def. of terms describing pain

Question 1

acupuncture

Answer 1

the practice of inserting needles at certain points in the skin to achieve specific effects such as pain relief

Question 2

adjunctive

Answer 2

additional therapy used together w. the 1* Tx

Question 3

adjuvant

Answer 3

a drug that is administered for a purpose other than analgesia, but that has independent or additive pain-relieving effects; Tx that is given in addition to the 1*, main, or initial Tx

Question 4

agonist

Answer 4

a drug that exerts its effect by binding to and activating specific receptors

Question 5

algogenic

Answer 5

pain inducing

Question 6

allodynia

Answer 6

pain caused by a stimulus that does not normally cause pain

Question 7

analgesia

Answer 7

loss of sensitivity to a stimulus that would normally produce pain (noxious stimulus)

Question 8

analgesic ceiling effect

Answer 8

the drug dosage beyond which no beneficial analgesic effect is observed

an analgesic ceiling effect is observed w both butorphanol AND buprenorphine

Question 9

anesthesia

Answer 9

total or partial loss of sensation

Question 10

antagonist

Answer 10

a drug that exerts its effects by competitively binding to receptors and Px the effects of agonists

Question 11

central sensitization

Answer 11

sensitization of Nn in the spinal cord and brain d/t amplification and facilitation of synaptic transfer from the peripheral nociceptor to dorsal horn neurons in the spinal cord

is triggered in central neurons by intense nociceptor input into the spinal cord (activity dependent) and is sustained beyond the initiating stimulus by changes in the molecular machinery of the cell (transcription dependent)

activation of N-methyl-D-aspartic acid (NDMA) receptors play a key role in the development of central sensitization

Question 12

distress

Answer 12

condition in which stress negatively affects biologic functions critical to the animal’s well-being

also: to cause pain of suffering, to make miserable

Question 13

dysesthesia

Answer 13

abnormal sense of touch

Question 14

epidural space

Answer 14

the space above the dura mater

injection into this are is commonly referred to as an epidural

Question 15

hyperalgesia

Answer 15

an increased response to a stimulation that is normally painful (heightened sense of pain) at the site of injury or in surrounding undamaged tissue

stimulated nociceptors respond to noxious stimuli more vigorously and at a lower threshold

1* and 2* hyperalgesia…

Question 16

primary hyperalgesia

Answer 16

increased sensitivity to a stimulus that is normally painful at the site localized to the area of tissue damage or inflammation

Question 17

secondary hyperalgesia

Answer 17

increased sensitivity to a stimulus that is normally painful in uninjured or inflamed tissues in areas around and beyond the 1* site of tissue injury

caused by central sensitization

Question 18

hyperesthesia

Answer 18

increased sensitivity to touch

Question 19

hyperpathia

Answer 19

a painful syndrome characterized by an increased reaction to a stimulus, especially if it is repetitive

Question 20

hypoalgesia

Answer 20

decreased sensitivity to a noxious stimulus

Question 21

hypoesthesia

Answer 21

decreased sensitivity to touch

Question 22

interventional pain management

Answer 22

an invasive procedure to Tx or manage pain through an injection of a drug or implantation of a drug delivery device

Question 23

local anesthesia

Answer 23

the temporary loss of sensation in a defined part of the body w/o loss of consciousness

Question 24

multi-modal analgesia

Answer 24

the use of multiple drugs w different mechanisms of action, which may act at different levels of the nociceptive pathways, to produce enhanced (additive, superadditive) analgesic effects

Question 25

myofascial pain

Answer 25

a syndrome of focal pain in a muscle or related tissues, stiffness, muscle spasm, a decreased range of motion

Question 26

nociception

Answer 26

the neural processes for encoding pain: transduction, conduction, and central nervous system processing of nerve signals generated by the stimulation of nociceptors the physiologic process that leads to the perception of pain

