T1- Pain,Temp Reg Flashcards
(139 cards)
0
Q
2 theories of pain
A
Specific and gate control theory
1
Q
“___ is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage”
A
Pain
2
Q
Which theory explains the amount of pain is related to the amount of tissue injury and accounts for many types of injuries but does not explain psychological contributions?
A
Specific Theory
3
Q
Which theory explains the complexities of the pain phenomenon?
A
Gate control theory
4
Q
What is the perception of pain?
A
nociception
5
Q
How many neurons are in the perception of pain?
A
3
Primary order, Secondary order and Third Order
6
Q
Which order of neurons bare nerve endings in skin, muscle, joints, arteries, and viscera that respond to chemical, mechanical and thermal stimuli?
A
Primary
7
Q
Which order of neurons can detect a wide range of of stimuli? A-delta fibers and Unmyelinated C polymodal fibers
A
Primary
8
Q
What are examples of low-threshold mechanical information that can distract from injury pain?
A
Touch, vibration and pressure
9
Q
Which neurotrasmitters excite pain?
A
glutamate and aspartate
10
Q
Which neurotransmitters inhibit pain?
A
serotonin, GABA and endorphins
11
Q
What is threshold depolarization from direct stimuli?
A
Direct excitation
12
Q
What is threshold depolarization from inflammatory mediators after tissue injury?
A
Indirect excitation
13
Q
An example of ___ excitation is increased sensitivity due to inflammatory mediators like in sunburn.
A
Indirect
14
Q
What is the point at which a stimulus is perceived as pain?
A
pain threshold
15
Q
T/f The pain threshold does not vary significantly among people or in the same person over time.
A
True
Crazy I know.. word for word off his slide
16
Q
T/F Intense pain at one location may cause an decrease in the threshold in another location
A
False
It increases the threshold in another location
17
Q
Duration of time or the intensity of pain that a person will endure before initiating pain responses and influenced by cultural perceptions, expectations, role behaviors and physical and mental health can be described as
A
Pain tolerance
18
Q
Decreased with repeated pain, fatigue, anger, boredum, apprehension and sleep deprivation and generally increased by alcohol consumption, persistent use of pain medication hypnosis can be described as
A
pain tolerance
19
Q
Point at which stimulus is perceived as pain is called
A
pain threshold
20
Q
Pain at one location may cause an increase in the threshold in another location is called
A
perceptual dominance
21
Q
Duration or time or the intensity of pain that a person will endure before initiating pain responses is called
A
pain tolerance
22
Q
What are two classifications of pain?
A
Nociceptive pain: pain with normal tissue injury (somatic, visceral)
Non-nociceptive pain: neuropathic pain (peripheral and central)
23
Q
This type of pain arises from connective tissue, muscle, bone and skin. When activated by A-delta fibers, is the pain sharp or dull? Is the pain well localized or poorly localized?
A
Acute somatic pain.
Since it is activated by A-delta, the pain is sharp and well-localized.
Pain activated by C-fibers is poorly localized and dull.
24
This type of pain is in the internal organs and abdomen, poorly localized due to lesser number of nociceptors.
Acute visceral pain.
25
This is pain in an area removed or distant from its point of organ. What type of pain is this?
Referred pain
- MI pain is described as referred pain.
26
This type of pain is a misinterpretation of nociceptive input. The cause of this type of pain is unknown, and is also defined as pain lasting longer than 3 months. What type of pain is this describing?
CHRONIC PAIN.. or medicaid pain.. whichever you like..:)
27
What are the most common types of chronic pain?
- Back pain (most common)
- Myofascial pain syndrome (injury to the muscle and fascia)
- Chronic postoperative pain
- Cancer pain
28
This type of pain is most often chronic, and is typically the result of trauma or disease of nerves. What type of pain?
Neuropathic pain
29
Phantom limb pain and complex regional pain syndrome are both characteristics of what type of pain?
Neuropathic pain
30
List the different considerations of neuropathic pain.
- Depression/anxiety
- Sleep disturbance
- Work-related issues of impairment and disability
- treatment expectations
- availability of social support
31
At what point during gestation is the nociceptor system functional?
24 weeks gestation.
32
In pediatrics, what are common expressions of pain?
- Facial expression
- Crying
- body language
33
Temperature regulation is variable based on 5 things, list these.
1. Location
2. Activity
3. Environment
4. Circadian rhythm
5. Gender
34
What are the three ways the body regulates temperature?
