Pain & thermoregulation

Question 1

Which theory of pain directly relates to amount of tissue injury? e.g. paper cut vs knife cut. Focusing on specific injuries & acute pain

Answer 1

Specificity Theory

Question 2

Which theory of pain focuses on how neural networks distributed along the dorsal horn of the spinal cord are responsible for relieving the pain in a specific body location when an intense tactile stimulation is applied at the same place (e.g. when you rub the place that got injured immediately when you feel the pain. This can reduce the amount of pain you experience)? With an emphases on mental status & pain experience

Answer 2

Gate control theory

Question 3

Which theory of pain proposes that pain isa multidimensional experience (involving physical & psychological aspects) produced by characteristic “neurosignature” patterns of nerve impulses? Focusing on genetic, psychological, & cognitive experiences

Answer 3

Neuromatrix Theory

Question 4

What is a theory of pain that describes he process of pain in 4 stages: Transduction, transmission, modulation, & perception?

Answer 4

Nociceptive pain

Question 5

(Nociceptive pain) Which stage of pain refers to when nociceptors (receptors for pain) are activated by a painful stimulus, this is because of the activation of the ion channels on nociceptors open, due to changes in chemical material around this receptor – This will create an electrical impulses within nociceptors which will travel through to spinal cord & then the brain through 2 types of axons: A fibres & C fibres?

Answer 5

Transduction

Question 6

(Nociceptive pain) In the trasnduction stage of the pain process:

Which fibres are larger myelinated axons, with rapid transmission of sharp, well-localized “fast” pain sensations – due to quick transmission it creates a reflex of withdrawal?

& which fibers are more numerous , smaller & unmyelinated – located in muscle, tendon, body organs, skin – slower transmission – dull, aching, or burning - they are poorly localized – constant?

Answer 6

• A fibres
• C fibres

Question 7

(Nociceptive pain) Which stage of pain involves many different mechanisms that can increase or decrease transmission of pain signals throughout the nervous system, where depending on the mechanism, this can happen before, during and after pain is perceived ?

Answer 7

Modulation

Question 8

(Nociceptive pain) Which stage of pain are signals conducted along axons into the spinal cord – cross the midline and ascend to the brain?

Which tract are impulses fast, and are related to acute sharp pain?

Which tract are impulses slow, related to dull & persistent pain

Answer 8

Transmission
- Anterior spinothalamic tract
- Lateral spinothalamic tract

Question 9

(Nociceptive pain) Which stage of pain are we consciously aware of pain, where the electrical impulse goes to the brain and we perceive the pain; going through 3 systems?

Which system identifies the presence, character (such as quality of pain), location, and intensity of pain – makes us want to withdraw our hand or act to stop pain?

Which system is responsible for conditioning avoidance behaviors & emotional responses to pain – includes depression, anger, anxiety. Is the emotional response to painful stimuli?

Which system do individual’s learned behaviour to modulate perception of pain. The type of behaviour that emerges when we feel pain & this behaviour can change pain perception, such as rubbing the painful area, which can reduce the amount of pain we are receiving?

Answer 9

Perception
- Sensory-discriminative system
- Affective-motivational system
- Cognitive-evaluative system

Question 10

(Pain modulation) List the 4 groups of pain modulation

Answer 10

Excitatory neurotransmitters, inhibitory neurotransmitters, endogenous opioids, & enkephalins

Question 11

(Pain modulation) Which pain modulation reduces the activation threshold which ↑ responsiveness to nociceptors? Such as prostaglandins, histamines, bradykinin, & lymphokines. These chemicals can sensitize nociceptors, by reducing activation threshold, so we expect that these chemicals increase the amount of pain we feel.

Answer 11

Excitatory neurotransmitters

Question 12

(Pain modulation) Which pain modulation contribute to pain inhibition?

Of these modulators, which is a natural occurring amino acid that can enhance rather than inhibit in some areas of brain, where they contribute to pain suppression & reduce pain transmission?

Which predominantly inhibits pain perception?

& which can inhibit and promote pain perception in the medulla and pons?

Answer 12

Inhibitory neurotransmitters
- Gamma-aminobutyric acid (GABA)
- Norepinephrine
- Serotonin

Question 13

(Pain modulation) Which pain modulation is an opioid peptide produced by the body, that inhibits the transmission of pain impulses?

What is an example of such, described as being distributed throughout the body giving you a feeling of well being?

Answer 13

Endogenous opioids
- Morphinelike neuropeptides

Question 14

(Pain modulation) Which pain modulation is where endorphins are most common & most important, producing an exhilaration as well as pain relief?

Answer 14

Enkephalins

Question 15

List the classifications of pain

Answer 15

• How pain is processed
• What is causing the pain
• Duration of the pain.

Question 16

(Descriptors of pain) Pain is defined as __ if it lasts less than 3 weeks & as __ if its anything above 3 weeks.

Answer 16

• Acute
• Chronic

Question 17

(Descriptors of pain)
Which term refers to pain that comes form the skin, muscles, & subcutaneous tissues?

Which term refers to pain comes form body organs?

Which term refers to the type of pain that is felt in a location different than the origin of the pain?

Which term refers to a pain caused by inflammation, irritation or neural tissue compression or arthritis?

