What is
Excessive sweating, often a symptom of acute pain or sympathetic nervous system activation.
Diaphoresis
69
What is the IASP's revised definition of pain?
An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.
70
What are the three main classifications of pain based on etiology/pathways?
Nociceptive, neuropathic, and psychogenic (somatoform) pain.
71
What are the four processes involved in the transmission of nociceptive pain?
Transduction, transmission, perception, and modulation.
72
What are A-delta fibers responsible for transmitting?
Well-localized, sharp pain that is sensitive to mechanical and thermal stimuli.
73
What is the Gate Theory of pain?
A theory proposing that there is a "gate" in the spinal cord that can facilitate or inhibit transmission of pain signals.
74
What is the difference between acute and persistent pain in terms of duration?
Acute pain lasts less than three months, while persistent pain lasts longer than three months.
75
What are some examples of chemical mediators released during the transduction phase of nociceptive pain?
Prostaglandins, substance P, histamine, bradykinins, serotonin, and potassium.
76
What is allodynia?
Pain due to a stimulus that does not normally provoke pain, such as touch.
77
What is hyperalgesia?
An increased pain response to noxious stimuli.
78
What are the two types of nociceptive pain?
Somatic and visceral pain.
79
What is referred pain?
Pain that is felt at a site other than the injured/diseased organ or body part.
80
What is phantom pain?
Pain felt in a body part that is missing.
81
What are some psychological factors that can influence pain perception?
Anxiety, sense of helplessness, depressive mood, and cognitive deficits.
82
What is the persistent pain cycle?
A cycle where pain leads to various psychosocial issues (e.g., depression, sleep disorders, isolation) which in turn can exacerbate the pain experience.
83
What is the difference between pain threshold and pain tolerance?
Pain threshold is the point at which a stimulus is felt as painful, while pain tolerance is the duration or intensity of pain a person is willing to endure.
84
What are C fibers responsible for transmitting?
Poorly localized, dull and aching pain that is sensitive to mechanical, thermal, and chemical stimuli.
85
What is the function of A-beta fibers in pain transmission?
They respond to light touch and transmit non-noxious stimuli. They are involved in the gate theory of pain inhibition.
86
What are the three main areas of the brain involved in pain perception?
The reticular formation, thalamus, and cortex.
87
What is central sensitization?
Hyperexcitability of central neurons initiated by prolonged binding of neurotransmitters like glutamate and substance P.
88
What is the difference between somatic and visceral nociceptive pain?
Somatic pain is well-localized and originates from skin, muscles, and joints, while visceral pain is poorly localized and originates from organs and body cavities.
89
What are endogenous opioids and how do they affect pain?
They are naturally occurring pain-inhibiting substances in the body, such as endorphins and enkephalins, that help modulate pain signals.
90
What is the role of the NMDA receptor in persistent pain?
NMDA receptor activation is involved in central sensitization and the development of persistent pain states.
91
What is breakthrough pain?
Sudden onset, short-duration pain that occurs despite ongoing pain management, common in cancer patients.
92
How does persistent pain differ from acute pain in terms of treatment goals?
Acute pain treatment aims for pain control and eventual elimination, while persistent pain treatment focuses on pain control to the extent possible and enhancing function and quality of life.
93
What is catastrophizing in the context of pain?
Negative thinking patterns where patients believe their pain will never improve or that it's the worst possible scenario.
94
How can cultural factors influence pain perception?
Cultural beliefs and practices can affect how pain is expressed, perceived, and managed.
95
What is the role of the limbic system in pain perception?
The limbic system is involved in the emotional and affective aspects of pain perception.
96
What is intractable pain?
Pain that is not relieved by ordinary medical, surgical, or nursing measures and is usually persistent and excruciating.
97
How does sleep disturbance relate to persistent pain?
Sleep disturbances can exacerbate pain, and persistent pain can lead to sleep problems, creating a cyclical relationship.
98
What is the difference between primary and secondary hyperalgesia?
Primary hyperalgesia occurs at the site of injury, while secondary hyperalgesia occurs in surrounding uninjured tissue.
99
How does the sympathetic nervous system respond to acute pain?
It can cause increased heart rate, blood pressure, respiratory rate, and other physiological changes.
100
What is the role of substance P in pain transmission?
Substance P is a neurotransmitter that helps transmit pain signals and contributes to neurogenic inflammation.
101
How does cognitive-behavioral therapy (CBT) help in managing persistent pain?
CBT can help patients develop coping strategies, change negative thought patterns, and improve pain management skills.
102
What is the biopsychosocial model of pain?
A model that considers biological, psychological, and social factors in understanding and managing pain.
103
How can genetics influence pain perception?
Genetic factors can affect pain sensitivity, analgesic response, and susceptibility to certain pain conditions.
104
What is nociception and how does it differ from pain?
