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Repair And Regeneration > Week 9 Part 1 > Flashcards

Week 9 Part 1 Flashcards

1
Q

What are the associations of functional somatic syndromes?

A

Autonomic dysregulation

Stress dysregulation

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2
Q

What are examples of functional gastrointestinal disorders?

A

IBS

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3
Q

What are examples of Musculoskeletal disorders?

A

FM
CFS
Chronic lower back pain

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4
Q

What is an example of Genitourinary?

A

Interstitial cystitis

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5
Q

What is an example of neurological?

A

Tension headache/ migraine

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6
Q

What is pain experienced in labour equated to?

A

IBS

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7
Q

Why is it such a burden?

A

Prepared to sacrifice 25% of remaining life
Pain in e.g. IBS equated to childbirth
QoL ratings worse than ESRF, DM

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8
Q

What is the economic burden?

A

Time off work: 20% greater than controls
Impaired productivity 30% of time
Healthcare costs

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9
Q

Who are they?

A

Multiple symptoms, multiple systems and Comorbid disorders
Negative effect and perceived loss of control
Anxiety and feared loss of control
Altered concentration/ memory
Often a history of abuse
Complicated by iatrogenic addiction

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10
Q

What is Interoception?

A

Capacity of being aware of what is going on inside our body

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11
Q

What is interception?

A

Sensitivity to stimuli occurring within the body

More salient and motivating

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12
Q

What is normal physiological processes of Interoception?

A

Abdominal bloating/ passage of flatus

Awareness of heart beat

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13
Q

What is ANS of Interoception?

A

Predominantly unconscious

Visceral functions

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14
Q

Why is it important to separate the symptoms?

A

Informs treatment
Informs how they have arisen
Precipitant causes of disorders developed might be different

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15
Q

Functional somatic syndrome

A 
Overlap - one versus many 
Dysregulation of:
Affect
ANS
Motivational salience 
Chronic pain
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16
Q

What is the definition of pain?

A

Unpleasant sensory or emotional experience that is associated with actual or potential tissue damage stimuli

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17
Q

Noxious

A

Damaging stimuli

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18
Q

What is noxious stimuli?

A

Something that doesn’t cause damage

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19
Q

What is the order of pain?

A

Specific injury caused pain
Tissue damage arises
Self-limiting process
Healing

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20
Q

What are two components of spinal component?

A

Painful and non-painful stimulus

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21
Q

Painful stimulus

A

High intensity

High capacity to activate receptors which have a relationship with nerve fibres

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22
Q

Non-painful stimulus

A

They do not activate the same receptors or nerve fibres or in the same cells of spinal cord

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23
Q

What neurosurgical does the descending inhibition require?

A

Dopamine
Serotonin
Noradrenaline
Opioids

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24
Q

What Brain regions are found in the lizard brain?

A

Thalamus

Basal Ganglia

25
Q

What is chronic pain?

A

A continued state of suffering

Pain that persists past the healing phase following an injury

26
Q

What is the normal healing time?

A

Chronic back pain = 6 months

Post herpetic neuralgia = 3 months

27
Q

What are the assumptions of pain?

A

Pain requires damage or injury to occur
Degree of peripheral damage/injury correlate with pain
If there is a disparity - all “psychological”

28
Q

What does chronic pain inform?

A

Diagnostic criteria
Which specialist you see
We continue to treat chronic pain as we would acute pain

29
Q

What happens when we are exposed to a constant stimulus?

A

We may habituate

We may become sensitised

30
Q

What happens when pain threshold decreases?

A

Allow pain to spread - secondary Hyperalgesia

31
Q

What are spinal cord mechanism detectable with?

A

Quantitative sensory tests

32
Q

What are some examples of QST?

A

Allodynia
Temporal summation
DNIC/CPM

33
Q

What has QST been used in FSS patients to demonstrate?

A

Spinal sensitisation

34
Q

What are examples of different substances at the level of spinal cord being examined?

A 
Substance P
Glutamate and other excitatory AAs
Serotonin
Nerve growth factor 
CCK
35
Q

What are 3 subsystems the pain triumvirate divided into?

A
  1. Sensory/discriminative
  2. Affective/ motivational
  3. Cognitive/evaluative
36
Q

Sensory/discriminative

A

Localisation in time/space - assessment of intensify

Lateral systems: lateral thalamic nuclei. S1, S2, SMA

37
Q

Affective/motivational

A

Emotional/unpleasant aspects
Reward in escape

Medial system - BG, medial thalamic nuclei, ACC, Insula

38
Q

Cognitive/evaluative

A

Interpretation of pain and it’s meaning

39
Q

What is chronic pain?

A

More than acute pain

Perception

40
Q

What is central augmentation?

A

Hyper-responsively of these brain areas

41
Q

What does integrated construct allow for?

A

Threat assessment and memory of pain

Repetition of behaviour

42
Q

In acute pain

A

Sensory component is dominant
Motivational component is reflexive
Affective component secondary

43
Q

In chronic pain

A

Affective and motivational components are primary

Determine sensory component

44
Q

Disruption in neurochemical circuits?

A

Symptoms of disorders

45
Q

MDD/ anxiety

A

Serotonin
Noradrenaline
Dopamine
Opioid system

46
Q

What is the function of serotonin?

A

Suppress sensation of normal bodily functions

47
Q

What is the function of noradrenaline?

A

Suppress sensation of normal bodily functions

48
Q

What is the function of dopamine?

A

Dampens pain

Application of importance and focuses attention

49
Q

What is the function of opioid system?

A

Prevents spread of pain
Dampens pain
Reinforces behaviour

50
Q

What are these different neurotransmitters viral for?

A

Interoception

51
Q

What does sensation and feelings affect our beliefs about?

A

Meaning of symptoms

Cause of symptoms

52
Q

What are 4 types of pain behaviours?

A

Negative affect
Facial/audible expression of distress
Distorted ambulation or posture
Avoidance of activity

53
Q

What does noxious stimulus act on?

A

A-delta and C fibres

54
Q

What is an example of sensory experience of pain?

A

Perception of noxious stimuli

55
Q

What is example of suffering?

A

Negative emotional response in higher nervous system

56
Q

What are examples of pain behaviour?

A

Expression of distress
Distortion of movement to posture
Bad mood
Avoidance of activity

57
Q

What is pathway of pain behaviours

A

Noxious stimulus
Sensory experience of pain
Suffering
Pain behaviours

58
Q

What are the altered activity?

A

Avoidance behaviour - most commonly
Excessive persistence
Pacing - listening to body

59
Q

What is the best approach?

A

Behavioural intervention: graded

Repair And Regeneration (16 decks)

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