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Repair And Regeneration > Week 9 Part 1 > Flashcards

Week 9 Part 1 Flashcards

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1
Q

What are the associations of functional somatic syndromes?

A

Autonomic dysregulation

Stress dysregulation

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2
Q

What are examples of functional gastrointestinal disorders?

A

IBS

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3
Q

What are examples of Musculoskeletal disorders?

A

FM
CFS
Chronic lower back pain

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4
Q

What is an example of Genitourinary?

A

Interstitial cystitis

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5
Q

What is an example of neurological?

A

Tension headache/ migraine

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6
Q

What is pain experienced in labour equated to?

A

IBS

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7
Q

Why is it such a burden?

A

Prepared to sacrifice 25% of remaining life
Pain in e.g. IBS equated to childbirth
QoL ratings worse than ESRF, DM

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8
Q

What is the economic burden?

A

Time off work: 20% greater than controls
Impaired productivity 30% of time
Healthcare costs

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9
Q

Who are they?

A

Multiple symptoms, multiple systems and Comorbid disorders
Negative effect and perceived loss of control
Anxiety and feared loss of control
Altered concentration/ memory
Often a history of abuse
Complicated by iatrogenic addiction

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10
Q

What is Interoception?

A

Capacity of being aware of what is going on inside our body

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11
Q

What is interception?

A

Sensitivity to stimuli occurring within the body

More salient and motivating

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12
Q

What is normal physiological processes of Interoception?

A

Abdominal bloating/ passage of flatus

Awareness of heart beat

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13
Q

What is ANS of Interoception?

A

Predominantly unconscious

Visceral functions

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14
Q

Why is it important to separate the symptoms?

A

Informs treatment
Informs how they have arisen
Precipitant causes of disorders developed might be different

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15
Q

Functional somatic syndrome

A 
Overlap - one versus many 
Dysregulation of:
Affect
ANS
Motivational salience 
Chronic pain
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16
Q

What is the definition of pain?

A

Unpleasant sensory or emotional experience that is associated with actual or potential tissue damage stimuli

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17
Q

Noxious

A

Damaging stimuli

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18
Q

What is noxious stimuli?

A

Something that doesn’t cause damage

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19
Q

What is the order of pain?

A

Specific injury caused pain
Tissue damage arises
Self-limiting process
Healing

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20
Q

What are two components of spinal component?

A

Painful and non-painful stimulus

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21
Q

Painful stimulus

A

High intensity

High capacity to activate receptors which have a relationship with nerve fibres

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22
Q

Non-painful stimulus

A

They do not activate the same receptors or nerve fibres or in the same cells of spinal cord

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23
Q

What neurosurgical does the descending inhibition require?

A

Dopamine
Serotonin
Noradrenaline
Opioids

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24
Q

What Brain regions are found in the lizard brain?

Study These Flashcards
A

Thalamus

Basal Ganglia

25
What is chronic pain?
A continued state of suffering | Pain that persists past the healing phase following an injury
26
What is the normal healing time?
Chronic back pain = 6 months | Post herpetic neuralgia = 3 months
27
What are the assumptions of pain?
Pain requires damage or injury to occur Degree of peripheral damage/injury correlate with pain If there is a disparity - all “psychological”
28
What does chronic pain inform?
Diagnostic criteria Which specialist you see We continue to treat chronic pain as we would acute pain
29
What happens when we are exposed to a constant stimulus?
We may habituate | We may become sensitised
30
What happens when pain threshold decreases?
Allow pain to spread - secondary Hyperalgesia
31
What are spinal cord mechanism detectable with?
Quantitative sensory tests
32
What are some examples of QST?
Allodynia Temporal summation DNIC/CPM
33
What has QST been used in FSS patients to demonstrate?
Spinal sensitisation
34
What are examples of different substances at the level of spinal cord being examined?
``` Substance P Glutamate and other excitatory AAs Serotonin Nerve growth factor CCK ```
35
What are 3 subsystems the pain triumvirate divided into?
1. Sensory/discriminative 2. Affective/ motivational 3. Cognitive/evaluative
36
Sensory/discriminative
Localisation in time/space - assessment of intensify Lateral systems: lateral thalamic nuclei. S1, S2, SMA
37
Affective/motivational
Emotional/unpleasant aspects Reward in escape Medial system - BG, medial thalamic nuclei, ACC, Insula
38
Cognitive/evaluative
Interpretation of pain and it’s meaning
39
What is chronic pain?
More than acute pain | Perception
40
What is central augmentation?
Hyper-responsively of these brain areas
41
What does integrated construct allow for?
Threat assessment and memory of pain | Repetition of behaviour
42
In acute pain
Sensory component is dominant Motivational component is reflexive Affective component secondary
43
In chronic pain
Affective and motivational components are primary | Determine sensory component
44
Disruption in neurochemical circuits?
Symptoms of disorders
45
MDD/ anxiety
Serotonin Noradrenaline Dopamine Opioid system
46
What is the function of serotonin?
Suppress sensation of normal bodily functions
47
What is the function of noradrenaline?
Suppress sensation of normal bodily functions
48
What is the function of dopamine?
Dampens pain | Application of importance and focuses attention
49
What is the function of opioid system?
Prevents spread of pain Dampens pain Reinforces behaviour
50
What are these different neurotransmitters viral for?
Interoception
51
What does sensation and feelings affect our beliefs about?
Meaning of symptoms | Cause of symptoms
52
What are 4 types of pain behaviours?
Negative affect Facial/audible expression of distress Distorted ambulation or posture Avoidance of activity
53
What does noxious stimulus act on?
A-delta and C fibres
54
What is an example of sensory experience of pain?
Perception of noxious stimuli
55
What is example of suffering?
Negative emotional response in higher nervous system
56
What are examples of pain behaviour?
Expression of distress Distortion of movement to posture Bad mood Avoidance of activity
57
What is pathway of pain behaviours
Noxious stimulus Sensory experience of pain Suffering Pain behaviours
58
What are the altered activity?
Avoidance behaviour - most commonly Excessive persistence Pacing - listening to body
59
What is the best approach?
Behavioural intervention: graded

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