Pathophysiology: Pain & Inflammation (Simplified)

What does SAMPLE stand for in patient assessment?

Signs/Symptoms, Allergies, Medications, Past Medical History, Last Oral Intake, Events Leading Up

What does S in SAMPLE stand for?

Signs and Symptoms (what is bothering the patient)

What does A in SAMPLE stand for?

Allergies (medications, food, environmental)

What does M in SAMPLE stand for?

Medications (prescription, over-the-counter, supplements)

What does P in SAMPLE stand for?

Past Medical History (existing conditions)

What does L in SAMPLE stand for?

Last Oral Intake (last time patient ate or drank)

What does E in SAMPLE stand for?

Events Leading Up (what patient was doing before symptoms started)

What does OPQRST stand for in pain assessment?

Onset, Provocation/Palliation, Quality, Region/Radiation, Severity, Time

What does O in OPQRST stand for?

Onset (when pain started)

What does P in OPQRST stand for?

Provocation/Palliation (what makes it better or worse)

What does Q in OPQRST stand for?

Quality (description of pain)

What does R in OPQRST stand for?

Region/Radiation (location and spread)

What does S in OPQRST stand for?

Severity (pain scale 1–10)

What does T in OPQRST stand for?

Time (duration and pattern)

What is pain?

An unpleasant sensory and emotional experience associated with tissue damage

What are causes of pain?

Inflammation, infection, ischemia, necrosis, stretching, chemicals, burns, muscle spasm

What is somatic pain?

Pain from skin, muscles, or bones

What is visceral pain?

Pain from internal organs

What are nociceptors?

Free nerve endings that detect pain

What stimulates nociceptors?

Temperature extremes, chemicals, pressure

What is pain threshold?

Minimum stimulation needed to feel pain

What is pain tolerance?

Ability to cope with pain

What are A-delta fibers?

Fast, myelinated fibers transmitting sharp pain

What are C fibers?

Slow, unmyelinated fibers transmitting dull chronic pain

What is a dermatome?

Area of skin supplied by one spinal nerve

What is the spinothalamic tract?

Pathway carrying pain to the brain

What is gate control theory?

Pain signals can be increased or decreased by neural “gates”

What happens when gates are open?

Pain signals travel to the brain

What happens when gates are closed?

Pain transmission is reduced

How does ice reduce pain?

Stimulates temperature receptors that close pain gates

What is TENS?

Electrical stimulation that blocks pain signals

How do opioids reduce pain?

Block pain transmission in CNS and mimic endorphins

What are endogenous opioids?

Natural painkillers like endorphins

What is Substance P?

A neurotransmitter that transmits and amplifies pain signals and promotes inflammation

What is referred pain?

Pain felt at a location different from the source

What is phantom pain?

Pain felt in a missing body part

What is acute pain?

Sudden, short-term pain indicating tissue damage

What is chronic pain?

Long-lasting pain that is harder to treat

What are exacerbations?

Sudden worsening of chronic pain

How do infants respond to pain?

Physiological signs like increased HR, BP, facial expressions

How do children cope with pain?

Eating, playing, crying, sobbing

Why is pain hard to assess in children?

They struggle to describe it

What may older children do when in pain?

Withdraw or communicate less

What is the most common headache type?

Tension headache

What causes tension headaches?

Muscle tension and stress

What structures cause headaches?

Brain membranes and blood vessels (not brain tissue)

What are causes of headaches?

Sinus congestion, eye strain, muscle tension, stress, TMJ, intracranial pressure

What causes migraines?

Neurologic and biochemical changes affecting blood flow

What is migraine mechanism?

Triggers → vasodilation → vasoconstriction → pain

What symptoms occur with migraines?

Nausea, vomiting, sensitivity to light and sound

What are types of migraines?

With aura and without aura

How long do migraines last?

1–2 days

What is neuropathic pain?

Pain from nerve damage

What is ischemic pain?

Pain from reduced blood flow

What is cancer-related pain?

Pain from cancer or treatmen

What are analgesics?

Pain-relieving medications

How are analgesics given?

Oral, injection, transdermal

Why are sedatives used in pain management?

Promote relaxation and reduce anxiety

Are sedatives painkillers?

No, they are adjuncts

How do sedatives affect analgesic use?

Reduce needed dosage

What is patient-controlled analgesia (PCA)?

Patient self-administers pain meds via IV

What is intractable pain?

Pain that cannot be controlled with medication

What is treatment for intractable pain?

Surgical intervention

What are examples of surgery for pain?

Rhizotomy and cordotomy

What is inflammation?

Body response to injury, infection, or immune reaction

What are causes of inflammation?

Injury, infection, ischemia, allergies, chemicals, temperature extremes

What chemicals are released in inflammation?

Histamine, prostaglandins, bradykinin

What does histamine do?

Increases capillary permeability

What do prostaglandins do?

Promote inflammation and pain

What are signs of inflammation?

Redness, heat, swelling, pain, loss of function

What is edema?

Fluid accumulation causing swelling

What is exudate?

Protein-rich fluid leaked into tissues

What are types of exudate?

Serous, purulent, hemorrhagic, fibrinous, membranous

What is pus?

Dead cells and debris

What is an abscess?

Collection of pus

What is acute inflammation?

Rapid response with neutrophils

What is chronic inflammation?

Long-term response with macrophages and lymphocyte

What is a granuloma?

Nodular mass walling off foreign material

What is fibrosis?

Scar tissue formation

What is regeneration?

Replacement with original tissue

What is replacement healing?

Scar tissue replaces normal tissue

What are adhesions?

Bands of scar tissue connecting tissues

What are contractures?

Restricted movement from scar tissue

What is a keloid?

Overgrown scar tissue

What are systemic effects of inflammation?

Fever, fatigue, malaise, headache, loss of appetite

What are NSAIDs?

Anti-inflammatory drugs like ibuprofen

What are glucocorticoids?

Steroids that suppress inflammation

What are side effects of glucocorticoids?

Infection risk, delayed healing, tissue breakdown

What is RICE therapy?

Rest, Ice, Compression, Elevation

What are burns?

Tissue damage from heat, chemicals, radiation, or electricity

What are burn types?

First-degree, second-degree, third-degree

What is the rule of nines?

Method to estimate burn area

What complications occur with burns?

Dehydration, shock, infection, pain

What happens during burn healing?

Hypermetabolism and scar formation

What is serous exudate?

Clear, watery fluid with little protein

What is purulent exudate?

Thick, yellow-green fluid with leukocytes, cell debris, and microorganisms

What is hemorrhagic exudate?

Exudate containing blood

What is fibrinous exudate?

Thick, sticky exudate containing fibrin

What is membranous exudate?

Thick exudate on mucous membranes containing necrotic cells

What is the kinin system?

A system of plasma proteins activated during inflammation