Pain Management

Front 1

Cutaneous and superficial pain

Back 1

Arises in the skin or the subcutaneous tissue
Ex: Touching a hot stove or getting a paper cut

Front 2

Visceral Pain

Back 2

Caused by stimulation of deep internal pain receptors
Most often in abdominal cavity, cranium, or thorax
Varies from local, achy discomfort to more widespread intermittent and crampy pain
Ex: Menstrual cramps, labor pain, GI infection, bowel disorders, organ cancers

Front 3

Deep somatic pain

Back 3

originates in ligaments, tendons, nerves, blood vessels, and bones
Tends to last longer
Ex: fracture or sprain, arthritis, and bone cancer

Front 4

Radiating pain

Back 4

starts at the source but extends to other locations
Ex: sore throat may extend to the ears and and head

Front 5

Referred Pain

Back 5

Occurs in an area that is distant from the original site
Ex: Pain from a heart attack may be experienced down the left arm , through the back, or into the jaw

Front 6

Phantom Pain

Back 6

pain that is perceived to originate from an area that has been surgically removed
Ex: Amputees may perceive that the limb exists and experience burning, itching, and deep pain in that area

Front 7

Nociceptive pain

Back 7

most common type of physical pain experienced
Occurs when pain receptors (nociceptors) respond to stimuli that are potentially damaging
Ex: result of surgery, trauma, or inflammation

Front 8

neuropathic pain

Back 8

a complex and often chronic that arises when injury to one or more nerves results in repeated transmission of pain signals even in the absence of painful stimuli
Ex: Poorly controlled diabetes, stroke, tumor, or viral infection

Front 9

Acute pain

Back 9

short duration and is generally rapid in onset
varies in intensity and may last up to 6 months
Ex: injury or surgery
Protective, in that it indicates potential or actual tissue damage

Front 10

Chronic Pain

Back 10

pain that lasted 6 months or longer and often interferes with daily activities
Progressive disorders

Front 11

Intractable pain

Back 11

Both chronic and highly resistant to relief
Should be approached with multiple methods of pain relief

Front 12

Adjectives used to describe pain

Back 12

sharp or dull, aching, throbbing, stabbing, burning, ripping, searing, or tingling
Periodicity may be referred to as episodic, intermittent, or constant

Front 13

Transduction of pain

Back 13

nociceptors become activated by the perception of potentially damaging mechanical, thermal, and chemical stimuli

Front 14

Mechanical stimuli

Back 14

external forces that result in pressure or friction against the body
Ex: stretching of tissue in joints and body cavities related to bleeding and swelling and compression of body tissues caused by the force of an accident
Surgical incisions, friction, or skin shearing

Front 15

Thermal stimuli

Back 15

exposure to exreme heat or cold
touching a hot object, or having an earache from being in the cold

Front 16

Chemical stimuli

Back 16

internal or external
external - lemon juice on an open cut
internal - chest pain in a heart attack

Front 17

Transmission of pain

Back 17

peripheral nerves carry the pain message to the dorsal horn of the spinal cord
conducted to spinal cord along two types of fibers: a-delta fibers, and C fibers

Front 18

A-delta fibers

Back 18

large-diameter myelinated fibers that transmit impulses at 6 to 30 meters per second
fast pain impulses
Ex: when you bump your knee , the initial sharp pain is carried by a-delta fibers

Front 19

C Fibers

Back 19

smaller unmyelinated fibers that transmit slow pain impulses
dull diffuse pain travels at a slow rate
conduct pain from mechanical, thermal, and chemical stimuli
Ex: bump your knee, the lingering ache in the tissue, carried by C fibers

Front 20

Pain perception

Back 20

the recognition and definition of pain in the frontal cortex

Front 21

Pain threshold

Back 21

the point at which the brain recognizes and defines a stimulus as pain

Front 22

Pain tolerance

Back 22

the duration or intensity of pain that a person is willing to endure
Ex: mother giving child a kidney may feel less pain than someone losing a kidney because of cancer

Front 23

Hyperalgesia

Back 23

extreme sensitivity to pain

Front 24

Pain modulation

Back 24

pain signals can be either facilitated or inhibited, and the perception of pain can be thereby changed
2 mechanisms allow for modulationof pain: endogenous analgesia system and the gate control mechanism

Front 25

Endogenous analgesia system

Back 25

Neurons in the brain stem activate descending nerve fibers that conduct impulses back to the spinal cord
Trigger the release of endogenous opiods and other substances to block the continuing pain impulses and provide pain relief
Natural occuring analgesic neurotransmitters that inhibit the transmission of pain impulses and the release of substance P
3 neurotransmitters are: enkephalins, dynorphins, and beta endorphins

Front 26

What must occur to generate pain?

Back 26

nociceptors must receive a sufficient number of noxious stimuli.

Front 27

What are the four physiological steps invovled in the pain process?

Back 27

Perception, Modulation, Transduction and transmission

Front 28

What are the 4 most common emotional responses to pain?

Back 28

fear, guilt, anger, helplessness, and lonliness

Front 29

what factors influence behavioral responses to pain

Back 29

Sociocultural - through interaction with family and social support groups