Pain 1 Flashcards

(46 cards)

1
Q

Define pain

A

Unpleasant sensory and emotional experience associated with actual or potential tissue damage

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2
Q

What is the epidemiology of pain

A

50% of patients experience moderate to severe post surgical pain 3-4.5% of the world suffer neuropathic pain

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3
Q

What is a synaptic transmission?

A

steps in the passage of a signal from one nerviest to another.

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4
Q

How do drugs affect the synaptic transmission

A

1) CA2+ block to prevent inflow (gabapentin) 2) block release of neurotransmitter 3) prevent neurotransmitter from binding with receptor

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5
Q

What is an active potential?

A

the movement of a signal along the axon of a nerve cel. channels are opened allowing flow of Na+ and Ca2+ into nerve cell. K+ close the channels returning to resting level

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6
Q

How are action potentials stoped?

A

nociceptive signals are blocked by blocking the action of the channels that control the movement of ons in the membranes.

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7
Q

How do local aesthetics work?

A

they stop Na+ channels from working, thus stop action potentials. (procaine)

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8
Q

What are the division and the definitions of the sensory systems?

A

1) Sensory system: transmits innocuous stimuli to touch pressurere warmth 2) Nociceptive: tissue damaged

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9
Q

Define Nociceptors:

A

free nerve ending that respond to stimuli that can cause tissue damage, or tissue damaged has been caused.

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10
Q

define transduction

A

the process of converting a stimuli into a nerve impulse

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11
Q

What causes a membrane potential to produce an action potential?

A
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12
Q

What is the transduction process at the periphery?

A
  1. chemical, mechanical, thermal stimuli
  2. changes in the receptor
  3. increase in ion flow across membrane (Na+ Ca2+)
  4. depolarisation of membrane potential
  5. action potential
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13
Q

What are transient receptor potential (TRP) channels?

A

TRP are receptor molecules that respond to strong stimuli

when mechanical, thermal and chemical stimuli produce a pain sentastion.

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14
Q

What are the characteristic of A type fibres

A

myelinated

action potential take 20m/sec

respond to mechanical and mechanothermal stimuli

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15
Q

what are the characteristic of C fibres?

A

Not myelinated

slow fibers 2m/s

polymodal fibres: respond to many modalities of stimuli

  • chemical
  • mechanical
  • thermal
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16
Q

WHat is epicritic pain?

A

sharp fast pain felt as soon as the injury occured produced by A fibers

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17
Q

what is protopathic pain?

A

Secondary pain, dull aching and long-lasting. produced by C type fibers.

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18
Q

What is the trigeminal pain pathway?

A

Brings stimuli from the face about location intensity and quality of the pain. project the pain to the sensory cortex

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19
Q

What is the spinothalamic pain pathway?

A

Brings stimuli from the body about location intensity and quality of the pain. project the pain to the sensory cortex

20
Q

Define nociceptive pain?

A

pain due to activation in cutanous, somatic and visceral structures. Tissue injury pain. physiological alarm system.

21
Q

Define neuropathic pain

A

Pain arising as an indirect consequence of a lesion or disease affecting the somatosensory nervous system either periphery or CNS

Example

  • alcoholism
  • entrapment syndrome
  • iatrogenic causes
  • spinal cord trauma
  • post-stroke pain
  • MS
22
Q

Define Acute pain

A

Occurs as a direct result of tissue damage or potential tissue damage.

it’s a symptom

well defined onset, with clear pathology

acute serves to protect tissue damage

can be treated with drugs and manual techniques

23
Q

Define chronic pain

A

Outlasts more than 3 to 6 months of healing time

the impairment is greater than expected from the physical findings of injury

pain occurs

**chronic pain does not serve a biological purpose

24
Q

what are the three dimensions of pain?

A
  1. sensory discriminative
  2. motivational affective:
  3. cognitive evaluative
25
What is hyperalgesia?
increased pain sensitivity
26
What is allodynia
painfull response to stimuli that would normally be painfull
27
what is hypoalgesia
absence o pain in response to stimuli that would be painful
28
what is Dysesthesia?
an unpleasant abnormal sensation whether spontaneous or evoked
29
what is neurogenic pain?
pain caused by primary injury or dysfunction or disruption in PNS or CNS
30
what is a pain threshold?
the least experience of pain a subject can identify
31
what is pain tolerance?
the greatest level of pain a subject can feel
32
what is a noxious stimulus?
an actual or potential tissue-damaging stimulus
33
what is a nociceptor?
sensory receptor that transmits a noxious stimulus
34
what is nociception?
the neural process of encoding and procesing noxious stimulus
35
what is sensatization?
increased responsiveness of neurons to their normal imput
36
What is the intensive (intensity) pain theory?
Pain is an emotion that occurs when a stimulus is stronger than usual
37
What is the pain Specificity theory?
1. There are **separate nerve endings** for each variety of sensations arising from cutaneous stimulation. * touch, cold, warmth, pain 2. **Specific pain receptors** transmit signals to the pain center in the brain that **produce the perception of pain**. 3. The body has **separate sensory systems** for perceiving pain. The **pain receptors** in the perifery are called **Nociceptors** which respond to tissue damage and send signals along n_erve pathways_ (**nerves**) to **target center**s in the brain
38
What is the pain Strong's theory?
Pain is an experienced based on _both_ a **noxious stimulus** and a **psychic reaction of displeasure** provoked by the sensation.
39
What is the pattern pain Theory?
pain results from a **patterned imput from sense organs** in the skin. Sensation is a learning event that **doesn't** require a specific **sensory chanel** ## Footnote Patteren impulse: satial and temporal impulses in the CNS
40
WHat is the gate control pain theory?
Pain is carried by **slow C fibres** into the **dorsal horn**. Other cells transmit impulses from the spine to the brain. **Rubbing** the area of pain **stimulates other sensory receptors** of touch pressure and vibration The **mechanoreceptors** send the signals using **fast A fibres** that **inhibit** the **slow fibres** to r**educe the pain signal** being sent to the brain
41
What is the neuromatrix pain theory?
Pain has a widespread network of neurons. The network creates a neurosignature that projects to the brain to create awareness of pain or motor movement.
42
What is cancer pain?
Cancer Pain: Pain associated with a neoplastic process or its treatment (eg radiotherapy) which pathologically-speaking, may be nociceptive and/or neuropathic in nature.
43
What is cutaneous pain
Pain associated with activation of nociceptors of the skin. Cutaneous pain is ‘sharp’, fast, well-localised and transmitted via (in evolutionary terms) neo-nociceptive pathways (eg spinothalamic tract) to the cortex. It is a fast, reactive system that responds to external (environmental) tissue threat and is of great survival benefit.
44
what is somatic pain
Pain associated with activation of nociceptors in muscle, tendon,ligament, bone or ‘lining tissues’ such as the peritoneum. The qualities of somatic (eg musculoskeletal) pain seem to share features of both cutaneous and visceral pain, which might reflect embryology (mesoderm) or function, in evolutionary terms.
45
What is visceral pain?
Visceral pain: Pain associated with activation of nociceptors (kidney stones) or neuropathy (porphyria) in visceral organs. Visceral pain is usually poorly defined and localised (referred), often ‘dull’, ‘aching’ and diffuse and associated with considerable autonomic and emotional activation. VP is slow pain conducted by C fibers (pain arising from parietal peritoneum, pleura and pericardium is sharp, pricking type).
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