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Flashcards in Pain (exam 2) Deck (73):
1

What are the 2 types of pain?

Nociceptive
Neuropathic

2

What is nociceptive pain?

Trigger nociceptors for pain
Somatic- joints, muscle, skin (very specific)
Visceral- organs (tumor/ obstruction) (very broad, referred pain)

3

What is neuropathic pain?

Brain feels pain
CNS or PNS
Don't always know the stimulus

4

What type of pain do small C fibers cause?

Prolonged, dull, achey, persistent pain
Small C fibers are unmyelinated

5

What type of pain do large A fibers cause? What other sensations?

Immediate, sharp pain
Large A fibers are myelinated
Touch, vibration, thermal

6

What are natural analgesics?

Endorphins
Enkephalin
Dynorphin

7

What does Transduction in pain pathway do?

Nociceptors activated, release substance to activate small C fibers

8

What does Transmission in pain pathway do?

Small C fibers to spinal cord through brain stem to the thalamus to the cerebral cortex

9

What does Perception in pain pathway do?

Once in cerebral cortex we feel and become aware of pain

10

What does Modulation in pain pathway do?

How we inhibit or control pain

11

What is the gate control theory?

Small C fibers open the gate, cause pain
Large A fibers close the pain gate, modulation: touch, thermal, vibration

12

What is endogenous modulation?

Release analgesics (endorphins, serotonin, Neorepinephrine)
Block pain at the level small C fibers came in
Block at spinal cord even though nociceptors are still firing

13

What is exogenous modulation?

Large A fibers doing the modulation and closing gate through touch, vibration and thermal
Nociceptors are still firing, but large A are myelinated and beat to spinal cord so we don't perceive it

14

How many months of persistent pain till it is classified as chronic pain?

3 months

15

Intermittent Chronic Pain

Comes and goes
Ex: chronic migraines

16

Persistent Chronic Pain

Always present
Ex: lumbago (low back pain)

17

Neuropathic Pain

Brains perception of pain
Characterized by:
Hyperalgesia (over exaggerated pain levels)
Allodynia (feel pain with no present stimulus)

18

What is perceptual dominance?

Second injury is masked by pain of greater injury

19

What causes a fever? What does fever mean?

Pyrogens
Mean infection

20

What is hyperthemia?

High body temp
Overexposure to heat source

21

What is malignant hyperthermia?

Increased body temp caused by anesthetics
Spontaneously, quick progression of body temp
Increase muscle contraction, increase body temp
Stop by removal of anesthetics

22

What is hypothermia?

To low body temp

23

What are the stages of sleep?

REM (dreaming, rapid eye movement)
Non-REM sleep (4 stages, deeper sleep)

24

What is Hypersomnia and the types?

To sleepy
Primary hypersomnia: always over sleepy
Secondary hypersomnia: something inducing it, usually drugs

25

What sleep disorders affect breathing?

Obstructive sleep apnea syndrome (usually overweight or obese)
Nocturnal paroxysmal dyspnea (CHF patients, overwork heart laying down, SOB)

26

What is insomnia?

Inability to fall or stay asleep

27

What is strabismus?

Deviation from center of eye
Lazy eye

28

What is nystagmus?

Eye shaking, twitching

29

What is diplopia? What is it a symptom of?

Double vision
Strabismus symptom

30

What is myopia?

Nearsightedness
Long eyeball
Focus in front of retina

31

What is hyperopia?

Farsightedness
Fat eyeball
Focus behind retina

32

What is astigmatism?

Uneven corneal curvature
No single retinal focus

33

What is an otitis externa ear infection?

Outside the tympanic membrane
Swimmers ear

34

What is an otitis media infection? Most common in who?

Eustachian tube infection
Children and infants

35

What is vestibular nystagmus?

proprioceptive dysfunction
Eyeball movement secondary to overstimulation of semicircular canals

36

What is vertigo?

Feel like you are spinning
Spinning sensation secondary to inflammation of semicircular canals

37

What is the primary cause of aphasia?

Stroke

38

What is anomic/ amnesia aphasia?

Without a name for person, place, thing

39

What is receptive aphasia?

Damage to wernicke's area
Difficulty understanding spoken or written language

40

What is expressive aphasia?