Nociception is the neural process of encoding noxious stimuli, while pain is the subjective perception and experience of these signals.
105
What is the role of the thalamus in pain processing?
The thalamus acts as a relay and processing center for sensory information, including pain signals, before they reach the cortex.
106
How does the gate control theory explain the effectiveness of rubbing a painful area?
Rubbing activates large-diameter A-beta fibers, which can "close the gate" on pain signals carried by smaller nerve fibers.
107
What is wind-up in the context of pain?
Wind-up refers to the progressive increase in pain perception due to repeated stimulation of C-fibers, leading to increased excitability of spinal cord neurons.
108
How does chronic pain affect the brain over time?
Chronic pain can lead to changes in brain structure and function, including alterations in gray matter density and connectivity patterns.
109
What is the role of descending pain modulation?
Descending pain modulation involves pathways from the brain that can either inhibit or facilitate pain signals at the spinal cord level.
110
How does anticipation of pain affect pain perception?
Anticipation of pain can increase anxiety and activate pain-related brain areas, potentially intensifying the pain experience.
111
What is the difference between tolerance and dependence in pain management?
Tolerance is the need for increasing doses of medication to achieve the same effect, while dependence is a physiological adaptation to the medication.
112
How does neuroplasticity contribute to chronic pain conditions?
Neuroplasticity can lead to maladaptive changes in the nervous system that perpetuate pain even after the initial injury has healed.
113
What is the role of glial cells in chronic pain?
Glial cells, once thought to be merely supportive, are now known to play a crucial role in pain modulation and the development of chronic pain states.
114
How does the placebo effect influence pain perception?
The placebo effect can activate endogenous pain modulation systems, leading to real pain relief even without active medication.
115
What is central pain syndrome?
Central pain syndrome is pain initiated by a primary lesion or dysfunction in the central nervous system.
116
How does stress affect pain perception?
Stress can exacerbate pain by increasing muscle tension, altering hormone levels, and affecting pain modulation systems.
117
What is the role of neuroimaging in pain research?
Neuroimaging techniques like fMRI and PET scans help researchers understand how the brain processes pain and how various factors influence this processing.
118
How does catastrophizing affect pain management outcomes?
Catastrophizing can lead to increased pain intensity, disability, and poorer treatment outcomes in chronic pain patients.
119
What is the IASP's definition of pain?
a) A physical sensation caused by tissue damage
b) An unpleasant sensory and emotional experience associated with actual or potential tissue damage
c) A response to noxious stimuli in the body
d) A subjective experience of discomfort
b) An unpleasant sensory and emotional experience associated with actual or potential tissue damage
120
Which of the following is NOT a main classification of pain based on etiology?
a) Nociceptive
b) Neuropathic
c) Psychogenic
d) Idiopathic
d) Idiopathic
121
What are the four processes involved in nociceptive pain transmission?
a) Sensation, perception, modulation, reaction
b) Transduction, transmission, perception, modulation
c) Reception, conduction, interpretation, response
d) Stimulation, conduction, perception, action
b) Transduction, transmission, perception, modulation
122
Which type of nerve fibers are responsible for transmitting sharp, well-localized pain?
a) A-beta fibers
b) A-delta fibers
c) C fibers
d) B fibers
b) A-delta fibers
123
What is the primary function of nociceptors?
a) To transmit touch sensations
b) To detect harmful stimuli
c) To modulate pain signals
d) To produce endorphins
b) To detect harmful stimuli
124
Which of the following best describes somatic pain?
a) Poorly localized pain from internal organs
b) Well-localized pain from skin, muscles, or joints
c) Burning or shooting pain from nerve damage
d) Psychologically induced pain with no physical cause
b) Well-localized pain from skin, muscles, or joints
125
Visceral pain is characterized by:
a) Sharp, well-localized sensations
b) Burning or electric-like sensations
c) Dull, poorly localized, and often referred pain
d) Itching and tingling sensations
c) Dull, poorly localized, and often referred pain
126
What is the primary cause of neuropathic pain?
a) Tissue damage
b) Psychological factors
c) Nerve damage or dysfunction
d) Inflammation
c) Nerve damage or dysfunction
127
Which of the following is a key difference between acute and persistent pain?
a) Acute pain lasts longer than persistent pain
b) Persistent pain serves a biological purpose, while acute pain does not
c) Acute pain decreases over time, while persistent pain continues beyond normal healing time
d) Persistent pain is always more severe than acute pain
c) Acute pain decreases over time, while persistent pain continues beyond normal healing time
128
What is allodynia?
a) An increased response to painful stimuli
b) Pain caused by a stimulus that doesn't normally provoke pain
c) The absence of pain in response to stimulation
d) A decreased pain threshold
b) Pain caused by a stimulus that doesn't normally provoke pain
129
Which of the following is a physiological change associated with acute pain?
