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19 Cards in this Set
- Front
- Back
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Define pain.
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Unpleasant SENSORY & EMOTIONAL experience arising from actual or potential tissue damage or described in terms of such damage.
Also a protective mechanism which encourages escape from a damaging stimulus |
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Nociceptors:
- respond to what? - adaptability - types x6 |
noxious stimuli
none cutaneous visceral somatic chemical mechanical thermal |
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Continuous stimulation of nociceptors can lead to what?
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Primary hyperalgesia
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Silent Nociceptors:
- response? - activation after? - mechanism? |
Does not respond to normal noxious stimuli.
Tissue injury Repetitive C fiber firing producing secondary hyperalgesia as a result of central sensitization. |
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Silent nociceptors are activated by ______ which can produce ______ as a result of _____.
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repetitive C fiber firing
secondary hyperalgesia central sensitization |
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A-delta fibers
- type of receptor - character of pain - myelination |
Mechanothermal
Mechanical Initial Sharp Well-localized pain Thinly myelinated |
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C fibers
- type of receptor - character of pain - myelination |
All types of nociceptors
(polymodal) Dull Diffuse pain Non-myelinated |
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Where is the synapse site for primary pain afferents?
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Laminae I and II
of Dorsal horn |
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What receptors are activated by aspartate and glutamate?
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NMDA receptors
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Explain why rubbing your bruise after slamming your shin on a coffee table alleviates the pain. Use the gate control theory of pain to explain.
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Initial pain from slamming your shin feeds in thalamus via A-delta and C afferent pain fibers which also inhibits the substantia gelotinosa fibers (pain inhibitory pathway)
Rubbing your shin will stimulate mechanoreceptor (A-beta) which stimulate the substantia gelatinosa neurons, thus blunting the pain. |
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Diagnosis of pain is based on what factors? x4
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Background (social, cultural)
Age Gender Interaction with PCP |
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What method is useful for chronic pain?
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Stairstep method
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Describe level 1 of stairstep method.
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Use non-opioid drugs
(NSAID or antidepressant drugs) +/- adjuvant drugs |
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Describe level 2 of stairstep method.
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Low potency opioid drugs
(codeine) +/- adjuvant drugs +/- non-opioid |
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Describe level 3 of stairstep method.
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Full agonist, high potency opioid drugs
(morphine) +/- adjuvant drugs +/- non-opioid |
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Adjuvant drugs used to treat pain. x6
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1. Antihistamine
2. Amphetamines 3. Benzodiazepines 4. Beta-adrenergic antagonists 5. Cytokine antagonists 6. Steroids |
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What type of therapy would be used with migraines?
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Preventative therapy
Abortive therapy |
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What type of drugs would you use for neuropathic pains? x4
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Antidepressants
Anticonvulsants Oral local anesthetic Topical local anesthetic |
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What drugs would you use with a Sickle cell crisis? x3
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Morphine
Meperidine NSAIDS |
