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NRP511 > Chapter 16: Pain, Temp, Sleep > Flashcards

Chapter 16: Pain, Temp, Sleep Flashcards

(78 cards)

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1
Q

Specificity theory of pain

A

Pain and touch are carried on distinct pathways that project to different brain centers
Intensity of pain is related to the amount of associated tissue injury

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2
Q

Pattern theory of pain

A

Different sense organs have different levels of responsiveness to stimuli with different spatial and temporal profiles firing

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3
Q

Gate control theory of pain

A

Gate either opens or closes

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4
Q

Nociception

A

the processing of potentially harmful stimuli through a normally functioning nervous system

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5
Q

Nociceptors

A

Free nerve endings in afferent PNS that selectively respond to stimuli

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6
Q

A delta fibers

A

Lightly myelinated, medium, fast transmission

Reflex withdrawal due to pain or heat
Fast like delta force

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7
Q

C fibers

A

Smaller and unmyelinated

Slow, dull, aching pain poorly localized

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8
Q

A beta fibers

A

Large and myelinated

Touch and vibration

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9
Q

Pain transduction

A

Tissue is damaged; activation of nociceptors

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10
Q

Pain transmission

A

Conduction of pain impulses along A delta and C fibers into dorsal horn of spinal cord up to cortex for interpretation

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11
Q

Pain perception

A

Conscious awareness

Occurs in reticular and limbic and cerebral cortex

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12
Q

Pain modulation

A

Increase or decrease in transmission of pain signals

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13
Q

Segmental inhibition of pain

A

Rubbing an area that is injured

A beta fibers stimulated and impulses arrive at same spinal level as A delta or C fibers

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14
Q

Conditioned pain modulation

A

Pain is relieved when 2 noxious stimuli occur at the same time from different sites

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15
Q

Perceptual dominance

A

Pain at one site may mask another painful area

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16
Q

Nociceptive pain

A

Pain with normal tissue injury from known cause

Normal protective mechanism

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17
Q

Acute pain

A

Can last up to 3 months

Increased HR, BP, Sweating, dilated pupils, increased glucose

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18
Q

Chronic pain

A

More than 3-6 months

Out of proportion to any tissue injury

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19
Q

Hyperalgesia

A

increased sensitivity to pain

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20
Q

Allodynia

A

Pain due to normally nonpainful stimuli

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21
Q

Myofascial pain syndrome

A

Injury to muscle fascia and tendons

Compression of trigger point causes referred pain and becomes more generalized

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22
Q

Normal body temp

A

97.2-99.9

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23
Q

What mediates temperature primarily

A

Peripheral thermoreceptors in skin and abdominal organs

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24
Q

Chemical thermogenesis

A

Hypothalamus stimulates release of TSH from anterior pituitary, thyroxine released, adrenal medulla releases epinephrine, leads to vasoconstriction, glycolysis and increased metabolic rate

