Chapter 47 COPY Flashcards by Fatima Avila

PHYSIOLOGY OF PAIN
-What is pain?

-An unpleasant sensory & emotional experience associated with actual or potential tissue damage
-It is one of the most common reasons why patients seek medical care

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CLASSIFICATION OF PAIN
-How is pain classified?

Duration
Source
Location
Referral pattern

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CLASSIFICATION OF PAIN
-Duration of pain?

Acute or chronic

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CLASSIFICATION OF PAIN
-Source of pain?

Cancer
Neuropathic
Ischemic

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CLASSIFICATION OF PAIN
-What is important to remember?

Pain is a symptom & there is ALWAYS an underlying condition –> it is ALWAYS the cause of something else (it is secondary & there is a primary factor involved)

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CLASSIFICATION OF PAIN
-When we attempt to alleviate pain, what do we have to do?

Discover & treat the underlying cause

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ACUTE PAIN
-What does this result from?

tissue injury & resolves when the injury heals (usually in less than 3 months)

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ACUTE PAIN
-Briefly describe acute pain

Short-term, self-limiting, and follows a predictable trajectory

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ACUTE PAIN
-What occurs during acute pain?

Elevated HR, RR, BP, pallor, sweating, & nausea

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ACUTE PAIN
-Describe the duration

Short duration (<3 months)

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ACUTE PAIN
-What is one of the most common causes of acute pain?

-Headaches

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HEADACHE ETIOLOGY & PATHOGENESIS
-What are the types of headaches?
-What are the most common?

-Tension, sinus, & migraine
-Migraine headaches

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HEADACHE CLINICAL MANIFESTATIONS
-What are the manifestations of a migraine?

Severe unilateral pounding or throbbing that may be accompanied by:
Nausea
Vomiting
Photophobia
Photophobia
Lacrimation

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HEADACHE DIAGNOSIS & TREATMENT
-How is this diagnosed?

history
physical examination
neuroimaging in some cases

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HEADACHE DIAGNOSIS & TREATMENT
-What needs to be ruled out?

Presence of brain tumors, infection, hydrocephalus, or increased intracranial pressure

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HEADACHE DIAGNOSIS & TREATMENT
-What do you do if someone develops a sudden headache & describes it as WHOL

You need to take action bc it could indicate they are having a brain aneurysm, which can be deadly

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HEADACHE DIAGNOSIS & TREATMENT
-In order to diagnose an aneurysm, what is needed

Neuroimaging

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HEADACHE DIAGNOSIS & TREATMENT
-What is used to treat this?

Pharmacologic
Avoidance of triggers
Diet
Stress managment
Prophylactic therapy

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HEADACHE DIAGNOSIS & TREATMENT
-What does treatment depend on?

The type of headache & frequency

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CHRONIC PAIN
-What is this?

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Any pain that continues several months beyond the expected healing time (usually more than 6 months)

CHRONIC PAIN
-This type of pain is generally not associated with what?

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signs & symptoms of sympathetic activity

CHRONIC PAIN
-Explain what the SNS has to do with this

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-As the body becomes accustomed to pain, the SNS desensitizes itself
1. Initially, when someone has acute pain, the SNS is activated –> everything increases (HR, etc.)
2. After a while, the body changes & starts to compensate to bring things to normal, but the patient still feels pain

CHRONIC PAIN
-What is a common finding in patients with chronic pain?
-People with depression are more likely to suffer from what?
-So what is this?

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-Depression
-chronic pain
-A cycle

CHRONIC PAIN: Fibromyalgia Syndrome
-What is this?

