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Pathophysiology > Chapter 14 - Pain And Temperature > Flashcards

Chapter 14 - Pain And Temperature Flashcards

1
Q

Pain

A

Dysfunctions of general or specific senses

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2
Q

Pain is unpleasant but

A

A protective phenomenon

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3
Q

Pain cannot be

A

Defined, identified or measured by an observer

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4
Q

Pain is complex

A

Interactions between physical, cognitive, emotional etc

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5
Q

McCaffery defined pain as

A

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

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6
Q

Temperature

A

Like pain, variations in temperature can signal disease

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7
Q

Fever

A

A common an infestation of dysfunction
-often first symptom of infectious or inflammatory conditions

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8
Q

Specificity theory of pain: what activates specific pain receptors to the brain?

A

Injury

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9
Q

Specificity theory of pain: intensity is related to

A

Tissue injury

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10
Q

Specificity theory of pain: pricking finger vs cutting hand with knife

A

Pricking finger = minimal pain

Cutting hand with knife = more pain

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11
Q

Specificity theory of pain: problem with this theory

A

It does not account for persistent, emotional pain

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12
Q

gate control theory of pain

A

Combines and builds upon theories to explain multidimensional aspects of pain

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13
Q

gate control theory of pain: pain transmission

A

Is altered by a balance of signals sent to spinal cord where cells work as a gate

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14
Q

gate control theory of pain: spinal gate controls

A

Pain transmission to higher centers in CNS

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15
Q

Neuromatrix theory of pain:

A

Brain produces patterns of nerve impulses drawn from various inputs
-including: genetic, psychological and cognitive experiences

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16
Q

Neuromatrix theory of pain: phantom limb

A

Believes that pain can be felt without experiencing them

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17
Q

Neuromatrix theory of pain: does stimuli produce pain?

A

Stimuli may trigger the patterns but does not produce them

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18
Q

Three portions of nervous system responsible for pain perception, sensation and response

A
  1. Afferent pathway
  2. Interpretive centers (CNS)
  3. Efferent pathways
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19
Q

Nociception

A

Processing of harmful (noxious) stimuli through nervous system

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20
Q

Nociceptors are ___ nerve endings found in

A

-free
-afferent PNS

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21
Q

Two types of nociceptors

A

A delta, C fibres

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22
Q

A delta fibres

A

Large and myelinated
-access large tracts in spinal cord

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23
Q

C fibres

A

Smaller and unmyelinated
-access smaller tracts in spinal cord

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24
Q

Fast sharp pain is what type of fiber

A

A delta fibres
-usually perceived first

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25
Q

Dull throbbing pain

A

C fibres
-followed by a dull throbbing pain

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26
Q

Transduction

A

Activation of nociceptors

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27
Q

Transmission

A

Conduction to dorsal horn and up spinal cord q

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28
Q

Sensory discriminative system

A

Identifies presence, location, and intensity

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29
Q

Sensory discriminative system is found

A

Somatosensory cortex

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30
Q

Motivation affective system

A

Determines avoidance and emotional responses

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31
Q

Motivation affective system is found

A

Reticular formation-> limbic system

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32
Q

Cognitive evaluative system

A

Learned pain experience

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33
Q

Cognitive evaluative system can therefore…

A

Modulate perception of pain

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34
Q

Transducer

A

Device that converts variations into electrical signal

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35
Q

Slow pain travels toward

A

-brain stem reticular formation
-thalamus
-somatosensory cortex

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36
Q

Fast pain travels

A

-thalamus
-somatosensory cortex

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37
Q

Pain perception

A

Conscious awareness of pain

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38
Q

Pain perception takes place in

A

-reticular and limbic system

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39
Q

Pain threshold

A

Lowest intensities of pain that a person can recognize

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40
Q

Pain tolerance

A

Highest intensity of pain a person can endure
-varies
-generally decreases with repeated exposure

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41
Q

perceptual dominance

A

Intense pain at one location may increase threshold in another location

Example: stubbed your toe, then someone punches your face, you will feel your jaw>the toe

42
Q

Pain modulation

A

Different mechanisms act to increase or decrease pain transmission through nervous system

43
Q

Peripheral triggering mechanism can Initiate excitatory neurotransmitters include

A

Tissue injury and chronic inflammation

44
Q

Excitatory neurotransmitters

A

-substance P
-glutamate
-histamine
-prostaglandins

45
Q

Function of excitatory neurotransmitters

A

Reduce nociceptors activation threshold = increased responsiveness of nociceptors

46
Q

Inhibitory neurotransmitters

A

-opioids
-GABA
-cannabinoids
-serotonin
-norepinephrine

47
Q

Inhibitory neurotransmitters function

A

Inhibit/reduce transmission of pain signal

48
Q

Descending pathway and endorphins response

A

Transmitted from brain to inhibit pain signal
-combination of endogenous and morphine

49
Q

Opiate receptors are ___ receptors for endorphins which are …

A

G proteins coupled receptors for endorphins which are opioid neuropeptides

50
Q

Morphine like neuropeptides bind with

A

Opioids receptors throughout body to inhibit pain impulses in peripheral, spinal cord and brain