Question 27

noxious stimulus

Answer 27

a stimulus (chemical, thermal, mechanical, electrical) that produces pain and damages or threatens to damage normal tissues

Question 28

opioid

Answer 28

a drug that is related naturally or synthetically to morphine

Question 29

pain

Answer 29

an unpleasant sensory or emotional experience associated with actual or potential tissue damage or described in terms of such damage the inability to communicate verbally does not negate the need for appropriate pain-relieving Tx

Question 30

acute pain

Answer 30

pain that follows some bodily injury, disappears with healing, and tends to be self-limiting

Question 31

adaptive pain

Answer 31

pain that contributes to survival by limiting or preventing contact w or movement of the injured part until healing is complete, thereby minimizing further damage inflammatory pain is typically adaptive and decreases as the damage and inflammatory response resolve

Question 32

breakthrough pain

Answer 32

a transient flare-up of pain in the chronic pain setting that can occur even when chronic pain is under control

Question 33

cancer pain

Answer 33

pain that can be acute, chronic, or intermittent; is related to the disease itself or to the Tx

Question 34

central pain

Answer 34

pain initiated or caused by dysfunction or a lesion in the CNS

Question 35

chronic pain

Answer 35

pain that lasts several weeks to months and persists beyond the expected healing time when nonmalignant in origin

Question 36

clinical pain

Answer 36

pain of inflammatory or neuropathic origin that is characterized by increased sensitivity to noxious (hyperalgesia) and non-noxious stimuli and a spread of hypersensitivity to uninjured tissue (2* hyperalgesia) differs from physiologic pain by the presence of pathologic hypersensitivity

Question 37

deep pain

Answer 37

pain that is present in "deep" anatomic structures (bone, muscle, tendon, ligament)

Question 38

dysfunctional pain

Answer 38

amplification of nociceptive signaling in the absence of inflammation or neural lesions

Question 39

first pain

Answer 39

the initial well-localized and generally brief pain produced by a noxious stimulus: produced by high-threshold nociceptors

Question 40

inflammatory pain

Answer 40

pain as a result of tissue damage and the release or activation of local inflammatory mediators (PGs, hydrogen ion, histamine) inflammatory pain typically decreases as the damage and inflammatory response resolve

Question 41

intractable pain

Answer 41

intense, constant, usually chronic pain that does not respond to any therapeutic medical intervention

Question 42

maladaptive pain

Answer 42

pain that is uncoupled from a noxious stimulus or healing tissue and generally occurs in response to damage to the nervous system (neuropathic pain) OR results from abnormal operation of the nervous system (dysfunctional pain) is the expression of abnormal sensory processing and usually is persistent or recurrent; it is pain as disease

Question 43

neuropathic pain

Answer 43

pain that originates from injury or involvement of the peripheral or central nervous system and is described as burning or shooting, possibly associated with motor, sensory, or autonomic deficits

Question 44

nociceptive pain

Answer 44

the sensation associated with the detection of potentially tissue damaging noxious stimuli; this type of pain is protective

Question 45

pathologic pain

Answer 45

a disease state that is caused by damage to the nervous system (neuropathic) or by its abnormal function (dysfunctional) and persists long after the healing process has occurred

Question 46

perioperative pain

Answer 46

pain that is present or occurs during the period extending from the time of hospitalization for Sx to the time of discharge

Question 47

second pain

Answer 47

delayed, diffuse and protracted, generally burning pain, that persists after the termination of the noxious stimulus severe, acute painful events (trauma) and chronic and visceral pain are almost always characterized as second pain

Question 48

superficial pain

Answer 48

pain that originates in "superficial" tissues (skin, subcutis)

Question 49

visceral pain

Answer 49

pain that originates from the body cavities (abdominal, thoracic) and the brain

Question 50

pain scales

Answer 50

visual, categoric, and numeric methods (instruments) used (by proxy) for diagnostic and therapeutic purposes to estimate the intensity of pain

