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Flashcards in Pain Deck (25)
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1

Definition of Pain

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

2

Types of Nociceptors

Mechanoceptors, thermoreceptors, chemical nociceptors, silent nociceptors
Can be unimodal or polymodal

3

Pain transmission

Nociceptors pick up painful stimuli, once threshold is reached an electrial signal is conducted to the spinal cord. Travels through spinothalamic tract before reaching the brain.

4

Spinothalamic tract pathways

Neospinothalamic tract - fast transmission, moves from receptor site to dorsal horn using myelinated A delta fibers and directly to the thalamus
Paleospinothalamic tract - continuous, moves from receptor site to spinal cord using unmyelinated C fibers, terminate throughout the brainstem.

5

Exhitatory mediators of Pain

Glutamate
Substance P

6

Prevention of Pain Transmission

Endorphins attach to opiate receptors inhibiting exhitatory release of substances

7

Gate Control Theory

A neural gate is present in the dorsal horn. Controlled by large and small fibers, opened once nociceptor info exceeds the inhibitory threshold, activating the pain pathway and allowing the brain to produce the conscious sensation of pain.

8

Reflex Arc

Strong stimulus causes the impulse to be transmitted down motor pathways to initiate response. At the same time the impulse is being transmitted to the cerebrum for interpretation.

9

Acute vs Chronic Pain

Acute: sudden, transient (up to 6 months), area is well defined, suffering decreases with time, relieve pain, eventually complete pain relief occurs.
Chronic: sudden or developed, prolonged, less easily to differentiate location, suffering increases over time, actions to modify the pain experience, complete pain relief is normally not possible.

10

Phantom Limb Pain

pain felt in the amputated limb

11

DOLOR

Description
Onset
Location
Other signs and symptoms
Relieving factors

12

QUESTT

Question the child
Use pain rating scales
Evaluate behaviour and psychological changes
Secure patient's involvement
Take cause of pain into account
Take action and evaluate results

13

Abbreviated Injury Score (AIS)

injury is allocated a number from 1 to 6. 6 is unsurvivable
looks at specific areas of the body and gives them a score up to 75

14

Injury Severity Score

Sum of the three highest numbers of AIS squared

15

3 impacts involved in MVAs

vehicle collide with object
occupant collide with inside of car
organs collide with inside of occupant

16

Injuries in an MVA depend on

type of collision
position of occupant
vehicle fitted restraints or airbags

17

Frontal Impact injuries

down and under - femoral and hip fractures, knee and lower leg fractures
up and over - rib fracture, pulmonary or cardiac contusion, abdo organ rupture and laceration, head and spinal injury

18

Lateral impact injures

Compression of pelvis
Rib fracture and pulmonary contusion
Organ rupture on impacted side
Pelvic fracture
Head and neck injuries

19

Rotational Impact injuries

injuries common to frontal and lateral impacts

20

Rollover injuries

multiple system injuries

21

Rear end injuries

spinal injury - hyperextension of C spine

22

Pedestrian Impact injuries

mutisystem
1st impact - lower leg fractures
2nd impact - fracture femur, pelvis, chest and spine
3rd impact - shoulder, pelvic, spinal
internal haemorrhage and head injury

23

Motorcycle accidents frontal impact injuries

compression injuries to head, chest, abdo
femur fracture - bilateral
pelvic fractures
peritoneal injury

24

Motorcycle accident angular impact injuries

fracture upper and lower extremities
abdo cavity injuries
compression injuries to affected side

25

Motorcycle accident ejection injuries

injury at impact point, radiating through body
head, arms, chest, abdo, legs