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32 Cards in this Set
- Front
- Back
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What is pain? |
An unpleasant sensory and emotional experience associated with actual or potential tissue damage. |
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Potentially damaging mechanical, thermal, and chemical stimuli that are detected by nerve endings on skin, internal organs, and on internal surfaces; it is a neural response to noxious stimuli |
Nociception |
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4 steps of nociception: |
Transmission, transduction, perception, and modulation |
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Name the tissues where pain receptors are located |
Everywhere but the brain |
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Substances released by cells during injury or inflammation |
Prostaglandins |
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3 types of nociceptive pain: |
Superficial somatic- sharp pain on skin or in mouth
Deep somatic- dull pain from muscles, joints, bones, and tendons.
Visceral pain- from internal organs. Often from inflammation, spasms, over stretching |
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Where can heart pain feel like it's coming from? |
Can be felt down the arm |
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Where does gallbladder pain feel like it's from? |
The shoulder blade |
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How do you explain pain that feels like it is coming from skin in a different area than the internal organ? |
Referred pain due to fibers entering the same segment of spinal cord |
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Compare acute & chronic pain |
Acute pain has a short duration, caused by injury or disease and may cause restlessness, anxiety, and irritability, and sleep disturbances.
Chronic pain lasts over 3 months or indefinitely. May be nociceptive including cancer and non cancer. May result in fatigue, insomnia, social and financial burdens and depression. |
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List several mechanisms in which cancer can cause pain: |
Local pressure, neuropathy, inflammation |
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What is the term for pain due to damage or dysfunction of the sensory system? |
Neuropathic pain |
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Name 4 examples/causes of neuropathic pain: |
Stroke, M.S, phantom limb, CNS injuries |
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How does damage to nerves lead to neuropathic pain? |
When nerve fibers are damaged they send incorrect signals to pain centers; hyper excitability of neurons causes increase in responsiveness to stimuli |
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What is the most reliable indicator of pain? |
The patient; pain is what the patient says it is |
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What aspects of pain should be assessed? |
Location, quality, severity, timing, progress, response to treatment, pain scale and effects on life (mood, sleep, work, relationships) |
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What group of analgesics is used initially to treat mild/moderate pain? |
Non- opiods Acetylsalicylic acid (aspirin), ibuprofen (Advil), and acetaminophen (Tylenol) |
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What group of analgesics are most effective at treating pain? |
Opioids : Morphine, codeine, oxycodone, fentanyl |
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How and where do NSAIDS work? |
They work in the transduction step by blocking prostaglandins |
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What are side effects of NSAIDS? |
Upset stomach, nausea, rash, fluid retention, kidney/heart problems |
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Why is acetaminophen (Tylenol) not an NSAID? |
Tylenol is a pain and fever reducer. It is not an anti-inflammatory drug |
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How and where do opioids work? |
Thy act in the central nervous system and block the signal where pain is felt. |
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What are 4 common side effects of opioids? |
Drowsiness, constipation, nausea, dry mouth (also dependency) |
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What's the difference between tolerance, dependence, and addiction? |
Tolerance refers to physiological state where the effectiveness of the drug has decreased (higher dose needed to reach therapeutic effect); dependency refers to physiologic adaption in response to drug use (withdrawal symptoms may occur of drug use is stopped abruptly); addiction is compulsive use of a drug for non medical reasons |
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Mind/body methods of pain relief: |
Relaxation techniques, hypnosis, imagery, music therapy, distraction |
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Physical non drug methods: |
Hot/cold packs, massage, chiropractic, acupuncture |
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How does TENS work? |
(1) stimulating nerve closes a "gate" mechanism in the spinal cord (2) electric currents release endorphins |
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Converts one form of energy into another; free nerve endings transduce noxious stimuli; in most body tissue; shows little sensory adaptation |
Transaction |
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Has two types of nociceptor fibers; cfibers (un myelinated with slow onset & dull); a-delta fibers ( myelinated, fast onset & sharp) |
Transmission |
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Signal travels on axons to dorsal horn of spinal cord and then to the thalamus |
Conduction |
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Person is becoming consciously aware of pain; involves 2 brain areas ( parietal lobe of cerebral cortex and limbic system); receptors respond to stimulus but sensation is felt in the brain |
Perception |
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Examples of chronic, non-cancer pain: |
Arthritis, low back pain, fibromyalgia syndrome |
