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52 Cards in this Set

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The International Association of Pain (IASP) defines pain as...
Unpleasant SENSORY and EMOTIONAL experience associated with tissue damage
Pain serves three important functions:
1. Prevents
2. Learning
3. Promotes rest
How do we measure pain?
1. Physiological measures
2. Behavioral Assessment
3. Self-reports
How do we measure pain in infants?
Facial Activity: Neonatal Facial Coding System (NFCS)
What is a nociceptor?
Afferent neurons that carry pain information
Three kinds of pain perception:
1. Mechanical nociception
2. Thermal nociception
3. Polymodal nocicpetion
What are the 2 major types of peripheral nerve fibers involved?
1. A-delta fibers
2. C-fibers
Central pain pathway: A-delta fibers
Synapse --> spinal cord --> ventrobasal complex --> somatosensory cortex
Central pain pathway: C-fibers
Synapse --> spinal cord --> midline nucleus (thalamus and limbic system)
What are C-fibers responsible for?
1. Motivational and emotional aspects of pain
2. Interpretation of pain
Specificity Theory:
Pain system: skin to brain
(direct and constant relationship)
Congenital Analgesia?
People born without the ability to feel pain
Trigeminal Neuralgia?
Neuropathic disorder of the trigeminal nerve. Slightest sensations lead to electric pain
Gate control theory of pain?
Neural gate can open and close: modulating pain
Where is the "gate" located?
In the substantia gelatinosa of the dorsal horns of the spinal cord
Gate-like mechanism is composed of three fibers:
1. Large A-beta fibers
2. Small A-delta fibers
3. Small C-fibers
Significance of non-painful stimulation?
Activates Projection (P) neurons and Inhibitory (I) neurons which BLOCKS the signal --> No pain!
Significance of pain stimulation?
Small nerve fibers --> activate P neurons and BLOCK I neurons --> Pain!
What are the 3 factors involved in opening/closing the Gate?
1. amount of activity in the pain fibers
2. amount of activity in other peripheral fibers
3. messages that descend from the brain
Name a few conditions that Open the Gate
1. extent of injury
2. anxiety
3. boredome
4. focusing on pain
Name a few conditions that Close the Gate
1. Medications
2. counter stimulation
3. relaxation
4. distraction
Define allodynia
Pain due to a stimulus that does not normally produce pain
Pain has many dimensions:
Sensory, affective and cognitive
Define Acute pain
1. < 6 months
2. Results from a specific injury
3. urgent search for relief
Define Chronic pain
1. > 6 months
2. pain does not decrease with treatment
3. pain does not decrease with time
3 different types of Chronic pain
1. Intractable benign pain (ex. low back pain)
2. Chronic recurrent pain (ex. migraine headaches)
3. Chronic progressive pain (ex. arthritis)
Pain is a psychological experience and can be influenced by...
context, culture, genes, gender, personality traits
Define Pain-Prone Personality
numerous personality traits predispose a person to experience chronic pain
3 key issues in gender differences
1. perception and response to pain
2. psychosocial and biological factors
3. Response of health care system
Who tends to report pain that is more severe, frequent, and lengthy?
Women
How do cultural differences affect pain experience?
1. Meanings
2. Stereotypes
3. Attitudes
Pharmacological control: 3 types
1. peripherally acting analgesics
2. centrally acting analgesics
3. local analgesics
Surgical control:
disruption of pain transmission from periphery to spinal cord (cutting pain fibers)
Sensory control:
Transcutaneuous Electrical Nerve Stimulation (TENS) = stimulation on the surface of the skin
Physical control:
Physical therapy and massage
Cognitive-behavioral control:
relaxation, PMR, MBSR, guided imagery
Cognitive control: Biofeedback
Learn how to modify bodily process
Cognitive control: Hypnosis
Successfully used to control acute pain (surgery, childbirth, burns) and chronic pain (cancer)
Cognitive control: Distraction
redirecting attention to reduce pain
What is the key to effective pain treatment?
Multidisciplinary pain management programs
Assessment of pain (6 factors)
location, sensory qualities, severity, duration, onset, history
Is nonadherence to pain regimens a common problem?
Yes!

Relapse ranges from 30% to 60%
Do programs intervene at a family level? Why?
Yes.
Chronic pain patients often withdraw from their families

Programs try to reduce counterproductive behaviors
Respondent Pain =
pain that occurs in response to noxious stimulation
Operant pain =
pain that is reinforced by the person's environment
Pain threshold =
the point at which the intensity of a stimulus is perceived as painful
Pain tolerance =
duration of time or intensity at which a person is willing to endure a stimulus beyond the point where it began to hurt
Box scale =
report pain by choosing a number from "no pain" to "worst pain imaginable" in a series of boxes
Verbal descriptor scale =
choosing a phrase that most closely resembles the pain they are experiencing
Visual analog scale =
mark a point on a line anchored by the phrase "no pain" to "worst pain imaginable"
Which is the best scale to use?
Box scale, VDS, VAS
V.A.S
Narcotics =
work by binding to opiate receptors in the central nervous system