Pain 1

Question 1

Define pain

Answer 1

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

Question 2

What is the epidemiology of pain

Answer 2

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

Question 3

What is a synaptic transmission?

Answer 3

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

Question 4

How do drugs affect the synaptic transmission

Answer 4

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

Question 5

What is an active potential?

Answer 5

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

Question 6

How are action potentials stoped?

Answer 6

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

Question 7

How do local aesthetics work?

Answer 7

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

Question 8

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

Answer 8

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

Question 9

Define Nociceptors:

Answer 9

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

Question 10

define transduction

Answer 10

the process of converting a stimuli into a nerve impulse

Question 11

What causes a membrane potential to produce an action potential?

Answer 11

Question 12

What is the transduction process at the periphery?

Answer 12

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

Question 13

What are transient receptor potential (TRP) channels?

Answer 13

TRP are receptor molecules that respond to strong stimuli

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

Question 14

What are the characteristic of A type fibres

Answer 14

myelinated

action potential take 20m/sec

respond to mechanical and mechanothermal stimuli

Question 15

what are the characteristic of C fibres?

Answer 15

Not myelinated

slow fibers 2m/s

polymodal fibres: respond to many modalities of stimuli

• chemical
• mechanical
• thermal

Question 16

WHat is epicritic pain?

Answer 16

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

Question 17

what is protopathic pain?

Answer 17

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

Question 18

What is the trigeminal pain pathway?

Answer 18

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

Question 19

What is the spinothalamic pain pathway?

Answer 19

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

Question 20

Define nociceptive pain?

Answer 20

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

Question 21

Define neuropathic pain

Answer 21

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

Question 22

Define Acute pain

Answer 22

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

Question 23

Define chronic pain

Answer 23

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

Question 24

what are the three dimensions of pain?

Answer 24

1. sensory discriminative
2. motivational affective:
3. cognitive evaluative

Question 25

What is hyperalgesia?

Answer 25

increased pain sensitivity

Question 26

What is allodynia

Answer 26

painfull response to stimuli that would normally be painfull

Question 27

what is hypoalgesia

Answer 27

absence o pain in response to stimuli that would be painful

Question 28

what is Dysesthesia?

Answer 28

an unpleasant abnormal sensation whether spontaneous or evoked

Question 29

what is neurogenic pain?

Answer 29

pain caused by primary injury or dysfunction or disruption in PNS or CNS

Question 30

what is a pain threshold?

Answer 30

the least experience of pain a subject can identify

Question 31

what is pain tolerance?

Answer 31

the greatest level of pain a subject can feel

Question 32

what is a noxious stimulus?

Answer 32

an actual or potential tissue-damaging stimulus

Question 33

what is a nociceptor?

Answer 33

sensory receptor that transmits a noxious stimulus

Question 34

what is nociception?

Answer 34

the neural process of encoding and procesing noxious stimulus

Question 35

what is sensatization?

Answer 35

increased responsiveness of neurons to their normal imput

Question 36

What is the intensive (intensity) pain theory?

Answer 36

Pain is an emotion that occurs when a stimulus is stronger than usual

Question 37

What is the pain Specificity theory?

Answer 37

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

Question 38

What is the pain Strong's theory?

Answer 38

Pain is an experienced based on _both_ a **noxious stimulus** and a **psychic reaction of displeasure** provoked by the sensation.

Question 39

What is the pattern pain Theory?

Answer 39

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

Question 40

WHat is the gate control pain theory?

Answer 40

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

Question 41

What is the neuromatrix pain theory?

Answer 41

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.

Question 42

What is cancer pain?

Answer 42

Cancer Pain: Pain associated with a neoplastic process or its treatment (eg radiotherapy) which pathologically-speaking, may be nociceptive and/or neuropathic in nature.

Question 43

What is cutaneous pain

Answer 43

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.

Question 44

what is somatic pain

Answer 44

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.

Question 45

What is visceral pain?

Answer 45

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).