At 4100: Pain And Pain Management Using Therapeutic Modalities

Front 1

Cultural prescription; expectations; role behaviors

Back 1

Factors influencing pain tolerance

Front 2

Pain initiated or caused by a primary lesion or dysfunction to the peripheral nerves.

Back 2

Neuropathic pain

Front 3

An unpleasant physical and emotional experience which signifies tissue damage or the potential for such damage.

Back 3

Pain

Front 4

Caused by a single event; usually sudden; has a short duration of symptoms

Back 4

Acute pain

Front 5

Three systems interacting to produce and perceive pain

Back 5

Sensory-Discriminative System; Motivational-Affective System; Cognitive-Evaluative System

Front 6

When using a pain diagram numbness and tingling is what color?

Back 6

Yellow

Front 7

When using a pain diagram a generally painful area is what color?

Back 7

Blue

Front 8

When using a pain diagram burning or hot spots are what color?

Back 8

Red

Front 9

Sensory receptor responsible for cold temperature and temperature changes

Back 9

Krause’s end bulbs

Front 10

Sensory receptor responsible for light press/touch

Back 10

Merkle dics (AKA A-beta)

Front 11

T or F: Pain threshold is the level of noxious stimulus required to alert the individual to possible tissue damage.

Back 11

True

Front 12

T or F: Pain threshold is the least experience of pain that a subject can recognize.

Back 12

False

Front 13

T or F: Pain tolerance is the measure of how much pain a person can or will withstand.

Back 13

True

Front 14

The greatest level of pain which a subject is prepared to tolerate.

Back 14

Pain tolerance

Front 15

Pain experienced when tissue damage is impending and/or immediately after an injury has occurred.

Back 15

Acute pain

Front 16

Pain that does not resolve in the usual period it takes the disorder to heal or that continues beyond the duration of the noxious stimulation.

Back 16

Chronic pain

Front 17

Pain occurring with acute trauma to the skin or subcutaneous tissues.

Back 17

Somatic pain

Front 18

T or F: Superficial somatic pain is well-localized pain.

Back 18

True

Front 19

Pain originating in the internal organs and the linings of the body cavities.

Back 19

Visceral pain

Front 20

Pain perceived in another area which seems to have little relation to the existing pathology (e.g.; Kehr’s sign).

Back 20

Referred pain

Front 21

When assessing pain using the “PAIN” mnemonic; the P stands for?

Back 21

Pattern

Front 22

When assessing pain using the “PAIN” mnemonic; the location of pain falls under what letter?

Back 22

Area

Front 23

Numeric Rating Scale (NRS); Pain Face Scales; Visual Analogue Scale (VAS); Pain charts are?

Back 23

Pain rating scales

Front 24

Used to assess the intensity of pain by asking a patient to rate his/her on a 0-10 scale.

Back 24

NRS

Front 25

Pain scale used to assess the intensity of pain by asking a child to rate his/her on a 0-10 scale.

Back 25

Face scales

Front 26

A self-report device measuring the magnitude of internal states such as pain and mood using a 10-cm or 100-mm line running either vertically or horizontally oriented with anchors placed at both poles.

Back 26

VAS

Front 27

This pain assessment tool is used to establish spatial property of pain.

Back 27

Pain Chart/Diagram

Front 28

Generally unmyelinated (naked-nerves); sensitive to and stimulated by potentially damaging mechanical; chemical; and thermal stresses.

Back 28

Nociceptors

Front 29

Neuropeptide responsible for transmitting a painful impulse?

Back 29

Substance P

Front 30

Impulses from sensory receptors to the brain.

Back 30

Afferent neural transmission

Front 31

Impulses from the brain toward the periphery.

Back 31

Efferent neural transmission

Front 32

Initial stimulation of the nociceptors due to lowering of the depolarization threshold; enhancing the pain response.

Back 32

Primary hyperalgesia

Front 33

Increases the painful area as the chemical mediators diffuse into the surrounding tissue causing them to become hypersensitized.

Back 33

Secondary hyperalgesia

Front 34

A neuron connecting sensory receptors in the PNS to neurons in the CNS.

Back 34

1st order neuron

Front 35

Pain results from excessive stimulation of sensory receptors if the stimulation is applied with long enough intensity.

Back 35

Intensity Theory

Front 36

Proposed the body contains different types of sensory n. endings and that a single n. would respond only to a specific stimulus (i.e.; hot; cold).

Back 36

Specificity Theory

Front 37

Proposed that perceptions of pain are the result of stimulus intensity and the summation of the impulses.

Back 37

Pattern Theory

Front 38

Stimulation from ascending A-beta afferents results in the blocking of impulses carried along the A-delta and C afferent fibers.

Back 38

Gate Control Theory

Front 39

In the Gate Control Theory impulses ascending on afferent fibers stimulate the SG (contain both excitatory and inhibitory cells) as they enter the dorsal horn of the spinal cord; influencing the ____?