1. Peripheral thermoreceptors
2. Hypothalamic control
3. Heat production and conservation (vasoconstriction, skeletal muscle contraction, chemical reactions of metabolism)
35
What are some of the ways that the body losses heat?
```
Radiation
Conduction
Convection
Vasodilation
Decreased muscle tone
Evaporation
Increased respirations
Voluntary measures
Adaptation to warmer climates
```
36
Why do pediatric patients have a problem with temperature regulation?
They produce sufficient body heat but are unable to conserve heat produced because of the small body size and high body surface-to-weight ratio and a thin subcutaneous layer
37
As we age, temperature regulation becomes more difficult. Why?
Slow blood circulation, vasocontrictive response and metabolic rate
Decreased sweating and perception of heat and cold
38
Fever decreases serum levels of ______, ______ and _______.
| Deprives bacteria of _______.
iron, zinc, and copper
food
39
Fever promotes _________ breakdown and autodestruction of cells and increases _________ ______ and _________ motility.
lysosomal breakdown
lymphocytic transformation and phagocyte motility
40
Fever is the resetting of the _______ thermostat and activates heat production and conservation measures to a new set point.
hypothalamic thermostat
41
Hyperthermia is NOT mediated by ________. Is the hypothalamic thermostat reset?
pyrogens
NO IT IS NOT RESET :)
42
If the body reaches this temperature while experiencing hyperthermia, nerve damage produces convulsions.
41 C or 105.8 F
43
If the body reaches this temperature while experiencing hyperthermia, death results.
43 C or 109.4 F
44
What are 3 forms of hyperthermia?
heat cramps
heat exhaustion
heat stroke
45
How do heat cramps present in a pt with hyperthermia?
they follow prolonged sweating and associated sodium loss as severe spasmodic cramps in the abdomen and extremities
46
Who may be at risk for heat cramps? What may accompany the cramps?
People not accustomed to heat or performing strenuous work in warm climates
fever, rapid pulse, and increased blood pressure
47
What is heat exhaustion?
It is a form of hyperthermia in which a person collapses due to prolonged high core or environmental temperatures
48
What are symptoms of heat exhaustion?
prolonged vasodilation, profuse sweating
| dehydration, depressed plasma vol, hypotension, decreased CO, tachycardia
49
Manifestations of heat exhaustion
dizziness, weakness, nausea and syncope
50
What is a heat stroke?
potentially lethal result of a breakdown in an overstressed thermoregulatory center
51
The brain cannot tolerate temperatures greater than _____.
40.5 C or 104.9F
52
What are some manifestations of heat stroke?
cerebral edema
degeneration of the CNS
swollen dendrites
renal tubular necrosis
53
In heat stroke, rapid peripheral cooling causes ______ ________ and limits core cooling.
peripheral vasoconstriction
54
Why are children more susceptible to heat stroke?
produce more metabolic heat when exercising, greater surface area-to-mass ratio, and their sweating capacity is less than adults
55
What is the cause of malignant hyperthermia?
precipitated by the administration of volatile anesthetics and neuromuscular-blocking agents (increased Ca release or decreased Ca uptake with muscle contraction)
causes sustained muscle contractions
56
A body temp less than _____ is considered hypothermia.
35 C or 95F
57
Hypothermia produces:
Vasoconstriction, alterations in the microcirculation, coagulation, and ischemic tissue damage
Ice crystals, which form inside the cells, cause them to rupture and die
58
Tissue hypothermia slows chemical reactions, ______ blood viscosity, and _____ blood through microcirculation; facilitates blood coagulation and stimulates _________.
increases blood viscosity
slows blood
stimulates vasoconstriction
59
_____ = commonly the result of sudden immersion in cold water or prolonged exposure to cold
accidental hypothermia
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_____ = used to slow metabolism and preserve ischemic tissue during surgery or limb reimplantation.
therapeutic hypothermia
61
What is a risk associated with therapeutic hypothermia?
may lead to ventricular fibrillation and cardiac arrest
62
______ temperature change = CNS trauma, Accidental injuries, Hemorrhagic shock, Major surgery, Thermal burns
Trauma induced temperature changes
63
Where is the major sleep center located?
Hypothalamus
64
What promotes wakefulness and rapid eye movement sleep?
Hypocreatins (ovexins)
65
Sleep is an active mulitphase process. What are the two phases?
