Download - Pain 1 Students Ppt
-
8/4/2019 Pain 1 Students Ppt
1/30
Pain
8/9/2011
-
8/4/2019 Pain 1 Students Ppt
2/30
Learning Outcomes Define pain
Describe the meaning of pain
Discuss the physiology of pain transduction,transmission, perception and modulation.
Describe theories of pain
Describe various types of pain
Identify clinical manifestations of pain.
Describe cultural beliefs and responses to pain.
-
8/4/2019 Pain 1 Students Ppt
3/30
QuestionWhy is it important for nurses to have an
understanding of pain?
(Think, pair, share)
-
8/4/2019 Pain 1 Students Ppt
4/30
Pain definition An unpleasant sensory and emotional experience
associated with actual or potential tissue damage ordescribed in terms of such damage
(The international Association for the study of pain).
-
8/4/2019 Pain 1 Students Ppt
5/30
What is pain Subjective sensation
Pain perceptions based on
Expectations Past experience
anxiety
-
8/4/2019 Pain 1 Students Ppt
6/30
Pain perceptionsAffective-ones emotional factors can affect pain
experience.
Behavioral how one expresses or controls pain Cognitive ones beliefs or attitudes about pain
-
8/4/2019 Pain 1 Students Ppt
7/30
Pain receptors and mediatorsNociceptors : are pain receptors which are sensitive
to noxious stimuli.
The term nociception refers to the process by whichpain information is carried from the peripherysense receptors in the skin and in the viscera tothe cerebral cortex through network of neuronal
networks
-
8/4/2019 Pain 1 Students Ppt
8/30
Physiology of painAcute pain is a physiological response.
It warns us of danger.
The process of nociception describes the normalprocessing of pain and the response to noxiousstimuli that are damaging or potentiallydamaging to normal tissue.
-
8/4/2019 Pain 1 Students Ppt
9/30
Nociceptors Nociceptors are distributed in the:
Somatic structures
Visceral structures The C fibers and A delta fibers are associated with
different qualities of pain.
-
8/4/2019 Pain 1 Students Ppt
10/30
Nociceptive action potentials are transmitted throughtwo types of afferent nerve fibers:
Myelinated A Delta fibers Unmyelinated C fibers
-
8/4/2019 Pain 1 Students Ppt
11/30
Characteristics and functions of C
fibersCharacteristics Pain quality
Primary afferent fibers
Small diameter Unmyelinated
Slow conducting
Receptor Type
Polymodal respond to morethan I type of noxiousstimuli.
. Diffuse
Dull Burning
Aching
Referred to as slow or secondpain
-
8/4/2019 Pain 1 Students Ppt
12/30
A Delta FibersCharacteristics Pain quality
Primary afferent fibers
Large diameter Myelinated
Fast conducting
Receptor Type
High thresholdmechanoreceptors respond tomechanical stimuli overcertain intensity.
Well localized
SharpStingingPrickingReferred to as
fast or first pain
-
8/4/2019 Pain 1 Students Ppt
13/30
Noxious stimuli and responsesCategories of noxiousstimuli
Causes of stimulation may be:
Mechanical
Thermal Chemical
Internal
External
-
8/4/2019 Pain 1 Students Ppt
14/30
Chemical mediators Prostaglandin
Bradyk inn
Serotonin
Potassium and histamine
-
8/4/2019 Pain 1 Students Ppt
15/30
4 basic processes involved in
nociception Transduction
Transmission
modulation perception
-
8/4/2019 Pain 1 Students Ppt
16/30
Transduction of pain Transduction begins when the free nerve endings
(nociceptors) of C fibers and A-Delta fibers of primaryafferent neurons respond to noxious stimuli whentissue damage and inflammation occurs.
-
8/4/2019 Pain 1 Students Ppt
17/30
Transmission Pain that may be described as sharp or pricking
and can easily be localized is transmitted by the Adelta fibers.
Pain that may be described as burning dull oraching and that is more diffuse results from impulsestransmitted by the C fibers.
-
8/4/2019 Pain 1 Students Ppt
18/30
Transmission From the site of conduction pain impulses move along
nociceptor fibers to the dorsal horn of the spinalcord.
From the spinal cord then to the brain stem
Then through connections between the thalamus,cortex and higher levels of the brain.
-
8/4/2019 Pain 1 Students Ppt
19/30
-
8/4/2019 Pain 1 Students Ppt
20/30
Modulation of pain The modulation of pain involves changing or
inhibiting transmission of pain impulses in the spinalcord.
-
8/4/2019 Pain 1 Students Ppt
21/30
Modulation of pain Descending inhibition involves the release of
inhibitory neurotransmitters that block or partiallyblock the transmission of pain impulses, and thereforeproduce analgesia.
-
8/4/2019 Pain 1 Students Ppt
22/30
Inhibitory neurotransmitters involved with themodulation of pain include;
Endogenous opoids (encephalins,endorphins anddynorphins))
Serotonin
Nor epinephrine
Gamma-aminobutyric acid (GABA) Neurotensin, acetylcholine and oxytocin.
-
8/4/2019 Pain 1 Students Ppt
23/30
Perception Perception of pain is the end result of the neuronal
activity of pain transmission and where pain becomesa conscious multidimensional experience.
The multidimensional experience of pain has;
Affective-motivational, sensory-discriminative,emotional and behavioral components.
-
8/4/2019 Pain 1 Students Ppt
24/30
PerceptionWhen painful stimuli are transmitted to the brain
stem and thalamus, multiple cortical areas areactivated and responses are elicited.
These areas are;
The reticular system
Somatosensory cortex
Limbic system
-
8/4/2019 Pain 1 Students Ppt
25/30
Reticular system This is responsible for the autonomic and motor
response to pain and for warning the individual to dosomething.
It also has a role in the affective motivationalresponse to pain.
-
8/4/2019 Pain 1 Students Ppt
26/30
-
8/4/2019 Pain 1 Students Ppt
27/30
Somatosensory cortex This is involved with the perception and interpretation
of sensations.
It identifies the intensity, type and location of the painsensation and relates the sensation to pastexperiences, memory and cognitive ability.
It identifies the nature of the stimulus before it
triggers a response.
-
8/4/2019 Pain 1 Students Ppt
28/30
Limbic system This is responsible for the emotional and behavioral
responses to pain.
-
8/4/2019 Pain 1 Students Ppt
29/30
Pain messages are two-way traffic. Inhibitory effectsare achieved through the descending pathways, whichreach from the conscious brain down to the gates in
the subconscious brain and the spinal cord. The reasonfor this is that the gates are places where the flow ofpain messages can be controlled or influenced (Wells &Nown 1998). By sending responses back to the
periphery, the brain can order the release of chemicalsthat have analgesic effects, which can reduce or inhibit
pain sensation.
-
8/4/2019 Pain 1 Students Ppt
30/30
Break Go over your notes
Any questions ??????????????