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Pathophysiology > Ch-14 Pain & Temp > Flashcards

Ch-14 Pain & Temp Flashcards

1
Q

What is pain?

A

dysfunctions of general or specific issues.

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2
Q

Characteristics of pain?

A
  • unpleasant but protective phenomenon
  • cannot be defined, identified or measured by an observer.
  • complex: interactions between physical, cognitive, emotional
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3
Q

How did McCaffery defined pain?

A

whatever the experiencing person says it is, existing whenever they say it does.

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4
Q

What is temperature?

A

like pain; variations in temp can signal disease.

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5
Q

What is the common manifestation of dsyfunction?

A

Fever

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6
Q

Fever is often the _____ symptom of infectious of inflammatory conditions.

A

first

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7
Q

What are the 3 theories of pain?

A

Specificity (1), Gate Control (2) & Neuromatrix (3)

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8
Q

Which theory activates specific pain receptors to brain?

A

Specificity theory

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9
Q

In Specificity theory, the ____ of pain is directly related to associated ____ injury

A

intensity; tissue

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10
Q

T or F: Prickling one’s finger = more pain compared to cutting hand with knife.

A

false; minimal pain

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11
Q

What is the problem associated with specificity theory?

A

does not account for persistent, emotional pain

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12
Q

Which theories of pain is associated with brain produces patterns of nerve impulses drawn from various inputs including genetic, psychological and cognitive experiences.

A

Neuromatrix theory

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13
Q

T or F: In Neuromatrix theory, pain can be felt without experiencing them.

A

true

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14
Q

What is an example of pain can be felt without experiencing them?

A

Phantom limb

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15
Q

What is the cause of phantom limb?

A

stimuli may trigger the nerve impulses patterns but do not produce them.

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16
Q

In Gate Control theory, it combines and builds upon theories to explain ____ aspects of pain.

A

multidimensional

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17
Q

What part of the body that is associated in gate control theory that controls pain transmission to higher centres like CNS?

A

spinal cord

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18
Q

How many portions of NS are responsible for pain perception, sensation, and response? Name them.

A

three; afferent pathway (1), interpretive centres (CNS) (2), & efferent pathways (3).

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19
Q

What terms describes the processing of harmful (noxious) stimuli through nervous system.

A

nociception

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20
Q

What are the pain receptors?

A

nociceptors

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21
Q

Nociceptors are _____ nerve endings in _____ PNS.

A

free; afferent.

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22
Q

What are the two types of nociceptors?

A

A delta fibers & C fibers

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23
Q

What are A delta fibers?

A

large, myelinated & has acces to large tracts in spinal cord.

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24
Q

What are C fibers?

A

smaller, unmyelinated & has access to smaller tracts in spinal cord.

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25
Q

______ sharp pain is perceived first by _____ fibers followed by a dull, throbbing pain by ____ fibers

A

sharp; A delta; C

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26
Q

What is a transducer?

A

device that converts variations into electrical signal.

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27
Q

Difference between transduction & transmission?

A

Transduction - activation of nociceptors; happens first.

Transmission - conduction to dorsal horn and up spinal cord.

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28
Q

In terms of perception of pain, what system identifies presence, location and intensity?

A

sensory-discriminative or somatosensory cortex.

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29
Q

In terms of perception of pain, what system determines avoidance and emotional responses?

A

motivational-affective system (e.g., reticular formation and limbic system)

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29
Q

In terms of perception of pain, what system is associated with learned pain experience?

A

Cognitive-evaluative system

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30
Q

With cognitive-evaluative system, individuals can ______ perception of pain.

A

modulate

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31
Q

What is pain perception?

A

conscious awareness of pain (reticular and limbic system)

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32
Q

What is pain threshold?

A

lowest intensity of pain that a person can recognize.

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33
Q

What terms describes as the highest intensity of pain a person can endure?

A

pain tolerance.

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34
Q

Pain tolerance, ____ greatly among people and in same person over time

A

varies.

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35
Q

Pain tolerance generally ____ with repeated exposure.

A

decreases

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36
Q

What is perceptual dominance?

A

intense pain at one location may increase threshold in another location

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37
Q

What is pain modulation?

A

these are different mechanisms that act to increases or decrease pain transmission through nervous system.