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Chronic pain syndrome that affects women more frequently than men

**CHRONIC PAIN**: *Fibromyalgia Syndrome Etiology & Pathogenesis* -Cause?

Unknown

**CHRONIC PAIN**: *Fibromyalgia Syndrome Etiology & Pathogenesis* -Patients with this have what?

A history of chronic widesrpread pain affecting all 4 extremities, sleep disturbances, & fatigue

**CHRONIC PAIN**: *Fibromyalgia Syndrome Etiology & Pathogenesis* -What is common?

Cognitive dysfunction, anxiety, & depression

**CHRONIC PAIN**: *Fibromyalgia Syndrome Etiology & Pathogenesis* -What is the suspected factor?

Disordered pain mechanism in the CNS

**CHRONIC PAIN**: *Fibromyalgia Syndrome Clinical Manifestations* -This incldues pain that...

waxes and wanes

**CHRONIC PAIN**: *Fibromyalgia Syndrome Clinical Manifestations* -Pain is exacerbated by what?

Physical exertion

**CHRONIC PAIN**: *Fibromyalgia Syndrome Clinical Manifestations* -What is the hallmark of the syndrome?

Fatigue

**CHRONIC PAIN**: *Fibromyalgia Syndrome Clinical Manifestations* -Pain is _____, meaning what?

-disabling -they are in so much pain that they cannot function the same --> without the pain, they would be normal

**CHRONIC PAIN**: *Fibromyalgia Syndrome Clinical Manifestations* -Is this fatal?

No, it doesn't shorten their life

**CHRONIC PAIN**: *Fibromyalgia Syndrome Diagnosis* -Diagnosis is of _____ -What do you rule out?

-exclusion -thyroid disorders, myopathies, rheumatoid arthritis, & chronic viral infections

**CHRONIC PAIN**: *Fibromyalgia Syndrome Treatment* -What are the treatments?

1. Medication 2. Restoration of sleep patterns 3. Lifestyle factors

**CHRONIC PAIN**: *Fibromyalgia Syndrome Treatment* -What are the medications that can be given?

-antidepressant medications -muscle relaxing agents -NSAIDs

**NEUROPATHIC PAIN** -What is this caused by?

Nerve injury or dysfunction, NOT tissue damage

**NEUROPATHIC PAIN** -What is it characterized by?

Burning, tingling, & electric shocklike pain

**NEUROPATHIC PAIN** -Neuropathic pain DOES NOT respond well to what medications?

Opioids

**NEUROPATHIC PAIN** -What medications are more effective for neuropathic pain?

Anticonvulsants & antidepressants

**NEUROPATHIC PAIN** -Examples?

-postherpetic neuralgia -diabetic neuropathy -trigeminal neuralgia -phantom limb pain (don’t have a limb, but it hurts)

**TRIGEMINAL NEURALGIA**: *Etiology & Pathogenesis* -What is this? -What is it caused by?

-Sudden, momentary, excruciating facial pain along the second & third divisions of the trigeminal nerve -Dysfunction of trigeminal nerve

**TRIGEMINAL NEURALGIA**: *Etiology & Pathogenesis* -This is a form of what? -What can it be for the patients?

-Neuropathic pain -Disabling

**TRIGEMINAL NEURALGIA**: *Etiology & Pathogenesis* -What is suspected in most cases?

Chronic compression of the trigeminal nerve by a vessel

**TRIGEMINAL NEURALGIA**: *Clinical Manifestations* -How will the patient feel this?

Sharp or shooting pain, compared to that of an electrical shock

**TRIGEMINAL NEURALGIA**: *Diagnosis* -How is this diagnosed?

Based on clinical history

**TRIGEMINAL NEURALGIA**: *Treatment* -What are the treatments? -What happens if they don't work?

-Antiseizure medications -Surgery would be an option

**DIABETIC NEUROPATHY**: *Clinical Manifestations* -Describe 4 things the patient feels

1. Pain, burning, numbess & tingling 2. Weakness 3. Loss of vibration sense 4. Sensitive to touch

**PAIN IN THE YOUNG & THE ELDERLY**: *Elderly* -What are the 4 reality checks for older adults?

1. Pain is **NOT** a normal part of aging 2. Pain perception stays the same in older adults (doesn't change) 3. Are at a higher risk of conditions that cause acute & chronic pain 4. Require proper assessment, diagnosis, & management of pain

Chapter 47 COPY Flashcards

Pain (49 cards)