& which term refers to a medical term used to describe the pain from physical damage or potential damage to the body?

Answer 17

• Somatic pain
• Visceral pain
• Referred pain
• Neuropathic pain
• Nociceptive pain

Question 18

(Descriptors of pain) What are some autonomic symptoms of visceral pain?

Answer 18

Sweating, nausea, vomiting, hypotension, & often radiates to another site and is classified as “referred”

Question 19

(Descriptors of pain) 2 categories of neuropathic pain:

Which category refers to pain related to damage or lesions of the peripheral nervous system, such as diabetic neuropathy, which causes damage to peripheral nerves which creates a burning persistent pain?

Which category refers to pain when we have damage or lesions or dysfunction in the brain or spinal column, the etiology for this type of pain can be trauma to spinal cord, or tumour in spinal cord or brain. Also. Phantom limb pain, which is perceived pain in limbs that have been amputated ?

Answer 19

• Peripheral nerve lesion
• Central nerve lesion or dysfunction

Question 20

(Descriptors of pain) In chronic pain: (acute pain is the opposite)

Duration:
Purpose:
Cause:
Prognosis:
Nerve conduction:
Associated illness:
Treatment:

Answer 20

• Months/years
• No purpose
• Commonly absent cause
• Unpredictable
• Slow
• Depression/Anxiety
• Multimodal

Question 21

Which term refers to a form of homeostasis (regulation), its a phenomenon or process which acts to maintain constant (fixed) internal environment?

& what is the normal human body temp range between?

Answer 21

Thermoregulation
- 36.2 – 37.7

Question 22

What is temperature regulated by?

Answer 22

Hypothalamus, temperature sensors & endocrines

Question 23

(Temperature regulation) What notifies the centre for thermoregulation, which is the hypothalamus of temperature changes in our environment?

What can activate some changes or process in our body which lead to Heat production, or conservation, or loss mechanisms are triggered as needed, depending on the temp of our environment?

& what are hormones that are involved in increasing heat by increasing the metabolic rate?

Answer 23

• Peripheral thermoreceptors
• The hypothalamus
• Endocrines

Question 24

(Temperature regulation disorders) What refers to a temporary reset of body thermostat – response to exogenous and endogenous pyrogens, that is. beneficial response that helps to kill microorganisms, ↓ bacteria replication, prevents viral replication, facilitates immune response, & ↑phagocytosis?

Answer 24

Fever

Question 25

(Temperature regulation disorders) What refers to an increase in temperature without a change in the hypothalamus set point.?

What occurs at 41 C ?

& what occurs at 43 C ?

Answer 25

Hyperthermia

• Nerve damage, coagulation of cell proteins (which damages cells)
• Death

Question 26

(Temperature regulation disorders) What are the 2 types of hyperthermia called?

Answer 26

Therapeutic & accidental hyperthermia

Question 27

(Temperature regulation disorders) What refers to thermal therapy that helps Helps damage and kill cancer cells with little or no harm to normal tissue?

Answer 27

Therapeutic hype

Question 28

(Temperature regulation disorders) What are examples of accidental hyperthermia?

Answer 28

• Heat cramps
• Heat exhaustion
• Heat stroke

Question 29

(Temperature regulation disorders)

Which term refers to individuals not accustomed to heat, & working in hot environments, causing spasmodic cramps in abdomen & extremities; Also accompanied by fever, ↑HR & ↑BP?

Answer 29

Heat cramps

Question 30

(Temperature regulation disorders) Which term refers to prolonged high core or environment temperature, that creates profound vasodilation, profuse sweating, causing dehydration, decreased cardiac output, tachycardia; as a result patient might experience weakness, dizziness, confusion, nausea, &/or fainting?

Answer 30

Heat exhaustion

Question 31

(Temperature regulation disorders) Which term refers to an overstressed thermoregulatory centre caused by exertion, overexposure to environmental heat, dysfunction of mechanisms for heat loss, where the core temperature is > 40 C, & the regulatory centre is no longer functioning & heat loss mechanisms no longer working. This leads to high core temperature, absence of sweating, ↑HR, confusion, agitation, &/or coma??

Answer 31

Heat stroke

Question 32

(Temperature regulation disorders) Which term refers to a hypermetabolic condition associated (side effect) with anesthetics & muscle relaxants, creating a hypermetabolic state which causes uncoordinated muscle contraction, increased oxygen consumption, increased lactic acid production (acidosis), hyperthermia, tachycardia, dysrhythmia, hypotension, &/or cardiac arrest?

Answer 32

Malignant hyperthermia

Question 33

(Temperature regulation disorders) Which term refers to < 35 C => can causes: Can happen due to cold environments
It creates, depression of the CNS and decrease in respiratory rate, vasoconstriction, ischemic tissue damage, damage to cell causes rupture & cellular death?

Answer 33

Hypothermia

Question 34

(Temperature regulation disorders) Which term refers to a practice that is used for people who are experiencing cardiac arrest (since our body is not well perfused)=> it helps by reducing metabolic rate in vital organs such as the brain, effects on cerebral blood flow, reduces of the critical threshold for oxygen delivery?

Answer 34

Induced Hypothermia