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1

Define pain

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

2

What is the epidemiology of pain

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

3

What is a synaptic transmission?

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

4

How do drugs affect the synaptic transmission

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

5

What is an active potential?

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

6

How are action potentials stoped?

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

7

How do local aesthetics work?

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

8

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

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

9

Define Nociceptors:

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

10

define transduction

the process of converting a stimuli into a nerve impulse

11

What causes a membrane potential to produce an action potential?

12

What is the transduction process at the periphery?

  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 

13

What are transient receptor potential (TRP) channels? 

TRP are receptor molecules that respond to strong stimuli 

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

14

What are the characteristic of A type fibres

myelinated 

action potential take 20m/sec 

respond to mechanical and mechanothermal stimuli

15

what are the characteristic of C fibres?

Not myelinated

slow fibers 2m/s

polymodal fibres: respond to many modalities of stimuli

  • chemical
  • mechanical
  • thermal

16

WHat is epicritic pain?

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

17

what is protopathic pain?

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

18

What is the trigeminal pain pathway?

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

19

What is the spinothalamic pain pathway?

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

20

Define nociceptive pain?

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

21

Define neuropathic pain

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

Define Acute pain

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

Define chronic pain

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

what are the three dimensions of pain?

  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