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Pain PPT McDizzels Flashcards

Josh's guide to McDizzles riveting lecture on pain!!!!!!!! drop your socks grab your cocks you in for a ride!!!!!!!!!! (55 cards)

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1
Q

Fun Fact

Benedictus de Spinoza stated “pain is a localized form of ________”

A

sorrow

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2
Q

3 psychosocial factors that influence pain?

A
  • intRApersonal (occurs within self)
  • intERpersonal (Occurs between individuals)
  • Social
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3
Q

where does pain Happen?

A

“brain”

pain isn’t pain until it gets to the brain

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4
Q

With the gate theory what happens when the gate is open?

A

pain

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5
Q

With the gate theory what happens when the gate is closed?

A

no pain

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6
Q

In relation to the DH (dorsal horn) NT (neurotransmitters):

what is found in large calls?

A

Excitatory amino acids (glutamate and aspartate)

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7
Q

In relation to the DH (dorsal horn) NT (neurotransmitters):

What do small cells contain?

A
  • FRAP (fluoride-resistant acid phosphatase
  • sP
  • VIP (Vasoactive intestinal polypeptide)
  • Somatistatin
  • CCK (cholecystokinin)
  • GRP (gastrin-releasing peptide
  • CGRP (calcitonin-gene-related peptide
  • ENK (leuenkephalin)
  • DYN (dynorphin)
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8
Q

What are the 3 primary pathways to the brain? (ascending tract)

A
  • Spinothalamic tract (STT)
  • Spinoreticular tract (SRT)
  • Spinomesencephalic tract (SMT)
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9
Q

Acute pain is a __________ experience!

A

multdimensional

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10
Q

Somatic events of acute pain are termed in:

A
  • space, time, intensity
  • motivational-emotional mechanisms
  • Aversive behavior (avoiding behavior)
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11
Q

Psychological components or acute pain are?

A
  • sensory-discriminative
  • motivational-affective
  • cognitive-evaluative
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12
Q 
Visceral Structures (pain):
what type of fibers involved
A

C-afferent fibers
A-delta fibers

(visCerAl)

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13
Q 
Visceral Structures (pain):
when do the C-afferent and A-delta fibers get activated? (what causes this type of pain)
A

-disease
-inflammation
-isometric contraction
-ischemia
-rapid distention
(remember these are organs- thus when you get appendicitis you hurt from the inflammation stretching, ischemia etc)

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14
Q 
Visceral Structures (pain):
C-afferent and A-delta fibers are activated by what?
A

noxious stimuli

alogenic substances

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15
Q 
Visceral Structures (pain):
the C-afferent fibers and A-delta fibers act as what???/
A

transducers

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16
Q 
Visceral Structures (pain):
the C-fibers and A-delta fibers are conducted to the \_\_\_\_ \_\_\_\_\_\_ or \_\_\_\_\_\_\_\_
A

dorsal horn
or
medulla

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17
Q 
Visceral Structures (pain):
The C-fibers and A-delta fibers are conducted to the dorsal horn and medulla, and are influenced by what?
A

intensity
duration
microenviroment

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18
Q

What are 2 ways to decrease pain?

A
  • augmentation

- inhibition

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19
Q

what is inhibition

A
  • counterirritation

- -rubbing, vibration, more sophisticated methods

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20
Q

what is augmentation?

A
  • sensation by repeated noxious stimuli

- lowering the threshold by alogenic substances

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21
Q

What opens the Gate after nerve injury?

