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Terms in this set (62)
an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.
the standard definition of pain
the receptors that detect pain
what are functions of pain?
1) withdraw from damaging stimuli
2) protect a damaged body part while it heals
3) avoid similar experiences in the future
pain that lasts a long time. extends beyond the expected period of healing.
pain that resolves quickly is called
what psychological factors can help modulate the intensity of pain?
social support, hypnotic suggestion, excitement, dsitraction
how does the International Association of Pain classify pain?
1. region of the body involved
2. system whose dysfunction might be causing pain
3. duration and pattern of occurance
4. intensity and time since onset
classes of pain:
inflammatory- tissue damage
pathological - disease state
produced by stimulation to peripheral nerve fibers that are responding to stimuli approaching or exceeding harmful intensity
can be classified by the "mode of noxious stimulation" and can be divided into visceral, deep somatic, and superficial somatic pain.
type of nociceptive pain
thermal: heat or cold
mechanical: crushing, tearing, etc
chemical: iodine in a cut, chill powder in eyes
diffuse pain, difficult to localize, often referred to as distant usually superficial structures
visceral pain (highly sensitive to stretch, ischemia, and inflammation, but not burning & cutting)
may be accompanied by nausea and vomiting along with other autonomic nervous system responses. often described as a sickening, deep, squeezing, and dull
initiated by stimulation of nociceptors in ligaments, tendons, bones, blood vessels, fascia, and muscles. dull, aching, poorly localized. sprains and broken bones cause this kind of pain. muscular ache.
deep somatic pain
initiated by activation of nociceptors in the skin and other superficial tissues. sharp, well defined, and CLEARLY LOCALIZED PAIN.
superficial somatic pain
minor wounds and minor burns (1st degree) produce this kind of pain. pin prick.
superficial somatic pain.
caused by damage or disease to any part of the nervous system affecting bodily feelings. often described as burning, tingling, electrical, stabbing, or pins and needles. ex. sciatica and bumping your "funny bone" are examples of this kind of pain
pain felt in a part of the body that has been lost or from which the brain no longer receives signals. a type of neuropathic pain. amputees often feel this: 82% upper, and 54% lower
pain caused by increased or prolonged by mental, emotional, or behavioral factors. heartaches, back pain, stomach pain
pain that comes suddenly and for short periods of time. not alleviated by the patients normal pain management methods. cancer pt. will periodically feel pain through their medication.
pain that arises as a result of activity. movement of a joint with arthritis, stretching a wound, etc.
what are the four stages of nociception?
occurs when nociceptors are stimulated by: damage to nerve endings, release of chemicals at the injury site.
involves the conduction of pain signals along afferent pathways in periphery to the spinal cord and brain. Primary fibers involved are A delta fibers (somatic) and C fibers (viscera)
the CONSCIOUS awareness of the pain. the cerebral cortex interprets pain signals and attaches meaning to them.
amount of pain stimulated required before pain is perceived - generally similar for all ppl
refers to the amount of pain someone is able to tolerate before seeking medical intervention.
the modification of pain signals by centers along the pain pathway in both the central nervous system and peripheral nervous system.
what does a dull aching pain tell us?
tends to be diffuse, last a long time, carried by slow conducting small unmyelinated C fibers
what does a sharp pain tell us?
tends to be well localized, tends to last a short time, carried by fast conducting large thinly myelinated A delta fibers.
pain receptors are
free nerve endings - other receptors when stimulated intensely enough may act as pain receptors as well.
these tracts are ASCENDING somatic sensory pathways that convey pain signals from the skin and skeletal muscles.
afferent signals travel from nociceptors in the skin, tissue, & muscles to the dorsal horn of spinal cord, release substance P, then the __________ travels from the spinal cord to the thalamus, which relays signals to the somatosensory area of the cerebral cortex.
sensory pathways that convey pain sensation from the face. afferent signals travel from nociceptors in the face via the CN V, to the thalamus from where they are relayed to the primary somatosensory areas of the cerebral cortex.
DESCENDING TRACTS that receive pain information from the periphery throughout the afferent spinal nerves that synapse in the formation of the brain stem. This signal travels to the raphe nuclei of brain stem and then they release endorphins through a DESCENDING pathway to the place of pain origin to decrease the sensation of pain.
bind to receptor sites and induce both analgesia and stupor
there are brain stem centers that provide natural analgesia. they are referred to as pain inhibiting centers.
-raphe nuclei in the medulla
- periaquaeductal gray matter in midbrain
- locus ceruleus in the pons
pain can be diminished at several levels
periphery, dorsal horn, supraspinal descending systems, hormonal systems, cortical level
decrease the synthesis of prostaglandins, which in turn sensitize peripheral pain receptors
inhibit prostaglandin production, thereby reducing the number of pain chemicals available to stimulate nociceptors
nonsteroidal anti-inflammatory drugs (NSAIDs, ibuprofen)
administered to nerve endings at the site of injury to stop propagation of impulse
alters the blood flow to the areas and reduces swelling
heat or cold
what intensifies pain?
edema and endogenous chemicals can sensitive free nerve endings in periphery
following a burn injury, sensory stimuli that would be normally be innocuous can cause heightened pain
fear and anxiety can also increase sense of pain
what factors can lead to chronic pain?
prostaglandins (bad guys) can form as a result of damaged cells.
arachidonic acid is formed which is further broken down into prostaglandins.
prostaglandins sensitize the nerve endings and lower pain threshold.
a condition in which non painful stimulus now produces pain
another factor that can lead to chronic pain is the
synaptic memory of pain in the nociceptive pathway can be formed when glutamate binds to certain receptors on the post synaptic neuron.
pain that is perceived to originate from one body region when it actually comes from a different organ.
referred pain for heart is
left chest, and left inner arm, upper-mid back
referred pain for the liver is
upper right shoulder and mid chest
referred pain for the kidneys
above pelvis, above butt crack
referred pain for bladder
above pelvis, on both lower butt checks
referred pain for appendix
right over appendix, lower right corner
primary non-invasive pain management systems.
massage, electrical stimulation, theromtherapy, cryotherapy, hydrotherapy, fluidtherapy, kindesiotape, acupuncture, stress management/meditation, biofeedback.
stimulates mechanoreceptors and then stimulates the release of enkephalin and diminishes the release of substance P
blocks the transmission of pain signals along the nerve. promotes the release of endorphins. causes vasodilation increasing oxygen to blood in affected areas
electrical stimulation (TENS, MET, IFC)
hot packs, ultrasound(converted into heat), parafinn, diathermy
cold packs, anesthetizing sensory receptors, causes vasoconstriction which reduces inflammation
heat using water, type of thermotherapy, whirlpools, showers, reduces stress to joints, reduces spasms
use of elastic tape over muscles to assist in function and provide support to prevent over use and to reduce pain and inflammation. used for muscular disorders
stimulates the release of naturally occurring opioids in the body. stimulates mechanoreceptors.
stimulate release of body's naturally occurring endorphins. visual imagery.
pts learn to consciously control body functions that are typically involuntary such as muscle tension and heart rate.
release muscles in areas of guarding.
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