Flashcards in Pain (exam 2) Deck (73):
What are the 2 types of pain?
What is nociceptive pain?
Trigger nociceptors for pain
Somatic- joints, muscle, skin (very specific)
Visceral- organs (tumor/ obstruction) (very broad, referred pain)
What is neuropathic pain?
Brain feels pain
CNS or PNS
Don't always know the stimulus
What type of pain do small C fibers cause?
Prolonged, dull, achey, persistent pain
Small C fibers are unmyelinated
What type of pain do large A fibers cause? What other sensations?
Immediate, sharp pain
Large A fibers are myelinated
Touch, vibration, thermal
What are natural analgesics?
What does Transduction in pain pathway do?
Nociceptors activated, release substance to activate small C fibers
What does Transmission in pain pathway do?
Small C fibers to spinal cord through brain stem to the thalamus to the cerebral cortex
What does Perception in pain pathway do?
Once in cerebral cortex we feel and become aware of pain
What does Modulation in pain pathway do?
How we inhibit or control pain
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
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
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
How many months of persistent pain till it is classified as chronic pain?
Intermittent Chronic Pain
Comes and goes
Ex: chronic migraines
Persistent Chronic Pain
Ex: lumbago (low back pain)
Brains perception of pain
Hyperalgesia (over exaggerated pain levels)
Allodynia (feel pain with no present stimulus)
What is perceptual dominance?
Second injury is masked by pain of greater injury
What causes a fever? What does fever mean?
What is hyperthemia?
High body temp
Overexposure to heat source
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
What is hypothermia?
To low body temp
What are the stages of sleep?
REM (dreaming, rapid eye movement)
Non-REM sleep (4 stages, deeper sleep)
What is Hypersomnia and the types?
Primary hypersomnia: always over sleepy
Secondary hypersomnia: something inducing it, usually drugs
What sleep disorders affect breathing?
Obstructive sleep apnea syndrome (usually overweight or obese)
Nocturnal paroxysmal dyspnea (CHF patients, overwork heart laying down, SOB)
What is insomnia?
Inability to fall or stay asleep
What is strabismus?
Deviation from center of eye
What is nystagmus?
Eye shaking, twitching
What is diplopia? What is it a symptom of?
What is myopia?
Focus in front of retina
What is hyperopia?
Focus behind retina
What is astigmatism?
Uneven corneal curvature
No single retinal focus
What is an otitis externa ear infection?
Outside the tympanic membrane
What is an otitis media infection? Most common in who?
Eustachian tube infection
Children and infants
What is vestibular nystagmus?
Eyeball movement secondary to overstimulation of semicircular canals
What is vertigo?
Feel like you are spinning
Spinning sensation secondary to inflammation of semicircular canals
What is the primary cause of aphasia?
What is anomic/ amnesia aphasia?
Without a name for person, place, thing
What is receptive aphasia?
Damage to wernicke's area
Difficulty understanding spoken or written language
What is expressive aphasia?
Damage to Broca's area
Difficulty in conveying thoughts speech or writing
What is global aphasia?
Damage to wernicke and broca areas
Loss of almost all language function
What is decorticate?
Hands stuck up on chest
Lower on brain stem
Corticospinal damage: opposite side
What is decerebrate?
Hands stuck down
Higher on brainstem
Ipsilateral damage: same side
What happens with both decorticate and decerebrate damage?
Brain damage is to straight are side
What is Brain Stem Death?
Lack of brain function
Vegetative state, living by machines
What is cerebral death?
Death exclusive of brain stem and cerebellum
Brain maintains internal homeostasis
What is a partial seizure?
Part of brain
Focal and unilateral
What is an absence seizure?
Spacing out, zoning out for a couple minutes
What is a tonic clonic seizure?
Convulsions (rigid and relax, repeat)
Grand mal seizures
What is an epileptic?
Chronic tonic clonic seizures
What is hydrocephalaus?
Excess CSF within cranial vault, subarachnoid space or both
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
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
Blunt force trauma/ motor vehicle accident
Between skull and dura mater
Arterial bleed, fast bleed
Lucid intervals= think you are fine
Don't break blood brain barrier
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
Inside brain tissue
Small arteries or veins, slow bleed
Fastest to produce symptoms
Break blood brain barrier
Forms penumbra, walling off area
Little to no change in ICP
Damage to T1 or above
T2 and below
Half the body
What is the circle of willis?
If get a blockage in part, then should still get bloodflow to brain
Bleeding into brain tissue
Lack of bloodflow
Inflammation of the meninges
Bacterial: skull fractures, antibiotics
Fungal: Super fatal and rare
Inflammation of the brain
Decrease cognitive function due to age
Severe short term memory loss
Initial symptom: memory loss
Secondary: motor function loss
Strong genetic component
Tau tangles and Amyloid plaques
Severe atrophy of brain
Initial symptom: motor function loss
Secondary: Memory loss
Loss of dopamine production/ release
Loss of inhibition of dopamine causes more Ach= muscle tremors
Amyotrophic Lateral Sclerosis (ALS)
Primary symptom: Muscle weakness
Degeneration of somatic motor neurons
Primary Symptom: Muscle weakness
Demyelination of CNS neurons
Autoimmune disease (type 4): cyto T's attack oligos
Females more prone
Primary symptom: Muscle weakness
Demyelination of PNS neurons (schwann cells)
Primary symptom: muscle weakness
Muscle protein (dystrohpin) problem
Duchenne MD= most common in kids
Myotonic MD= most common in adults