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BSNC 2000 > Pain > Flashcards

Pain Flashcards

(65 cards)

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1
Q

Physiological process of pain

A

transduction
transmission
perception
modulation

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2
Q

Nociceptors

A

sensory neurons that detect painful stimuli

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3
Q

Chemical Mediators causing pain

A 
prostaglandins (tissue cell membrane)
histamine (mast cells)
bradykinin (liver protein)
serotonin (platelets)
substance P
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4
Q

Epidemiology of pain in OA

A

> 50% in community have chronic pain

>80% in nursing homes have chronic pain

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5
Q

Acute Pain

A

rapid onset
clearly linked to triggering injury/event
short duration
decreases with healing

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6
Q

Chronic Pain

A

pain lasting >3 months. can last years

can be d/t underlying pathology, injury, medical treatment, inflammation, neuropathic

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7
Q

Pain Theories

A

gate-control theory

neuromatrix theory

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8
Q

Eudynic pain

A

normal transduction of pain sensation d/t noxious stimuli

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9
Q

Types of pain

A

referred
cutaneous
somatic
visceral

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10
Q

Somatic pain

A

sharp pain localized to an area of injury

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11
Q

Visceral pain

A

pain that occurs w/i a body cavity (thorax, abdomen, pelvis)
may radiate to other area
caused by: swelling, stretching, hypoxia

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12
Q

Hypoxia

A

pain caused by decreased availability of oxygen to tissue cells
can occur d/t hypoperfusion or hypoxemia

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13
Q

Nociceptive pain

A

eudynic pain

normal associated with tissue injury

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14
Q

Neuropathic pain

A

caused by disease or pathology to the somatosensory system

pain sensation that originates in the PNS/CNS without afferent stimuli

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15
Q

Neuropathic pain exemplars

A 
postherpetic neuralgia
diabetic neuropathy
phantom pain
trigeminal neuralgia
post-stroke pain
complex regional pain syndrome
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16
Q

Individual Risk Factors

A

communication barriers

cognitive impairment or developmental barriers

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17
Q

Pain assessment tools

A

pain scale (numbers or faces)
self-assessment
behavioral pain tools

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18
Q

Analgesic classes

A

non-opioid
opioid
adjuvant analgesic

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19
Q

Non-Opioid analgesia

A

acteminophen
NSID
COX-2 selective NSAID
*mild pain. used as an adjunct w/ opioids

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20
Q

Opioid analgesia

A 
hydromorphone
oxycodone
fentanyl 
morphine
*moderate-severe pain
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21
Q

Adjuvant analgesai

A

anticonvulsant (gabapentin)
local anesthesia
antidepressant

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22
Q

First Line Treatment for Neuropathic Pain

A

anticonvulsants (gabapentin)

antidepressants

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23
Q

Somatic Senses

A

pain
touch
temperature
proprioception

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24
Q

Types of somatic neurons

A

general - pain, touch, temp. widespread
special somatic - muscles, joints, tendons. proprioception & kinesthesia
general viscera - viscera. fullness & discomfort

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25
Somatosensory pathway
1st order neuron - periphery to CNS 2nd order neuron - reflex/sensory pathway. spinal cord --> thalamus 3rd order neuron - thalamus --> cerebral cortex
26
Types of somatosensory fibers (peripheral)
A, B, C
27
Sensory neurons transmitting info from limbs/trunk
first-order dorsal root ganglia
28
Sensory neurons transmitting info from head
trigeminal sensory neurons
29
A-delta fibers
myelinated. fastest rate of conduction detect somatic stimuli (touch, heat, heat/mechanical pain) associated with withdrawal reflex
30
B fibers
myelinated | detect cutaneous/subcutaneous stimuli
31
C fibers
non-myelinated. slowest rate of conduction | detect warm-hot mechanical/chemical pain, heat-cold pain
32
Hyperalgesia
hypersensitivity to pain
33
Pain etiology
nociceptive - stimulation of pain receptors | neuropathic - damaged or dysfunctional sensory axons
34
Pain threshold
minimum amount of stimuli required for pain perception
35
Pain tolerance
maximum amount of pain a person is willing to tolerate
36
Peripheral nerve fibers that detect pain
A & C
37
Pain Classification
duration (acute, chronic) location (cutaneous, somatic, visceral, referred) etiology (nociceptive, neuropathic) frequency (intermittent, constant)
38
Somatic tissue
muscle joints tendons periosteum
39
Physiological pathway of pain
1st order 2nd order. decussates and ascends to thalamus 3rd order
40
Factors influencing pain
``` psychological state cultural/spiritual other (age, sex, comorbidities) cognitive past experience ```
41
Noxious Stimuli
mechanical thermal chemical
42
Mechanical stimuli
pressure swelling/distension incision, cut, abrasion
43
Thermal stimuli
burns (contact, fire, electrical, radiation) scalds (steam, hot liquid) frostbite
44
Chemical stimuli
inflammatory or chemical mediators acid capsaicin
45
Substance P
neuropeptide released by C-fibers at the dorsal horn | may result in unlocalized pain d/t diffusion of neuropeptide
46
Cutaneous pain
superficial structures can have slow or rapid onset sharp, burning localized region
47
Somatic pain
deeper somatic structures (periosteum, bone, muscle, tendon, joints) diffuse area radiation can occur
48
Visceral pain
occurs in the organs. caused by damage to visceral walls usually diffuse, unlocalized area. can be referred elsewhere. commonly associated with pathology & SNS symptoms
49
Referred pain
pain that manifests in a location different from the origin moreso assoc with visceral > somatic pain occurs d/t convergence of somatic/visceral afferent neurons in the spinal cord & embryologic origin of tissue
50
Examples of referred pain
peritoneum --> umbilicus diaphragm --> shoulder myocardium --> radiating up jaw or down arm
51
Characteristics of acute pain
``` <3-6 months recent onset nociceptive assoc with SNS symptoms , anxiety subsides when underlying pathology resolved protective function ```
52
Characteristics of chronic pain
>3-6 months no SNS activation psychological/behavioral changes (irritability, anxiety, depression, withdrawal, decreased sleep, libido, appetite changes) pathological condition
53
Types of opioid receptros
mu | kappa
54
Mu side effects
``` analgesia pupillary constriction respiratory depression decreased GI motility euphoria physical dependence ```
55
Kappa side effects
some analgesia pupillary constriction sedation dysphoria
56
Transduction
transformation of sensation into neurochemical stimulus that travels from sensory receptor --> spinal cord
57
Transmission
transmission of nerve impulse from spinal cord to cortex for processing
58
Perception
conscious awareness/perception of painful stimuli
59
Modulating
release of endorphins/chemicals that help minimize or affect the sensation of pain
60
4 P's of Pain Mgmt
Prevention Psychological Physical Pharmaceutical
61
Preventive pain mgmt
mobilization use of mobility aids proactive referrals use of braces/splints
62
Psychological pain mgmt
``` Guided imagery Meditation Relaxation techniques Reiki Counseling Humor ```
63
Physical pain mgmt
``` RICE hot/cold therapy acupuncture TENS machine massage physiotherapy positioning exercise ```
64
Pharmaceutical mgmt
Opioid analgesics Non-opioid analgesics Adjuvant analgesics
65
PQRST
``` provoking/palliative factors quality/quantity region/radiation severity temporal ```

BSNC 2000 (9 decks)

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