Week 5: Pain Flashcards by Ang A

Pain is ___

Subjective

How well did you know this?

Not at all

Perfectly

Pain __ is the level of stimulation required to activate the ___ __ sufficiently for the in individual to __ pain

Threshold
Nerve ending
Perceive

How well did you know this?

Not at all

Perfectly

Pain ___ is the ability to withstand pain or the perception or the ___

Tolerance

Intensity

How well did you know this?

Not at all

Perfectly

Pain ___ is relatively constant over time and between individuals

Threshold

How well did you know this?

Not at all

Perfectly

Pain ___ varies considerably with past pain experiences and overall state of health

Tolerance

How well did you know this?

Not at all

Perfectly

__ is a feeling of discomfort resulting from ___ of ___ ___ in the body when __ damage occurs or is about to occur

Pan
Stimulation
Pain receptors
Tissue

How well did you know this?

Not at all

Perfectly

Pain may be felt because of i___, i__, i___, tissue ___, __ of tissue, c___ or b____

Inflammation
Infection
Ischemia 
Tissue necrosis
Stretching of tissue
Chemicals 
Burns

How well did you know this?

Not at all

Perfectly

In skeletal muscle pain may result from __ or ___

Ischemia

Hemorrhage

How well did you know this?

Not at all

Perfectly

Organs such as ____, ___, or ___ are characterized by pain receptors in the covering ___ and pain is felt when the ___ is stretched by __

Liver
Kidney 
Brain 
Capsule 
Capsule 
Inflammation

How well did you know this?

Not at all

Perfectly

Stretching of t____, ligaments, and j____ c___ also elicit pain

Tendons; joint capsules

How well did you know this?

Not at all

Perfectly

Effects of pain might occur secondary to ____ or _____ ____ to guard a joint or painful body part

Inflammation

Joint capsules

How well did you know this?

Not at all

Perfectly

In stomach and intestines, pain results from inflammation of the m___, i___,d___, or m____ _____

Mucosa
Ischemia
DISTENTION
Muscle spasm

How well did you know this?

Not at all

Perfectly

Pain pathways include _____, __, __, ___,____,_____

Nociceptors 
Affrent fibers
efferent fibers 
Dermatomes
Reflex response 
Reticular activating system

How well did you know this?

Not at all

Perfectly

_____ are free sensory nerves endings that are present in ____ body tissue

Nociceptors

Most

How well did you know this?

Not at all

Perfectly

____ are stimulated by t___, ___, or ____ means

Nociceptors
Thermal
Chemical
Physical

How well did you know this?

Not at all

Perfectly

____ means extremes in temperature

Thermal

How well did you know this?

Not at all

Perfectly

____ refers to pressure

Physical

How well did you know this?

Not at all

Perfectly

____ refers to acids or compounds produced in the body such as bradykinin, histamine, or prostaglandin

Chemical

How well did you know this?

Not at all

Perfectly

2 afferent fibers that conduct pain impulses m___ _ ____ fibers and the u___ __ fibers

Myelinated A delta

Unmyelinated C

How well did you know this?

Not at all

Perfectly

The Afferent m___ _ ___ fiber transmits impulses rapidly

Myelinated A delta

How well did you know this?

Not at all

Perfectly

The afferent fiber u___ _ fiber transmits impulses slowly

Unmyelinated

How well did you know this?

Not at all

Perfectly

Acute pain is that is sudden sharp and localized, related to thermal and physical stimuli primarily ____ and ____ membranes is transmitted primarily by the ___ __ ___ fiber

Skin
Mucous
Myelinated A delta

How well did you know this?

Not at all

Perfectly

Chronic pain experienced as dull, diffuse, burning or aching is transmitted by ___ _ fibers

Unmyleinated C fibers

How well did you know this?

Not at all

Perfectly

C fibers relieve chemical, thermal, and physical stimuli from m___, t___, my___ and d___ t__, and s___

Muscle 
Tendon
Myocardium 
Digestive tract 
Skin

How well did you know this?

