Pain

Question 1

What is pain

Answer 1

Unpleasant sensory and emotional experience, asssoc with actual tissue damage or described in terms of such damage

Question 2

What are the 4 process in physiology of pain

Answer 2

Transduction
Transmission
Modulation
Perception

Question 3

What is transduction

Answer 3

Translation of noxious stimulus into electrical activity at the peripheral nociceptors

Question 4

What is transmission

Answer 4

Propagation of pain signal as nerve impulses through nervous system

Question 5

What is modulation

Answer 5

Hindering of pain transmission in the nervous system e.g. inhibitory neurotransmitters like endogenous opioids

Question 6

What is perception

Answer 6

Conscious experience of pain

Question 7

What are nociceptors

Answer 7

Specific primary sensory afferent neurones normally activated by intense noxious stimuli e.g. mechanical, thermal, chemical

Question 8

What are the function of nociceptors

Answer 8

First order neurones that relay info to 2nd order neurones

Question 9

Where do second order neurones ascend from

Answer 9

Spinal cord in the anterolateral system ( terminates in the thalamus (

Question 10

What are the subtypes of nociceptors

Answer 10

Delta fibres

C fibres

Question 11

What are delta fibres

Answer 11

Mechanical / thermal nociceptors, thinly myelinated

Medicare fast and first pain, SHARP

Question 12

What are C fibres

Answer 12

Unmyelinated, response to all noxious stimuli
Mediate second or slow
Achy, dull pain

Question 13

What are classifications of Paul

Answer 13

Nociceptive pain, inflammatory, pathological, neuropathic / dysfunctional

Question 14

What is nociceptive pain

Answer 14

Normal Response to injury of tissue by noxious

Function is a early warming physiological protective system to detect and avoid

Question 15

What is inflammatory pain

Answer 15

Caused by activation of immune system by tissue injury or infection
Discourages physical contact with affected pain and discourages moment

Question 16

What are the two types of pathological pain

Answer 16

Neuropathic and dysfunctional

Question 17

What is neuropathic pain

Answer 17

Caused by damage of neural tissue

Can be burning, shutting, numbness, pin and needles

Question 18

What is dysfunctional pain

Answer 18

No identifiable damage or inflammation

Question 19

Can pathological pain be treated with analgesics

Answer 19

NO

Question 20

Features of mechanical back pain

Answer 20

Presents age: 20-55

Lumbosacrol region, bum and thighs

Question 21

Features of nerve root pain

Answer 21

Unilateral leg pain
Radiates to foot or toes
Numbness or Paraesthesia in same distribution

Question 22

What are serious spinal pathology

Answer 22

Cauda equina syndrome

Acute flaccid foot

Question 23

Risk factors for serious spinal pathology

Answer 23

Severe night pain 
Cancer 
Systemic steroids, premature menopause, DMARDS 
Tb/ IV drug abuse / HIV 
Unexplained weight loss 
Widespread neurological changes 
Structural deformity

Question 24

What is cauda equina syndrome

Answer 24

Saddle anaesthesia ( anus, perineum, genitals)
Difficultly with micturition
Loss of anal sphincter tone or faecal incontinence
Widespread or progressive motor weakness in the leg or gait disturbance