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Lecture 1 Flashcards

Introduction to Pain

1
Q

Who discovered the placebo effect?

A

Henry Beecher

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2
Q

Is there a correlation between how bad your pain is and how bad your osteoarthritis is?

A

No. Pain and the conditions that cause them can be dissociative from one another. Osteoarthritis does not always cause pain.

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3
Q

What are the most common pain events?

A

Scratched skin (95.2%),
Paper cut (95.2),
Pinched skin (94.6%),
Headaches (94.1%),
Mosquito bite (94.1%)

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4
Q

What are the least common pain events?

A

Heart attack (0%),
Advanced cancer (1.1%),
Childbirth (1.1%),
Skin ulcer (2.1%),
Stabbed with a knife (2.2%)

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5
Q

What is the lifetime prevalence of chronic pain?

A

1 in 2

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6
Q

What is the point prevalence of chronic pain?

A

1 in 4

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7
Q

What is the epidemiologist’s bathtub?

A

Point prevalence is the amount of water inside the tub. It can be affected by people dying (draining out of the tub), new cases being added (water being added to the tub), and people recovering from chronic pain (water evaporating).

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8
Q

What are the top most common self-reported chronic pain events?

A

Back pain (22.2% in women, 19.8% in men)
Arthritis (19.2% in women, 12.6% in men)
Migraine (14.9% in women, 6.6% in men)
Bowel disorder/Crohn’s disease/colitis (6.1% in women, 2.9% in men)

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9
Q

What are the most common parts of the body that chronic pain resides in?

A

Unspecified back (24%)
Lower back (18%)
Knee (16%)
Head (15%)
Leg (14%)

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10
Q

What is comorbidity?

A

The simultaneous presence of two or more diseases.

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11
Q

What is pain comorbid with?

A

Sleep problems, anxiety, depression, cognitive issues, drowsiness, and lack of energy.

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12
Q

What is a Kaplan-Meier plot?

A

It starts at a certain point with everyone alive, and every time someone dies, the line ticks down one and creates a curve to show the death rate over time.

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13
Q

What are the top three causes of death?

A

Cardiovascular disease, cancer, and pulmonary disease.

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14
Q

What is the annual cost of headaches?

A

$14 billion

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15
Q

What is the annual cost of back pain?

A

$200 billion

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16
Q

What is the annual cost of arthritis?

A

$189 billion

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17
Q

What did Aristotle think about pain?

A

Pain is an emotion; like all emotions, it lives in the heart.

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18
Q

What did Galen think of pain?

A

Pain is a sensation; like all sensations, it lives in the brain.

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19
Q

What did Avicenna think about pain?

A

Pain is an independent sensation from touch or temperature.

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20
Q

What did Descartes think about pain?

A

He was the first to talk about a pain pathway from the body to the brain.

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21
Q

What is theodicy?

A

The question of why God would permit evil in the world if God is good.

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22
Q

What is utilitarianism?

A

The idea that the thing to do in any situation is the thing that brings the most good and the least bad - pleasure vs. pain. You want to maximize pleasure and minimize pain.

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23
Q

What is the mind-body problem?

A

The issue of ‘how is it possible that the body can produce the mind and are they the same or different?’

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24
Q

What is the dualist perspective on the mind-body problem?

A

A soul lived in the body, and when you died, it left.
This was Descartes’ view.