1. Rapid eye movement Sleep (REM sleep)
| 2. Non-rapid eye movement sleep (NREM sleep)
66
_______ phase is 75% to 80% of sleep time.
NREM sleep
67
_____ phase is 20% to 25% of sleep time?
REM Sleep
68
What is another name for REM sleep phase?
Paradoxic sleep
69
WHen does REM Sleep occur?
occurs every 90 minutes beginning after 1 to 2 hours of sleep
70
How many hours do newborns sleep per day?
16 to 17 hours per day
71
In infants, 53% of their sleep time is spent in _____ sleep.
active (REM) sleep
72
How long is the infant sleep cycle?
50 to 60 minutes
73
When do infants enter REM sleep?
immediately on falling asleep
74
What is the effect of age on sleep?
total sleep time is decreased
older adults take longer to fall asleep
awake more frequently during the night
amount of time in stage IV decreases
75
What causes the changes in sleep in older adults?
physical ailments
lack of daily routine
circadian rhythm changes
medications
76
_____ is a sleep disorder initiating sleep?
insomnia
77
What are the 3 types of sleep-disordered breathing?
1. upper airway resistance syndrome
2. obstructive sleep apnea
3. obesity hypoventilation syndrome
78
What are the 4 disorders of sleep-wake cycle?
1. parasomnias
2. somnambulism
3. night terros
4. enuresis
79
Disruptions of sleep, sleep tags, or partial arousals cause ____.
sleep disorders
80
Alterations in the quality and/or quantity of sleep due to primary diseases is the cause of ______.
Secondary sleep disorders
81
What are some causes of secondary sleep disorders?
depression, pain, sleep apnea syndromes, and alterations in thyroid hormone secretion
82
_______ are sleep stage alterations produced in certain disease states.
Sleep-provoked disorders
83
____ = inflammation of the eyelids
Blepharitis
84
____ = infection of sebaceous glands of the eyelids
Hordeolum (stye)
85
_____ = infection of the meibomian (oil secreting) gland
Chalazion
86
_____ = infection of the cornea.
Keratitis
87
_____ = inflammation of the conjunctiva
conjunctivitis
88
____ = pinkeye; highly contagious; mucopurulent drainage from one or both eyes
Acute bacterial conjunctivitis
89
____ = caused by an adenovirus; watering, redness, and photophobia of the eye
viral conjunctivitis
90
_____ is associated with a variety of antigens, including pollens. ocular itching is associated with photophobia, burning, and gritty sensations in the eye.
allergic conjunctivitis
91
____ = associated with poor hygiene, and is the leading preventable blindness in the world. inflammation with scarring of the conjunctiva and eyelids causing disorted lashes to abrade the cornea leading to corneal scarring.
Trachoma (chlamydial conjunctivitis)
92
Change in which part of the eye due to age is characterized by thicker and less curved and formations of a gray ring at its edge? The consequences to the age related change to this structure are increase in astigmatism, but is NOT detrimental to vision.
Cornea
93
Change to ____ is characterized by decers in size and volume caused by thickening of the lens. The consequences to this change are occasionally exertions of pressure on Schlemm canal and may lead to increased intraocular pressure and glaucoma.
anterior chamber
94
Age related change causes increase in opacity to which structure of the eye?
The consequences to this change are decrease in refraction with increase light scattering and decreased color vision(green and blue) ; can lead to cateracts.
lens
95
Age related change to this structure of the eye is characterized by reduction in pupil diameter, atrophy of radial dilation muscles.
Consequences to this change are persistent constriction (senile miosis); decrease in critical flicker frequency
Ciliary muscles
96
Age related changes to this structure in the eye is characterized by reduction in number of rods at periphery and loss of rods and associated nerve cells.
consequences to this change are increase in the minimum amount of light necessary to see an object.
retina
97
___ = the deviation of one eye form the other when a person is looking at an object resulting in failure of the two eyes to simultaneously focus on the same image with loss of binocular vision.
strabismus
98
What is the primary symptom of strabismus?
diplopia (double vision)
99
____ = an involuntary unilateral or bilateral rhythmic movement of the eyes and can occur in infants (congenital) or adults (acquired)
What are the two types?
