pain pathology

Question 1

population affected by pain

Answer 1

116 million in US
up to 20% of all primary care visits- chronic pain
26% of adults have had pain for >3 months and 1/3 report it as disabling.

Question 2

allodynia

Answer 2

pain due to a stimulus that does not normally provoke pain

Question 3

hyperalgesia

Answer 3

increased pain from a stimulus that is normally painful

Question 4

hyperesthesia

Answer 4

increased sensitivity to stimulation, excluding the special senses (includes both allodynia and hyperalgesia

Question 5

hyperpathia

Answer 5

painful syndrome characterized by an abnormally painful reaction to a stimulus, especially a repetitive stimulus, as well as an increased threshold (augmented response to any sensory stimuli)

Question 6

causalgia

Answer 6

syndrome of a sustained burning pain, allodynia, hyperpathia after a traumatic nerve lesion, often combined with vasomotor and sudomotor dysfunction (such as diabetic autonomic neuropathy) and later trophic changes

Question 7

analgesia

Answer 7

absence of pain in response to stimulation that is painful

Question 8

dysesthesia

Answer 8

unpleasant abnormal sensation, whether spontaneous or provoked

Question 9

paresthesia

Answer 9

abnormal sensation, whether spontaneous or evoked

Question 10

nociceptive pain

Answer 10

nociceptive pain is pain in the muscles, tissue, ligaments, soft tissue; modulates from physical pain or damage to the body
response to an immediate noxious stimulus; results in inflammatory pain

Question 11

neurogenic pain

Answer 11

damage or disfunction of the nervous system
two types: central neruogenic pain and peripheral neruogenic pain

Question 12

central neruogenic pain

Answer 12

injury to CNS (spinal cord- brain)
burning, aching, prickling, hyperalgesia, allodynia

Question 13

peripheral neurogenic pain

Answer 13

injury to the PNS (spinal cord- nerve endings) paresthesia, dysesthesia, pain

Question 14

fibromyalgia

Answer 14

widespread MSK pain and fatigue accompanied by tenderness of the muscles and adjacent soft tissue
effects mostly females
triggered by trauma, surgery, infection, or psychological stress

Question 15

myofascial pain syndrome

Answer 15

persistent, deep aching pain in muscle; characterized by well-defined higly sensitive tender spots “trigger points”

Question 16

postural stress syndrome

Answer 16

postural malalignment produces chronic muscle lengthening and/or shortneing and stress on tissues

Question 17

movement adaptation syndrome

Answer 17

habituated movement dysfunction leading to muscle strain and pain

Question 18

psychosomatic pain

Answer 18

origin is related to mental or emotional factors

Question 19

referred pain

Answer 19

pair arising from deep visceral tissue that is felt in a body region remote from the site of origin

Question 20

free nerve endings

Answer 20

most abundant type of nerve ending
near blood vesselse between epithelial layers of skin

Question 21

merkels disc

Answer 21

tactile end organ, abundant in fingertips and whiskers

Question 22

krause’s end bulb

Answer 22

speacialized sensory nerve ending in skin, temperature sensation

Question 23

meissner’s corpuscle

Answer 23

cutaneous nerve ending responsible for transmitting the sensation of fine touch and vibration.

Question 24

Pacinian corpuscle

Answer 24

encapsulated ending of s sensory nerve that acts as a receptor for pressure and vibration

Question 25

ruffini corpuscle

Answer 25

found in superficial dermis of both hairy and glaborour skin, sense low-frequency vibration or pressure

Question 26

fast, localized pain

Answer 26

transmitted over thinly myelinated A delta fibers; processed in dorsal horn

Question 27

slow pain

Answer 27

transmitted over small diameter; unmyelinated C gibers; processed in dorsal horn

Question 28

transduction of pain

Answer 28

process by which a painful physical or chemical stimulus is transformed into a signal that can be carried via transmission to CNS and perceived as pain;
changin external action into neruological signal

Question 29

gate control theory

Answer 29

modulation of pain happens in brain stem; gate open- pain signal is let through
gate closed- pain signal restricted
(chronic pain- gate stays open)

Question 30

pain modulation C fibers and A beta fibers

Answer 30

painful stimuli travel on C fibers, but A beta fibers travel faster and can inhibit the full response of the nervous system (before the c fibers)
ex) hitting your shin on something and then rubbing it with your hand immediately after, inhibits full sensation delivered by C fibers

Question 31

endogenous opioids

Answer 31

endorphins and enkephalins
can depress pain transmission at various presynaptic locations
another way to modulate pain

Question 32

referred pain for heart, stomach, kidney

Answer 32

heart: Left chest, arm
stomach: center of back, center of abdomen near xiphoid process
kidney: Both lower quadrants into legs

Question 33

sensory aspects of pain (pathway)

Answer 33

detection, localization, intensity, stimulus identification
first pathway: pain signal comes from anywhere in body and activated the anterior cingulate cortex of the brain which is associated with teh perception of pain

Question 34

affective aspects of pain (pathway)

Answer 34

(second pathway): travels to the prefrontal cortex and nucleus accumbens which are associated with motivation and emotion.
nagging, uncomfortable, excruciating role of mood change

Question 35

pain threshold vs pain tolerance

Answer 35

threshold: minimum point at which something causes you pain
tolerance: maximum amount of pain you can tolerate

Question 36

central sensitization vs peripheral sensitization

Answer 36

central: amplification of neural signal associated with chronic pain- hypersensitivity
peripheral: reduced pain threshold

Question 37

medical management of chronic pain

Answer 37

lab tests, diagnostic nerve blocks to help determine the structure involved
NSAIDs, ms relaxors, opiods, topicals