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The Nature & Symptoms of Pain. Chapter 11. Qualities & Dimensions of Pain. Organic pain vs. Psychogenic pain Acute vs. Chronic Pain. Qualities & Dimensions of Pain. Chronic pain Benign vs. Malignant Continuous vs. Episodic Types Chronic/recurrent Chronic/intractable/benign
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The Nature & Symptoms of Pain Chapter 11
Qualities & Dimensions of Pain • Organic pain vs. Psychogenic pain • Acute vs. Chronic Pain
Qualities & Dimensions of Pain • Chronic pain • Benign vs. Malignant • Continuous vs. Episodic • Types • Chronic/recurrent • Chronic/intractable/benign • Chronic/progressive
Assessing Pain • Self-Report Methods • Questionnaires • Behavioral Assessment • Physiological Measures
Personal & Social Experiences and Pain • Learning • Emotions
Physiology of Pain Perception • Noxious stimulation release of algogenic substances at the site • e.g., serotonin, histamine, bradykinin • Algogenic substances promote immune system activity (inflammation) • Inflammation activates free nerve endings signaling pain • Free nerve endings: nociceptors
Physiology of Pain Perception • Afferent peripheral fibers • A-delta fibers • C fibers
Pain Without Apparent Physical Basis • Types • Neuralgia • Causalgia • Phantom Limb Pain
Theories of Pain • Specificity Theory • Pattern Theory • Gate Control Theory
Gate Control Theory Brain Small A-delta & C fibers + + + Substantia Gelatinosa “The Gate” Transmission cells (T cells) - - + Large A-beta fibers
Opiates inhibit inhibitory neurons of PAG Theories of Pain Basbaum & Field’s Descending Analgesic Pathway Periaqueductal Grey disinhibition + Interneurons Raphe Nucleus - Spinal Cord Incoming Pain Signals Ascending Anterolateral Pathway to brain