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71 Cards in this Set
- Front
- Back
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an unpleasant physical and emotional experience which signifies tissue damage or the potential for such damage
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Pain
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Pain is influenced by
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past experiences, expectations
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The level of noxious stimulus required to alert the
individual to possible tissue damage” or “The least experience of pain which a subject can recognize |
pain threshold
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pain threshold is represented by
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complaints of pain after an injury, or the first pain
produced by a noxious stimuli being transmitted via A-delta fiber to the synapse at the dorsal horn |
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Strength, intensity, and location of pain
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Sensory-Discriminative System
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Reports the quality of pain
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Motivational-Affective System
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Interprets sensations based on past experiences and expected
outcomes to block, modulate, or enhance the perception of pain |
Cognitive-Evaluative System
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“Measure of how much
pain a person can or will withstand” or “The greatest level of pain which a subject is prepared to tolerate |
Pain tolerance
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Pain tolerance is influenced by
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=Cultural prescription
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Experienced when tissue damage is impending and/or
after an injury has occurred |
Acute pain
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Pain occurring with trauma to the skin, skeletal
muscles and bones. |
Somatic pain
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well-localized (e.g., pin
prick) |
Superficial somatic pain
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not well-localized (e.g., muscle ache)
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Deep somatic pain
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Defined as pain that does not resolve in the usual time
frame it takes for the disorder to heal or that continues beyond the duration of the noxious stimulation |
Chronic pain
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Pain perceived in an another area which seems to have
little relation to the existing pathology (e.g., Kehr’s sign |
Referred pain
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May outlast the causative events because of altered reflex
patterns, continuing mechanical stress on muscles, learned habits of guarding, or the development of hypersensitive areas, called trigger points. |
Referred pain
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Function of acute pain
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Alerts an individual to an actual problem or
potential tissue damage |
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duration of acute pain
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May last minutes-to-days, depending upon the
presence of a noxious stimulus |
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Pain of recent and sudden onset with
demonstrable etiology and limited course |
acute pain
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Muscle contractions or prolonged spasms cause
ischemia and chemical mediators (bradykinin, histamine, prostaglandins) to sensitize A-delta and C-fibers thereby causing pain and spasms (positive feedback loop) to continue. pain spasm pain spasm |
skeletal muscle
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Pain of long duration associated with anguish,
apprehension, and depression |
chronic pain
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duration of chronic pain
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May persist for months-to-years
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Destroys large primary afferents, resulting in imbalance
of large (tactile) and small (pain) fiber input, therefore the gate for pain is left open |
chronic pain
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A self-report device
measuring the magnitude of internal states such as pain and mood14 |
Visual Analog Scale VAS
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what is a better scale NRS or VAS?
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NRS
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Used to establish spatial
property of pain |
Pain Chart/Diagram
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painful areas
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blue
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numbness and tingling
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Yellow
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burning or hot areas
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Red
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cramping
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Green
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A validated, multidimensional tool assessing
pain in 3 dimensions based on 20 sets of words that the patient selects to describe his/her pain |
McGill Pain Questionnaire
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3 dimensions of MPQ?
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Sensory, affective, evaluative
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64 question profile to assess
functional impairment associated with pain |
Activity Pattern Indicators
Pain Profile |
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Patient-completed
questionnaire measuring the extent to which chronic interferes with a persons ability to engage in life activities |
Pain Disability Index
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Light pressure/touch
p ) Sensitive to bending hair follicle Responds to pressure on skin |
Mechanoreceptor (superficial)
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Temperature and temperature
changes |
thermoreceptor (superficial)
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pain
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nociceptor (superficial)and (Deep)
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Changes in muscle length
Changes in muscle tension Changes in joint position Joint end range, possible heat |
proprioceptors (deep)
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generally unmyelinated, naked-nerves, sensitive to and
stimulated by potentially damaging mechanical, chemical, and thermal stress |
Nociceptors
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Classified as mechanical, thermal or polymodal (ability
to be depolarized by different stimuli) |
Nociceptors
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Irritation/deformation of n. results in depolarization of
the pain fibers and release of a variety of neuropeptides (e.g., Substance P) to transmit the painful impulse |
nociceptor
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Display sensitization to repeated or prolonged
stimulation (e.g., accommodation |
nociceptor
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Impulses from sensory
receptors to the brain |
Afferent neural
transmission |
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Impulses from the
brain toward the periphery |
Efferent neural
transmission |
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Changes in muscle length
and tension |
A-alpha
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Touch/pressure
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A-beta
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Noxious mechanical
(sharp pain) and temperature |
A-delta
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Noxious mechanical (dull
pain), touch, and temperature |
C-fiber
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occurs immediately
after injury due to the release of chemical mediators |
Primary hyperalgesia
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Increases the painful area as the chemicals diffuse
into the surrounding tissue causing them to become hypersensitized |
secondary
hyperalgesia |
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substance that passes information between neurons
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neurotransmitters
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facilitators of pain
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Substance P
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Inhibitors of pain
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Enkephalins, betaendorphins, serotonin, dynorphins (opioid)
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“A neuron that connects
the sensory receptors in the PNS to neurons in the CNS” |
1st
order neuron |
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where do multi tract pathways carry the sensory information to?
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Brain
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natural occuring opiod, inhibits pain impulse and prevents nociceptive information from passing to the second order neuron
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Enkephalins
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acts on opiate receptors throughout the nervous system and inhibits activity in pain system
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beta endorphins
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this is where cell bodies of second order neurons are
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dorsal horn of spinal cord
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cells organized from posterior to anterior on the dorsal horn
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lamina
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lamina II
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SG
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what system is the first order neuron in?
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PNS
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what system is the second order neuron in
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CNS
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Neurotransmitter released centrally to produce the pain response and peripherally producing hyperalgesia and inflammatory responses
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Substance P
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sensitization of the nerve fibers so that other mediators can enhance nociception
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prostaglandin
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directly stimulates nociceptors
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bradykinins
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2 components of descending pathway?
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PAG, Nucleus raphe magnus
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connects the emotional centers of cortex to pain centers in spinal cord, block painful stimuli, projects to medulla
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PAG
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activated by PAG then project to dorsal horn, activating interneurons that inhibit activity of tract cells through the action of neurotransmitter enkephalin fibers from NRM release neurotransmitter serotonin which inhibits tract cells
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Nucleus raphe magnus
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3 parts of MPQ
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1. localize pain areas using diagram, superficial or internal or both or with colors
2. VAS 3. circle or underline words in each group, only 1 word per category. |
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neurons in the spinal cord and thalamus that respons to a broad range of mechanical pressures. they respond to both touch and pain
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wide dynamic range cells
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2nd order afferent neurons
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Transmittion T-cell
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