Patho Exam 4 Ch. 4 Pain – Flashcards
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How to we perceive pain?
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Nociceptors - free sensory nerve ending that are present in most tissues of body
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What does the pain threshold refer to?
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Pain threshold refers to level of stimulation required to activate nerve ending sufficiently to perceive pain
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A pt had surgery on his fractured humerus with application of pins and a cast. He complains of pain in the surgical area. What type of pain is he feeling?
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Somatic pain
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Define somatic pain?
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may arise from the skin (cutaneous) or deeper structures such as bone or muscle, conducted by sensory nerves
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Define visceral pain?
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originates in organs and travels through sympathetic fibers
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What is the pain threshold?
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level of stimulation required to activate teh nerve ending sufficiently for the individual to perceive pain.
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The ability to withstand pain or the perception of its intensity is what?
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pain tolerance
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What are the 2 types of afferent fibers?
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-Myelinated A delta - transmit impulse rapidly -Unmyelinated C - transmit slowly
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Each spinal nerve conducts impulses from a specific area of the skin called____?
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dermatome
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What is an impulse that tracels BACK to the muscle that initiate involuntary muscle contraction to move body away from source of pain?
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Efferent
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What is the GATE theory?
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control systems, or "gates" are built into the normal pain pathways in the body that can modify the entry of pain stimuli into the spinal cord and brain.
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What is TENS?
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transcutaneous electrical nerve stimulation is a therapeutic intervention that increases sensory stimulation at the site, thus blocking pain
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When pain occurs at two or more sites the individual will report only pain at one site. What is this called?
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Perceptual dominance
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An opiate like chemical released during exercise that blocks the conduction of pain impulses?
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Endorphins
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What type of pain is perceived at a site distant from the source?
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referred pain
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Source of pain stimulus localized to specific area
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localized
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Originates in deep organ/muscle, but perceived on surface of body in different area
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referred pain
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Example: pain in left neck and arm = heart attack or ischemia in heart
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referred pain
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• After amputation experience itching, tingling, pain in lost limb
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phantom pain
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• Brain acts as if limb is still present when processing incoming stimuli
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phantom
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• Prolonged or severe chronic pain in history increases risk of _____ pain
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phantom
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What is perceptual pain?
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Pain at one location may cause an increase in threshold at another location
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Caused by dysfunction or damage to brain or spinal cord
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central
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• Example: abscess, infarction, hemorrhage, tumor, or damage resulting from direct injury • Can be localized or involve a large area of body
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central
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• Persistent, irritating, and can cause considerable suffer over extended period of time
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central
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• Sudden, severe, short-term indicating tissue damage either localized or generalized
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Acute
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• Initiates a physiologic stress response with increased blood pressure, heart rate, cool, pale moist skin' increased respiratory rate, and increased skeletal muscle tension
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Acute
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• Vomiting may occur • Strong emotional response indicated by facial or verbal expression and high anxiety level
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Acute
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A Myelinated fibers
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acute
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C unmyelinated fibers
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chronic
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• More difficult to treat and prognosis less certain • Often perceived as generalized and difficult to discern exact location
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Chronic
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• More difficult to deal with and quite debilitating • Impossible to sustain a stress response over long period of time fatigue, irritable, depressed
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Chronic
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• Sleep disturbances, appetite affected weight gain or loss • Loss of hope, depression, anger
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chronic
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• Associated w/ chronic pain due to advancement increased pressure on nerve ending, stretching of tissues, obstruction of vessels, ducts or intestines
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Cancer
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Application of an ice pack to a painful site may reduce pain because you are more aware of the cold than the pain? What is this an example of?
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Gate theory: closure of gate in response to other stimuli along competing nerve pathways
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• Caused by trauma or disease involving peripheral nerves • Tingling to burning or severe shooting pain
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Neuropathic
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• Movement can stimulate as well as injured nerves that can become hyperexcitable
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Neuro
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• Example: Neuralgias extremely painful resulting from damage to peripheral nerves caused by infection or disease
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Neuropathic
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• Causalgia (type of neuralgia) severe burning pain triggered by normally "nontraumatic" stimuli such as a light touch, sound, cold
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Neuropathic
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• Results from profound, sudden loss of blood flow to organ or tissues in specific area of body hypoxia tissue damage and release of inflammatory and pain-producing substances
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Ischemic pain
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Aching, burning, prickling to a strong, shooting pain
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Ischemic
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•Example: Atherosclerotic disorders that cause blocking of arterial blood flow. Especially in the lower extremeties
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Ischemic
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The impulses related to acute pain are usually transmitted by:
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myelinated A delta fibers.
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In which structure do pain impulses ascend the spinal cord?
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Spinothalamic tract
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According to the gate-control theory, passage of pain impulses may be naturally blocked:
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at the synapse by entry of other sensory impulses.
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What is the term used to describe the degree of pain that is endured before an individual takes action?
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Pain tolerance
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Pain perceived in the left arm during the course of a heart attack is an example of:
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referred pain.
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A headache that is related to changes in cerebral blood flow is classified as a/an ________ headache.
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migraine
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What is a common analgesic administered to control a moderate level of pain?
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Codeine
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Which of the following applies to spinal anesthesia? a. It causes analgesia with loss of consciousness. b. The drug is injected into cerebrospinal fluid (CSF) or the epidural space of the spinal cord. c. The drug stimulates release of endorphins in the spinal cord. d. The transmission of pain impulses is blocked in a small area of the body.
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The drug is injected into cerebrospinal fluid (CSF) or the epidural space of the spinal cord.
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Which of the following is a characteristic of acute pain but not of chronic pain? a. Depression and debilitation b. A perception of increased generalized pain and discomfort c. Fatigue and lower pain tolerance d. Severe but short term
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Severe but short term
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hat is the role of nociceptors? They are:
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pain receptors that are stimulated by thermal, chemical, or physical means.
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Intractable pain is best defined as:
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severe pain that cannot be controlled by medication.
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Which of the following statements is TRUE? The brain is more aware of pain impulses when the reticular activating system is depressed. b. Acute pain does not cause a reflex response at the spinal cord synapses. c. Young infants typically respond to pain with tachycardia and increased blood pressure. d. Chronic pain is easier to tolerate without negative effects.
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Young infants typically respond to pain with tachycardia and increased blood pressure.
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Which of the following analgesics acts to reduce pain at the peripheral site?
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Acetaminophen
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Cancer-related pain has been broken down into three basic categories: pain caused by the advance of the disease and resultant damage to the body, pain that is the result of a coexisting disease unrelated to the cancer, and:
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pain associated with the treatment of the disease.
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Pain that is caused by trauma or disease involving the peripheral nerves is referred to as:
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neuropathic pain.
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Pain resulting from a profound, sudden loss of blood flow to an organ or tissues in a specific area of the body is referred to as:
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ischemic pain.
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Which of the following is a characteristic of chronic pain?
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It is more difficult to diagnose and treat than is acute pain.
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A headache that results from pressure on the meninges surrounding the brain is referred to as a/an:
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intracranial headache.
