Podcast
Questions and Answers
Which of the following chemical mediators directly contribute to the transduction of painful stimuli by activating nociceptors?
Which of the following chemical mediators directly contribute to the transduction of painful stimuli by activating nociceptors?
- Prostaglandins and Kinins (correct)
- GABA and Serotonin
- Endorphins and Norepinephrine
- Substance P and Glutamate
What is the primary role of nociceptive pain?
What is the primary role of nociceptive pain?
- To protect the body by alerting it to potential or actual tissue damage. (correct)
- To facilitate the transmission of non-essential sensory information to the brain.
- To induce a state of euphoria that masks underlying tissue damage.
- To initiate the release of endorphins, thereby promoting a sense of well-being.
Which of the following accurately describes the key differences between A$\delta$ and C sensory fibers in the transmission of pain signals?
Which of the following accurately describes the key differences between A$\delta$ and C sensory fibers in the transmission of pain signals?
- A$\delta$ fibers are inhibitory neurotransmitters, while C fibers are excitatory neurotransmitters.
- A$\delta$ fibers are myelinated and transmit sharp, stinging pain, while C fibers are unmyelinated and transmit dull, aching pain. (correct)
- A$\delta$ fibers are unmyelinated and transmit dull, aching pain, while C fibers are myelinated and transmit sharp, stinging pain.
- A$\delta$ fibers primarily transmit signals related to temperature, while C fibers transmit signals related to pressure.
Which of the following neurotransmitters, when released in the spinal cord, would most likely reduce the perception of pain?
Which of the following neurotransmitters, when released in the spinal cord, would most likely reduce the perception of pain?
A patient describes their pain as 'poorly localized' and 'aching'. Which type of sensory fiber is primarily responsible for transmitting this pain signal?
A patient describes their pain as 'poorly localized' and 'aching'. Which type of sensory fiber is primarily responsible for transmitting this pain signal?
Which of the following is the MOST accurate description of referred pain?
Which of the following is the MOST accurate description of referred pain?
Damage to the nerves, is the Etiology (E) for:
Damage to the nerves, is the Etiology (E) for:
Which of the following is MOST characteristic of chronic pain's clinical manifestations (CM)?
Which of the following is MOST characteristic of chronic pain's clinical manifestations (CM)?
A patient reports deep, squeezing pain that is difficult to pinpoint. This BEST aligns with which type of nociceptive pain?
A patient reports deep, squeezing pain that is difficult to pinpoint. This BEST aligns with which type of nociceptive pain?
Which of the following is the primary mechanism by which NSAIDs interrupt peripheral pain transmission?
Which of the following is the primary mechanism by which NSAIDs interrupt peripheral pain transmission?
Of the opioid receptors listed, which one does NOT provide analgesia?
Of the opioid receptors listed, which one does NOT provide analgesia?
Which of the following factors has the LEAST influence on an individual's perception of pain?
Which of the following factors has the LEAST influence on an individual's perception of pain?
Which of the following adverse effects is MOST associated with mu (μ) opioid receptor activation?
Which of the following adverse effects is MOST associated with mu (μ) opioid receptor activation?
Breakthrough pain is BEST described as:
Breakthrough pain is BEST described as:
Which intervention is LEAST likely to be used for interrupting peripheral pain transmission?
Which intervention is LEAST likely to be used for interrupting peripheral pain transmission?
Flashcards
Nociceptor pathways
Nociceptor pathways
Anatomic pathways in the spinal cord and somatosensory cortex for pain processing.
Dermatome map
Dermatome map
A representation of the areas of skin innervated by specific spinal nerves.
Perception of Pain
Perception of Pain
Neural processing of pain influenced by awareness, emotion, and past experiences.