Nystagmus
1. Pendular nystagmus
2. Jerk nystagmus
100
____ = a regular to and fro movement of the eyes in which both phases of movements are equal in length.
Pendular nystagmus
101
____ = one phase of the ye moves faster than the other
Jerk nystagmus
102
____ = a reduction or dimness of vision for unknown reasons. It does not result from a change in refraction (deviation of light rays) or from any visible change in the eye. It is associated with strabismus and anisometropia (refractive error in one eye differs from the other eye). It is the most common cause of vision loss in children and is usually treated by patching the unaffected eye for extended periods of time.
Amblyopia
103
___ = circumscribed defect of the central field of vision. It is most often a sequel to demyelinating optic neuritis, an inflammatory lesion of the optic nerve frequently associated with multiple sclerosis.
Scotoma
104
_____ = a cloudy or opaque area in the ocular lens. develop due to alterations of metabolism and transport of nutrients within the lens.
cateracts
105
____ = edema and inflammation of the optic nerve at its point of entrance into the eyeball. generally caused by some obstruction to the venous return from the retina. an early sign is distension of the renal vein. Obliteration of the physiologic cup (a bright area normally located in the center of the optic disc) follows. with severe PATCHES of WHITE EXUDATE develop.
Papilledema
106
_____ affects visual acuity; low illumination; need more than twice the amount of light; changes in the quantity and quality of rhodopsin, a substance found in the rods and responsible for low light vision & Vit. A deficiencies can cause this
dark adaptation
107
____ = intraocular pressures above the normal pressures of 12 to 20 mmHg maintained by aqueous fluid causing impaired visual acuity.
Glaucoma
108
_____ = loss of central vision, the major cause of vision loss in individuals older than 60;
Age related Macular Degeneration (AMD)
109
What is the process whereby the thickness of the lens changes?
accommodation
110
What are 2 visual dysfunction alterations in accommodation?
1. oculomotor nerve changes
| 2. decreased flexibility of the lens
111
What are 3 manifestations of accommodation alterations?
1. diplopia
2. blurred vision
3. headache
112
What are 3 alterations in refraction?
1. myopia
2. hyperopia
3. astigmatism
113
T/F: Astigmatism may coexist with myopia or hyperopia.
TRUE
114
What are alterations in color vision?
1. age-related yellowing of the lens
| 2. color blindness
115
Color blindness is generally a(n) _____ trait.
X-linked recessive trait
116
What are 3 neurologic disorders of visual dysfunction?
1. hemianopia
2. injury to the optic chiasm
3. homonymous hemianopsia
117
T/F: Cochlear hair cell degeneration occurs with aging.
TRUE
118
T/F: Loss of auditory neurons in spiral ganglia of the organ of Corti occurs with aging.
True
119
T/F: Increased vascularity of the cochlea occurs with aging.
FALSE!
| decreased vascularity
120
T/F: Loss of cortical auditory neurons occurs with aging.
TRUE
121
A patient comes into the clinic with an infection of the outer ear. What is the condition this patient has?
otitis externa
122
impaired sound conduction = _____.
conductive hearing loss
123
impairment of the organ of Corti or its central connections = ____.
sensorineural hearing loss
124
Which type of auditory dysfunction is presbycusis?
sensorineural hearing loss
125
Which cranial nerves are involved with olfaction?
CN I & part of CN V
126
What are 7 olfactory stimulants?
1. camphoraceous
2. musky
3. floral
4. peppermint
5. ethereal
6. pungent
7. putrid
127
Which cranial nerves are involved with taste?
CN VII & part of IX
128
Nerves in which parts of the body are involved in taste?
1. tongue
2. soft palate
3. uvula
4. pharynx
5. upper esophagus
129
What are 4 gustatory stimulants?
1. sour
2. sweet
3. salty
4. bitter
130
T/F: an increase in odor sensitivity occurs with aging?
FALSE!
| a decline occurs
131
T/F: loss of olfactory sensory neurons and cells in the olfactory bulbs.
TRUE
132
What does age-related olfaction cause?
diminished appetite and food selection
133
T/F: In age-related taste changes, a lower concentration of flavors is required.
FALSE
| a higher concentration is required
134
T/F: in age-related taste changes, a(n) increase in the number of fungiform papillae occurs.
FALSE
| a decline occurs
135
What does sensation involve?
modality, intensity, location, and duration
136
T/F: Touch receptors are present in the skin.
True
137
What does proprioception depend on?
inner ear, vision, and receptors in joints and ligaments
138
What are 3 proprioceptive dysfunctions?
1. vestibular nystagmus
2. vertigo
3. Ménière's disease
