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DSC Modalities Book

Pain

QuestionAnswer
Acute pain Pain of less than 6 months’ duration for which an underlying pathology can be identified.
A-beta fibers Large, myelinated nerve fibers with receptors located in the skin, bones, and joints that transmit sensation related to vibration, stretching of skin, and mechanoreception. When working abnormally, these fibers can contribute to the sensation of pain.
A-delta fibers Small, myelinated nerve fibers that transmit pain quickly to the CNS in response to high-intensity mechanical stimulation, heat, or cold. Pain transmitted by these fibers usually has a sharp quality.
Afferent nerves Nerves that conduct impulses from the periphery toward the CNS.
Allodynia Pain that occurs in response to stimuli that do not usually produce pain.
Analgesia Reduced sensibility to pain.
Autonomic nervous system The division of the nervous system that controls involuntary activities of smooth and cardiac muscles and glandular secretion. The autonomic nervous system is composed of the sympathetic and parasympathetic systems.
C fibers Small, unmyelinated nerve fibers that transmit pain slowly to the CNS in response to noxious levels of mechanical, thermal, and chemical stimulation. Pain transmitted by these fibers is usually dull, long-lasting, and aching.
Central sensitization process of CNS adptn to nociceptive input that chngs transmission fr PNs to CNS, incrs mag & dur of respns to noxious stimuli; enlarging receptor fields of nerves (sec hyperalgesia) reducing pain threshold, so normally nonnoxious stimuli become painful
Chronic pain Pain that persists beyond the usual or expected length of time for tissue healing.
Complex regional pain syndrome (CRPS) A chronic disease characterized by severe pain, usually in an arm or leg, associated with dysregulation of the sympathetic nervous system and central sensitization, usually following trauma. CRPS was previously called reflex sympathetic dystrophy.
Efferent nerves Nerves that conduct impulses from the CNS to the periphery.
Endogenous opioid theory The theory that pain is modulated at peripheral, spinal cord, and cortical levels by endogenous neurotransmitters that bind to the same receptors of exogenous opioids.
Endorphins See Opiopeptins.
Enkephalins Pentapeptides that are naturally occurring in the brain and that bind to opioid receptors, producing analgesic and other opioid-associated effects.
Gate control theory of pain modulation The theory that pain is modulated at the spinal cord level by inhibitory effects of innocuous afferent input.
Hyperalgesia Increased sensitivity to noxious stimuli.
Neurotransmitter A substance released by presynaptic neurons that activates postsynaptic neurons.
Nociception The sensory component of pain.
Nociceptors Nerve endings that are activated by noxious stimuli, contributing to a sensation of pain.
Noxious stimulus Any stimulus that triggers the sensation of pain.
Opiopeptins Endogenous opioid-like peptides that reduce the perception of pain by binding to opioid receptors. Opiopeptins were previously called endorphins.
Pain An unpleasant sensory and emotional experience associated with actual or threatened tissue damage.
Pain gating The inhibition of pain by inputs from nonnociceptive afferents.
Pain-spasm-pain cycle nociceptor activation results in transm cell activation that stimulates anterior horn cells to cause muscles to contr. -> produces compr of blood vessels, accum. of chemical irritants, mech compr of nociceptor, & resultant incr in nociceptor activation.
Patient-controlled analgesia (PCA) method for controlling pain by which pts use a pump to self-administer repeated intravenous doses of analgesic medication. In hospitalized pts, this method often results in more effective pain control & fewer adverse effects than physician-controlled
Peripheral sensitization Lowering of nociceptor firing threshold in resp to release of various substances, including substance P, neurokinin A, & calcitonin gene–related peptide (CGRP), fr nociceptive afferent fibers.
Referred pain Pain experienced in one area when the actual or threatened tissue damage has occurred in another area.
Sensitization A lowering of the pain threshold that increases the experience of pain.
Substance P A chemical mediator thought to be involved in the transmission of neuropathic and inflammatory pain.
Sympathetic nervous system The part of the autonomic nervous system involved in the “fight-or-flight” response of the body, causing increased heart rate, blood pressure, and sweating, as well as dilation of the pupils.
Synapse The site of functional connection between neurons where an impulse is transmitted from one neuron (the presynaptic neuron) to another (the postsynaptic neuron), usually by a chemical neurotransmitter.
Transduction A process by which a chemical or mechanical stimulus is converted into electrical activity.
Transmission cells (T cells) Second-order neurons located in the dorsal horn of the spinal cord that receive signals from pain fibers and make connections with other neurons in the spinal cord.
Peripheral sensitization This causes an incrd magnitude of response to stimuli & an incrs in the area fr which stimuli can evoke APs.
Acute pain is generally Of less than 6 months' duration, well localized, mediated through slowly conducting pathways
All of the following pharmacological agents are used to control pain opiates, NSAIDs, atidepressants
Multidisciplinary pain treatment programs generally focus on: teaching the patient coping skills, incresing physical activity, and involving the pts family
the transmission of pain at the spinal cord may be inhibited by increased activity of A-beta nerves
Ms. Jones presents to your clinic w/ complaints of left shoulder pain w/ activity. You find that her pain is aggravated by repetitive raising of her left arm but also by fast walking and by repetitive raising of her right arm. What is causing her pain? inadequate blood flow to the hear
elevated levels of substance P means association with an increased sensation of pain, as it is a chemical mediator for sensitization of nociceptors, lowering their threshold for firing, thus increasing the sensation of pain
Physical agents can control pain by moderating the release of inflammatory mediators, increasing opiopepting levels, and altering nerve conduction
Which tool is most appropriate for localizing the area and nature of a patient's symptoms? body diagram
naloxone reverses the effect of? endorphins (it blocks opioid receptors)
Which tool is most appropriate for quickly estimating a patients's perceived progress or change in severity of symptoms over time? visual analog scale
When working with a patient who presents with chronic pain, the therapist should consider what? whether counseling would be beneficial
Which tool is most appropriate for obtaining detailed quantifiable information about a pt's pain? semantic differential scale
Cognitive behavior therapy includes: perform activities more slowly, divert one's attention away from pain to focus on participation in life activities, "hurt doesn't necessarily equal harm"
cutaneous pain is well localized and sharp, pricling, or tingling
musculoskeletal pain is poorly localized and dull, heavy or aching
visceral pain refers superficially and has an aching quality
What are the different types of pain? nociceptive, neuropathic, radicular pain, dysfunctional, psychogenic
Nociceptive pain is from mechanical, chemical, or thermal stimuli, associated with ongoing tissue damage, has a clear stimulus-response relationship with the initial injury, felt locally
Neuropathic pain is from lesion or disease affecting nerves, burning or lancinating quality, accompanied by paresthesias, itching anesthesia, weakness
what type of physical agents are good for treating neuropathic pain? estim, heat cold
Radicular pain is from compression of a nerve root (dermatome, myotome)
Created by: LBazzell