CH 6Nociception and Pain

Question 1

Pain is

Answer 1

primarily a symptom rather than a disease

-often the chief complain

Question 2

Pain scales do what

Answer 2

compare pain over time but not among patients

Question 3

Acute pain is

Answer 3

• an adaptive mechanism

- protects from potential threats

Question 4

Chronic pain

Answer 4

• malfunction of the nervous system

- can be considered a disease

Question 5

Nociception

Answer 5

pathological processes of pain

Question 6

Transduction

Answer 6

conversion of painful stimulus to action potentials at the sensory receptors

Question 7

nociceptors

Answer 7

free nerve endings

Question 8

modulation

Answer 8

modification of nociceptor impulses can occur in the spinal cord, peripheral nociceptor endings, and the brain

Question 9

Endorphin

Answer 9

Endogenous peptides that produce analgesia

Question 10

Dermatome

Answer 10

sensory area that corresponds to a spinal nerve

Question 11

Perception

Answer 11

neural processing of pain sensations in the brain

Question 12

transmission

Answer 12

Process by which specialized sensory nerve fibers carry impulses to the central nervous system

Question 13

prostaglandins

Answer 13

formed by cell damage, lower nociceptive fiber threshold (make pain worse)

Question 14

SIgns and Symptoms of SNS pain response

Answer 14

Increased HR
Increased BP
Increased RR
Dilated pupils
Pallor and perspiration
nausea and vomiting
urine retention

Question 15

SNS physiological pain response

Answer 15

-blood shifts from superficial vessels to striated muscle, heart, lungs, and brain
-bronchioles dilate to increase oxygenation
-increased gastric secretions
-Decreased gastrointestinal motility
-increased circulating blood glucose
hypermotility of bladder and ureters

Question 16

How does physiological pain differ from pathological pain?

Answer 16

Physiological pain is the result of tissue injury while pathological pain develops after injury and results from nervous system changes

Question 17

What is the difference between acute and chronic pain?

Answer 17

Pain is considered chronic when it lasts >6 months. Generally, acute pain resolves when tissue injury heals

Question 18

How do neuropathic and nociceptive pain differ?

Answer 18

Neuropathic pain results from nerve injury rather than stimulation of pain receptors as in nociceptive pain

Question 19

Why is pain referred?

Answer 19

Nociceptors from internal organs converge with somatic afferents from the body’s surface

Question 20

What is the cause of ischemic pain?

Answer 20

tissue hypoxia and injury lead to release of inflammatory and pain mediators

Question 21

Acute Pain: Headache

Answer 21

• very common

- tension, migraine, sinus headaches

Question 22

Acute pain: Migraine

Answer 22

• probably due to dysfunction of brainstem and release of inflammatory chemicals
• involves a trigger
• Rule out life threatening conditions like brain tumor, infection, increased intercranial pressure, H&P exam

Question 23

Acute Pain: Strained muscle, broken bone, appendicitis

Answer 23

• damaged tissue and associated pathology

- often involves inflammation

Question 24

Chronic Pain Example

Answer 24

Fibromyalgia

• collection of symptoms
• no identifiable physiological cause
• not degenerative or progressive

Question 25

Peripheral sensitization Theory of chronic pain

Answer 25

• reduction of threshold + amplification in responsiveness of nociceptors
• increased peripheral transduction sensitivity

Question 26

Central Sensitization Theory of Chronic Pain

Answer 26

• changes in the properties of neurons in the CNS
• increased spontaneous activity
• reduced threshold for activation by peripheral stimuli
• increased responsiveness to stimulation
• enlargement of receptor field

Question 27

Cancer pain is

Answer 27

• often chronic, called malignant pain
• can suffer from acute pain due to
• -growing tumors: referred or ischemic pain
• -secondary to treatment, radiation or chemo

Question 28

Expression of Pain

Answer 28

-overt physiologic responses of acute pain may no longer manifest in chronic pain=

Question 29

Individual expression of pain factors

Answer 29

age
gender
cultural influences

Question 30

Pain in older adults is often…

Answer 30

often not treated adequately