Acute & Chronic Pain Mgmt Definitions Flashcards

1
Q

Define Allodynia

A

Perception of an ordinarily nonnoxious stimulus as pain

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2
Q

Define Analgesia

A

Absence of pain perception

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3
Q

Define Anesthesia

A

Absence of all sensation

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4
Q

Define Chronic Pain

A

Pain that persists beyond the usual course of an acute disease or after a reasonable time for healing to occur, typically varies from 1-6 months

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5
Q

Define First Order Neurons

A

The majority of first order neurons send the proximal end of their axons into the spinal cord via the dorsal (sensory) spinal root at each cervical, thoracic, lumbar, and sacral level.

Some unmyelinated afferent C fibers enter the spinal cord via ventral nerve (motor) root.

Once in the dorsal horn, in addition to synapsing with second order neurons, the axons of 1st order neurons may synapse with interneurons, sympathetic neurons, and ventral horn neurons.

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6
Q

Cell bodies of 1st order neurons are located:

A

Facial- geniculate ganglion
Glossopharyngeal- superior and petrosal ganglia
Vagal nerve- jugular ganglion (somatic) and ganglion nodosum (viseral).
Trigeminal- gaussian ganglion

The proximal axonal processes of the first order neurons in these ganglia reach the brainstem nuclei via their respective cranial nerves, where they synapse with second order neurons.

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7
Q

Define Hyperalgesia

A

Increased response to noxious stimulation

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8
Q

Define Hyperesthesia

A

Increased response to mild stimulation

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9
Q

Define Hyperpathia

A

Presence of hyperesthesia, allodynia, and hyperalgesia usually associated with overreaction, and persistence of the sensation after the stimulus

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10
Q

Define Lateral Spinothalamic Tract

A

The lateral spinothalamic (neospinothalamic) tract projects mainly to the ventral posterolateral nucleus of the thalamus and carries discriminative aspects of pain, such as location, intensity, and duration.

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11
Q

Define Medial spinothalamic Tract

A

The medial spinothalamic (paleospinothalamic) tract projects to the medial thalamus and is responsible for mediating the autonomic and unpleasant emotional perceptions of pain.

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12
Q

Define Modulation

A

Occurs peripherally at the nociceptor, in the spinal cord, and in the supraspinal structures. Can either inhibit (suppress) or facilitate (intensify) pain

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13
Q

Define Neuralgia

A

Pain in the distribution of a nerve or a group of nerves

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14
Q

Define Neuropathic Pain

A

Is the result of injury or acquired abnormalities of peripheral or central neural structures.

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15
Q

Neuropathic pain tends to be

A

Tends to be paroxysmal and sometimes lancinating with a burning quality, and is usually accompanied by hyperpathia.

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16
Q

Neuropathic Pain is associated with:

A

It is associated with diabetic neuropathy, causalgia, phantom limbs, postherpetic neuralgia, stroke, spinal cord injury, and multiple sclerosis.

17
Q

Neuropathic Pain is difficult to treat and :

A

Is difficult to treat and multiple therapeutic modalities may be needed

Like:

  • anticonvulsants like gabapentin and pregabalin,
  • antidepressants like TCAs or SNRIs,
  • antiarrhythmics like mexiletine,
  • alpha 2 agonists like clonidine,
  • topical agents like lidocaine or capsaicin, and
  • analgesics like NSAIDs and opioids
18
Q

Define Nociceptive Pain

A

Caused by activation or sensitization of peripheral nociceptors, specialized receptors that transduce noxious stimuli.

19
Q

Define Parasthesia

A

Abnormal sensation perceived without an apparent stimulus

20
Q

Define Perception

A

Is the final common pathway, which results from the integration of painful input into the somatosensory and limbic cortices.

Generally speaking, traditional analgesic therapies have only targeted pain perception.

21
Q

Define Radiculopathy

A

Functional abnormality of one or more nerve roots

22
Q

Second Order Neurons are located

A

Second order neurons are located in the gray matter of the ipsilateral dorsal horn where they synapse with the first order neurons through interneurons.

23
Q

Second order Neurons care signals from

A

the spinal cord to the thalamus

24
Q

Second order neurons are either

A
  1. nociceptive-specific or

2. wide dynamic range neurons.

25
Q

Nociceptive-specific neurons serve only (second order neurones)

A

noxious stimuli and are arranged in somatotopically in lamina I and have discrete somatic receptive fields. They only respond to high threshold noxious stimuli.

26
Q

Wide dynamic neurons (second order) receive

A

noxious and non noxious afferent input from A- gamma, delta, and C fibers. They are the most prevalent cell type in the dorsal horn, but they are most abundant in lamina V.

27
Q

The most prevalent cell type in the dorsal horn is:

A

second order / wide dynamic neurons

  • most abundant in lamina V
28
Q

define Somatic Pain

A

Classified as superficial or deep pain due to nociceptive input arising from skin, subcutaneous tissues, and mucous membranes. Characteristically its well localized and described as a sharp, pricking, throbbing or burning sensation

29
Q

Third Order Neurons

A

Location of perception and discrete pain

Located in the thalamus and send fiber to the somatosensory areas I and II in the postcentral gyrus of the parietal cortex and the superior wall of the sylvian fissure.

30
Q

Third order neurons are located in the

A

Located in the thalamus and send fiber to the somatosensory areas I and II in the postcentral gyrus of the parietal cortex and the superior wall of the sylvian fissure.

31
Q

Define Transduction

A

Is the event whereby noxious thermal, chemical, or mechanical stimuli are converted into an action potential.

32
Q

Define Transmission

A

Occurs when the action potential is conducted through the nervous system via the first, second, and third-order neurons which have cell bodies located in the dorsal root ganglion, dorsal horn, and thalamus, respectively.

33
Q

Define Visceral Pain

A

Visceral acute pain is due to a disease process or abnormal function involving an internal organ or its covering.

34
Q

Four Subtypes of Visceral Pain:

A

Four subtypes:

  1. True localized visceral pain (dull, diffuse, midline)
  2. Localized parietal pain (sharp, stabbing)
  3. Referred parietal pain
  4. Referred Visceral pain
35
Q

True visceral pain is associated with

A

abnormal sympathetic or parasympathetic activity causing nausea, vomiting, sweating, and changes in BP and HR.