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Biochem Exam 5 > Oral Pain and its mangament (no lecture) > Flashcards

Oral Pain and its mangament (no lecture) Flashcards

1
Q

What are the structures in the oral cavity and the maxillofacial region?

A

teeth, gingiva, mucosa, salivary glands, muscles, bones, ligaments, tendons, blood and lymphatic vessels, taste buds, nerves

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2
Q

What is the most prevalent pain in the facial region?

A

toothache
-odonalgia

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3
Q

what percentage of people report tooth ache in the past 6 months?

A

12-14%

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4
Q

Are all toothahces the same?

A

nah fam

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5
Q

What are odotogenic?

A

pulpal and periodontal

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6
Q

What are non-odontogenic?

A

sinus/nasal, myofascial, neurovascular, neuropathic, cardiogenic, systemic, idiopathic

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7
Q

What are other sources of orofacial pain?

A

mucosal pain, TMDs, orofacial neuropathic pain, neurovascular pain, sleep disorders

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8
Q

What does TMD involve?

A

joint sounds

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9
Q

What is pain?

A

unpleasant sensory and emotional experience assiociated with actual or potential tissue damage or described in terms of such damage

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10
Q

Why do we feel pain?

A

instills protectivebehavior but if unabated, pain can be harmfuil

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11
Q

What are the principles of pain?

A

-always subjective
-may or may not be tied to a stimulus
-always a consequence of an emotioanl experience and psychological state

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12
Q

How do we experience pain usually?

A

-environmentla stimulus
-receptor activaiton
-generation of action potential
-transmission through primary afferent to dorsal horn
-projection from dorsal horn to brain for perception and interpretation

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13
Q

What are the biological factors of pain experience?

A

-genetics
-physiology
-neurochemistry
-tissue heath

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14
Q

What are the psychological factors of pain experience?

A

perceived control, self-efficacy, catastrophic thinking, hypervigilance, depression, anxiety, anger

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15
Q

What are the social factors of pain experience?

A

socioeconomic status, social, skepticism, operant, social support, social learning

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16
Q

What is the descending spinal pathway

A

-endogenous opoid signaling
-non-opioid inhibitatory neurotransmitters

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17
Q

What is the descending supraspinal pathway?

A

-influenced by psychological
-neurons from the cortex and amygdala
-periaqueductal gray and rostroventral

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18
Q

What is involved with supraspinal modulation?

A

psychological, emotional, and placebo

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19
Q

What is involved with spinal modulation?

A

neurotransmitters, neuropeptides, interneurons, endogenous opioids, central sensitization

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20
Q

What is involved with peripheral modulation?

A

peripheral sensitization, inflammatory mediators, intense/repetitive/prolonged noxious stimulus

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21
Q

What is pain modulation?

A

dynamic process- can occur at multiple levels of the ascending and descending pathway

22
Q

What is neuronal sensitization?

A

arise when neurotransmitters are left to linger in the synapse
-due to failure in diffusion, enzymatic destruction, and reuptake

23
Q

What does neuronal sensitization do?

A

prolong the effect of the post-synaptic neurons, allow subthreshold input to recruit a response, spontaneous discharge, and increase the size of receptive field

24
Q

What is normal input of neuronal sensitization?

A

increased responsiveness of nociceptive neurons

25
Q

What is the the subthreshold input of neuronal sensitization?

A

recruitment of a response

26
Q

What is spontaneous discharge of neuronal sensitization?

A

increased size of receptive field

27
Q

What is peripheral sensitization?

A

nociceptive neurons at periphery of receptive field
-increased responsiveness of noiceptive neurons

28
Q

What is reduced threshold to stimulation?

A

primary hyperalgesia

29
Q

What is hyperalgesia?

A

an increased pain experience in response to a painful stimulus

30
Q

What is central sensitization/

A

nociceptive neurons in the central nervous system

31
Q

What is allodynia?

A

pain resulting from a stimulus that does not normally provoke pain

32
Q

What can cause allodynia?

A

dysfunctional endogenous pain control

33
Q

What is the revised gate control theory?

A

myelinate non-nociceptive affect fiver can activate inhibitory interneurons modulating nocicpective transmition

34
Q

What does revised gate control theory do?

A

instinctively wave, hold, clench, your fingers when they burn

35
Q

What is diffuse noxious inhibitor control?

A

thresold for nociception can be raised when another noxious stimulus is provoke in another pain area
-pain inhibits painWh

36
Q

What is the placebo effect?

A

psychological
-leads to released of endogenous analgesic substance

37
Q

What are the different ways to categorize different pain?

A

neurophysiology, structures involved, timing

38
Q

What is nocieptive pain?

A

-pain resulting form damage or threatened damage to non-neural tissue
-activation of nociceptor

39
Q

What is neuropathic pain?

A

-pain resulting from the presence of a lesion or disease of the somatosensory nervous system

40
Q

What is nociplastic pain?

A

-new concept
-pain that arises from altered nociception
-does not satisfy the defintions of nociceptive or neuropathic pain
-possible for a patient to present with nociceptive and nociplastic pain at the same time

41
Q

What is acute pain?

A

pain with close temporal relationship to a stimulus, injury, or disease
-tends to respond to treatment in a linear dose-dependent fashion

42
Q

What is chronic pain?

A

more than 3 months
-does not typically respond to treatment in a linear dose-dependent fashion
-presence of other/multiple ongoing pains is a predictor for transition from acute to chronic
-more influence of psychosocial factor
-more difficult to treat

43
Q

Most common psychosocial disorders?

A

-anxiety
-major depression
-personality disorders
-pain distress

44
Q

What are coping mechanisms for psychological disorders?

A

-internal locus of control
-perceived control
-catastrophic thinking
-hypervigilance
-fear avoidance

45
Q

What are the assessments for pain?

A

-pain intensity
-pain distress
-pain-related interference (functional limitation, disability)
-oral habits

46
Q

What is homotopic pain?

A

when the site of the pain is the source of the pain

47
Q

What is heterotropic pain?

A

when the site of the pain is not the source

48
Q

What is central pain?

A

source is central but percieved peripherally

49
Q

What is projected pain?

A

pain follows same nerve distribution as primary source

50
Q

What is referred pain?

A

pain in different nerve than primary source and is spontaneous
-not aggravated by palpation
-does not respond to anesthesia
-does not cross midline

51
Q

What is the most important part of pain management?

A

understanding why the patient is in pain

52
Q

What are examples of opioids?

A

codeine, oxycodone, morphine, hydromorphone, and meperidine

Biochem Exam 5 (12 decks)

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