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Flashcards in Physiology of Pain Deck (38):
1

What is nociception?

*Ability* to feel pain, caused by stimulation of a nociceptor

2

What are the four processes of nociception?

-Transduction
-Transmission
-Modulation
-Perception

3

What is transduction?

Process of changing external stimuli into action potential

4

What is CIPA?

Congenital indifference to pain, with anhidrosis

5

How can chronic pain present?

Altered functions within the MS and visceral systems

6

Chronic pain is caused by what?

Overstimulation of peripheral nerve in a permanent alteration in the dorsal horns (facilitated segments)

7

Why does chronic pain gets worse?

Leads to more activation of nerves

8

Sharp or pricking pain is fast or slow?

Fast

9

Burning, aching, throbbing pain is fast or slow?

Slow

10

What temp does tissue damage occur?

113 F

11

Chemical pain can only elicit fast or slow pain?

Slow

12

What are the chemical mediators of pain? (4)

-Bradykinin
-5HT
-Histamine
-K

13

How do bradykinins and other chemokines elicit pain?

Increase [K] and make nerves more permeable

14

True or false: prostaglandins cause pain

False--only enhances sensitivity of nerve endings

15

How do muscles spasms cause pain?

Stimulating mechano-sensitive pain receptors and compressing blood vessels, causing ischemia

16

What are pain receptors?

C fibers (free nerve endings)

17

True or false: pain receptors adapt very little and sometimes not at all

True

18

What are the fibers that transmit acute/fast pain?

A-delta

19

What is the fast pathway for pain?

Neospinothalamic pathway

20

What is the slow pathway for pain?

Paleospinothalamic

21

What is the neurotransmitter involved in the neospinothalamic pathway?

Glutamate

22

What is the neurotransmitter involved in the paleospinothalamic pathway?

substance P

23

True or false: viscera have sensory receptors for no other kind of sensation besides pain

True

24

What is the MOA Of referred pain?

Visceral pain synapse in the spinal cord on the same nerve endings that receive pain from the skin

25

What is the trifurcation that nerves undergo? What is the consequence of this?

Afferents go up, down, and at spinal level in the dorsal horn

Pain spreads to more than just the spinal level involved

26

How does the brain stop pain?

Sends signals down the dorsal horn of the spinal cord

27

What are the transmitter substances that block pain signals going up?

enkephalins and 5HT

28

Stimulation of what fibers from peripheral receptors can depress the transmission of pain signals?

A-beta

29

Where do opioids act in the body to prevent pain?

Brain
Dorsal horn

30

Where do NSAIDS act in the body to prevent pain?

Peripherally

31

True or false: in pts with chronic pain, there is no relationship between the damage the body has undergone and the level of their pain

True

32

Most deep tissues are not extensively supplied with pain endings, but can still cause pain. Why?

Widespread tissue damage causes a summation effect to cause the slow/chronic aching pain in those areas

33

Pain receptors cannot adapt to a stimuli like other nerves. What is the consequence of this?

Person is kept apprised of the tissue damage

34

Stimulation of what fibers in the periphery can depress the transmission of pain signals? What can you do to simulate these fibers?

A-beta

Rubbing skin

35

What is the medical model of pain? How accurate is this?

Degree of injury or disease correlates with the degrees of pain

Inaccurate

36

What is the biopsychosocial model of pain?

Model of pain that takes into account social/economic factors

37

True or false: patients who transition from acute to chronic pain undergo a psychological change

True

38

What are the physical signs that point toward psychological in patients with pain? (3)

-Overreaction
-Odd emotions
-Inappropriate response to physical exam