3220: Pian

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3220: Pian
2013-09-24 22:53:08
pain 3220 nursing

exam 1
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  1. what is the most common reason why patients seek health care?
    Pain complaint
  2. nearly what percentage of Americans annually have ACUTE pain?
    ~ 15% to 20% of nearly 270 million Americans
  3. managing pain is whose responsibility ?
    it's a nursing responsibility
  4. what is subjective pain?
    it is whatever the person is experiencing the pain SAYS it is
  5. what is the objective definition of pain?
    unpleasant sensory and emotional experience associated with actual or potential tissue damage
  6. pain experience depends on both ____ and ____
    both sensory and perception
  7. etiologies [causes] of pain?
    • - inflammation
    • - infection
    • - ischemia
    • - stretching of tissue
    • - chemicals
    • - burns
    • - usually, damage
  8. what are Nociceptors?
    nociceptors are pain receptors that are free sensory nerve ending present in most tissues
  9. nociceptors function
    to sense and transmit pain signals
  10. nociceptive pain
    • pain receptors activated in response to actual or impending tissue injury, including
    • - somatic pain
    • - visceral pain
  11. somatic pain can be located where
    skin and muscles etc.
  12. visceral pain can be located where
    abdomen [guts] area, organs
  13. nociceptors can be stimulated by what three means?
    • by
    • - thermal means
    • - chemical means
    • - physical means
  14. what are the 4 major neural mechanisms
    • - transduction
    • - transmission
    • - perception 
    • - modulation
  15. transduction occurs at what level?
    occurs at the level of peripheral nerves, where nociceptors are located
  16. what does transduction represent?
    the conversion of the pain stimuli into a neural action potential
  17. give an example of transduction
    tissue injury leads to relsease of inflammatory mediators (bradykinin, serotonin, histamine, substance P) which sensitize the afferent fibers to send a signal to the dorsal horn of the spinal cord
  18. what is [pain] transmission?
    neural action potential must be transmitted to and through the CNS for pain to be preceived
  19. [pain] transmission ends up where in the body?
    ends up in the dorsal horn in the spinal cord
  20. describe a [pain] transmission scenario
    release of neurotransmitters (substance P[increases pain], serotonin [modify the response], prostaglandins [modify the response]) which may activate nearby cells which can facilitate or inhibit transmission of pain
  21. name the types of nerve fibers that transmit somatosensory information
    • - type A-delta
    • - type C
  22. type A-delts
    is a nerve fiber that conveys sharp, well-localized pain and has a very rapid conduction rate [meylinted] [fast pain ]
  23. type C
    • one of the older nerve fibers the convey a dull, aching, burning pain and has the slowest rate of conduction [unmyelinated][slow-wave pain][can't tell exact spot of pain]
    • - found in belly area
  24. pain perception
    • - in the brain, nociceptive input in perceived as pain 
    • - perception is modified in the brain, related to previous experience, other information, etc.
  25. what is [pain] modulation
    • process of inhibiting or chaning/increasing pain inpulses
    • - neurons that originate in the brain stem descend to the odrsal horn and change the neuro transmission 
    • - release substances such as serotonin and endorphins [morphine like substance] which inhibit transmission of pain
  26. explain the gate control theory
    • If
    • you have pain coming from a certain location and you touch the touch receptors
    • in that area the to different transmissions [the pain transmission and the
    • touch transmission] are going through the same pathway to the brain. The touch
    • transmission is slowing or reducing the pain transmission to the brain
  27. 2 physiological reactions to pain
    • - sympathetic stimulation [fight/flight]
    • - parasympathetic [rest/digest]
  28. sympathetic physiological reaction to pain are
    • - increase in respiratory rate
    • - increase in heart rate
    • - peripheral vasoconstriction [person looks pale]
    • - increase in blood glucose 
    • - diaphoresis 
    • - increased muscle tension
  29. parasympathetic physiological reaction to pain are
    • - pallor [peripheral vasoconstiction]
    • - muscle tension
    • - nausea and vomiting
    • - weakness
    • - rapid irregular breathing
  30. which physiological reaction to pain do we tend to see first? sym or parasym?
  31. name the types of pain
    • - cutaneous
    • - deep somatic
  32. what is cutaneous pain
    on the outside of the body, localized, protect the body from outside foreign substances
  33. what is deep somatic pain?
    deep within the muscle etc.
  34. what is the most common pain produces by disease
    visceral pain
  35. which type of pain has the tendency to refer to other locations
    visceral pain
  36. what are the pain classifications
    • - acute
    • - chronic
  37. what is acute pain?
    • - lasting less than 6 months
    • - associated with anxiety, and reflex musculoskeletal spasms [associated with situation requiring immediate response]
  38. what is chronic pain?
    • - lasting 6 months or longer
    • - associated with loss of appetite, sleep disturbances, and depression [associated with more generalized symptoms. not sleeping well, being depressed, not eating well, etc.]
  39. what is neuropathic pain
    abnormal processing of sensory input by the peripheral or central nervous system
  40. centrally generated neuropathic pain can cause what to occur?
    can cause "phantom pain" to occur
  41. peripherally generated neuropathic pain can cause what?
    • - painful polyneuropathis [diabetic neuropathy] 
    • - painful mononeuropathies [nerve entrapment]
  42. what is neuralgia
    - damage to a specific nerve
  43. neuralgia can cause what to occur?
    • - trigeminal-facial tics with stabbing paroxsmal attacks of pain
    • - pstherpetic: injury to the peripheral nerves and altered CNS processing [herpes zoster]