pain Flashcards

1
Q

what is pain

A

a subjective unpleasant sensory or emotional experience associated with actual or potential tissue damage

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2
Q

what is subjective experience

A

fear, anxiety and panic -> motor actions, learned avoidance, behavior modification

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3
Q

what is nociception

A

event of sensing mechanical, chemical, and thermal stimuli, which have the ability or the potential ability to cause damge to the tissues

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4
Q

what is the difference between pain and nociception

A

pain requires awareness

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5
Q

what are nociceptors

A

free nerve endings of Adelta and C fibers

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6
Q

what do nociceptors encode for

A

physical insults into electrical signals and transduce them to the dorsal horn of the spinal cord

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7
Q

nociceptors can lower their activation threshold following repeated stimulation, which results in:

A

peripheral sensitization

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8
Q

how does pain travel

A

through 3 orders of neurons from the periphery to the brain cortex

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9
Q

describe the 3 orders of neurons for pain

A
  • first order neuron - nociceptors -> spinal cord
  • second order neuron - spinal cord -> thalamus
  • third order neuron - thalamus -> somatosensory cortex
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10
Q

what are Adelta fibers

A
  • fast conduction
  • myelin
  • sharp and pricking pain
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11
Q

what are C fibers

A
  • slow conduction
  • no myelin
  • burning type pain
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12
Q

second order neurons

A
  • low threshold mechanosensitive neuron (LT) - light touch, pressure, proprioception
  • nociception specific neuron (NS) - noxious stimuli
  • wide dynamic range neuron (WDRN) - wide range stimuli
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13
Q

neospinothalamic tract

A

fast transmission of pain and readily localized

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14
Q

paleospinothalamic tract

A

emotional and visceral response to pain

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15
Q

archispinothalamic tract

A

emotional and autonomic response to pain

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16
Q

third order neurons

A

relay information received from 2nd order neurons in the thalamus to the somatosensory cortex (awareness)

17
Q

what is windup

A

progressive, frequency dependent facilitation of the responses of a neuron after the application of repetitive (usually electrical) stimuli

18
Q

what horn is more esasily excitable after the application of a windup-evoking stimulus

A

dorsal horn

19
Q

are windup and central sensitizations equivalent

A

no

20
Q

can the presense or absense of windup by itself be a marker of the presence of central sensitization

A

no

21
Q

what is central sensitization

A

a global event that involves all the pathways ascending and descending

22
Q

windup is a phenomena limited to the:

A

spinal cord

23
Q

what is hyperalgesia

A

increased response to a stimulus that is normally painful

24
Q

what is allodynia

A

painful response to a normally nonpainful stimuli

25
Q

why do we treat pain

A
  • ethics
  • decrease morbidity/mortality
  • deleterious effects (cardiac output, cardiac work & oxygen ocnsumption, vasocontriction, immuno-suppression)
26
Q

what are common signs of pain

A

thrashing, restlessness, vocalization, circling and continuous activity

27
Q

dysphoria

A
  • opioids, ketamine
  • artic breeds, labrador ret
  • emergence delirium, absent
28
Q

pain

A
  • response to manipulation
  • aggression
  • increase HR and BP