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Flashcards in Pain Management Deck (83)
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What are the two main categories of chronic pain?

neuropathic and nociceptive


What is neuropathic pain?

pain arising from abnormal neural activity secondary to disease, injury, or dysfunction of the nervous system (described as burning or tingling)


What are the types of nociceptive pain?

musculoskeletal, inflammatory, mechanical/compressive


What is hyerpalgesia?

increased response to a stimulus that is normally painful


What is hypoalgesia?

diminished response to a normally painful stimulus


What is analgesia?

absence of pain in response to a stimulus that is normally painful


What is hyperesthesia?

increased sensitivity to stimulation, especially the skin (excluding the special senses - senses that have specialized organs devoted to them: vision [the eye] hearing and balance [the ear, which includes the auditory system and vestibular system] smell [the nose] taste [the tongue])


What is hypesthesia?

diminished sensitivity to stimulation, excluding the special senses


What is dysesthesia?

act of touching a part of the body causes some unpleasant sensation, such as pain, burning, or tingling - may be spontaneous or evoked


What is paresthesia?

an abnormal sensation, typically tingling or pricking (“pins and needles”), caused chiefly by pressure on or damage to peripheral nerves - may be spontaneous or evoked


What is allodynia?

pain resulting from a stimulus (such as a light touch) that does not normally elicit pain


What is nerve convergence?

convergence of sensory nerves from the viscera and superficial areas onto the same neurons in the spinal cord


What is the spinothalamic pathway?

major route by which pain and temperature information ascend to the cerebral cortex


What are nociceptors?

highly specialized sub-set of primary sensory neurons preferentially sensitive to a noxious stimulus or to a stimulus that would become noxious if prolonged - categorized by the kind of stimulation they respond to and the nature of their response


What are myelinated nociceptors?

relatively fast-conducting A-delta fibers that are responsible for the first (immediate) sharp pain associated with a noxious stimulus


What is the pathway of the pain response from an external stimulus?

nociceptors on the skin pass signals through the sympathetic ganglion of the ANS - the signal then passes through the dorsal root ganglion of the spinal cord and then along to the brain, which perceives the pain in the somatosensory cerebral cortex


What is transduction?

conversion of a noxious stimulus into electrical activity in the peripheral terminals of nociceptor sensory fibers


What is transmission?

passage of action potentials from the peripheral terminal along axons to the central terminal of nociceptors in the CNS


What is conduction?

the synaptic transfer of input from one neuron to another


What is modulation?

alteration (i.e., augmentation or suppression) of sensory input


What is perception?

the decoding/interpretation of afferent input in the brain that gives rise to the indiviudal's specific sensory expeirence (i.e., realization that something is painful)


What is the International Association for the Study of Pain's Pain Taxonomy?

Axis I: anatomic regions; Axis II: organ systems; Axis III: temporal characteristics/patterns of occurrence; Axis IV: intensity/time since onset of pain; Axis V: etiology


What are the six major categories of treatment options for chronic pain?

(1) pharmacologic, (2) physical medicine, (3) behavioral medicine, (4) neuromodulation, (5) interventional (neural blockade, spinal cord stimulation), (6) surgical


What is included in Step 1 for management of chronic (mild) pain?

aspirin, acetaminophen (analgesic, *not* anti-inflammatory), NSAIDs, COX-2 inhibitors, adjuvants


What is included in Step 2 for management of chronic (moderate) pain?

acetaminophen or aspirin, codeine, hydrocodone, oxycodone, dihydrocodeine, tramadol, adjuvants


What is included in Step 3 for management of chronic (severe) pain?

morphine, hydromorphone, methadone, levorphanol, fentanyl, oxycodone, nonopioid analgesics, adjuvants


What is adaptive pain?

contributes to survival by protecting the organism from injury and/or promoting healing after injury


What is maladaptive pain?

represents pathologic functioning of the nervous system


What are the two components of the nervous system?

CNS and peripheral nervous system


What are the two components of the peripheral nervous system?

somatic (voluntary) and autonomic (involuntary)