Back 39

T-cell

Front 40

By stimulating the SG one is able to inhibit synaptic transmission in the large and small (A-_____ and ___-fiber) afferent pathways.

Back 40

A-delta and C-fiber

Front 41

Increased neural activity in the A-alpha and A-beta primary afferent pathways triggers a release of enkephalin (chemical in the endorphin family) from enkephalin interneurons found in the dorsal horn.

Back 41

Castel’s Spinal Level I

Front 42

T or F: Enkephalins bind with excited nociceptors and diminishing the release of Substance P.

Back 42

True

Front 43

Stimulation of the PAG of the midbrain and raphe nucleus medulla by ascending neural input (C-fiber afferents) activate the descending mechanism.

Back 43

Castel’s Spinal Level II

Front 44

Stimulation of rhythmic muscles contraction; A-delta and C-fibers (favors A-delta) over a long period of time with a low pulse frequency can stimulate the release of endogenous opioids (beta-endorphins).

Back 44

Castel’s Spinal Level III

Front 45

Physical agents used to stimulate large-diameter afferent fibers.

Back 45

TENS; massage; analgesic balms

Front 46

Physical agents used to decrease pain fiber transmission velocity.

Back 46

Cryotherapy and ultrasound

Front 47

Physical agents used to stimulate small-diameter afferent fibers and descending pain control mechanism.

Back 47

Acupressure; deep massage; TENS

Front 48

T or F: Cryotherapy acts to slows nerve transmission of 1st order afferent neurons.

Back 48

True

Front 49

T or F: Warming sensations do not override the transmission of pain impulses.

Back 49

False

Front 50

Electrical stimulation technique with a pulse frequency 60-120 pps; sensory perception - no visible muscle contraction; stimulates only large afferents (A-beta)

Back 50

Sensory or High TENS

Front 51

Electrical stimulation technique for non-acute pain; good for deep throbbing/chronic pain, or trigger point pain; produces visible muscle contraction; 1-7 pps; 200-300 µs phase duration; high amplitude

Back 51

Motor or Low TENS

Front 52

Referred to as hyperstimulation analgesia; 2-4 pps or 100-150 pps with long phase duration 300-1000 µs (1 msec); High intensities (with/without muscle contraction)

Back 52

Noxious or Brief Intense

Front 53

Nociceptor producing fast onset of pain and are short-lasting and help to localize the pain.

Back 53

A-delta

Front 54

Dull; non-localized (protopathic) nociceptor.

Back 54

C-fiber

Front 55

To or F: A-beta sensory receptors have a larger diameter and faster conduction velocity compared to A-delta fibers.

Back 55

True

Front 56

T or F: A-beta sensory receptors have a smaller diameter and a slower conduction velocity compared to C-fibers.

Back 56

False

Front 57

T or F: A-delta pain receptors have a larger diameter and a slower conduction velocity compared to C-fibers.

Back 57

False

Front 58

T or F: C-fiber pain receptors have a larger diameter and faster conduction velocity compared to C-fibers.

Back 58

True

Front 59

Chemical mediators that provides direct stimulation of nerve fiber carrying the noxious stimuli?

Back 59

Bradykkinin

Front 60

Chemical mediator that sensitization of the nerve fibers so that other chemical mediators can initiate pain?

Back 60

Prostaglandin

Front 61

Portion of the gray matter of the spinal cord that is divided into 10 layers of cell bodies and houses different types of fiber information.

Back 61

Lamina

Front 62

Neuron receiving sensory input from the first-order neurons and projects to neurons at higher levels of the CNS.

Back 62

2nd order neurons

Front 63

The SG is located in lamina?

Back 63

II

Front 64

A-delta fibers transmit mainly mechanical/thermal pain along which tract?

Back 64

Neospinothalamic tract

Front 65

C-fibers transmit dull and achy pain along which tract?

Back 65

Paleospinothalamic tract

Front 66

Pain is influenced by a variety of characteristics. Name some of them.

Back 66

Age; sex; race; ethnicity; personality; past experiences; situational variables (mood; stress)

Front 67

Substance P is a neurotransmitter that _____ pain.

Back 67

Facilitates

Front 68

Enkephalins; serotonin; beta-endorphins; dynorphins (opioid) _____ pain.

Back 68

Inhibit

Front 69

T or F: Motor level stimulation of Castel's Spinal Level III is enhanced by low-frequency (1-7 pps); high intensity muscle contraction.

Back 69

True

Front 70

T or F: Increased blood flow help to rid the body’s inflammatory chemical mediators including: bradykinin; prostaglandins; histamines; and non-granular leukocytes.

Back 70

Acupressure; deep massage; TENS

Front 71

Suggest that each individual has a genetically built-in network of neurons called the “body-self neuromatrix.”

Back 71

Neuromatrix Theory