Intro

Question 1

Purpose of Pain

Answer 1

• Alerts a problem
• Protects from further injury (Reflexes)
• Facilitates healing

Question 2

Pain Definition

Answer 2

The unpleasent sensory and emotional experience associated with actual or potential tissue damage
- More than just physical pain
- Emotional experience

Question 3

Cognitive Insenssitivity

Answer 3

May be able to sense pain, but lack the affective response
- Can lead to multiple injuries and early death

Question 4

Allodynia

Answer 4

Pain from substance that does not usually cause pain

Question 5

Analgesia

Answer 5

Absence of pain from a stimulation that would usually cause pain

Question 6

Hyperalgesia

Answer 6

Increased pain from a stimulus that normally causes pain

Question 7

Dysesthesia

Answer 7

Unpleasant abnormal sensation
- Spontaneous or evoked
- Unpleasent

Question 8

Noxious Stimulus

Answer 8

Stimulus that is damaging or threatens normal tissue

Question 9

Pain Threshold

Answer 9

Minimum intensity of stimulus to evoke pain

Question 10

Paresthesia

Answer 10

Abnormal sensation
- Spontaneous or evoked
- Is not unpleasant

Question 11

Sensitization

Answer 11

Increased responsiveness of nociceptive neurons to their normal input
- Normally subthreshold inputs give increased response

Question 12

Pain Factors

Answer 12

Mental states and other factors can affect pain

Question 13

Goals in Acute Pain

Answer 13

Minimize suffering

Prevent transition to chronic pain

Question 14

Acute vs Chronic Pain

Answer 14

Chronic pain is not just simply the constant activation of acute pain neurons

Question 15

Transition of Acute Pain to Chronic Pain

Answer 15

1. Injury activates peripheral nociceptive fibers
   - Normally should subside
2. Sustained activation sensitizes peripheral nociceptive fibers
3. Structural remodelling (Hyperactivity)

Question 16

Acute Pain
- Definition

Answer 16

• Limited duration
• Usually has identifiable cause
• Physiologic protective function

Question 17

Chronic Pain
- Definition

Answer 17

• Persists past the time of healing of an injury
• No clear identifiable cause
• No longer serves a pathological function

Question 18

Preoperative and Postoperative Pain management
- Chronic Pain

Answer 18

Reducing preoperative and postoperative pain definitely does play a role in reducing chronic pain
- But chronic pain can still develop
- Chronic pain is complex

Question 19

Nociceptive Pain

Answer 19

Stimulus dependent pain

Evoked by high intensity noxious stimuli
- No nervous system inflammation

Adaptable
- Protects to signal potential tissue damage

Question 20

Inflammatory Pain

Answer 20

Spontaneous and stimulus dependent pain

Evoked by low and high intensity stimuli
- Active inflammation

Adaptable and Reversible
- Protects Pain hypersensitivity during healing

Question 21

Dysfunctional Pain

Answer 21

No known structural lesion or inflammation
- Present even with lack of stimulus

Maladaptive and potentially persistient

Question 22

Neuropathic Pain

Answer 22

Nervous system lesion or disease

Maladaptive and commonly persistient

Question 23

Nociplastic Pain

Answer 23

Dysfunctional pain
- No known structural cause or inflammation

Question 24

Neuropathic Pain

Answer 24

• Peripheral Neuropathic Pain
• Spinal Neuropathic Pain
• Supraspinal Neuropathic Pain

Question 25

Central Neuropathic Pain

Answer 25

- Spinal Neuropathic Pain - Supraspinal Neuropathic Pain

Question 26

Order from greatest to lowest Opioid Usefulness for Pain

Answer 26

1 = Nociceptive Pain 2 = Peripheral Neuropathic Pain 3. = Spinal Neuropathic Pain 4. Supraspinal Neuropathic Pain

Question 27

Opioid Crisis Causes

Answer 27

- Unmet clinical need to treat chronic pain - Emphasis on profits - Misleading risks on opioid addiction - World events

Question 28

Porter and Jick Article

Answer 28

Misleadingly concluded that opioid use was not addictive - Study was on acute pain in hospital setting