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38
Q

_____ triggering mechanism that initiate excitatory neurotransmitters include tissue injury and chronic inflammation.

A

peripheral

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39
Q

Substance P, Glutamate, Histamine & Prostaglandins are what type of neurotransmitters?

A

excitatory neurotransmitters

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40
Q

Opioids, GABA, Cannabinoids, Serotonin & Norepinephrine are what type of neurotransmitters?

A

inhibitory neurontransmitters

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41
Q

What type of neurotransmitters reduce nociceptors activation threshold?

A

excitatory

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42
Q

T or F. If there is a reduce in nociceptors activation threshold, there is increased responsiveness of nociceptors.

A

True

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43
Q

What type of neurotransmitters inhibit/ reduce transmission of pain signal?

A

inhibitory

44
Q

The descending inhibitory impulse is transmitted from ___ to inhibit pain signal

A

brain

45
Q

What hormones is a combination of endogenous and morphine?

A

endorphins

46
Q

Opiate receptors are ____ protein coupled receptors for _____ (hormone) which are opioid neuropeptides

A

G; endorphins

47
Q

Morphine- like ____

A

neuropeptides.

48
Q

Morphine binds with ______ receptors throughout body to inhibit pain impulses in periphery, spinal cord and brain

A

opioid

49
Q

Morphine – responsible for sensations of ____-_____

A

well-being

50
Q

What drugs produces a resin containing cannabinoids?

A

Cannabis or marijuana

51
Q

______ (relieve pain) in humans

A

analgesic

52
Q

What are the drawbacks of cannabinoids (neurotransmitter)?

A

psychoactive (affects the mind) and addictive properties.

53
Q

When was cannabis legalized in Canada?

A

2020

54
Q

What neurotransmitter synthesized in body from phospholipids and modulate pain and other functions?

A

endocannabinoids

55
Q

Endocannabinoids synthesized in body from _____

A

phospholipids

56
Q

What does alcohol do in pain reduction?

A
  • depressing CNS
  • slows down brain and NS
  • delivers a certain amount of pain relief.
57
Q

What do you call to a potion used as an anesthetic in 1200 to 1500 in England?

A

dwale

58
Q

What is dwale made up of?

A

alcohol-based, bile, opium, lettuce, hemlock (highly toxic plant) and vinegar

59
Q

What was created in 1840 as a traditional methods of pain relief?

A

ether

60
Q

When did the first pain-free surgery performed in amphitheater of Massachusetts General Hospital

A

1846

61
Q

Another name for acute pain or (A)?

A

nociceptive pain

62
Q

What type of pain is associated with protective mechanism that alerts to harmful condition and mobilizes person to relieve it?

A

acute pain

63
Q

Acute pain last for ____ to several ___

A

minutes; weeks

64
Q

Acute pain arises from what three areas?

A

somatic (1), visceral (2) & referred (3)

65
Q

What are some characteristics of referred pain?

A
  • felt distant from point of origin
  • cutaneous (skin) and visceral receptors converge on same ascending neuron
66
Q

Under referred pain, skin has more receptors so..??

A

pain is referred to a skin area.

67
Q

What are some characteristics of somatic pain?

A
  • includes skin, joints, muscles; very localized
  • sharp and well localized = A delta fibers
  • dull throbbing = C fibers
68
Q

What are some characteristics of visceral pain?

A

-internal organs and lining of body cavities.
- poorly localized, aching, throbbing quality to pain
- C fibers

69
Q

Another name for persistent pain or (B = clinical description)

A

intractable pain

70
Q

In persistent pain, the pain lasts more than ____ months

A

3-6

71
Q

What are some characteristics of persistent pain?

A
  • serves no purpose/ poorly understood
  • ongoing (back pain) or intermittent (migraine headache)
72
Q

Studies under persistent pain is that change in brain _____ ability to cope with pain.

A

reduced

73
Q

What is the cause of neuropathic pain?

A

dysfunction of NS, meaning there is a long term changes in pain pathway and ab processing.

74
Q

What are some characteristics of neuropathic pain?

