Pain

Question 1

Allodynia meaning?

Answer 1

Perception of a nonnoxious stimulus as pain

Question 2

Anesthesia meaning?

Answer 2

Abscence of all sensation

Question 3

Anesthesia dolorosa meaning?

Answer 3

Pain in an area that lacks sensation

Question 4

Dysesthesia

Answer 4

Unpleasent or abnormal sensation with or without a stimulus

Question 5

Hyperesthesia

Answer 5

Increased response to mild stimulation

Question 6

Hyperpathia

Answer 6

Hyperesthesia, allodynia, hyperalgesia

Question 7

Hyperalgesia

Answer 7

Increased response to noxious stimulation

Question 8

Hypesthesia

Answer 8

Reduced cutaneous senation

Question 9

Neuralgia

Answer 9

Pain inthe distribution of a nerve or a group of nerves

Question 10

Paresthesia

Answer 10

Abnormal sensation percieved without an apparent stimulus

Question 11

Radiculopathy

Answer 11

Functional abnormality of one or more nerve roots

Question 12

Acute pain causes:

Answer 12

• Injury
• Disease process
• Abnormal function of muscle or viscera

Question 13

When pain fails to resolve because of either abnormal healing or inadequate treatment, it becomes…

Answer 13

Chronic

Question 14

Superficial pain recieves input from:

Answer 14

Skin, subcutaneous tissues and mucous membranes

Question 15

Deep pain recieves input from:

Answer 15

Muscles, tendons, joints or bones

Question 16

True visceral pain typical location and type?-

Answer 16

• Midline, dull and diffuse
• Associated with abnormal sympathetic and parasympathetic activity
  -> nausea, vomiting, sweating and changes in BP and HR

Question 17

Parietal pain

Answer 17

• Sharp, stabbing pain

Question 18

Chronic pain

Answer 18

Attenuated or absent neuroendocrine stress responses and have prominent sleep and affective disturbances

Can be neuropathic or nociceptive

Question 19

Persistent postsurgical pain

Answer 19

Chronic pain continuing beyond the typical healing period of 1-2 months

Question 20

Inflammatory pain examples:

Answer 20

Appendictis, rheumatoid arthritis, inflammatory bowel disease, herpes zoster

Question 21

Inflammatory pain mediators:

Answer 21

cytokines, TNF, acids, lipids, mast cells, ATP, vasoactive amines

Question 22

Types of nociceptors:

Answer 22

• Mechanonociceptors - pinch and pinprick
• Silent nociceptors - inflammation
• Polymodal mechanoheat nociceptors - excessive pressure, heat, noxious substances (bradykinin, histamine, seratonin, H+, K+, prostaglandins, caspaicin, adenosine triphosphate)

Question 23

Nociceptive _ fibres from the esophagus, larynx and trachea travel with the ______ nerve to enter the ______ in the brainstem

Answer 23

C
vagus
nucleus solitarius

Question 24

Describe neurons structures in the pain pathway:

Answer 24

• Primary afferent neurons are found in the dorsal root ganglia and contain an axon which bifurcates (one to the peripheral tissues and one to the dorsal horn)
• Second order neurons are found in the dorsal horn and cross the midline to reach the thalamus (in the contralateral spinothalamic tract)

Question 25

Which are the main pain fibers?

Answer 25

Aδ (pain, temperature, touch), 2-5m diameter, 12-30 ms-1 conduction speed (myelinated and fast) C (dorsal root), pain, temprature, mechanoreceptors, reflex responses, 0.4-1.2m fibre diameter, 0.5-2ms-1 conduction speed

Question 26

Excitatory neurotransmitters modulating pain:

Answer 26

Substance P, calcitonin gene-related peptide, glutamate, aspartate, ATP

Question 27

Main excitatory pain neurotransmitters and their location:

Answer 27

- Glutamate - main CNS NT - Substance P - DRG Calcitonin gene-related peptide - DRG

Question 27

Inhibitory neurotransmitters modulating pain:

Answer 27

Somatostatin, acetylcholine, enkephalins, B-endorphin, norepinephrine, adenosine, serotonin, GABA, glycine

Question 28

Opiois drugs classification:

Answer 28

Full agonists - morphine, heroine, methadone, meperidine, codeine, fentanyl Partial agonists - buprenorphine Mixed agonists/ antagonists - butorphanol, nalbuphine, pantazocine Full antagonists - Naloxone, naltrexone, methylnaltrexone

Question 29

Non-opioid classification:

Answer 29

Salicylates - Acetylsalicyclic acid (aspirin) P-aminophenols - Acetominophen Proprionic acids - Ibuprofen - Naproxen Indoles - Indomethacin COX-2 inhibitors: - Celecoxib

Question 30

Antidepressants are used for _______ Examples

Answer 30

Neuropathic pain Escitalopram, Bupropion, Citalopram

Question 31

ARDS diagnosis:

Answer 31

PaO2/FiO2 <300mmHg