Chapter 14 - Pain and Temperature Flashcards
1
Q
Pain Definition
A
dysfunction of general or specific senses
2
Q
Pain is a ________ phenomenon
A
protective
3
Q
Is pain subjective or objective? Why?
A
subjective, it is not measurable
4
Q
The physical, cognitive, and emotional interactions of pain make it very ________
A
complex
5
Q
How did McCaffery define pain?
A
“Whatever the experiencing person says it is, existing whenever they say it does.”
6
Q
Variations in temperature can signal _________
A
disease
7
Q
_______ is a common symptom of dysfunction
A
fever
8
Q
What is often the first symptom of infectious or inflammatory conditions?
A
fever
9
Q
Specific Pain Theory =
A
receptors
10
Q
The specific pain theory says that injury activates specific pain ________ to the brain
A
receptors
11
Q
The specific pain theory says that pain intensity is related to…
A
direct association with tissue injury ie. cutting hand with knife hurts more than finger prick
12
Q
What is the problem with the specific pain theory?
A
it doesn’t account for emotional pain
13
Q
Gate Control Theory =
A
spinal cord
14
Q
The gate control pain theory explains _____________ aspects of pain
A
multidimensional
15
Q
The gate control pain theory uses the spinal cord as a gate to control transmission to the _____
A
CNS (brain)
16
Q
The Neuromatrix Theory =
A
brain
17
Q
In the neuromatrix theory, stimuli trigger _______ of nerve impulses, but don’t produce them
A
patterns
18
Q
Where are patterns of nerve impulses taken from?
A
genetic, psychological, or cognitive EXPERIENCES
19
Q
What is an example of pain being felt without experience?
A
phantom limb
20
Q
The afferent pathway brings the pain impulse from the _______ to the _______
A
epithelial receptors to the CNS
21
Q
What part of the body interprets pain?
A
the brain and spinal cord
22
Q
The efferent pathway brings the pain response from the _______ to the _________
A
CNS to the response organ (ie. muscle)
23
Q
Nociception
A
processing of harmful stimuli through the nervous system
24
Q
Nociceptors are _____ nerve endings in the ___________ PNS
A
free; afferent
25
What is larger: A delta or C fibres?
A Delta
26
Which of A delta or C fibres are myelinated?
A delta are myelinated, C fibres are not
27
_______ fibres access the large spinal cord tracts
A Delta
28
______ fibres access the small spinal cord tracts
C fibres
29
Which type of fibres produce the initial fast and sharp pain?
A delta
30
Which type of fibres produce the latter dull and throbbing pain?
C fibres
31
What is the "activation of nociceptors"?
transduction
32
What is the "conduction to dorsal horn and up the spinal cord"?
transmission
33
A transducer is...
a device that converts variations into an electrical signal
34
What does the sensory discriminative system do?
identify presence, location, and intensity of pain
35
What part of the brain is involved in sensory discrimination?
somatosensory cortex
36
What does the motivational-affective system do?
determines avoidance and emotional responses
37
What parts of the brain are involved in the motivational-affective system?
reticular formation and limbic system
38
The cognitive-evaluative system is involved with the ________ pain experience
learned
39
Pain Perception
conscious awareness of pain
40
The _______ and _______ systems are involved in pain perception
reticular and limbic
41
Pain Threshold
lowest recognizable intensity of pain
42
Pain Tolerance
highest intensity of pain a person can endure
43
**Pain tolerance ________ with repeated exposure
decreases
44
The concept of perceptual dominance says that intense pain at one location _______ the threshold at another location.
increases
45
What do pain modulation mechanisms do?
increase or decrease pain transmission
46
What are two triggers that initiate excitatory neurotransmitters?
tissue injury and chronic inflammation
47
What do excitatory neurotransmitters do?
reduce nociceptor activation threshold (increase their responsiveness)
48
Name 4 Examples of Excitatory Neurotransmitters
-substance P
-glutamate
-histamine
-prostaglandins
49
What do inhibitory neurotransmitters do?
reduce the transmission of a pain signal
50
Name 5 Examples of Inhibitory Neurotransmitters
-opioids
-GABA
-cannabinoids
-serotonin
-norepinephrine
51
What does the descending inhibitory pathway do?
releases endorphins to inhibit the pain signal
52
Endorphins (opiates) are a mixture of _______ and _________
endogenous and morphine
53
Where do endorphins bind?
opiate receptors
54
Opiate receptors are G _________ coupled
protein
55
Morphine-like neuropeptides are responsible for what sensation?
well-being
56
What do morphine-like neuropeptides bind with? What do they do?
opioid receptors; inhibit pain impulses
57
Cannabis produces a ________ containing cannabinoids
resin
58
Cannabinoids are an analgesic meaning...
they relieve pain
59
Cannabinoids have _________ and ___________ drawbacks
psychoactive and addictive
60
When was Cannabis legalized in Canada?
2020
61
Endocannabinoids are synthesized in the body from ___________ to modulate pain
phospholipids
62
How does alcohol relieve pain?
depressing the CNS
63
In 1200 to 1500 England a potion called ________ was used as an anesthetic.
dwale
64
Dwale Ingredients
-alcohol base
-bile
-opium
-lettuce
-hemlock (highly toxic plant)
-vinegar
65
When was Ether created?