Damage to Broca's area
Difficulty in conveying thoughts speech or writing

41

What is global aphasia?

Damage to wernicke and broca areas
Loss of almost all language function

42

What is decorticate?

Hands stuck up on chest
Lower on brain stem
Corticospinal damage: opposite side

43

What is decerebrate?

Hands stuck down
Higher on brainstem
Ipsilateral damage: same side

44

What happens with both decorticate and decerebrate damage?

Brain damage is to straight are side

45

What is Brain Stem Death?

Lack of brain function
Vegetative state, living by machines

46

What is cerebral death?

Death exclusive of brain stem and cerebellum
Brain maintains internal homeostasis

47

What is a partial seizure?

Part of brain
Focal and unilateral

48

What is an absence seizure?

Spacing out, zoning out for a couple minutes

49

What is a tonic clonic seizure?

Convulsions (rigid and relax, repeat)
Grand mal seizures

50

What is an epileptic?

Chronic tonic clonic seizures

51

What is hydrocephalaus?

Big head
Excess CSF within cranial vault, subarachnoid space or both
Increased ICP

52

What is a coup and counter- coup injury?

Coup is injury where hit on brain
Counter-coup is brain bouncing off opposite side of head, secondary injury

53

Cerebral Concussion

Most common type of traumatic brain injury
Chemical injury with loss of ATP
Confusion, Amnesia, Fatigue, Dizziness
Loss of consciousness not needed
No major broken blood vessels

54

Epidural Hematoma

Blunt force trauma/ motor vehicle accident
Between skull and dura mater
Increase ICP
Arterial bleed, fast bleed
Lucid intervals= think you are fine
Progressive
Don't break blood brain barrier

55

Subdural Hematoma

Elderly/ alcoholics/ shaken baby syndrome
Increase ICP (highest of all)
Below dura, above pia
Venous bleed, slow bleed
Most common, most fatal
Brain becomes hypoxic then necrosis
Break blood brain barrier
Inflammation and macrophage in brain
Liquifactic necrosis

56

Intracerebral Hematoma

Stroke causes
Inside brain tissue
Small arteries or veins, slow bleed
Fastest to produce symptoms
Break blood brain barrier
Liquifactic necrosis
Forms penumbra, walling off area
Little to no change in ICP

57

Quadrapelegia

Complete paralysis
Damage to T1 or above

58

Paraplegia

Lower half
T2 and below

59

Hemiplegia

Half the body
Stroke

60

What is the circle of willis?

Colateral flow
If get a blockage in part, then should still get bloodflow to brain

61

Hemorrhagic Stroke

Bleeding into brain tissue
Poor oxygenation
Necrosis

62

Ischemic Stroke

Lack of bloodflow
Hypoxia
Permanent necrosis

63

Meningitis

Inflammation of the meninges
Bacterial: skull fractures, antibiotics
Aseptic (Viral)
Fungal: Super fatal and rare

64

Encephalitis

Inflammation of the brain

65

Senility

Physiologic
Decrease cognitive function due to age

66

Dementia

Severe short term memory loss

67

Alzheimer's Disease

Initial symptom: memory loss
Secondary: motor function loss
Strong genetic component
Tau tangles and Amyloid plaques
Severe atrophy of brain

68

Parkinson's Disease

Initial symptom: motor function loss
Secondary: Memory loss
Loss of dopamine production/ release
Loss of inhibition of dopamine causes more Ach= muscle tremors

69

Amyotrophic Lateral Sclerosis (ALS)

Primary symptom: Muscle weakness
Degeneration of somatic motor neurons
Rapidly prgressive

70

Multiple Sclerosis

Primary Symptom: Muscle weakness
Demyelination of CNS neurons
Autoimmune disease (type 4): cyto T's attack oligos
Females more prone

71

Guillan barre

Primary symptom: Muscle weakness
Demyelination of PNS neurons (schwann cells)
From infection
Can recover

72

Muscular Dystrophy

Primary symptom: muscle weakness
Muscle protein (dystrohpin) problem
Duchenne MD= most common in kids
Myotonic MD= most common in adults

73

Myasthenia Gravis (MG)

Primary symptom: muscle weakness
Autoimmune disease: Ab to Ach receptors- block/ destroy- low muscle function