4. Pain and Chronic Wounds / Treating People with Chronic Pain Flashcards Preview

Integ Patho (PTH 701) Quiz #1 > 4. Pain and Chronic Wounds / Treating People with Chronic Pain > Flashcards

Flashcards in 4. Pain and Chronic Wounds / Treating People with Chronic Pain Deck (27):
1

What are the three components of pain?

1. Sensory / Discriminative (input)
2. Cognitive / evaluative (processing)
-Pain modulation
3. Motivational / affective (output)

(no actual way to objectify pain)

2

When is pain a problem?

When it decreases function or impedes Quality of Life (but pain can be helpful)

3

What are the symptoms of a Venous Leg Ulcer?

80% report pain
Dull aching
Heaviness
Burning
Itching

4

What are the symptoms of arterial ulcers?

Claudication
Ischemic pain / rest pain
Ache
Cramping
Numbness

5

What are the symptoms of diabetic foot ulcers?

50-75% report pain
Neuropathic pain
Burning
tingling
Sharp / shooting
(may feel nothing w/ touch)

6

What are the symptoms of pressure ulcers?

59-88% report pan
Burning
Stabbing
Stinging
Tugging
Throbbing
Sharp

7

What constitutes wound pain?

Spontaneous pain
Activity-related pain
Dressing changes (80% report)
Compression wraps
Procedures / debridement

8

How does pain affect healing?

Lack of sleep --> physiologic stress --> poor healing
Lack of activity / mobility
LAck of socialization
Decreased access to care
Decreased QoL / mood

9

What are the different nociceptors of pain?

Cutaneous (dermis - temp, mech, chem)
Skeletal muscle
Joint (capsular, ligamentous, bone ... NOT CARTILAGE; pressure and movement)
Visceral (no distinction between mechanoreceptors and nociceptors; share the somatosensory pathways / ascending tracts)

10

What are the two primary afferent fibers?

A-Delta and C-fibers

11

What are the characteristics of A-Delta Fibers?

Sensitive to mechanical stimulus when tissue is injured
-Myelinated & fast
-Perceived as sharp, localized pain
-Neurotransmitter is L-Glutamate!!!

12

What are the characteristics of C-Fibers?

Sensitive to mechanical, chemical, and temperature!!!-Unmyelinated and slow
-Perceived as dull, diffuse pain
-Neurotransmitters are Substance-P and Calcitonin Gene Related peptide

13

Where do primary afferents synapse with secondary afferents?

In the dorsal horn

14

What are two ascending pathways?

Spinothalamic and Spinoreticular

15

What are the characteristics of the descending pathways?

Descending pain inhibition systems originate in the periaqudeductal gray area
-Rely on endogenous opioids and serotonin
-Synapse in dorsal horn
-Inhibit pain

16

What is Hyperalgesia?

Disproportionate pain to a typically noxious stimulus (overreacting to pain)
-Primary
-Secondary

17

What is Allodynia?

Pain in response to a stimulus that is NOT typically deemed painful

18

What is peripheral sensitization?

Increased sensitivity and/or firing of the nociceptors ("sunburn of the nerves")

19

What is central sensitization?

Increased real-estate devoted to pain processing

20

What is acute pain?

Less than 3 months
characerized by tissue damage

21

What is persistent pain?

Ongoing / recurrent / episodic

22

What is chronic pain?

Longer than expected healing time (longer than 3-6 months). Great than expected given injury / tissue damage

23

What is Chronic pain syndrome?

Pain that affects elements of life

Phantom pain: less likely in tramatic amputee but more likely in chronic pain person (used to pain)

24

Should wound healing be in a dry or moist environment?

MOIST!

25

Is chronic pain a diagnosis?

Yes

26

What are some characteristics of chronic pain

Uses biopsychosocial model (hard to explain when you lack the experience)

Central sensititzation (more areas of brain alerted - 7 alarm fire)

27

What model does acute pain use?

Nociceptive model (chronic uses biopsychosocial)