1840
66
When was the first pain free surgery performed? Where?
1846 in the amphitheatre at Mass Gen
67
What is another name for acute pain?
Nociceptive pain
68
Acute pain is a protective mechanism that...
alerts to harmful conditions and mobilizes person to relieve it
69
How long does acute pain last?
minutes to weeks
70
3 Types of Acute Pain:
1. somatic
2. visceral
3. referred
71
Where does somatic pain occur?
localized to skin, joints, muscles
72
What fibres are responsible for sharp and localized somatic pain?
A delta
73
What fibres are responsible for dull, throbbing somatic pain?
C fibres
74
Where does visceral pain occur?
internal organs and body cavity lining
75
Is visceral pain localized?
no, it is more achy
76
Which fibres are responsible for visceral pain?
C fibres
77
Where is referred pain felt?
distant to the point of origin
78
Which receptors converge on the same ASCENDING neuron to provide referred pain?
cutaneous and visceral
79
Why does referred pain happen?
the brain can't distinguish which receptors are affected
80
Why is referred pain often felt on the skin?
the skin has more receptors
81
Persistent pain is aka __________ pain
intractable
82
How long does persistent pain last?
3-6 months
83
What is the purpose of persistent pain?
there isn't one
84
Persistent pain can be _________ or __________
-ongoing ie. back pain
-intermittent ie. migraine headaches
85
Studies on persistent pain show a change in the _______ that show a _______ ability to cope with pain
brain; reduced
86
Neuropathic pain is caused by a dysfunction of the _________ system
nervous
87
Neuropathic pain results from ______ term changes in pain _________ and ________
long; pathway; processing
88
Neuropathic pain ________ pain to a burning, shooting, tingling sensation
amplifies
89
Neuropathic pain is characterized by an increased ____________ to stimuli, painful or not
sensitvity
90
__________ (increased pain capacity) is a characteristic of neuropathic pain
hyperalgesia
91
Hyperalgesia
increased capacity to feel pain
92
Analgesia
absence of pain
93
Fever Definition: the _________ resetting of __________ thermostat to higher levels in response to exogenous or endogenous pyrogens
temporary; hypothalamic
94
Pyrogen
substance that produces fever when released into blood
95
Pyro
related to fire
96
Exogenous
growing from or on the outside
97
Endogenous
growing/originating within
98
Exogenous Pyrogens
pathogens
99
Endogenous Pyrogens
TNF-a, IL-1, IL-6
100
__________ pyrogens cause the release of __________ pyrogens
exogenous; endogenous
101
How do pyrogens raise the thermal set point?
inducing hypothalamic synthesis of prostaglandin E2 (PGE2)
102
How do prostaglandin's increase temperature?
increased heat production and conservation
103
Heat conservation through cutaneous ___________ and decreased sweating makes the individual feel ______
vasoconstriction; colder
104
How long does the body maintain the increased temperature?
until the fever breaks and the original set point is reinstated
105
Pathogen activates the release of m_________ that release ___________ and signal the temperature regulating centre to release ______ to raise the set point
macrophages; cytokines (TNF-a, IL-1, IL-6); PGE2
106
How is heat generated after the set point is raised?
-increased muscle contraction
-shivering reflex
-increased metabolism
107
Fever kills __________ and affects their growth an replication
microorganisms
108
Fever decreases serum levels of ______ needed for bacterial growth
minerals
109
Increased temperature causes ___________ breakdown which prevents...
lysosomal; viral replication
110
Fever enhances ________ and antiviral _________
phagocytosis; interferon
111
Hyperthermia
elevation of body temp without an increased hypothalamic set point
112
What are 3 risks of hyperthermia?
-nerve damage
-protein coagulation
-death
113
Heat cramps are severe________ (sporadic) cramps
spasmodic
114
Heat cramps follow a) prolonged ________ and b) associated ______ loss
sweating; sodium
115
How many mmol of sodium are in a L of sweat?
40-60
116
Who is at risk for heat cramps?
-those not accustomed to heat
-those performing strenuous work in warm climates
117
S&S of Heat Cramps
-↑ core temp
-rapid pulse
-↑ BP
118
Heat exhaustion can result from high _____ or ___________ temperatures
core or environmental
119
Heat Exhaustion: intense vasodilation and sweating leads to:
-dehydration
-hypotension (low BP)
-tachycardia (fast HR)
120
Heat exhaustion manifests as: ______, _________, ________, and __________
dizziness, weakness, nausea, and confusion
121
Heat stroke can be ________
lethal
122
What body temperature does nerve damage and convulsions occur at?
41℃
123
What body temperature does death occur?
43℃
124
What is the normal core body temperature?
37℃
125
Hypothermia occurs when the body temp is less than ____℃
35
126
During hypothermia, what is produced inside cells that causes cellular rupture?
ice crystals
127
Tissue hypothermia: ________ metabolic rate, ______ blood viscosity, ________ blood coagulation and vasoconstriction
slows; increases; facilitates
128
When is therapeutic hypothermia used?
during surgery
129
Why is therapeutic hypothermia used?
to slow metabolism and prevent ischemic tissue
130
What is the risk of therapeutic hypothermia?
V fib or cardiac arrest
