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Pain Flashcards

1
Q

Cartesian model of pain states

A

All pain is caused by injury and increased pain means more damage

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2
Q

3 treatments from the Cartesian model

A

Avoidance
Injections/meds
Surgery

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3
Q

Pain def

A

An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage

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4
Q

3 types of pain

A

Nociceptive pain
Neuropathic pain
Central sensitization (cs) pain or nociolastic pain

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5
Q

Nociolastic pain def

A

Pain that arises from altered nociception despite no clear evidence of actual or threatened tissue damage causing the activation of peripheral nociceptors or evidence for disease or lesion of the somatosensory system causing the pain

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6
Q

Nociceptive pain description

A

Damage to body tissue usually localized and diminishes naturally

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7
Q

Neuropathic pain description

A

Derive from CNS/PSN damage or disorder/disease causing pain and sensory dysfunction

They are neuroanatomically logical

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8
Q

How is pain described in Nociceptive pain

A

Sharp achy throbbing

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9
Q

How is pain described in nueropathic pain

A

Burning
Shooting
Pricking

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10
Q

Central sensitization pain or nociolastic pain would be described as

A

Vague or dull

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11
Q

Def dysesthesia

A

Unpleasant abd normal sensation (encoded or spontaneous)

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12
Q

Allodynia def

A

Pain encoded by stim that is not usually noxious

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13
Q

Hyperalgesia def

A

Excessive sensitivity to stimuli that are normally mildly painful

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14
Q

2 types of dysesthesia

A

Allodynia

Hyoeralgesia

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15
Q

When part of your body is injured, special pain receptors convey the pain messages to your brain: t/f

A

False

Receptors send Nociceptive (a sensation) and the pain is interpreted by the brain

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16
Q

Pain only occurs when you’re inured: t/f

A

False

Injury or degenerative processes may be present in absence of pain

Significant pain may be present with no identifiable disease process or after tissue healing (emotional experience - cane develop due to emotional overload)

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17
Q

The timing and intensity of pain matches the timing and

number of signals in nociceptors (danger receptors): t/f

A

False

Repeated stimulation can result in a progressive increase in action potentials (action potential wind up)

  • if prolonged can result in death of interneuron
  • can also change receptors in the end order neuron (can increase danger messages)
18
Q

Nerves should connect a body part to the brain in order for that part to be in pain: t/f

A

False

Phantom limb pain

Pain dependent on how the body part is represented in the somatosensory homunculus

19
Q

In chronic pain, the central nervous system becomes more sensitive to nociception: t/f

A

True

Changes interneurons, second order neurons, expands and sprouts receptor fields > increasing sensitization

Changes descending modulation (endogenous chemicals reduced in chronic pain)

20
Q

The body tells the brain when it is in pain: t/f

A

False

Body sends Nociceptive signals and Brian interprets how they are expressed (neuro/pain tag or pain neuromatrix)

21
Q

Pain neurotag includes what structures (bonus: what do they do?)

A

Premotor/motor cortex: org. Motor reaction
Cingulate cortex: concentration
Prefrontal cortex: problem solving and memory
Amygdala: fear, fear conditioning
Sensory cortex: sensory discrimination
Hypothalamus/thalamus: stress response, autonomic dev, motivation
Cerebellum: coordination and movement
Hippocampus: memory, recognition, fear conditioning
Spinal cord : gate to periphery

22
Q

The brain sends messages down your spinal cord that can increase the nociception (danger messages) going up your spinal cord: t/f

A

True

Changes in the CNS as a result of action potential windup allow for increased info to be processed in the brain

23
Q

Nerves adapt by increasing resting level of excitement: t/f

A

True

Various types of ion channels exist on nerves
• Voltage, chemical, temperature, mechanical, immune, spontaneous, hydrogen, light-gated

24
Q

Ion channels posses _______________ characteristics

A

Neuroplastic

Can change sensitivity

25
Q

Ion expression continually changes: half life is reported to be __________

A

48 hrs

26
Q

Chronic pain means that an injury hasn’t healed properly: t/f

A

False

27
Q

Receptors on nerves work by opening ion channels (gates) in the wall of the nerve: t/f

A

True

Ion channel expression is dependent on genetic coding and brains expression of survival needs

Challenge expression constantly changes: (increased expression can cause sensitivity)

28
Q

Worse injuries always result in worse pain

A

False

29
Q

Environment has no effect on the amount of pain: t/f

A

False

Injuries in high stress environments are 7-8 times more likely to result in persistent pain

30
Q

It is possible to have pain and not know about it

A

False

Pain is a conscious decision by the brain

31
Q

The placebo effect is an _________ mechanism to modulate pain experience

A

Endogenous

32
Q

Second order neuron activation is dependent on

A

Amount of nociception from tissues
interneuron activity

competing info from contralateral side of the body and spinal levels above and below

ion channel availability in second-order neuron

availability of neurotransmitters & descending modulation

33
Q

In persistent pain, a ____________ (greater/lesser) concentration of f protein channels may be seen in second order neurons

A

Greater

34
Q

When you are injured, chemicals in your tissues can make nerves more sensitive: t/f

A

True

Can influence opening/closing of specific ion channels

Adrenaline and cortisol (can increase sensitivity)

35
Q

What is the stress response

A

Response during an immediate threat is complex and involves multiple body systems
• Adrenaline, muscles, language, breathing, GI system, other

36
Q

Effects of cortisol

A

Primarily increases blood sugar, suppresses the immune system and aids in fat, protein and
carb metabolism
• Prevents release of substances that cause inflammation
• Increases cytokines which can increase inflammatory process throughout body

37
Q

Chronic pain demonstrates differences in ___________ function

A

Cns

38
Q

Chronic pain = “_______________ neuroplasticity” or ________________

A

Maladaptive

Increased sensitivity

39
Q

Chronic pain can be associated with …..

A

Associated with abnormal intracortical inhibitory mechanisms
• Bodily-related neural representations become less precise= “Smudging”

Ultimately the increased sensitivity and decreased precision contribute to complexity of chronic pain

40
Q

Testing for sensitive nervous system

A
  • Graphesthesia
  • Grid Localization
  • 2-Point Discrimination
    • Pain Pressure Thresholds
    • NeurodynamicTesting
    • Nerve palpation
    • Left/Right Discrimination
41
Q

When testing the goal is to achieve ________% accuracy

A

80

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