a) Decreased heart rate
b) Lowered blood pressure
c) Increased respiratory rate
d) Decreased muscle tension
c) Increased respiratory rate
130
In persistent pain, which of the following physiological changes is commonly observed?
a) Consistently elevated heart rate and blood pressure
b) Increased immune system function
c) Altered sleep patterns
d) Improved appetite and digestion
c) Altered sleep patterns
131
Which condition is most likely to cause nociceptive somatic pain?
a) Diabetic neuropathy
b) Appendicitis
c) Osteoarthritis
d) Multiple sclerosis
c) Osteoarthritis
132
Neuropathic pain is commonly associated with which of the following conditions?
a) Fractures
b) Muscle strains
c) Shingles (herpes zoster)
d) Kidney stones
c) Shingles (herpes zoster)
133
Which of the following is an example of visceral pain?
a) Toothache
b) Migraine
c) Pancreatitis
d) Carpal tunnel syndrome
c) Pancreatitis
134
What is catastrophizing in the context of pain?
a) A coping strategy to minimize pain
b) Exaggerated negative thinking about pain experiences
c) A medical treatment for chronic pain
d) Physical therapy exercises for pain management
b) Exaggerated negative thinking about pain experiences
135
How can cultural factors influence pain perception?
a) They have no impact on pain perception
b) They only affect acute pain, not chronic pain
c) They can influence how pain is expressed and managed
d) They determine the physical intensity of pain
c) They can influence how pain is expressed and managed
136
Which of the following is NOT typically part of the persistent pain cycle?
a) Depression
b) Sleep disorders
c) Increased social engagement
d) Lowered self-esteem
c) Increased social engagement
137
What role does the Gate Control Theory play in understanding pain?
a) It explains how certain neurons can "close the gate" on pain signals
b) It describes how pain medications work in the body
c) It outlines the stages of chronic pain development
d) It defines the different types of pain receptors
a) It explains how certain neurons can "close the gate" on pain signals
138
Which fact about pain in the elderly is true?
a. Pain is part of the ageing process.
b. Elderly persons often do not report pain because they consider it a normal part of the ageing process.
c. Opioid medications are inappropriate for the elderly
d. The elderly have a greater tolerance to pain than younger adults.
b. Elderly persons often do not report pain because they consider it a normal part of the ageing process.
138
How does stress typically affect pain perception?
a) It always reduces pain sensitivity
b) It has no effect on pain perception
c) It can exacerbate pain by increasing muscle tension and affecting pain modulation systems
d) It only affects psychogenic pain, not physical pain
c) It can exacerbate pain by increasing muscle tension and affecting pain modulation systems
139
An example of a behavioural indicator of acute pain is:
Question 2Answer
a. Moaning/groaning
b. Rapid shallow breathing
c. All options are correct
d. Restlessness
c. All options are correct
140
If pain is not assessed or treated, it can cause:
a. Decreased recovery time
b. A decreased chance of addiction
c. Decreased tolerance to opioids
d. Unnecessary suffering
d. Unnecessary suffering
141
Patients who experience pain always demonstrate an elevated pulse rate and blood pressure.
True or False
False
142
Allodynia is defined as:
a. Pain due to a lack of nociceptors in the body
b. A failure to feel pain when a stimulus would normally provoke pain
c. Pain caused by a stimulus that does not normally provoke pain
d. A fear of experiencing pain
c. Pain caused by a stimulus that does not normally provoke pain
143
Analgesia is defined as:
a. Abnormal physiological response to pain
b. Increased sensitivity to pain
c. Absence of sensitivity to pain
d. Absence of emotional reaction to pain
c. Absence of sensitivity to pain
144
Hyperalgesia is defined as:
a. Decreased physiological response to pain
b. Perception of a painful stimulus as more painful than normal
c. Increased vocalisation in reaction to pain
d. Perception of a painful stimulus as less painful than normal
b. Perception of a painful stimulus as more painful than normal
145
Paraesthesia is defined as:
a. Abnormal burning, tingling or numbing sensation typically associated with neuropathic pain
b. Abnormal burning, tingling or numbing sensation typically associated with acute pain
c. Abnormal burning, tingling or numbing sensation typically associated with persistent pain
d. Abnormal burning, tingling or numbing sensation typically associated with visceral pain
a. Abnormal burning, tingling or numbing sensation typically associated with neuropathic pain
146
The pain threshold is:
a. the point at which a person feels numbness
b. the point at which the body temperature increases
c. the point at which a person feels pain
d. the point at which a person is paralysed by pain
c. the point at which a person feels pain
147
Pain tolerance is:
a. the point at which a person is paralysed by pain
b. the level of pain at which a person cries
c. the level of pain at which a person is conscious of the sensation
d. the level of pain that a person can endure
d. the level of pain that a person can endure