Not at all

Perfectly

Afferent fibers travel from the ____ nerves -> d___ r___ g___ -> s___ c___ through the dorsal ___ or su___ ge____

``` Peripheral Dorsal root ganglia Spinal cord Dorsal horn Substantial gelatinousa ```

Each spinal nerve conducts nerve impulses from a specific area of the skin called a ____

Dermatome

The s_________ c__ is mapped to correspond to the area of the body so that the source of the pain can be interpreted in the brain

Somatosensory cortex

Dermatomes can be used to test for areas of ___ loss, or pain ___ and thus determine the site of damage after spinal cord injuries

Sensory | Sensation

At a spinal cord synapse a ___ response to sudden pain results in a motor efferent impulse back to the muscle that initiates an _____ muscle ___ to move the body away from the source of the pain

Reflex Involuntary Contraction

The arousal state of the ____ in the reticular formation in the p__ and m__ influences the brains awareness of incoming pain stimuli

RAS Pons Medulla

Many drugs decrease the _____ thereby decreasing the pain experience

RAS

h_______ plays a role in the response to pain through its connections with the pituitary gland and ___ nervous system

Hypothalamus | Sympathetic

Response to pain usually involves a s____ response and an ___ response such as crying moaning or aching

Stress | Emotional

A p___ response to pain involves rigidity, splinting or guarding an area of the body

Physical

The T___ possesses many types of sensory stimuli as they enter the brain and is important in the e______ response to pain through the l____ s___

Thalamus Emotional Limbic system

2 tract of the spinothalmic bundle are the ne___ tract and the pa___ tract

Neospinothalmic | Paleospinothalmic

Fast impulses for a cure, sharp pain travel in the _____ tract of the spinothalmic bundle

Neospinothalmic

Slow impulses for chronic/ dull pain pain travel in the _____ tract of the spinothalmic bundle

Paleospinothalmic

The 2 pathways of the spinothalmic bundle explain why one experiences s___ severe pain followed by d___

Sharp | Duller

The spinothalmic tracts connect with the r___ formation in the brain system, h___, t___ and other structures as they ascent to the somatosensory area in the c__ cortex of the p___ lobe of the brain. It is here that the ____ and characteristics of pain are perceived

``` Reticular Hypothalamus Thalamus Cerebral Parietal Location ```

Endorphins include e___, d____, and b__ l___

Enkephalins Dynorphins Beta lipotropin

E___ is released from the s__ cord and attached to the ____ receptors on the a____ n__ thus blocking the release of the neurotransmitter at the synapse

Enkephalins Spinal cord Opiate receptors Afferent neuron

S___ is a chemical released in the spinal cord that acts on other neurons in the spinal cord to increase the release of E___

Serotonin | Enkephalins

Patient who are clinically depressed report pain due to decrease in ____ levels

Serotonin

When the pain gate is _____ pain impulses are transmitted from the p___ to the b___

Open Periphery Brain

When the pain gate is _____ it reduces or modifies the passage of pain impulses

Closed

Gate ___ can occur in response to other sensory stimuli along competing nerve pathways that may diminish pain sensations of by modulating or our inhibitory impulses from h____ c___ in the b___

Closure Higher centers Brain

____ pain is caused by simulation of p_____ nerve fibers that respond only to stimuli that are approaching or exceeding harmful intensity

Nociceptive

n____ may be v___ or s___

Nociceptive Visceral Somatic

N____ pain is caused by damage or disease affecting any part of the NS. Described as Burning, tingling, electrical, stabbing pains

Neuropathic

P____ pain is pain caused by increased or prolonged mental, emotional, or behavioral factors

Psychogenic

S____ pain is located in the skin and deep tissue. These nociceptors pic up sensations related to temperature, vibration, swelling in the skin, joints, and muscles

Somatic

Somatic pain responds well to ___ and a___

NSAIDS | Anergerics

S___ pain usually fades once the injury heals; if lasts longer than can become chronic

