最新PATHOPHYSIOLOGY OF PAIN：病理生理疼痛教学讲义ppt.ppt

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1、PATHOPHYSIOLOGYOFPAIN：病理生理疼痛●Alterationinsensoryfunctiondysfunctionsofthegeneralorspecialsenses•Dysfunctionsofthegeneralsenseschronicpain,abnormaltemperatureregulation,tactiledysfunctionDefinitionsofpain•Painisacomplexunpleasantphenomenoncomposedofsenso

2、ryexperiencesthatincludetime,space,intensity,emotion,cognition,andmotivation•Painisanunpleasantoremotionalexperienceoriginatinginrealorpotentialdamagedtissue•Painisanunpleasantphenomenonthatisuniquelyexperiencedbyeachindividual;itcannotbeadequatelydefined

3、,identified,ormeasuredbyanobserverTheexperienceofpainThreesystemsinteractusuallytoproducepain:1.sensory-discriminative2.motivational-affective3.cognitive-evaluative1.Sensory-discriminativesystemprocessesinformationaboutthestrength,intensity,qualityandtemp

4、oralandspatialaspectsofpain2.Motivational-affectivesystemdeterminestheindividual´sapproach-avoidancebehaviours3.Cognitive-evaluativesystemoverliestheindividualslearnedbehaviourconcerningtheexperienceofpain.Itmayblock,modulate,orenhancetheperceptionofpainP

5、sychologicalresponsetochronicpainIntermittentpainproducesaphysiologicresponsesimilartoacutepain.Persistentpainallowsforadaptation(functionsofthebodyarenormalbutthepainisnotreliefed)ChronicpainproducessignificantbehaviouralandpsychologicalchangesThemaincha

6、ngesare:-depression-anattempttokeeppain-relatedbehaviourtoaminimum-sleepingdisorders-preoccupationwiththepain-tendencytodenypainPainthresholdandpaintoleranceThepainthresholdisthepointatwhichastimulusisperceivedaspainItdoesnotvarysignificantlyamonghealthyp

7、eopleorinthesamepersonovertimePerceptualdominance-intensepainatonelocationmaycauseanincreaseinthepainthresholdinanotherlocation•Thepaintoleranceisexpressedasdurationoftimeortheintensityofpainthatanindividualwillendurebeforeinitiationovertpainresponses.Iti

8、sinfluencedby-personsculturalprescriptions-expectations-rolebehaviours-physicalandmentalhealth•Paintoleranceisgenerallydecreased:-withrepeatedexposuretopain,-byfatigue,anger,boredom,apprehension,-sleepdeprivation•T