Ch-14 Pain & Temp Flashcards
What is pain?
dysfunctions of general or specific issues.
Characteristics of pain?
- unpleasant but protective phenomenon
- cannot be defined, identified or measured by an observer.
- complex: interactions between physical, cognitive, emotional
How did McCaffery defined pain?
whatever the experiencing person says it is, existing whenever they say it does.
What is temperature?
like pain; variations in temp can signal disease.
What is the common manifestation of dsyfunction?
Fever
Fever is often the _____ symptom of infectious of inflammatory conditions.
first
What are the 3 theories of pain?
Specificity (1), Gate Control (2) & Neuromatrix (3)
Which theory activates specific pain receptors to brain?
Specificity theory
In Specificity theory, the ____ of pain is directly related to associated ____ injury
intensity; tissue
T or F: Prickling one’s finger = more pain compared to cutting hand with knife.
false; minimal pain
What is the problem associated with specificity theory?
does not account for persistent, emotional pain
Which theories of pain is associated with brain produces patterns of nerve impulses drawn from various inputs including genetic, psychological and cognitive experiences.
Neuromatrix theory
T or F: In Neuromatrix theory, pain can be felt without experiencing them.
true
What is an example of pain can be felt without experiencing them?
Phantom limb
What is the cause of phantom limb?
stimuli may trigger the nerve impulses patterns but do not produce them.
In Gate Control theory, it combines and builds upon theories to explain ____ aspects of pain.
multidimensional
What part of the body that is associated in gate control theory that controls pain transmission to higher centres like CNS?
spinal cord
How many portions of NS are responsible for pain perception, sensation, and response? Name them.
three; afferent pathway (1), interpretive centres (CNS) (2), & efferent pathways (3).
What terms describes the processing of harmful (noxious) stimuli through nervous system.
nociception
What are the pain receptors?
nociceptors
Nociceptors are _____ nerve endings in _____ PNS.
free; afferent.
What are the two types of nociceptors?
A delta fibers & C fibers
What are A delta fibers?
large, myelinated & has acces to large tracts in spinal cord.
What are C fibers?
smaller, unmyelinated & has access to smaller tracts in spinal cord.
______ sharp pain is perceived first by _____ fibers followed by a dull, throbbing pain by ____ fibers
sharp; A delta; C
What is a transducer?
device that converts variations into electrical signal.
Difference between transduction & transmission?
Transduction - activation of nociceptors; happens first.
Transmission - conduction to dorsal horn and up spinal cord.
In terms of perception of pain, what system identifies presence, location and intensity?
sensory-discriminative or somatosensory cortex.
In terms of perception of pain, what system determines avoidance and emotional responses?
motivational-affective system (e.g., reticular formation and limbic system)
In terms of perception of pain, what system is associated with learned pain experience?
Cognitive-evaluative system
With cognitive-evaluative system, individuals can ______ perception of pain.
modulate
What is pain perception?
conscious awareness of pain (reticular and limbic system)
What is pain threshold?
lowest intensity of pain that a person can recognize.
What terms describes as the highest intensity of pain a person can endure?
pain tolerance.
Pain tolerance, ____ greatly among people and in same person over time
varies.
Pain tolerance generally ____ with repeated exposure.
decreases
What is perceptual dominance?
intense pain at one location may increase threshold in another location
What is pain modulation?
these are different mechanisms that act to increases or decrease pain transmission through nervous system.
_____ triggering mechanism that initiate excitatory neurotransmitters include tissue injury and chronic inflammation.
peripheral
Substance P, Glutamate, Histamine & Prostaglandins are what type of neurotransmitters?
excitatory neurotransmitters
Opioids, GABA, Cannabinoids, Serotonin & Norepinephrine are what type of neurotransmitters?
inhibitory neurontransmitters
What type of neurotransmitters reduce nociceptors activation threshold?
excitatory
T or F. If there is a reduce in nociceptors activation threshold, there is increased responsiveness of nociceptors.
True
What type of neurotransmitters inhibit/ reduce transmission of pain signal?
inhibitory
The descending inhibitory impulse is transmitted from ___ to inhibit pain signal
brain
What hormones is a combination of endogenous and morphine?
endorphins
Opiate receptors are ____ protein coupled receptors for _____ (hormone) which are opioid neuropeptides
G; endorphins
Morphine- like ____
neuropeptides.
Morphine binds with ______ receptors throughout body to inhibit pain impulses in periphery, spinal cord and brain
opioid
Morphine – responsible for sensations of ____-_____
well-being
What drugs produces a resin containing cannabinoids?
Cannabis or marijuana
______ (relieve pain) in humans
analgesic
What are the drawbacks of cannabinoids (neurotransmitter)?
psychoactive (affects the mind) and addictive properties.
When was cannabis legalized in Canada?
2020
What neurotransmitter synthesized in body from phospholipids and modulate pain and other functions?
endocannabinoids
Endocannabinoids synthesized in body from _____
phospholipids
What does alcohol do in pain reduction?