Question 51

pain threshold

Answer 51

the least amount of pain that an animal can recognize

Question 52

pain tolerance level

Answer 52

the greatest level of pain that an individual can tolerate

Question 53

paresthesia

Answer 53

a spontaneous or evoked abnormal sensation generally occurring in animals with neuropathic pain

Question 54

pathologic pain

Answer 54

pain that has an exaggerated response much beyond its protective usefulness is often associated with tissue injury incurred at the time of Sx or trauma

Question 55

peripheral sensitization

Answer 55

injury and inflammation of tissue result in alterations of the chemical environment of the peripheral nerve terminal of nociceptors injured or inflamed tissues release intracellular contents such as ATPs, K+, and H+, cytokines, chemokines, GFs, PGs these factors act directly to activate (nociceptor activators) or to sensitize (nociceptor sensitizers) the terminal so that it becomes hypersensitive to subsequent stimuli

Question 56

physiologic pain

Answer 56

pain that acts as a protective mechanism and that is initiated by high threshold receptors well localized and transient incites individuals to move away from the cause of potential tissue damage or to avoid movement or contact with external stimuli during a reparative phase

Question 57

preemptive analgesia

Answer 57

a pharmacologic intervention performed before a noxious event (Sx) that is intended to minimize the impact of the stimulus by Px peripheral and/or central sensitization

Question 58

preventative analgesia

Answer 58

analgesic Tx that is initiated before a procedure to reduce the consequences of nociceptive transmission initiated by the procedure goal: to minimize sensitization induced by noxious perioperative stimuli including those arising before, during, and after the procedure an analgesic therapy that is designed for the purpose of decreasing analgesic consumption relative to a placebo Tx or compared w no Tx and to produce an analgesic effect that extends for a period of time that outlasts the pharmacologic effect (more than 5.5 half-lives) for the drug in question

Question 59

radiculopathy

Answer 59

irritation of or injury (compression, inflammation, tissue damage) to a nerve root

Question 60

regional anesthesia

Answer 60

the loss of sensation in part of the body caused by interruption of the sensory Nn conducting impulses from that region of the body

Question 61

sedation

Answer 61

CNS depression, mediated via the cerebral cortex, in which the individual is drowsy but arousable

Question 62

somatic pain

Answer 62

pain that originates from damage to bones, joints, muscle, or skin and is described in human beings as localized, constant, sharp, aching, and throbbing

Question 63

stress response

Answer 63

neuroendocrine-immune and behavioral response to actual or potential tissue damage "fight or flight response"

Question 64

subarachnoid space

Answer 64

the space above the pia mater and below the arachnoid mater, in which cerebrospinal fluid can be found a subarachnoid injection is also referred to as a "spinal"

Question 65

suffering

Answer 65

a state of emotional distress associated with events that threaten the biologic and/or psychosocial integrity of the individual often accompanies severe pain but can occur in its absence; hence pain and suffering are phenomenologically distinct

Question 66

sympathetic mediated pain

Answer 66

a syndrome in which there is abnormal sympathetic nervous system activity causing a severe debilitation that is often associated with tenderness to a light touch

Question 67

trigger zone or point

Answer 67

hypersensitive area on the body surface where touch or pressure elicits a painful response

Question 68

tolerance

Answer 68

a shortened duration and decreased intensity of the analgesic, euphoric, sedative and other CNS depressant effects, as well as considerable increase in the average dose required to achieve a given effect

Question 69

tranquilization

Answer 69

a state of calmness, mediated through the reticular activating system, in which the individual is relaxed, awake, unaware or its surroundings, and potentially indifferent to minor pain

Question 70

visceral pain

Answer 70

pain that arises from stretching, distension, or inflammation or the viscera is described as deep, cramping, aching, or gnawing, without good localizaiton

Question 71

wind-up

Answer 71

sensitization of nociceptors and peripheral and central pain pathways in response to a barrage of afferent nociceptive impulses resulting in expanded receptive fields and an increased rate of discharge