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47 Cards in this Set
- Front
- Back
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nociception
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Activation of specialized nerve fibers that signal tissue damage as occurred
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Nociception is accompanied by: |
Cognitive, behavioral and affective states Chronic pain patients experience more psychopathology than AIDS, diabetes and cancer patients |
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Suffering
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Purely emotional pain Diffuse, becomes more psychological and physiological |
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Does pain have survival value?
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Yes, it warns of danger or injury and can prompt seeing a doctor
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What are the different pain receptors for?
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Cutting, burns, and acidity
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Cultural variations in experience of pain
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Women experience and report more pain than men (socialization) Differences between pain perception and geographic areas, as well as different ethnicities and perceptions of pain With age is increase in pain thresholds but more reporting of pain |
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Acute pain
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Short-term pain
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Chronic pain
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Long-term pain
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Chronic malignant pain
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pain associated with diseases such as cancer
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Chronic non-cancer pain
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pain not associated with another disease process (i.e. lower back pain)
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Psychogenic Pain
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purely psychological pain
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neuropathic pain
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pure nociception firing of nerve, telling you there's a problem |
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Somatic pain
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pure physiological pain without damage (can be psychogenic)
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Recurrent acute pain
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series of intermittent episodes of pain that are acute but chronic due to lasting more than 6 months (migraine headaches) Flare up, then disappears |
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Chronic progressive pain
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persists longer than 6 months and increases in severity over time (malignancies)
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Chronic benign pain
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varies in severity, affects any muscle group, persists for 6 months or longer and intractable to treatment (chronic lower back pain)
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Four distinct processes in understanding pain
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Transduction: at level of receptors (sensation Transmission: information from receptors relayed to CNS (spinal cord) Modulation: Neural activity leading to control of pain information in brain (Increasing or decreasing of pain, volume) Perception: neural activity of transmission and modulation results in experience of pain (at brain) |
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Efferent
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effecting a change think it so you make it happen; from the brain to the body |
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afferent
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takes from the body to the brain
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A-beta fibers
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large myelinated nerve fibers quick sharp pain |
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A-delta fibers
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small fibers slow aching pain |
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C fibers
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small non-myelinated nerve fiber non-myelinated is slow pain |
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Substance P
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chemical transmitter of information for pain system
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EMG
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electromyography muscles |
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EEG
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electroencephalogram brain |
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Specificity Concept
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Von Frey 1894 Pain is an independent sensation with specific receptors responding to specific types of pain Burn, chemical, cutting (there are different receptors) |
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Pattern Theory
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Goldschneider 1886 Different patterns of stimulation create different types of pain way something fires transmits pain (long or short firing) |
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Pain Prone Personality
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Engel, 1959 Focused on emotion and pain Could be suffering or not, just depressed and anxiety |
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Cognitive-Behavioral MOdel
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People are conditioned to experience pain based on expectations Therapy is very self-instructional to teach patient to control process on their own First homework assignment: schedule to see what they do (behavior) 2nd: next week add what you were thinking (cognition) 3rd: next week link with emotion Try to link cognition, emotion and behavior |
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Diathesis-Stress model
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Physiological predispositions interact with psychological factors to create pain Two factors: genetic predisposition and some other factor that creates pain Ex: alcoholic parents, plus a social group that pressures you to drink |
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Gate Control Theory (GCT)
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the substanstia gelatinosa of the spinal cord acts as a gate allowing pain to be perceived or not Purpose of a gate is to keep stuff out or let stuff in Close gate: stop pain at spinal cord through distraction or counter-irritation Open gate: boredom and depression lend themselves to feel pain |
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Why is gate control theory difficult to apply?
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It takes time to learn Meds are too common, expect those first People don't think they're making the pain worse (psychogenic pain) so they think it's purely biological |
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Anxiety and fear can ____ pain
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increase
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Happiness and optimism can ______ pain
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decrease
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Appraisal
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how we appraise a wound impacts the perception of pain
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Counterirritation
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scratching or rubbing around the area of pain to reduce pain
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Transcutaneous electrical nerve stimulation (TENS)
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minute bursts of electricity to nerve endings under skin near the painful area
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Stimulation produced analgesia (SPA)
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electrical stimulation of the brain
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Surgery
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severing nerves transmitting pain or lesioning parts of the brain
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Placebo effect
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expecting something to work
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cognitive biases
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catastrophize, locus of control (it's biological in nature, I'm not in control), learned helplessness
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distraction
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engaging in some other activity reading, guided imagery, meditation |
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Hypnosis
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combination of relaxation and distraction Requires booster sessions to really teach a person |
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Biofeedback
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teaching control of autonomic activity
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Self-management programs
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Make patient responsible for changes and focus on the following goals: Training to divert attention from pain improve physical condition (physical therapy) increase daily activity teach new coping methods (change locus of control, learned helplessness) management of depression, anger decrease tension, anxiety and conflict |
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____ relaxes blood vessels, relieves pressure in veins
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Caffeine
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Pain and its impact on doctor-patient relationship
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Can create problems pain meds can become acclimated in the body, keep switching pain meds Pain management is covered lightly in med school despite it being a primary factor in assisted suicide |
