Flashcards in Lecture 7 - Anatomy & Physiology of Pain Deck (148)
-unpleasant sensory and emotional experience
-pain is whatever the experiencing person says it is
-pain is a perception
Is there a way to quantify pain?
No - no way to quantify pain objectively or biochemically
Is pain proportional to tissue damage?
may or may not be
_______ is usually the issue because of subjective nature of pain
Pain amplifies the body's stress response (_____) to traumatic injury
sympathetic nervous system
Pain ____ patient's recovery from trauma, surgery, and disease.
Pain overactivates the SNS:
what are symptoms of this?
-keeps intestines from working properly
-lasts less than 6 months
-subsides once the healing process is accomplished
-involves complex processes and pathology
-usually involves altered anatomy and neural pathways
-constant and prolonged
-lasts longer than 6 months and sometimes, for life
_____ and ______ systems are significantly affected by the pathophysiology of pain
Give examples of how cardiovascular and respiratory systems are significantly affected by the pathophysiology of pain
-adrenergic stimulation (SNS)
-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)
-suppression of immune functions, predisposing trauma patients to wound infections and sepsis
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
Why is it important to treat pain?
so it doesn't become chronic pain and worsen the condition
T or F: neuropathic pain is always from a known cause
False - it can be from a known or unknown cause
Two types of neurons involved in pain pathway: Describe them
1) A-delta: first pain, sharp
2) C: second pain, dull
specialized receptors = ?
free nerve endings
Types of stimulation of pain pathway? (3)
4 distinct processes
local biochemical changes in nerve endings that generate a signal
movement of that signal from the site of pain to the spinal cord and brain
Synthesis and analysis in the brain
Endogenous systems in place that can inhibit pain at any point along the pathway
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
Substances released from traumatized tissue during transduction that cause pain?
histamine - inflammation and exacerbation
prostaglandin - target of NSAIDS
Substances released from traumatized tissue during transduction that cause ??
cell depolarization by sodium flux
How do NSAIDs (aspirin, ibuprofen, and diclofenac) help with pain during transduction?
reduce pain because they minimize the production of prostaglandins
How do corticosteroids (cortisone and dexamethasone)
also inhibit prostaglandins as well as other inflammatory mediators
-initial damage/ stimulation
-central structures of brain (where pain is processed)
Transmission requires ___________