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D & D Exam 2 > Chapter 35 > Flashcards

Chapter 35 Flashcards

1
Q

Three types of afferent (sensory) neurons

A

General somatic
special somatic
general visceral

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2
Q

General somatic

A

Receptors found throughout the body

sense pain, touch, temperature

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3
Q

Special somatic

A

receptors in muscles, tendons, joints

able to sense muscle position and movement of the body

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4
Q

General visceral (internal)

A

Receptors various visceral structures

Sense fullness and discomfort

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5
Q

5th vital sign

A

pain

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6
Q

Cutaneous

A

skin, subcutaneous tissue

Examples: cut, incision, scrape, paper cut

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7
Q

deep somatic

A

muscle, tendon, joints

splanchnic - could be felt in visceral organs as well

Examples: arthritis, muscle soreness

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8
Q

visceral

A

often from disease

organs

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9
Q

referred

A

pain is in a different place instead of where it actually is

heart attack isn’t referred pain because cells are actually dying

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10
Q

1st level of neurons involved in somatic sensation

A

1st order neurons
sensory impulses travel up the spinal nerves to the spinal cord

ability to detect sensation, area of stimuli

the receptor

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11
Q

2nd level of neurons involved in somatic sensation

A

2nd order neurons

distinct/discriminative pathway

from spinal nerve root to medulla then crosses over to the Thalamus on other side of the brain

rapid transmitting discriminative pathway and anterolateral sensory pathway

travels up the spinal cord, purpose is to transmit to the brain

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12
Q

3rd level of neurons involved in somatic sensation

A

brain itself, purpose is to interpret the stimuli

is constant

primary somatosensory cortex and somatosensory association cortex

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13
Q

primary somatosensory cortex

A

necessary for localization, discrimination interpretation of stimuli

identifies sensation

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14
Q

somatosensory association cortex

A

relates sensation to memories, sensations, etc.

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15
Q

rapid transmitting discriminative pathway

A

Relaying info regarding spacial orientation, muscle movement, vibration, delicate touch

3 types of neurons:

  1. dorsal root ganglion = transmits from limbs and trunk
  2. dorsal column = cross medulla up to the Thalamus
  3. Thalamic (Thalamus) = sensory cortex through brain stem and joins with trigeminal nerves
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16
Q

Anterolateral pathway

A

Neospinothalamic tract

  • to the Thalamus and parietal cortex
  • allows localization, identification of pain

Crosses at same segment
Ascend
Crossover to contralateral (other) side

OR…

Paleospinothalamic
-to reticular activating system (RAS)

RAS - collects all stimuli, tries to weed out what isn’t necessary to focus on

Effects: arousal, mood, attention span

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17
Q

Specificity theory

A

special pain receptors detect pain or noxious stimuli (nociceptors) to the peripheral tissues

Specific receptors for each type of pain

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18
Q

pattern theory

A

pain receptors share pathways or endings with other modalities but that different patterns of activity of the same neurons can be used to signal both painful and non-painful stimuli

same receptors can tell difference

19
Q

Gate control theory

A
  • pain is carried by distinct fibers in the spinal cord
  • pain intensity can be temporarily modified by the stimulation of other sensory fibers
  • pinch self to lessen pain
20
Q

Neuromatix theory

A
  • The brain identifies pain
  • Helpful in identifying chronic pain and phantom pain in which there is not a simple one to one relationship between tissue injury and the pain experience
21
Q

Delta fibers

A
  • large, myelinated fibers
  • impulses travel quickly = fast pain
  • releases glutamate at the synapse with the spinal neurons
22
Q

C fibers

A
  • small, non myelinated
  • impulses slower
  • release glutamate and substance P
23
Q

Neurogenic inflammation

A

-tissue damage –>inflammatory mediators –> stimulate nociceptors –> impulses run up C fibers –>dorsal nerve root reflex –> inflammatory mediators move back down and are released into tissues –»> back up to stimulate nociceptors

24
Q

Periaqueductal gray matter

A
  • Endogenous (innate/internal to us)
  • analgesic (pain release) center is stimulated by opioids
  • simulation can send nerve impulses to inhibit other neurons in the pain pathway
25
Q

opioids

A
  • narcotics
  • blocks pain pathway so it no longer hurts or intensity is reduced
  • remember they supress impulse to breath
26
Q

Why don’t we try to get patients pain to fully go away?

A

So they don’t do more damage and because opioids are respiratory suppressants

27
Q

Hyperpathia

A

continued simulation results in pain

28
Q

Paresthesias

A
  • spontaneous unpleasant sensation

- like tingling in foot after it falls asleep

29
Q

Dysesthesia

A

Distortion of somesthetic (a body sensation)

30
Q

Hypalgesia

A

reduced pain sensation - think diabetic

31
Q

Hyperalgesia

A

increased pain sensation interpretation - think drug users (why they have withdrawals)

32
Q

Analgesia

A

absence of pain - like for surgeries

33
Q

Allodynia

A

pain after a non noxious stimuli

Ex: friction from clothing

34
Q

Causes of neuropathic pain

A
  • Pressure on nerve - sitting continuously
  • physical injury to neuron
  • chemical injury to neuron
  • infection of neuron
  • ischemia = cell death, heart attack
  • inflammation
35
Q

Conditions that cause pain

A
  • poorly controlled diabetes mellitus = no insulin, starving cells result in death = pain
  • long term alcohol use
  • Hypothyroidism
  • Renal insufficiency
  • drug treatment with neurotoxic agents (side effects)
36
Q

Pain assessment

A
  • subjective

- report of character and severity of pain

37
Q

A high systolic BP reading could indicate presence of pain

A

True though not always the case

38
Q

What should you take into consideration when seeing if what the patient says their pain is and how they are acting?

A

culture

39
Q

Migraine

A
  • present w/self limited (come and go)
  • recurrent
  • severe
  • autonomic system
  • associated with females more because of hormones
  • opioids are not affective
  • no surgical option
  • auras
40
Q

auras

A

visual that precedes the headache

41
Q

cluster headache

A

-repeated attacks of excruciatingly severe pain that always occurs on one side of the head (unilateral)

42
Q

Tension headache

A

radiates from lower back of head, neck or eyes or another muscle group in the body

43
Q

TMJ pain

A

Temperomandibular joint pain

-Pain/dysfunction of muscles that move jaw and joints and which connect the mandible to the skull

D & D Exam 2 (4 decks)

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