A

decreased inhibition

increased excitation

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22
Q

what the reduction in inhibitory postsynaptic currents the consequence of (r/t peripheral nerve injury related pain)

A

decreased GABA responsiveness

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23
Q

what causes the decreased GABA release and consequent reduced inhibition? (r/t teh gate theory)

24
Q

Neuropathic Pain:

is a ____________ disease

Study These Flashcards
A

neurodegenerative diseas

25
Neuropathic Pain: | what type of treatment can about the neuropathic pain?
neuroprotective and disease-modifying theraoy
26
what are the goals of an organized program for pain management?
educate pts reduce incidence and severity of pain enhance pt comfort and satisfaction reduce post-op complications
27
what are the principles or treatment for pain?
- assessment requires rapport - unreleived pain has negative effects - all pain will not be eliminated - prevention is better than treatment - communication problems requuire special attention - unexpected intense pain raises suspicion
28
what are controllable factors of pain
- HR - Preload - Afterload
29
Pain treatment: | the approach must be what?
- collaborative and interdisciplinary - individual and proactive - assessment intense - formal and structured
30
what is involved in the pain assessment?
- Pt self report - numerical or visual analog scale - cognitive appropriate tools
31
Pyschological responses to pain include what?
- fear - anxiety - unpleasent uneasy feelings - communication issues
32
What is known about communication issues and pain?
- 70% hospitalized pts did not discuss pain - negative social connotations - insignificant compared to others - >66% do not mention pain until severe
33
What are some adjunct treatments for pain management?
- cognitive behavior techniques - systemic opioids or NSAIDs - PCA - Epidural analgesia - INTERMTANT NEURAL BLOCKADE - PHYSICAL AGENTS - TENS
34
Contraindications for epidural
- Pt refusal (thats for you jake) - coagulopathy - infection at injection site - uncorrected hypovolemia
35
Epidural complications
- Hypotension - total spinal - Local toxicity - Headache - Local site pain - Zebras (also the red panda)
36
Continuous epidural analgesia dose, meds, rate etc. (this is just Mcd's way)
10mL 0.25% bupivicaine (2.5mg/ml=25mg) 100 mcgs fentanyl 8 ml PF NS After this loading dose maintain rate at 3-5 ml/hr
37
ITA advantages
excellent analgesia no sympathetic block ambulatory pt
38
ITA (with or without anesthetic) meds and doses
25 mcgs fentanyl | 100-150 mcgs (0.2-0.3 ml) astromorph
39
What is the combined tech??? "the best of both worlds"
Perform ITA | place epidural catheter for later use if needed
40
Chronic pain: | is prolonged pain for how long?
> 6 months
41
Chronic pain: is can be _____ or _______ pain?
persistent or intermittent (eg. low back pain VS migraines)
42
Chronic pain: | what happens to endorphins?
May have decreased amount
43
Chronic pain: | may have a predominance of ____ neuron stimulation
C
44
Chronic pain: | due to adaptation what will happen to physical signs?
may be normal!
45
Chronic pain: | what are 9 syndromes that cause chronic pain?
``` Neuralgias Causalgia Complex regional pain syndrome (RSD) hyperesthesias Myofacial pain syndromes Hemiagnosia phantom leg pain Back d/o Herpes zoster ```
46
Chronic pain: | what are 3 chronic back d/o
Low back pain Spinal stenosis Lumbar radiculopathy
47
Music and the experience of pain: | what are the therapeutic use of music?
reduces pain reduces anxiety Reduces medication use Improves pleasantness of recall
48
Accupunture dates back to when
1500 B.C.
49
Accupunture is the balance of what?
Yin | yang
50
What is yin and yang?
Yin- female, cold, death Yang- Male, warm, Life (i love how the non-round eyes associate women with cold and death, they are smarter than we though more than just math)
51
Accupunture | there are >____ points along the "meridians"
360
52
Accupunture probably works on what?
gate control
53
Hypnosis and the experience of pain: | what are some misconceptions?
``` loss of consciousness weakening of the will giving away secrets loosing control to the therapist inability to dehypnotize ```
54
Hypnosis and the experience of pain: | phases of Hypnosis!
I) induction II) deepening and maintenance III) utilization IV) Termination
55
Hypnosis and the experience of pain: | induction techniques
closed eyes deep breathing progressive relaxation eye fixation

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