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25
Body heat conservation
Hypothalamus stimulates SNS, which stimulates adrenal cortex, increased skeletal muscle tone and shivering and vasoconstriction keeps heat from escaping
26
Radiation
Heat loss through electromagnetic waves
27
Conduction
Direct molecule to molecule transfer
28
Convection
Through currents of gases or liquid
29
Mechanisms to lose heat
Vasodilation, hyperventilation, sweating
30
Aging and temperature
Slowed blood circulation, decreased shivering, decreased metabolic rate, decreased sweating Decreased or no fever response to infection
31
Pathogenesis of fever
Pathogens produce endotoxins; production of prostaglandin E2 in periphery and brain; Increased temperature, B cell proliferation, increased catecholamines, vasoconstriction, shivering
32
Benefits of fever
Kills microorganisms, decreases iron, zinc and copper, causes lysosomal breakdown and auto destruction of cells
33
Hyperthermia
Increase in body temperature without increase in hypothalamic set point Can produce nerve damage, coagulation of cell proteins and death
34
Heat cramps
Severe, spasmodic cramps in abdomen and extremities due to prolonged sweating and Na loss Fever, increased HR and BP
35
Heat exhaustion
Prolonged high core temperature; profound vasodilation and sweating Leads to dehydration
36
Heat stroke
At 104 degrees, regulatory system stops and body's heat loss mechanisms fail Absence of sweating, increased HR, confusion
37
Malignant hyperthermia
Inherited muscle disorder triggered by anesthetics increased intracellular Ca levels: sustained uncoordinated muscle contractions No reflexes, fixed pupils, apnea
38
Hypothermia causes
Depression of CNS and resp system, vasoconstriction and ischemic tissue damage
39
Parodoxical undressing
as hypothermia deepens, there is a shift to vasodilation--patient feels hot
40
NREM sleep
Slow wave sleep Decreased SNS and Increased PNS activity Growth hormone released in N3 Decreased corticosteroids and catecholamine release
41
Aging and sleep
Total sleep time decreased | Decreased slow wave sleep
42
Dyssomnias
Difficulty in initiating or maintaining sleep or presence of excessive sleepiness
43
Types of dyssomnias
•Insomnia •restless leg syndrome •obstructive sleep apnea syndrome •hypersomnia •narcolepsy •circadian rhythm disorders
44
Parasomnias
Awakening from REM or partial arousal form NREM
45
Examples of parasomnias
Sleep walking, night terrors, night cramps, SIDS
46
Touch and sedatives or prefrontal injury
Decreased interpretation of tactile sensations
47
Meniere disease
Episodic vestibular disorder due to neuroepithelial damage related to abnormalities in the quantity, composition and pressure of endolymph in the middle ear Vertigo, hearing loss, tinnitus
48
Blepharitis
Inflammation of eyelids due to staph | Redness, edema, tearing, itching
49
External hordeolum
Stye | Infection of sebaceous glands
50
Entropion
Lid margin turns inward against eyeball
51
Ectropion
Lid margin turns outward
52
Trichasis
Eyelashes grow back towards eye
53
Acute bacterial conjunctivitis
Pinkeye | Usually self limiting
54
Viral conjunctivitis
Caused by adenovirus
55
Trachoma
Caused by chlamydia | Leading cause of preventable blindness
56
Keratitis
Inflammation of cornea | Can be noninfectious or infectious
57
Strabismus
Deviation of one eye from other when looking at object Neuromuscular disorder of eye muscle Primary s/s: diplopia
58
Nystagmus
May be due to imbalance in normally coordinated reflex activity of inner ear
59
Amblyopia
Lazy eye | Due to altered development of visual cortex
60
Scotoma
Circumscribed defect of central field of vision | Age related to do with this
61
Cataract
Cloudy/opaque area in ocular lens | Due to alterations of metabolism and transport of nutrients within lens
62
Glaucomas
Intraocular pressure >12-20 | Degeneration of peripheral vision followed by central vision
63
Retinal detachment
Fluid separates photoreceptors from retinal pigment epithelium Deprives outer retina of O2 and nutrients
64
Age related macular degeneration
Severe and irreversible loss of vision | Due to age, htn, smoking, diabetes, family hx
65
Presbyopia (Nearsightedness)
Ocular lens becomes larger, firmer, less elastic Occurs >45 years old Decrease in near vision
66
Myopia
Nearsightedness
67
Hyperopia
Farsightedness
68
Astigmatism
Unequal curvature of corna | Light rays bent unevenly
69
Presbycusis
Loss of hearing in increased age | Loss of hearing high frequency common
70
Conductive hearing loss
Due to change in outer or middle ear
71
Sensorineural hearing loss
Impairment of organ of corti | Due to noise exposure, aging, meniere disease, ototoxicity, systemic disease
72
Risk factor for otitis externa
Swimming
73
Otitis media due to
HIB most commonly in children
74
Hyposmia
Impaired sense of smell
75
Hypoguesia
Impaired taste sensation
76
When does nocturnal angina occur
REM sleep
77
Visceral pain transmitted by
Sympathetic afferent nerves
78
Diabetic neuropathy causes
Chronic, peripheral pain | Due to damaged nerves--become hyper excitable and fire even when absence of pain signals

NRP511 (23 decks)

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