Somatic

V___ results from activation of nociceptors in the thoracic abdominal or pelvic vesera. Can be acute or chronic

Visceral

r____ pain is characteristic of v___ damage in the abdominal organs. Pain is in some distance from the actual source

Referred | Visceral

P___ pain may occur after an amputation and is more common if chronic pain occurred before surgery. Usually does not respond to common pain therapies

Phantom

Pain t_____ may be increased with ____ endorphin release

Tolerance | Higher

Anxiety/ stress can result in a ____ pain tolerance. The CNS is at a ___ level of awareness

Lower

Pain perception is s___ but can be compared from day to day in the same person

Subjective

Response to pain

Influenced by personality, emotions, cultural norms

___ adults often won't say that they have pain, and it may manifest in other behaviors (anxiety, agitation)

Older

___ cannot express pain and can be noticed though facial expressions

Children

COLD SPA to define pain characteristics

C- character/ quality O- onset L- location D- duration S- symptoms P- precipitating factors A- alleviating

Pain drawing

Patient indicated pain level on particular part of body by marking it with a number

Wong- Baker faces pain rating scale

Asses pain in children and infants via facial expression because they can't communicate their pain

PAINAD

Behavior observation tool developed for patients with advanced dementia

A___ pain indicates tissue damage and is sudden, severe and short term

Acute

Acute pain initiates a p___ s___ response with increased b____, r____ and h__;;;; c____, p___, m__ skin and increased s____ m___ t___;;;; strong emotional response and possible vomiting

``` Physiological stress BP RR HR Cool Pale Moist Skeletal muscle tension ```

C__ pain occurs over an extended period of time and may be recurrent. More difficult to treat and perceived to be more generalized

Chronic

Effects of chronic pain

``` Loss of employment Interference with personal relationships Fatigue Weight loss or gain Periods of acute pain Reduces tolerance to additional pain Irritable ADLs Depression Sleep disturbances ```

Nausea and vomiting and anxiety/ fear are common with ___ pain

Acute

Patient might be restless or in constant motion when in pain

Children clench fist have have ridged faces

Treatment of pain: remove the ____ as soon as possible

Cause

___ causes the impulses from temperature receptors to close gates and reduce the s__ that causes pain

Ice | Swelling

TENS ____ sensory stimulation at the site _____ pain transmission

Stimulate | Block

Non pharmacological treatment of pain includes ____ ____ therapy

Cognitive behavior

Opiate like chemicals are secreted by the i____ of the CNS; ___ conduction of pain impulses on the CNS

Interneruons | Block

E___, d___, b___ l___ resemble morphine

Enkephalins Day orphans Beta lipoproteins

Analgesic drugs: mild pain- a____, a__, n__

ASA Acetaminophen NSAIDS Side effects: ulcers, nausea, gastric bleeding

Analgesic drugs: Moderate pain- C__ and o__

Codeine Oxycodone Side effects: respiratory depression and tolerance or addiction

Analgesic drugs: Severe pain- m__, m___

Morphine Meperidine Side effects: respiratory depression and tolerance or addiction

P___ is used after surgery for pain management. Allows patients to administer medication as needed by pressing a button. Lessons consumption

Patient controlled analgesia (PCA)

Adjuncts to analgesics are s___ and a___ for rest and relaxation

``` Sedatives Anti anxiety (ie lorazepam) ```

L___ a___ is another way to treat or prevent pain

Local anesthesia

Pharmacological including opioids and non-pharm pain management interventions have been shown to be effective in ____

Children

Non pharm methods for children should be based on d___ s__

Developmental stage;; teach to kid and parent

Risk of adverse events is ___ in elderly

Higher

For older adults _____ treatment are usually less costly and cause fewer side effects

Non pharm

When prescribing pharm or non pharm treatment for older adult consider cause, h___ s___, c___ therapies and m___ s___

Health state Concurrent therapies Mental state