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52 Cards in this Set
- Front
- Back
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The International Association of Pain (IASP) defines pain as...
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Unpleasant SENSORY and EMOTIONAL experience associated with tissue damage
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Pain serves three important functions:
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1. Prevents
2. Learning 3. Promotes rest |
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How do we measure pain?
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1. Physiological measures
2. Behavioral Assessment 3. Self-reports |
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How do we measure pain in infants?
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Facial Activity: Neonatal Facial Coding System (NFCS)
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What is a nociceptor?
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Afferent neurons that carry pain information
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Three kinds of pain perception:
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1. Mechanical nociception
2. Thermal nociception 3. Polymodal nocicpetion |
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What are the 2 major types of peripheral nerve fibers involved?
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1. A-delta fibers
2. C-fibers |
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Central pain pathway: A-delta fibers
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Synapse --> spinal cord --> ventrobasal complex --> somatosensory cortex
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Central pain pathway: C-fibers
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Synapse --> spinal cord --> midline nucleus (thalamus and limbic system)
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What are C-fibers responsible for?
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1. Motivational and emotional aspects of pain
2. Interpretation of pain |
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Specificity Theory:
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Pain system: skin to brain
(direct and constant relationship) |
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Congenital Analgesia?
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People born without the ability to feel pain
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Trigeminal Neuralgia?
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Neuropathic disorder of the trigeminal nerve. Slightest sensations lead to electric pain
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Gate control theory of pain?
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Neural gate can open and close: modulating pain
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Where is the "gate" located?
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In the substantia gelatinosa of the dorsal horns of the spinal cord
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Gate-like mechanism is composed of three fibers:
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1. Large A-beta fibers
2. Small A-delta fibers 3. Small C-fibers |
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Significance of non-painful stimulation?
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Activates Projection (P) neurons and Inhibitory (I) neurons which BLOCKS the signal --> No pain!
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Significance of pain stimulation?
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Small nerve fibers --> activate P neurons and BLOCK I neurons --> Pain!
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What are the 3 factors involved in opening/closing the Gate?
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1. amount of activity in the pain fibers
2. amount of activity in other peripheral fibers 3. messages that descend from the brain |
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Name a few conditions that Open the Gate
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1. extent of injury
2. anxiety 3. boredome 4. focusing on pain |
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Name a few conditions that Close the Gate
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1. Medications
2. counter stimulation 3. relaxation 4. distraction |
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Define allodynia
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Pain due to a stimulus that does not normally produce pain
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Pain has many dimensions:
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Sensory, affective and cognitive
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Define Acute pain
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1. < 6 months
2. Results from a specific injury 3. urgent search for relief |
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Define Chronic pain
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1. > 6 months
2. pain does not decrease with treatment 3. pain does not decrease with time |
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3 different types of Chronic pain
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1. Intractable benign pain (ex. low back pain)
2. Chronic recurrent pain (ex. migraine headaches) 3. Chronic progressive pain (ex. arthritis) |
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Pain is a psychological experience and can be influenced by...
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context, culture, genes, gender, personality traits
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Define Pain-Prone Personality
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numerous personality traits predispose a person to experience chronic pain
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3 key issues in gender differences
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1. perception and response to pain
2. psychosocial and biological factors 3. Response of health care system |
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Who tends to report pain that is more severe, frequent, and lengthy?
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Women
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How do cultural differences affect pain experience?
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1. Meanings
2. Stereotypes 3. Attitudes |
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Pharmacological control: 3 types
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1. peripherally acting analgesics
2. centrally acting analgesics 3. local analgesics |
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Surgical control:
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disruption of pain transmission from periphery to spinal cord (cutting pain fibers)
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Sensory control:
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Transcutaneuous Electrical Nerve Stimulation (TENS) = stimulation on the surface of the skin
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Physical control:
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Physical therapy and massage
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Cognitive-behavioral control:
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relaxation, PMR, MBSR, guided imagery
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Cognitive control: Biofeedback
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Learn how to modify bodily process
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Cognitive control: Hypnosis
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Successfully used to control acute pain (surgery, childbirth, burns) and chronic pain (cancer)
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Cognitive control: Distraction
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redirecting attention to reduce pain
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What is the key to effective pain treatment?
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Multidisciplinary pain management programs
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Assessment of pain (6 factors)
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location, sensory qualities, severity, duration, onset, history
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Is nonadherence to pain regimens a common problem?
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Yes!
Relapse ranges from 30% to 60% |
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Do programs intervene at a family level? Why?
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Yes.
Chronic pain patients often withdraw from their families Programs try to reduce counterproductive behaviors |
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Respondent Pain =
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pain that occurs in response to noxious stimulation
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Operant pain =
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pain that is reinforced by the person's environment
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Pain threshold =
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the point at which the intensity of a stimulus is perceived as painful
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Pain tolerance =
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duration of time or intensity at which a person is willing to endure a stimulus beyond the point where it began to hurt
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Box scale =
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report pain by choosing a number from "no pain" to "worst pain imaginable" in a series of boxes
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Verbal descriptor scale =
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choosing a phrase that most closely resembles the pain they are experiencing
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Visual analog scale =
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mark a point on a line anchored by the phrase "no pain" to "worst pain imaginable"
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Which is the best scale to use?
Box scale, VDS, VAS |
V.A.S
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Narcotics =
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work by binding to opiate receptors in the central nervous system
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