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Phys agents > pain > Flashcards

pain Flashcards

1
Q

what is pain?

A

an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage

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2
Q

is there always tissue damage with pain?

A

no there may or may not have tissue damage

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3
Q

T/F: there are pain receptors in the body

A

false the correct terms are nocicpetors

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4
Q

which fiber type conduct pain?

A

a and c fibers

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5
Q

what are c fibers?

A

they are unmyelinated fibers, create longer lasting and slower pain normally a day or 2 later

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6
Q

what are a fibers?

A

thinly myelinated create initial pain

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7
Q

what do tissues do?

A

they tell you what is going on

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8
Q

what makes the final decision?

A

the brain

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9
Q

which fibers are nociceptive?

A

C and A delta fibers

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10
Q

what do nociceptive fibers do?

A

free nerve endings that convey pain, temperature, and crude touch

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11
Q

which fibers are non nociceptive?

A

A beta fibers

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12
Q

what do non nociceptive fibers do?

A

touch, pressure, and vibration (fake pain)

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13
Q

what are the three ways for the nervous system to be stimulated?

A
  1. mechanically
  2. thermally
  3. chemically
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14
Q

T/F: the amount of pain and the severity of an injury do not always correlate with each other

A

true
ex) painless battle wounds, painless nail in head, and phantom limb pain

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15
Q

what is one of the most common reasons people seek care from physical therapists?

A

pain

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16
Q

when does pain normally resolve for acute tissue injury and infection?

A

48-72 hours

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17
Q

T/F: pain isn’t subjective and not always real

A

False pain is always subjective and always real

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18
Q

what are some contextual factors contributing to the experience of pain?

A

biological, physical, psychological, occupational, social, cultural, and environmental factors

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19
Q

how do we feel pain?

A

through ascending pathways

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20
Q

describe the ascending pathway

A

injury to body
release of cytokines
PGs stimulate C fibers and A delta fibers
C fibers and A delta fibers carry the nociceptive information to the ipsilateral dorsal horn of the spinal cord
at the same time information from surrounding levels are also sensing information that needs to be regulated

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21
Q

where do first order neurons synapse?

A

on the substantia gelatinosa

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22
Q

first order neurons activates substance P which activates what?

A

second order neurons which project to the spinothalamic tract

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23
Q

what is sensed in the anterior spinothalamic tract?

A

crude touch

24
Q

what is sensed in the lateral spinothalamic tract?

A

pain and temperature

25
Q

where do second order neurons ascends through?

A

spinal cord and the brain stem and projects to the thalamus

26
Q

what happens in the thalamus?

A

the second order neuron will synapse on third order neuron

27
Q

what does the third order neuron project on?

A

to the primary somatosensory cortex on the left side of the brain

28
Q

what do the ascending pathways do what?

A

detect pain

29
Q

what do the descending pathways do?

A

control pain

30
Q

where is nociceptive information sent to?

A

dorsal horn

31
Q

do non noxious stimulus get sent to the brain?

A

no

32
Q

T/F: interneurons are mainly inhibitory

A

true

33
Q

how are touch fibers (A beta fibers) activated?

A

with light touch, pressure, or vibration

34
Q

touch receptors send action potentials into where and give off what?

A

posterior grey horn and give off collateral neurons which synapse on interneurons

35
Q

what do interneurons release?

A

gamma aminobutyric acid (GABA)

36
Q

what does GABA inhibit?

A

activity at substantia gelatinosa (which inhibits substance P)

37
Q

what is pain inhibition also known as?

A

the gate control theory

38
Q

during the descending analgesic pathway activation of a delta and c fibers produce what?

A

stimulation of hypothalamus, thalamus, cortex, and amygdala that causes a projection of the periaqueductal grey matter and stimulation of the lotus

39
Q

projections down to substantia gelatinosa of the dorsal horn when releases?

A

NE and serotonin to interneurons in dorsal horn

40
Q

what do interneurons release?

A

enkephalins, endorphins, and dynorphins which inhibit substantia gelatinosa resulting in decreased pain

41
Q

what is acute pain?

A

a natural sensation that warns of possible injury

42
Q

what is chronic pain?

A

defined as pain lasting more than 3 months. serves no benefits, cognitive and emotional factors have a critical influence on pain perception

43
Q

how does central sensitization (allodynia) play a huge role in chronic pain?

A

with persistent nociception via C fibers, permanent neuroplastic changes are likely to occur, after constant barrage from C fibers, the interneuron may die due to high levels of amino acids. decreased ability to modulate nociception and the pain experience, now everything gets projected to the brain including light touch which may now be painful

44
Q

what can allodynia result in?

A

in spreading pain or mirror pain from abnormal synapsing in spinal cord

45
Q

sensory maps are genetically determined and sculpted based on?

A

movement and exercising it

46
Q

what is smudging?

A

not using a body part therefore losing it

47
Q

what are central changes that occur with/are caused by pain?

A

homunculus become blurry
enlarged map
difficulty with L vs R discrimination

48
Q

what is central processing of persistent pain?

A

when the brain starts questioning its map, threat level of nervous system goes up and can cause pain or increase pain for a prolonged period of time. this smudging of map causes a ramp ip phenomena of nervous system because the brain wants to know more

49
Q

how does a stressful situation affect pain and the development of chronic pain?

A

if you hurt yourself in a high stress environment, you are 8X more likely to develop chronic pain
ex) surgery, car accident, work, abuse

50
Q

how do sport situations affect pain and the development of chronic pain?

A

kids who play contact sports in life experience less pain in life
ex) learn injury and pain is normal

51
Q

How does pain work in the brain and ask if it is being threatened?

A

potentially novice-give information is sent up to the brain via ascending system and the brain processes this via the neuromatric and asks “am I in danger”

52
Q

what happens if the brain thinks it is in danger?

A

it wants to know more information known as facilitation

53
Q

what happens if the brain doesn’t think it is in danger?

A

it concludes no threat and we see inhibition

54
Q

what is occurring when we experience pain and the fight or flight response is active?

A

adrenocorticotropic hormone (ACTH) is released from pituitary gland to stimulate the adrenal glands to produce adrenaline. cortisol helps to mobilize glucose reserves but can leave you feeling sore, tired, sensitive, and fatigued

55
Q

how does cortisol affect the immune system?

A

chronic conditions including stress- 3 immune chemicals seem to be very active. nerves become more sensitive to immune system

56
Q

what are some effects of long term pain?

A

fatigue, insomnia, and hypervigilance

Phys agents (12 decks)

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