Workshop Manual - Faculty of pain medicine - Australian and New ...

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2. Spinal cord (Fig 4) • The dorsal horn of the spinal cord is the “first relay station”. This is a vital area for two main reasons: — The Aδ and C fibres connect (synapse) with “second order” pain nerves. — There is input from other peripheral and spinal cord nerves – this may change the signal. • The second order pain nerve crosses to the other side of the spinal cord and travels up the spinothalamic tract to the thalamus at the base of the brain. PHYSIOLOGY AND PATHOLOGY Fig 4: Dorsal horn connections 14 ESSENTIAL PAIN MANAGEMENT
3. Brain (Fig 5) • The thalamus is the “second relay station”. There are many connections with other parts of the brain, including: — Cortex — Limbic system — Brainstem • The cortex is the main area responsible for us being aware of the pain (i.e. pain perception). • The limbic system is responsible for many of the emotions we feel when we experience pain (e.g. anxiety, fear). Fig 5: Brain connections PHYSIOLOGY AND PATHOLOGY ESSENTIAL PAIN MANAGEMENT 15
Page 1: ESSENTIAL PAIN MANAGEMENT Workshop
Page 4 and 5: Essential Pain Management by Wayne
Page 6 and 7: INTRODUCTION Pain affects all of us
Page 8 and 9: WHY SHOULD WE TREAT PAIN CASE 1: Mr
Page 10 and 11: CLASSIFICATION OF PAIN Not all pain
Page 12 and 13: PHYSIOLOGY AND PATHOLOGY Understand
Page 14 and 15: The pain pathway 1. Periphery (Fig
Page 18 and 19: 4. Modulation (Fig 6) • The pain
Page 20 and 21: PAIN TREATMENT Because many factors
Page 22 and 23: Non-drug treatments Both physical a
Page 24 and 25: Where do analgesics work Local anae
Page 26 and 27: Drug effectiveness The effectivenes
Page 28 and 29: Possible barriers: • Patient fact
Page 30 and 31: 2. ASSESS To treat pain better, we
Page 32 and 33: 3. TREAT Treatment can be divided i
Page 34 and 35: PAIN MANAGEMENT EXAMPLES EXAMPLE 1:
Page 36 and 37: EXAMPLE 3: 24-year-old woman with a
Page 38 and 39: EXAMPLE 4: 12-year-old girl with bu
Page 40 and 41: EXAMPLE 5: 51-year-old man with 2 y
Page 42 and 43: EXAMPLE 6: 55-year-old woman with m
Page 44 and 45: CASE DISCUSSIONS CASE 1: A 22-year-
Page 46 and 47: CASE 3: A 5-year-old girl has advan
Page 48 and 49: DISCUSSION TOPICS TOPIC 1: Treatmen
Page 50 and 51: APPENDICES Appendix 1: WHO Essentia
Page 52 and 53: Appendix 2: Medicine Formulary for
Page 54 and 55: Pethidine Generally very safe As fo
Page 56 and 57: Appendix 3: Paediatric Medicine Dos
Page 58 and 59: Appendix 5: Using Morphine for Canc

Workshop Manual - Faculty of pain medicine - Australian and New ...

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