Med Surge

Front 1

The Theory of Pain

Back 1

The Theory of Pain
• Pain receptors
• Gate control theory • “Pieces of pain”
• Endorphins
• Known as the “6th” Vital sign

Front 2

The Classification of Pain
2 types and 4 phases:

Back 2

The Classification of Pain
Somatic nociceptive pain and visceral nociceptive pain
• Four phases of nociceptive pain: –
--Transduction
– Transmission
– Perception
– Modulation
• Nursing implications

Front 3

Transduction: 1 st phase

Back 3

conversion of pain stimuli to an electrical impulse through peripheral nerve fibers (nociceptors)

book def: Begins with tissue damage causes the release of substances (prostaglandins, bradykinin, substance p, histamine) that stimulate the sensation of pain.

Above substances increase pain transmission and cause an inflammation response.

Front 4

Transmission : second phase

Back 4

-occurs as the electrical impulse travels along the nerve fibers and is regulated by neurotransmitters.

book def: Involves pain sensation to spinal cord
site of injury-spinal
spinal to brainstem
thalamus to cortex for processing

Front 5

Perception: third phase of pain

Back 5

Awareness of pain, occurs in the brain and is influenced by thought and emotional processes

book def: Conscious experience of pain

Front 6

Modulation: last phase of pain

Back 6

Occurs in spinal cord, causing muscles to contract reflexively, moving the body away from painful stimuli.

Book def:Neurons originating in the brainstem descend to the spinal cord and release substances (ex: endogenous opioids) that inhibit nociceptive impulses.

Front 7

Substances that decrease pain transmission and produces analgesia:

Back 7

Serotonin, and Endorphins

Front 8

Pain Threshold:

Back 8

The point at which one feels pain

Front 9

Pain Tolerance:

Back 9

The amount of pain that one is willing to bear.

Front 10

Pain Categories:

Back 10

Acute
Chronic
Nociceptive
Neuropathic

Front 11

Acute Pain:
Def-
Physiological responses:
Behavioral responses:
Interventions:

Back 11

Temporary, usually self limiting, and resolves with tissue healing.
Physi: Sympathetic Nervous System- are fight or flight (tachycardia, hypertension, anxiety, diaphoresis, muscle tension)
bio: Include grimacing, moaning, flinching, and guarding
Interventions: tx of underlying problem

Front 12

Chronic:
Def
physi
psychosocial

Back 12

Not protective, ongoing, occurs frequently, lasting longer than 6 mo, persisting beyond tissue healing.
Physi: Do not usually alter vital signs, but client may experience depression, fatigue, and decreased level of functioning.
Psychosocial implications may lead to disability.
Management of pain is aimed at symptomatic relief.
Can be malignant or nonmalignant

Front 13

Nociceptive Pain:

Back 13

Arrises from damage to or inflammation of tissue other than that of peripheral and Central NS's
-Usually throbbing, aching, and localized
-Pain typically responds to opioids and nonopioid medications.
-TYPES:
Somatic: in bones, joints, muscles,skin, or CT
Visceral: Internal organs/ can cause referred pain
Cutaneous: In skin or subcutaneous tissue

Front 14

Neuropathic Pain:

Back 14

Arrises from abnormal or damaged pain nerves.
Includes phantom pain, pain below the level of spinal cord injury, and diabetic neuropathy.

Front 15

Causes of Acute or Chronic Pain:

Back 15

-Trauma
-Surgery
-Cancer(tumor invasion, nerve compression, immobility etc.
-Arthritis
-Fibromyalgia
-Neuropathy
-Diagnostic and Tx procedures