Pain Threshold
Pain Threshold
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Pain Tolerance
Pain Tolerance
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Nociceptive Pain
Nociceptive Pain
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Neuropathic Pain
Neuropathic Pain
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Acute Pain
Acute Pain
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Chronic Pain
Chronic Pain
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Referred Pain
Referred Pain
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Pain
Pain
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Transduction
Transduction
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Transmission
Transmission
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Neurotransmitters in Pain
Neurotransmitters in Pain
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Study Notes
Pain
- Pain is defined as an "unpleasant sensory and emotional experience associated with actual or potential tissue damage," according to the International Association for the Study of Pain (IASP). It is also what the patient says it is, as determined by the Joint Commission.
Reason for Pain
- Pain serves to protect the body.
- Pain alerts the body to dangerous situations.
- Pain allows the body to remove itself from a harmful situation.
Types of Pain
- Nociceptive Pain:
- Over-the-counter (OTC) analgesics:
- Tylenol
- NSAIDs
- Prescription analgesics (opioids):
- Morphine
- Over-the-counter (OTC) analgesics:
- Neuropathic Pain:
- Anticonvulsants:
- Neurontin
- Lyrica
- Anticonvulsants:
Nociceptive Pain
- Nociception: The process of pain receptors (nociceptors) detecting and signaling noxious stimuli.
Nociceptive Pain Pathway
- Transduction: Converting painful stimuli into action potentials.
- Chemical Mediators:
- Prostaglandins
- NSAIDs
- Lactate
- Kinins
- K+, H+
- Histamine
- Serotonin
- Transmission: Spinal nerves transmit pain signals to higher centers.
- Myelinated (Aδ) fibres: Fast, sharp, stinging pain
- Unmyelinated (C) fibres: Slow, dull, aching, poorly localized pain
- Perception: Brain interprets the signals as pain, considering factors such as awareness, mood, prior experience, expectations and culture.
Spinal Neurotransmitters
- Excitatory:
- Substance P
- Glutamate
- Histamine
- Inhibitory:
- Endorphins
- Norepinephrine
- GABA
- Serotonin
How Does the Brain Localize Pain?
- Nociceptor pathways follow anatomical order in the spinal cord and the somatosensory cortex.
- Dermatome map
Acute Pain
- Etiology: Tissue injury
- Duration: Less than 3 months
- Clinical Manifestations (CM): Self-report and SNS stimulation (increased heart rate, respiration rate, blood pressure; pallor/diaphoresis; hyperglycemia; dilated pupils; nausea/vomiting; and urinary retention)
- Treatment (TI): Short-term pain relief via opioid/nonopioid analgesics.
Chronic Pain
- Etiology: Underlying disease process; unclear cause; comorbidities e.g., sleep disturbances and depression
- Duration: More than 6 months
- Clinical Manifestations (CM): Non-SNS stimulation; mood disturbances, inability to function, chronic hyperglycemia, fatigue and sleep disturbances, and a weakened immune system.
- Treatment (TI): Multimodal (e.g., opioid, antidepressants, anti-convulsants).
Referred Pain
- Etiology: Injury to a different site that is referred to a tissue in the same sensory dermatome.
- Visceral nociceptor activity with primary somatic afferent nerves in the posterior horn of the spinal cord.
- Clinical Manifestations (CM): Variable
- Treatment (TI): Relief of underlying injury
Neuropathic Pain
- Etiology: Possible tissue injury to nerves; nerve damage or dysfunction; altered central processing of nociceptive input
- Clinical Manifestations (CM): Shooting, burning, electric shock-like, tingling/pins and needles
- Treatment (TI): Anticonvulsants, antidepressants
Treatment Implications
- Interrupting Peripheral Transmission:
- Thermal treatment: reduces inflammation/swelling
- Local anesthetics: block pain stimulus
- Splinting: prevents further tissue injury/inflammation
- NSAIDs: reduce prostaglandins, reduce inflammation and pain
Altering the Perception and Integration of Pain
- Medication: Opioids, Non-opioids, Anticonvulsants, Antidepressants
- Non-medication:
- Distraction
- Imagery
- Relaxation
- Biofeedback
- Hypnosis
Opioids
- Side effects:
- Nausea/vomiting (N/V)
- Respiratory depression (decreased respiratory rate)
- Constipation
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