Lecture 7 - Anatomy & Physiology of Pain Flashcards Preview

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Flashcards in Lecture 7 - Anatomy & Physiology of Pain Deck (148)
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1

Define pain

-unpleasant sensory and emotional experience
-pain is whatever the experiencing person says it is
-pain is a perception

2

Is there a way to quantify pain?

No - no way to quantify pain objectively or biochemically

3

Is pain proportional to tissue damage?

may or may not be

4

_______ is usually the issue because of subjective nature of pain

Undertreatment

5

Pain amplifies the body's stress response (_____) to traumatic injury

sympathetic nervous system

6

Pain ____ patient's recovery from trauma, surgery, and disease.

stops

7

Pain overactivates the SNS:
what are symptoms of this?

-keeps intestines from working properly
-increase HR

8

acute pain

-lasts less than 6 months
-subsides once the healing process is accomplished

9

chronic pain

-involves complex processes and pathology
-usually involves altered anatomy and neural pathways
-constant and prolonged
-lasts longer than 6 months and sometimes, for life

10

_____ and ______ systems are significantly affected by the pathophysiology of pain

cardiovascular

respiratory

11

Give examples of how cardiovascular and respiratory systems are significantly affected by the pathophysiology of pain

-adrenergic stimulation (SNS)
-increased HR
-increased cardiac output
-increased myocardial oxygen consumption
-decreased pulmonary vital capacity
-decreased alveolar ventilation
-decreased functional residual activity (so decreased O2 delivery during healing, decreased cardiac O2 during increased demand)
-arterial hypoxemia
-suppression of immune functions, predisposing trauma patients to wound infections and sepsis

12

What can chronic pain result from?

acute, unrelieved pain - such as trauma, phantom limb, repeated back surgeries, etc.

can also stem fro neuromuscular disorders such as fibromyalgia, RA, MS, etc

13

Why is it important to treat pain?

so it doesn't become chronic pain and worsen the condition

14

T or F: neuropathic pain is always from a known cause

False - it can be from a known or unknown cause

15

Two types of neurons involved in pain pathway: Describe them

1) A-delta: first pain, sharp

2) C: second pain, dull

16

Pain pathway:
specialized receptors = ?

free nerve endings

17

Types of stimulation of pain pathway? (3)

-mechanical damage
-extreme temperature
-chemical irritation

18

Pain pathway:
4 distinct processes

transduction
transmission
modulation
perception

19

Transduction

local biochemical changes in nerve endings that generate a signal

20

Transmission

movement of that signal from the site of pain to the spinal cord and brain

21

Perception

Synthesis and analysis in the brain

22

Modulation

Endogenous systems in place that can inhibit pain at any point along the pathway

23

Nociceptors are involved in transduction: Describe them

-free nerve endings with the capacity to distinguish between noxious and innocuous stimuli

-when exposed to mechanical (incision or tumor growth), thermal (burn), or chemical (toxic substance) stimuli, tissue damage occurs

-substances are released by the damaged tissue which facilitates the movement of pain impulse to the spinal cord

24

Substances released from traumatized tissue during transduction that cause pain?

bradykinin
serotonin
substance P
histamine - inflammation and exacerbation
prostaglandin - target of NSAIDS

25

Substances released from traumatized tissue during transduction that cause ??

cell depolarization by sodium flux

26

How do NSAIDs (aspirin, ibuprofen, and diclofenac) help with pain during transduction?

reduce pain because they minimize the production of prostaglandins

27

How do corticosteroids (cortisone and dexamethasone)

also inhibit prostaglandins as well as other inflammatory mediators

28

Describe transmission

-initial damage/ stimulation
-nerve
-spinal cord
-brain stem
-thalamus
-central structures of brain (where pain is processed)

29

Transmission requires ___________

neurotransmitters

30

_____ inhibit release of neurotransmitters

Opioids