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42 Cards in this Set
- Front
- Back
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Pain is ____ and is a ______ that ______ us.
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pain is ADAPTIVE and is a signal that INFORMS us
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t/f
Infection is the number one symptom and cause for people to go seek help |
False -
PAIN is the number one reason for people to seek medical help |
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___ is the number one cited reason for euthanasia and assisted suicides
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pain
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What are some example of a pain's meaning having a positive influence of the pain experience?
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- WWII Soldiers - pain meant they were being shipped back home
- India --> hanging ritual pain is an honor |
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What are some things that can influence the experience of pain?
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- meaning of the pain
- context of the pain (arousing context seems to decrease pain sensitivity) - cultural influences in expression - cultural differences in sensitivity |
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Describe the cultural difference in pain expression in the following cultures:
English Italian American |
english - stoic in pain reporting
italian - quiet vocal, often verbalized that they were in pain american - quite vocal and more strongly affected by pain Why? - individual physical comfort is stressed in our culture |
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____ ______ reported having a greater pain sensitivity other than Caucasians
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african americans
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What were some reasons that Mechlin (2005) proposed that African Americans have a higher pain sensitivity?
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- AA are under chronic stress from racial discrimination
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t/f
ethnic minorities are across the board getting pain medication and treatment in higher doses that white Americans |
false.
ethnic minorities are receiving suboptimal pain management from their healthcare system. why? suspicions of malingering, drug abuse, etc etc |
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What are three subjective but informative pain measurement items?
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1) McGrill pain questionnaire (MPQ) - patient will rate then they are experiencing. ie. scale 0 (not painful) to 10 (excruciatingly painful)
2) visual analog scales - i.e. faces scale (:]) no pain (:|) some pain (;[) very painful good for children, non verbal people, and non english speakers 3) pain behaviors formally measured with scales informally measured by observation - any behavior that lets others know that you are in pain (crying, limping, grimacing) |
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What is algology?
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the study of pain
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Describe how the SPECIFICITY THEORY explains transmission of pain.
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the specificity theory states that there are specialized nerve fibers that are responsible for pain transmission
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Describe how the PATTERN Theory explains transmission of pain.
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the pattern theory states that there are certain patterns of neural stimulation that are responsible for pain
- rate/degree/amount of nerve firing --> stimulation |
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nociception is...
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perception of a noxious stimulus
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What are two types of peripheral nerve fibers?
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a-delta fibers
C-fibers |
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Small, myelinated fibers, fast transmission
-associated with sharp pain goes quickly through the thalamus and cortex |
a-delta fibers
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small, unmyelinated fibers with slower transmission.
associated with a dull, aching pain |
c-fibers
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What are the differences in connections between a-delta fibers and c-fibers?
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a-delta fibers - goes through thalamus to the cortex
c-fibers - innervates through lower brain areas, connecting to arousal system and limbic system (emotional center) , may reflect why chronic patients are more depressed |
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t/f
a practitioner may choose to use either a centralist or a peripheralist theory on pain |
true - has to do with the source of the pain and where it arises from
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Describe how a practitioner who follows the CENTRALIST theory may explain pain
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peripheral (outside the CNS) nociception is no longer present, but there are mechanisms in the CNS that are continuing the processes associated with pain
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What do recent theories about the centralist approach suggest?
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recent theories suggest that persistent chronic pain --> induces changes in the nervous system such that non-nociceptive nerve receptors become nociceptive.
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Describe how the PERIPHERALISTS theorize where pain arises from.
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Peripheralists suggest that there is continued pain input from the periphery, and that it should be addressed at the periphery.
ie. if hit in hand, would look at hand tissue then in brain, etc etc. Preferred treatment would be to block messages to the periphery. |
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Both the centralist and peripheralist view on pain management are highly ___ and a practitioner bay choose ___ to work with.
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highly individual, either
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What are the two ways of distinguishing clinical management of pain? (how is pain described clinically?)
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acute and
chronic distinction |
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Acute distinction of pain:
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pain is due to a specific injury, when the tissue heals, the pain will go away.
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Chronic distinction of pain:
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often begins as acute pain, but does not go away.
3/6 months is the main cutoff for pain persistence |
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Classification of pain complaints:
ACUTE |
- up to a few days duration
- can be mild to severe - cause known or unknown - presumed nociceptive input - "fix me" model |
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Classification of pain complaints:
SUB ACUTE |
- a few days to a few months in duration
- pain is no longer an emergency, but in most ways is treated like an acute pain, ie using the "fix me" model |
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Classification of pain complaints:
RECURRENT ACUTE |
- recurrent or continued nociceptive input from underlying chronic pathological processes (ie arthritis)
- pain waxes/wanes |
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Classification of pain complaints:
ONGOING ACUTE |
- due to uncontrolled malignant neoplastic disease (cancer)
- continued nociceptive input |
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Classification of pain complaints:
CHRONIC BENIGN |
- Non-neoplastic (benign)
- 6 month duration - no known nociceptive input - pain made more severe by any type of subsequent sensory input - "central pain" - no input source - seemingly adequate coping by the patient |
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Classification of pain complaints:
CHRONIC INTRACTABLE BENIGN PAIN SYNDROME (CIBPS) |
Chronic pain with poor patient coping
pain becomes central focus of the patient's existence |
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What type of pain complaint classification is characterized by being a few months in duration and where the pain is not signifying an underlying emergency
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sub-acute classification
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What type of pain complaint classification is characterized by presence of uncontrolled malignant neoplastic disease and continued nociceptive input?
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ongoing acute
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What type of pain complaint classification is characterized by poor patient coping and the pain becoming central to their life?
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chronic intractable benign pain syndrome
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What are the four ways that pain patients can be classified?
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Class I, Class II, Class III, Class IV
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Class I
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"pain amplifier"
- pathology + pain behavior less documented pathology, more exhibition of pain behaviors |
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Class III
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"chronic sufferer"
+ pathology + pain behavior more documented pathology, more exhibited pain behaviors |
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Class II
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"pain verbalizers"
- pathology - pain behaviors just talk about the pain but do not demonstrate pain behaviors (limping, etc) |
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Class IV
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" pain reducers"
+ pathology - pain behaviors |
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why should acute and chronic pain be differentiated?
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chronic pain presents a different profile,
most pain control techniques are less effective on chronic pain |
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Why is chronic pain different to treat that acute pain?
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chronic pain is multi dimensional
results from an interaction among physiological, psychological, social, and behavioral factors |
