Review this week’s media presentation on the neurological system, as well as Chapter 14 in the Huether andMcCance text

The following is a brief introduction to the topic:

The symptom of pain is common to all patients, regardless of age, gender, race, or behavior. Neurological system has a major role to play in pain perception. The nervous systems receives and interprets stimuli which are then translated into painful sensations. The three main types of pain are acute, chronic and referred. Acute or sudden pain usually subsides quickly. Chronic pain occurs when pain persists or returns after a time period greater than six months. Referred Pain occurs when pain does not originate at the original site. This paper discusses factors that affect the treatment, diagnosis, and pathophysiology associated with acute, chronic or referred chronic pain. These include genetics and gender.

The Pathophysiology and Treatment of Chronic Pain, Acute Pain, and Referred pain

Acute Pain is an abrupt pain that can occur in response to tissue damage or inflammation. A-delta myelinated fibers with high conduction speeds transmit acute pain. A-delta fibres transmit pain to the dorsal cord of the spine when noxious stimuli are applied. Second-order neuronal cells in the dorsal cord receive the pain signals sent by the A-delta fibres, and then transmit the signal to the thalamus. The thalamus acts as a relay station for pain signals and transmits them to the somatosensory cortex, where they are processed and perceived as pain sensations (Huether & McCance, 2017).

The chronic pain is persistent pain or pain that occurs repeatedly and lasts longer than six months. Chronic pain is nociceptive or neuropathic. The cause of nociceptive or neuropathic chronic pain is tissue damage, inflammation or injury. Chronic pain can be transmitted through C-fibers that are not myelinated, and which have a very slow conduction rate. The C fibers transmit pain to the dorsal spinal cord horn when activated. Dorsal-horn neurons receive signals of pain from C-fibers. They then send them on to brainstems, thalami, and the cortex. Chronic pain also activates the descending pain pathway, which modulates pain perception by releasing endogenous opioids, serotonin, and norepinephrine (Huether & McCance, 2017).

Referred pain occurs if the pain site is different from the source of the pain. Referred pain is caused by the convergence of nerves that originate in different areas within the spinal cord. Referred pain can be caused by the convergence of sensory nerves from different regions in the spinal cord. For instance, the pain coming from the heart could be sent to the shoulder or arm on the left, while pain from the Gallbladder might be directed to the shoulder and the back on the right. Referred Pain is a result of the overlapping dermatomes. Dermatomes are areas of skin that receive innervation from a spinal nerve. The brain misinterprets the pain signals and perceives them as originating from the referred site (Huether & McCance, 2017).

Patients’ factors and their impact on pathophysiology. Diagnosis and treatment of pain

The patient’s gender, ethnicity and age are all factors that may influence the treatment, diagnosis or pathophysiology of pain. The expression of genes for neurotransmitters, pain receptors and ion channel codes can alter pain perception. Individuals with mutations of the SCN9A, the gene that codes for the sodium channel Nav1.7, can experience CIP or erythromelalgia. This is marked by burning pain on the hands and feet.