PSYCH 360:500Final Exam Study Guide Lectures: 19 - 27Lecture 19 (November 6)Introduction to Pain and Pain Management What are the reasons for Pain?It is an adaptive trait that alerts us to dangerMotivates escape and avoidance learningMotivates recovery from illnessHow did the Beecher Studies done on civilians and soldiers show that pain is partly subjunctive?The study showed that perception of pain was different for similar injuries because of the different situations Soldier reported experiencing relatively less pain than civilians (even though civilians had fewer wounds) What factors influence Pain?Expectations, Emotional State of Individual, the Context, Nature of InjuryWhat is the International Association for Study’s definition of Pain?“A sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage”How does Acute Pain differ from Chronic Pain?Acute pain:Is typically transient (not long lasting)Happens recurrentlyIs reversible Chronic pain:Is persistent pain that cannot be easily overcomeIs long-lastingMay or may not be reversibleWhat are nociceptors? In what pathway do they signal pain to the brain?Definition: Sensory receptors that detect signals from damaged tissue or the threat of damage and once activated they become hyperalgesic for the rest of the injuryPathway: 1. Axons of nociceptor neurons carry signal to cord 2. Release of neurotransmitters 3. Activation of pain transmission neurons in spinal cord4. Signal is carried to regions of brainTypes: Chemical, Mechanical, and Temperature/ThermalWhat are the two different ways in which nociceptive information is transmitted?Ascending Transmission“Bottom-up” process of signal transmission that provides the brain with information about tissue damageThalamus is the major convergence pointDescending Modulation “Top-down” process of nociceptive modulation that regulates pain transmissionPeriaqueductal grey (PAG) is the major convergence point How does the Descending Modulation Process regulate the pain experience?Brain alters the activity of the pain transmission system by amplifying or inhibiting pain signals coming through the PAGInhibition – pain is controlled and inhibited by the release of opioids and some non-opioids (i.e. serotonin and norepinephrine) which block the ascending neuronsFacilitation – enhance transmission of pain to enhance pain Are examples of pain therapies? Pharmacotherapy (i.e. non-opioid analgesics, opioid analgesics and nerve block)Electrical stimulation AcupunctureChiropractics Physical Therapy What is Conditioned Place Preference?A type of conditioning that is studies how an unconditioned stimulus that makes the mouse (or other animal) either associate the place of stimulus with an avoidance or preference approachLecture 20 (November 11) Pain and Pain Management Continued … What is a homeostatic emotion and how does it relate to pain?Pain is a homeostatic emotion Homeostatic emotion – an attention demanding motivation that occurs from an internal body state that will lead to a certain behavior to restore the internal ideal condition What are Free Nerve Endings?Definition: Neurons not surrounded by special capsules or end organs; these neurons are found in all body tissues where pain is sensed Types: Thermal, Mechanical, Polymodal, Silent What is Thunberg’s Illusion?A sensory illusion of a burning sensation that occurs when a hand presses against a grill that has a combination of cool bars and warm barsWhat are the types of Peripheral Pain Neurons? What type of pain is each pain neuron fiber responsible for?A-Delta Fibers – thick, myelinated, fast conducting neuronsInvolved in the feeling of fast and sharp pain C Fibers – very thin, unmyelinated, slow-conductingInvolved in feeling of slow and dull pain Neuropathic Pain v. Nociceptive Pain?Nociceptive Pain – nociceptors in tissues send pain signals This pain is associated with mild sprains and strains, severe arthritis or tumors invading small tissuesNeuropathic Pain – caused by damage to the nerve This pain is associated with peripheral nerve cut/crushed, diabetes, MS, herpes zoster (aka shingles)What is Phantom Limb Pain? What are treatments for it?Neuropathic Pain that originates from an absent limbTreatment includes drugs (i.e. antidepressants) and spinal cord stimulationWhat is Hyperalgesia?Definition: Increased burning of pain on the skin or tissueTypes: Primary – prolonged changes of peripheral nociceptors and central neurons; can be seen in sensitivity at burn site)Secondary – sensitization of surrounding neurons; can be seen in sensitivity to surrounding skin of burn siteAllodynia – severe pain from the touch of a non-painful stimulationLecture 21 (November 13)Pain and Pain Management Continued … Describe Chronic Pain and the different types of chronic pain. Give examples for each.Definition: Pain that does not decrease with treatment and does not decrease and time passesPatients have high sensitivity to pain, low pain inhibition, and pain that interfereswith life activities Types: Chronic Benign Pain – Persists more than 6 months and varies in severity (i.e. Chronic Back Pain)Recurrent Acute Pain – Includes intermittent episodes of acute pain, but is considered to be chronic pain because it lasts more than 6 months (i.e. Migraine Headaches)Chronic Progressive Pain – Pain increases in severity over time and is typically associated with degenerative disorders or malignancies (i.e. Rheumatoid Arthritis, Cancer) How does Chronic Pain affect Lifestyle and Relationships?Leads to little or social/recreational lifeDifficulty performing simple tasksSleep disturbancesNegatively affects relationships (especially ones that are sexually involved)What is the relationship between Depression and Chronic Pain?Pain is not a direct causation for depression, but increases the risk of depressionPain reduces activity and perceptions of control leads to the risk of depressionWhat characteristics are often shown to have elevated scores on the Minnesota Multiphasic Personality Inventory?Neurotic Triad – Hypochondriasis, Hysteria, DepressionWhat techniques are used to control pain?Pharmacological Morphine is most commonSurgical ControlSensory Control Counter-irritation, Dorsal Column StimulationIncrease Activity and Mobility Biofeedback Patient is given ongoing information about a particular physiological process by a machine so that they can learn to