51
Q

Morphine like neuropeptides are responsible for

A

Sensations of wellbeing

52
Q

Cannabinoids

A

-cannabis—> resin containing cannabinoids
-analgesic

53
Q

Drawbacks of cannabinoids

A

Psychoactive and addictive properties

54
Q

When was cannabis legalized in Canada

A

2020

55
Q

Endocannabinoids

A

Synthesized in body form phospholipids
-modulates pain

56
Q

Alcohol pain reduction

A

-depressing CNS
-slows down brain and ns
-certain amount of pain relief

57
Q

1200 to 1500 England: Dwale

A

Alcohol based, bile, opium, lettuce, hemlock (toxic plant) and vinegar

58
Q

what was used in 1200 to 1500 as anesthetic

A

Dwale

59
Q

1840 what was created for pain relief

A

Ether

60
Q

1846 pain relief milestone

A

The first pain free surgery performed in amphitheater of massachusetts GH

61
Q

Acute pain is otherwise known as

A

Nociceptors pain

62
Q

Acute pain

A

-protective mechanism to alert of harmful condition
-mobilizes person to relieve it

-lasts min/weeks

63
Q

acute pain arises from three areas

A
  1. Somatic
    2.visceral
  2. Referred
64
Q

Acute somatic pain

A

-skin, joints, muscles, very localized
-sharp (A) and dull (C)
-well localized

65
Q

Acute visceral pain

A

Internal organs and lining of body cavities
-poorly localized
-aching throbbing quality to pain
- C fibres

66
Q

Acute referred pain

A

Distant from point of origin

-both cutaneous and visceral receptors converge on ascending neuron —> brain cannot distinguish the two
-since skin has more receptors, pain is often referred to a skin area

67
Q

Persistent pain is also known as

A

Intractable pain

68
Q

Persistent pain

A

More than 3-6 months
-no purpose/misunderstood

Example: ongoing back pain, or intermittent migraines

69
Q

Studies with persistent pain

A

Change in brain = reduced ability to cope with pain

70
Q

Cause of Neuropathic pain

A

Dysfunction of nervous system = long term changes in pain pathway and abnormal processing

71
Q

Neuropathic pain

A

Chronic amplification of pain
-burning, shooting, chock like or tingling

72
Q

Neuropathic pain is characterized by

A

Increased sensitivity to painful and non painful stimuli with hyperalgesia (increased)

73
Q

Algesia

A

Capacity to feel pain

74
Q

Analgesia

A

Absence of pain

75
Q

Fever definition

A

Temporary resetting of hypothalamic thermostat to a higher levels in response to exogenous or endogenous pyrogens

76
Q

Pyrogen

A

Substance that produces fever when released into blood

77
Q

Exogenous pyrons

A

Cause release of endogenous pyrogens

78
Q

Examples of exogenous pyrogens

A

TNFa, IL1, IL6

79
Q

Pyrons raise… by inducing…..

A

-thermal set point
-hypothalamic synthesis of prostaglandin E

80
Q

Prostaglandins effect

A

Increases temperature through increased heat production and conservation

81
Q

Individual: feels colder, curls up to decrease body surface area, goes to bed to get warm
Cause:

A

Heat conservation through cutaneous vasoconstriction

82
Q

Inc body temp is maintained until

A

Fever breaks and original set point is reinstated
-Indian fgeels warm, throws off covers and stretches out

83
Q

Heat conservation

A

-cutaneous vasoconstriction
-decreased sweating

84
Q

Heat generation

A

-inc muscle contraction
-shivering reflex
-inc metabolism

85
Q

Benefits of fever

A

-kills microorganisms (affects their growth/replication)
-Dec serum levels of minerals
-lysosomal breakdown
-immune response
-enhances phagocytosis and interferon is augmented

86
Q

Hyperthermia

A

Elevation of body temperature without an increase in hypothalamic set point

87
Q

Hyperthermia risks

A

Can produce nerve damage, coagulation of cell proteins and death

88
Q

Heat cramps

A

Severe spasmodic cramps in abdomen and extremities
-follows sweating
-sodium loss (40-60)

89
Q

Heat cramps are common in individuals who are

A

Not accustomed to heat or performing strenuous work in warm climates

90
Q

S/S of heat cramps

A

Inc core temp, rapid pulse, inc bp

91
Q

Heat exhaustion

A

Result of prolonged high core or environmental temperatures
-vasodilation and sweating

92
Q

risk of heat exhaustion

A

-dehydration, hypotension, tachycardia

93
Q

Manifestations of heat exhaustion

A

Dizziness, weakness, nausea, confusion

94
Q

Heat stroke

A

Potentially lethal

95
Q

Heat stroke: 41

A

Nerve damage, convulsions

96
Q

Heat stroke: 43

A

Death

97
Q

Normal core body temperature is

A

37

98
Q

Hypothermia

A

Body temp less than 35

99
Q

Hypothermia produces

A

Ice crystals inside cells causing cellular rupture

100
Q

Tissue hypothermia

A

-slows cellular rate
-inc blood viscosity
-facilitates blood coagulation
-vasoconstriction

101
Q

Therapeutic hypothermia

A

Used to slow metabolism and preserve ischemic tissue during surgery

102
Q

Risk of therapeutic hypothermia

A

May lead to ventricular fibrillation and cardiac arrest

Pathophysiology (20 decks)

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