The Sensory system and Torment.

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What is Pain?. An offensive tactile and passionate experience connected with real or potential tissue damage.NOCICEPTIONPAINSUFFERINGPAIN BEHAVIORPain is constantly subjective. One of the body\'s barrier instruments - cautions the cerebrum that its tissues may be in jeopardyMay be activated with no physical harm to tissues.Acute torment is the essential reason individuals look for medicinal consideration and the major
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The Nervous System and Pain CHAPTER 7

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What is Pain? An obnoxious tactile and passionate experience connected with genuine or potential tissue harm . NOCICEPTION PAIN SUFFERING PAIN BEHAVIOR Pain is constantly subjective One of the body\'s guard instruments - cautions the cerebrum that its tissues might be in danger May be activated with no physical harm to tissues. Intense agony is the essential reason individuals look for restorative consideration and the real objection that they portray on beginning assessment Chronic torment can be so sincerely and physically weakening that it is a main source of suicide.

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The Nervous System and Pain

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PNS – Nerve Fiber Types Afferent – Sensory Neurons Three Types Are Important to Understand Pain A-delta filaments – littler, quick transmitting, myelinated strands that transmit sharp agony Mechanoreceptors – Triggered by solid mechanical weight and serious temperature C-strands – littlest, moderate transmitting unmyelinated nerve filaments that transmit dull or throbbing torment. Mechanoreceptors – Mechanical & Thermal Chemoreceptors – Triggered by chemicals discharged amid aggravation A-beta strands – expansive distance across, quick transmitting, myelinated tangible filaments Efferent – Motor neurons

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Spinal Cord Multiple rising and sliding tracts of interneurons (interface afferent & efferent) Afferent Neurons – Enter to dorsal (back) side Efferent Neurons – Exit the ventral (front) side

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Spinal Cord Spinal Layers Spinal dark matters separated into 10 layers Substantia Gelatinosa Composed of a layer of cell bodies running here and there the dorsal horns of the spinal string Receive contribution from An and C-strands Activity in SG hinders torment transmission

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The Brain Thalamus Somatosensory Cortex

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Thalamus The tactile switchboard of the cerebrum Located amidst the mind

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Somatosensory Cortex Area of cerebral cortex situated in the parietal projection directly behind the frontal flap Receives all information on touch and torment. Somatotopically composed

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Pain Pathways – Going Up Pain data goes up the spinal string through the spino-thalamic track (2 sections) PSTT Immediate cautioning of the nearness, area, and force of a harm NSTT Slow, throbbing update that tissue harm has happened

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Pain Pathways – Going Down Descending agony pathway in charge of torment hindrance

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The Neurochemicals of Pain Initiators Glutamate - Central Substance P - Central Brandykinin - Peripheral Prostaglandins - Peripheral Pain Inhibitors Serotonin Endorphins Enkephalins Dynorphin

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Theories of Pain Specificity Theory Began with Aristotle Pain is hardwired Specific "torment" filaments convey information to a "torment focus" Refuted in 1965 Gate Control Theory

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Gate-Control Theory – Ronald Melzack (1960s) Described physiological system by which mental elements can influence the experience of torment. Neural door can open and close subsequently adjusting torment. Door is situated in the spinal rope. It is the SG

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Opening and Closing the Gate When the door is shut signs from little width torment filaments don\'t energize the dorsal horn transmission neurons. At the point when the door is open torment signals energize dorsal horn transmission cells

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Three Factors Involved in Opening and Closing the Gate The measure of action in the agony strands. The measure of movement in other fringe strands. Messages that dive from the cerebrum.

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Conditions that Open the Gate Physical conditions Extent of harm Inappropriate movement level Emotional conditions Anxiety or stress Tension Depression Mental Conditions Focusing on agony Boredom

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Conditions That Close the Gate Physical conditions Medications Counter incitement (e.g., warm, rub) Emotional conditions Positive feelings Relaxation, Rest Mental conditions Intense fixation or diversion Involvement and enthusiasm forever exercises

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Categories of Pain can be arranged by source: Cutaneous – Skin, ligaments, tendons Deep substantial - Bone, muscle connective tissue Visceral – Organs, hole linings Neuropathic – Nerve torment By specific qualities Radiating Referred Intractable

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Phantom Limb Pain in a truant body part Very normal in amputees Ranges from shivering top sensation to torment

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Acute Pain ACUTE – Pain going on for under 6 months Highly related to harm Anxiety lessens w/treatment De-actuation frequently accommodating

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Chronic Pain enduring > 6 months Not corresponded to tissue harm Learned/Reinforced Often related w/psychopathology or adapting issues More liable to manhandle liquor and medications Leads to closing down Typically does not react to drugs exceptionally well Activity is the best solution

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Measuring Pain Physiological Unreliable Self-report Behavioral perceptions Rankings Pain polls Psych tests

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Headaches Tension - Muscular Daily bothers and hairsplitting anticipate recurrence and term of cerebral pains (Hons & Dewey, 2004) Migraine – Muscular and vascular Neuroticism scores foresee headaches for females, however not guys. Abbate-Daga et. Al, (2007) 105 Migrane w/out quality versus 79 wellbeing controls Migraine bunch more noteworthy than controls on Depression Anger administration Overcontrol Harm-shirking, steadiness and lower in self-directedness

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Back Pain 80% of US occupants encounter LBP Many causes, yet just 20% have unequivocal distinguishing proof Burns (2006) Chronic LBP Induced outrage and trouble Anger fixed LB muscles in CLBP not C Sadness did not have and impact No impact found in different muscles

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MANAGING PAIN Medical and Psychosocial Approaches

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Multiple Sites of Control

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Medical Treatments for Pain Non-sedative Analgesics Act incidentally NSAIDS COX inhibitors Advil, Vioxx, Aleve Steroidal Drugs Suppress invulnerable framework Cortisone, Prednisone

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Medical Treatments for Pain Opiate Analgesics Act midway by means of endogenous sedative framework Short-acting Long-acting Problems Tolerance Dependence

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Medical Treatments for Pain Skin Stimulation Massage Great as an extra TENS Mixed outcomes Acupuncture Effective for various sorts of torment Reduces the requirement for meds

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Medical Treatments for Pain Surgery to diminish torment Brain surgery – remove thalamus For unmanageable agony (malignancy) Surgery to reestablish work Surgery for only torment alleviation ought to be stayed away from Back Carpal Tunnel

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Psychosocial Interventions to Improve Coping w/Pain Hypnosis Biofeedback Relaxation Training Behavior Modification Cognitive Therapy/CBT Multimodal Approaches

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Relaxation Training Variety of systems using unwinding, diversion and re-concentrating Generally Effective and Cheap Progressive Muscle Relaxation Meditative Relaxation Mindfulness Meditation Guided Imagery

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Behavior Modification Programs Selectively strengthen new and more versatile adapting practices Exercise Activities Communication with respect to torment - quench torment conduct

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Cognitive Therapy/CBT CT = Reappraisal + Coping Skills and Emotional Expression … CBT = CT + Behavior Mod Inoculation Training (CBT) Conceptualization Skill obtaining and practice Application and finish Overall CT & CBT Effective for some conditions Table in your book LBP Recurrent Abdominal Pain Rheumatoid Arthritis Many more

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