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25
What is the monist perspective on the mind-body problem?
The mind is a secretion of the brain feeling as thought it were a separate thing as an epiphenomenon.
26
When did Montreal declare that pain management was a fundamental human right?
2010
27
Which countries have the highest opioid consumption?
Canada, Switzerland, Germany, Spain, and Denmark.
28
Which countries have the lowest opioid consumption?
West Africa, Venezuela, Egypt, Chile, and the United Arab Emirates.
29
What was the old definition of pain and when was it created?
'An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.' It was created in 1979.
30
What were some of the problems with the old definition of pain?
1) Masochists exist and they don't find pain necessarily unpleasant 2) Stimulus/response mismatch 3) sensitization vs. habituation 4) Sometimes people don't have actual or potential tissue damage, but it still hurts (phantom limb pain) 5) The verb describe implies that if you cannot verbally describe your pain, you do not have it (implying that babies, animals, and those who are mute cannot feel pain)
31
What is the stimulus/response mismatch?
The intensity of the pain does not predict the pain levels. If pain were a sensation, the correlation would be much higher.
32
What is sensitization vs. habituation?
Habituation is the phenomenon whereby repeated or continuous exposure to a stimulus decreases the subjective strength of the perception. All sensations habituate except for pain.
33
What is the adequate stimulus for pain?
Pungent natural compounds, noxious cold, heat, environmental irritants, inflammatory peptides, and noxious mechanical stimuli.
34
What is the new definition of pain and when was it created?
'An unpleasant sensory or emotional experience associated with, or resembling that associated with, actual or potential tissue damage.' It was created in 2020.
35
What is nociception?
The operation of the circuitry that results in pain perception - pain is the conscious perception of what nociception eventually produces.
36
What is the Thermal Grill Illusion?
You set up a series of bars that can be heated or cooled intermittently. If you touch one bar, you will either feel cool or hot; there will be no pain. However, if you put your hand on several at once, the perception you feel is described as a 'burning cold', and you will not be able to keep your hand on the grill for more than a few seconds. You feel pain, however there is no nociception or noxious stimulus to process.
37
What is Fordice's Rainbow?
A model of pain created by Fordice. In the center there is nociception, then pain, then suffering, then pain behaviour.
38
How long does acute pain last?
Second to minutes
39
Why do we have acute pain?
Your body's way of telling you that you are experiencing actual or potential tissue damage and to make it stop. Also a way of teaching you not to do that again.
40
How long does tonic pain last?
Hours to weeks.
41
Why do we have tonic pain?
Your body's way of punishing movement to help with healing and to stave off infection.
42
How long does chronic pain last?
Weeks to years.
43
Why do we have chronic pain?
There is no evolutionary advantage; it is a pathology.
44
What is CIPA?
Congenital insensitivity to pain with anhidrosis (inability to sweat). Also known as HSN (hereditary neuropathy type IV)
45
What is the splitting vs. lumping problem?
Should things with similarities be lumped together in a group (fewer things), or should they be split due to their differences (more precise)?
46
How can you split pain?
Duration, etiology, location, symptoms, etc.
47
What is etiology?
The type of pain that something is.
48
What is superficial pain?
Skin pain.
49
What is deep pain?
Muscle, joint, and bone pain.
50
What is visceral pain?
Internal organ pain that is poorly localized.
51
What is neuropathic pain?
Pain that feels like it's in your skin, but is actually in your nerves or brain.
52
What is spontaneous pain?
Continuous and paroxysmal (episodic)
53
What is evoked pain?
Pain hypersensitivity. Allodynia and hyperalgesia (heat, cold, mechanical, or vibration). Static vs. dynamic (poke vs. brush). Activity-evoked.
54
What is paresthesia?
A sense that is strange but isn't pain.
55
What is dysethesia?
A strange sensation that isn't pain, and you don't like it.
56
After what amount of time is pain considered to be chronic?
3 to 6 months.
57
What are paradoxical thermal sensations?
Feeling something hot where it should be cold and vice versa.
58
What are aftersensations?
Sensations that last too long.
59
What is allodynia?
A situation where a previously non-noxious stimulus is now noxious.
60
What is hyperalgesia?
A situation where a previously noxious stimulus is now more noxious.
61
What is the difference between a symptom and a sign?
A symptom is reported by the patient; a sign is something that shows up in medical tests.
62
What are some advantages of chronic pain and the hypersensitivity produced by chronic pain?
It reminds you that you're injured and makes you hypervigilant to social stimuli.

PSYC 302 (7 decks)

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