- depressing CNS
- slows down brain and NS
- delivers a certain amount of pain relief.
What do you call to a potion used as an anesthetic in 1200 to 1500 in England?
dwale
What is dwale made up of?
alcohol-based, bile, opium, lettuce, hemlock (highly toxic plant) and vinegar
What was created in 1840 as a traditional methods of pain relief?
ether
When did the first pain-free surgery performed in amphitheater of Massachusetts General Hospital
1846
Another name for acute pain or (A)?
nociceptive pain
What type of pain is associated with protective mechanism that alerts to harmful condition and mobilizes person to relieve it?
acute pain
Acute pain last for ____ to several ___
minutes; weeks
Acute pain arises from what three areas?
somatic (1), visceral (2) & referred (3)
What are some characteristics of referred pain?
- felt distant from point of origin
- cutaneous (skin) and visceral receptors converge on same ascending neuron
Under referred pain, skin has more receptors so..??
pain is referred to a skin area.
What are some characteristics of somatic pain?
- includes skin, joints, muscles; very localized
- sharp and well localized = A delta fibers
- dull throbbing = C fibers
What are some characteristics of visceral pain?
-internal organs and lining of body cavities.
- poorly localized, aching, throbbing quality to pain
- C fibers
Another name for persistent pain or (B = clinical description)
intractable pain
In persistent pain, the pain lasts more than ____ months
3-6
What are some characteristics of persistent pain?
- serves no purpose/ poorly understood
- ongoing (back pain) or intermittent (migraine headache)
Studies under persistent pain is that change in brain _____ ability to cope with pain.
reduced
What is the cause of neuropathic pain?
dysfunction of NS, meaning there is a long term changes in pain pathway and ab processing.
What are some characteristics of neuropathic pain?
- chronic/ amplification of pain
- described as burning, shooting, shock-like or tingling
Neuropathic pain is characterized by ______ sensitivity to painful and ___-painful stimuli with ____
increased; non; hyperalgesia
What is hyperaglesia?
increased capacity to feel pain
What is analgesia?
absence of pain
Fever is a _____ resetting of _____ thermostat to a higher levels in response to _____ or endogenous pyrogens
temporary; hypothalamic; exogenous
What is pyrogen?
substance that produces fever when release into blood
What is exogenous?
pyrogens (pathogens) cause release of endogenous pyrogens
What are the endogenous pyrogens?
TNF-a, IL-1, IL-6
What is the prostaglandin’s effect?
increase temp through increased heat production and conservation.
Why do individuals feel colder, curls up to decrease body SA, goes to bed to get warm?
heat conversation through cutaneous vasoconstriction.
What is the disorder of temp regulation?
prostaglandin’s effect
During fever, increased body temp is maintained until fever ‘breaks’ and ____ set point is _____
original’ reinstated
What are the benefits of fever?
- 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
What minerals needed for bacterial replication?
iron
What is HYPERthemia?
elevation of body temp without an increase in hypothalamic set point
Hyperthermia can produce ___ damage, ______ of cell proteins and ____
nerve; coagulation; death
What are some characteristics of heat cramps?
- 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
What is the amount of sodium loss associated with heat cramps?
40-60 mmol of Na/liter of sweat
What are the signs and symptoms of heat cramps?
increased core temp, rapid pulse & increased b.p
What are the manifestations of heat exhaustion?
- dizziness, weakness, nausea and confusion
What is heat exhaustion?
-result of prolonged high core or environmental temp
- profound vasodilation and profuse sweating = dehydration, hypotension and tachycardia
In heat exhaustion, profound _____ and profuse _____ = dehydration, hypotension & _____
vasodilation; sweating; tachycardia
What is heat stroke?
- potentially lethal
What is the temp that leads to nerve damage and convulsion when suffering from heat stroke?
41 degrees celsius
What is the temp that leads to death when suffering from heat stroke?
43 degrees celsius
What is the normal core body temp?
37 degrees celsius
What is the body temp of hypothermia?
body temp less than 35 degrees celsius
When suffering from hypothermia, body produces ___ ____ inside cells = cellular _____
ice crystals; rupture
What are the characteristics of tissue hypothermia?
- slows cellular metabolism rate
- increases blood viscosity
- facilitates blood coagulation & vasoconstriction
What are some characteristics of therapeutic hypothermia?
-used to slow metabolism = preserve ischemic tissue during surgery
What is the risk for therapeutic hypothermia?
may lead to ventricular fibrillation and cardiac arrest.
T or F: Therapeutic hypothermia used rapid metabolism = preserve ischemic tissue during surgery
False; slow metabolism
What are the pain facilitators?
- glutamate
- substance P
- histamine
- prostaglandin
- bradykinin
What are the pain inhibitors?
- opioids
- GABA
- Cannabinoids
- Serotonin
- Norepinephrine
What term describes to intense pain in finger, decreases sensation of pain in other area?
perceptual dominance