A
  • chronic/ amplification of pain
  • described as burning, shooting, shock-like or tingling
75
Q

Neuropathic pain is characterized by ______ sensitivity to painful and ___-painful stimuli with ____

A

increased; non; hyperalgesia

76
Q

What is hyperaglesia?

A

increased capacity to feel pain

77
Q

What is analgesia?

A

absence of pain

78
Q

Fever is a _____ resetting of _____ thermostat to a higher levels in response to _____ or endogenous pyrogens

A

temporary; hypothalamic; exogenous

79
Q

What is pyrogen?

A

substance that produces fever when release into blood

80
Q

What is exogenous?

A

pyrogens (pathogens) cause release of endogenous pyrogens

81
Q

What are the endogenous pyrogens?

A

TNF-a, IL-1, IL-6

82
Q

What is the prostaglandin’s effect?

A

increase temp through increased heat production and conservation.

83
Q

Why do individuals feel colder, curls up to decrease body SA, goes to bed to get warm?

A

heat conversation through cutaneous vasoconstriction.

84
Q

What is the disorder of temp regulation?

A

prostaglandin’s effect

85
Q

During fever, increased body temp is maintained until fever ‘breaks’ and ____ set point is _____

A

original’ reinstated

86
Q

What are the benefits of fever?

A
  • kills microorganisms and adversely affect their growth and replication
  • decreases serum levels of minerals needed for bacterial replication
  • increased temp causes lysosomal breakdown, preventing viral replication in infected cells
  • heat facilitates immune response
  • phagocytosis enhanced and antiviral interferon is augmented.
  • suppression of fever can be effective but should be used with caution
87
Q

What minerals needed for bacterial replication?

A

iron

88
Q

What is HYPERthemia?

A

elevation of body temp without an increase in hypothalamic set point

89
Q

Hyperthermia can produce ___ damage, ______ of cell proteins and ____

A

nerve; coagulation; death

90
Q

What are some characteristics of heat cramps?

A
  • severe spasmodic cramps in abdomen & extremities
  • follows prolonged sweating and associated sodium loss
  • common in individuals not accustomed to heat or performing strenous work in warm climates
91
Q

What is the amount of sodium loss associated with heat cramps?

A

40-60 mmol of Na/liter of sweat

92
Q

What are the signs and symptoms of heat cramps?

A

increased core temp, rapid pulse & increased b.p

93
Q

What are the manifestations of heat exhaustion?

A
  • dizziness, weakness, nausea and confusion
94
Q

What is heat exhaustion?

A

-result of prolonged high core or environmental temp
- profound vasodilation and profuse sweating = dehydration, hypotension and tachycardia

95
Q

In heat exhaustion, profound _____ and profuse _____ = dehydration, hypotension & _____

A

vasodilation; sweating; tachycardia

96
Q

What is heat stroke?

A
  • potentially lethal
97
Q

What is the temp that leads to nerve damage and convulsion when suffering from heat stroke?

A

41 degrees celsius

98
Q

What is the temp that leads to death when suffering from heat stroke?

A

43 degrees celsius

99
Q

What is the normal core body temp?

A

37 degrees celsius

100
Q

What is the body temp of hypothermia?

A

body temp less than 35 degrees celsius

101
Q

When suffering from hypothermia, body produces ___ ____ inside cells = cellular _____

A

ice crystals; rupture

102
Q

What are the characteristics of tissue hypothermia?

A
  • slows cellular metabolism rate
  • increases blood viscosity
  • facilitates blood coagulation & vasoconstriction
103
Q

What are some characteristics of therapeutic hypothermia?

A

-used to slow metabolism = preserve ischemic tissue during surgery

104
Q

What is the risk for therapeutic hypothermia?

A

may lead to ventricular fibrillation and cardiac arrest.

105
Q

T or F: Therapeutic hypothermia used rapid metabolism = preserve ischemic tissue during surgery

A

False; slow metabolism

106
Q

What are the pain facilitators?

A
  • glutamate
  • substance P
  • histamine
  • prostaglandin
  • bradykinin
107
Q

What are the pain inhibitors?

A
  • opioids
  • GABA
  • Cannabinoids
  • Serotonin
  • Norepinephrine
108
Q

What term describes to intense pain in finger, decreases sensation of pain in other area?

A

perceptual dominance

Pathophysiology (20 decks)

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