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NRP511 > Chapter 16: Pain, Temp, Sleep > Flashcards

Chapter 16: Pain, Temp, Sleep Flashcards

1
Q

Specificity theory of pain

A

Pain and touch are carried on distinct pathways that project to different brain centers
Intensity of pain is related to the amount of associated tissue injury

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2
Q

Pattern theory of pain

A

Different sense organs have different levels of responsiveness to stimuli with different spatial and temporal profiles firing

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3
Q

Gate control theory of pain

A

Gate either opens or closes

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4
Q

Nociception

A

the processing of potentially harmful stimuli through a normally functioning nervous system

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5
Q

Nociceptors

A

Free nerve endings in afferent PNS that selectively respond to stimuli

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6
Q

A delta fibers

A

Lightly myelinated, medium, fast transmission

Reflex withdrawal due to pain or heat
Fast like delta force

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7
Q

C fibers

A

Smaller and unmyelinated

Slow, dull, aching pain poorly localized

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8
Q

A beta fibers

A

Large and myelinated

Touch and vibration

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9
Q

Pain transduction

A

Tissue is damaged; activation of nociceptors

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10
Q

Pain transmission

A

Conduction of pain impulses along A delta and C fibers into dorsal horn of spinal cord up to cortex for interpretation

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11
Q

Pain perception

A

Conscious awareness

Occurs in reticular and limbic and cerebral cortex

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12
Q

Pain modulation

A

Increase or decrease in transmission of pain signals

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13
Q

Segmental inhibition of pain

A

Rubbing an area that is injured

A beta fibers stimulated and impulses arrive at same spinal level as A delta or C fibers

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14
Q

Conditioned pain modulation

A

Pain is relieved when 2 noxious stimuli occur at the same time from different sites

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15
Q

Perceptual dominance

A

Pain at one site may mask another painful area

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16
Q

Nociceptive pain

A

Pain with normal tissue injury from known cause

Normal protective mechanism

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17
Q

Acute pain

A

Can last up to 3 months

Increased HR, BP, Sweating, dilated pupils, increased glucose

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18
Q

Chronic pain

A

More than 3-6 months

Out of proportion to any tissue injury

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19
Q

Hyperalgesia

A

increased sensitivity to pain

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20
Q

Allodynia

A

Pain due to normally nonpainful stimuli

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21
Q

Myofascial pain syndrome

A

Injury to muscle fascia and tendons

Compression of trigger point causes referred pain and becomes more generalized

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22
Q

Normal body temp

A

97.2-99.9

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23
Q

What mediates temperature primarily

A

Peripheral thermoreceptors in skin and abdominal organs

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24
Q

Chemical thermogenesis

A

Hypothalamus stimulates release of TSH from anterior pituitary, thyroxine released, adrenal medulla releases epinephrine, leads to vasoconstriction, glycolysis and increased metabolic rate

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25
Q

Body heat conservation

A

Hypothalamus stimulates SNS, which stimulates adrenal cortex, increased skeletal muscle tone and shivering and vasoconstriction keeps heat from escaping

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26
Q

Radiation

A

Heat loss through electromagnetic waves

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27
Q

Conduction

A

Direct molecule to molecule transfer

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28
Q

Convection

A

Through currents of gases or liquid

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29
Q

Mechanisms to lose heat

A

Vasodilation, hyperventilation, sweating

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30
Q

Aging and temperature

A

Slowed blood circulation, decreased shivering, decreased metabolic rate, decreased sweating
Decreased or no fever response to infection

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31
Q

Pathogenesis of fever

A

Pathogens produce endotoxins; production of prostaglandin E2 in periphery and brain; Increased temperature, B cell proliferation, increased catecholamines, vasoconstriction, shivering

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32
Q

Benefits of fever

A

Kills microorganisms, decreases iron, zinc and copper, causes lysosomal breakdown and auto destruction of cells

33
Q

Hyperthermia

A

Increase in body temperature without increase in hypothalamic set point
Can produce nerve damage, coagulation of cell proteins and death

34
Q

Heat cramps

A

Severe, spasmodic cramps in abdomen and extremities due to prolonged sweating and Na loss
Fever, increased HR and BP

35
Q

Heat exhaustion

A

Prolonged high core temperature; profound vasodilation and sweating
Leads to dehydration

36
Q

Heat stroke

A

At 104 degrees, regulatory system stops and body’s heat loss mechanisms fail
Absence of sweating, increased HR, confusion

37
Q

Malignant hyperthermia

A

Inherited muscle disorder triggered by anesthetics
increased intracellular Ca levels: sustained uncoordinated muscle contractions
No reflexes, fixed pupils, apnea

38
Q

Hypothermia causes

A

Depression of CNS and resp system, vasoconstriction and ischemic tissue damage

39
Q

Parodoxical undressing

A

as hypothermia deepens, there is a shift to vasodilation–patient feels hot

40
Q

NREM sleep

A

Slow wave sleep
Decreased SNS and Increased PNS activity
Growth hormone released in N3
Decreased corticosteroids and catecholamine release

41
Q

Aging and sleep

A

Total sleep time decreased

Decreased slow wave sleep

42
Q

Dyssomnias

A

Difficulty in initiating or maintaining sleep or presence of excessive sleepiness

43
Q

Types of dyssomnias

A

•Insomnia
•restless leg syndrome
•obstructive sleep apnea syndrome
•hypersomnia
•narcolepsy
•circadian rhythm disorders

44
Q

Parasomnias

A

Awakening from REM or partial arousal form NREM

45
Q

Examples of parasomnias

A

Sleep walking, night terrors, night cramps, SIDS

46
Q

Touch and sedatives or prefrontal injury

A

Decreased interpretation of tactile sensations

47
Q

Meniere disease

A

Episodic vestibular disorder due to neuroepithelial damage related to abnormalities in the quantity, composition and pressure of endolymph in the middle ear
Vertigo, hearing loss, tinnitus

48
Q

Blepharitis

A

Inflammation of eyelids due to staph

Redness, edema, tearing, itching

49
Q

External hordeolum

A

Stye

Infection of sebaceous glands

50
Q

Entropion

A

Lid margin turns inward against eyeball

51
Q

Ectropion

A

Lid margin turns outward

52
Q

Trichasis

A

Eyelashes grow back towards eye

53
Q

Acute bacterial conjunctivitis

A

Pinkeye

Usually self limiting

54
Q

Viral conjunctivitis

A

Caused by adenovirus

55
Q

Trachoma

A

Caused by chlamydia

Leading cause of preventable blindness

56
Q

Keratitis

A

Inflammation of cornea

Can be noninfectious or infectious

57
Q

Strabismus

A

Deviation of one eye from other when looking at object
Neuromuscular disorder of eye muscle
Primary s/s: diplopia

58
Q

Nystagmus

A

May be due to imbalance in normally coordinated reflex activity of inner ear

59
Q

Amblyopia

A

Lazy eye

Due to altered development of visual cortex

60
Q

Scotoma

A

Circumscribed defect of central field of vision

Age related to do with this

61
Q

Cataract

A

Cloudy/opaque area in ocular lens

Due to alterations of metabolism and transport of nutrients within lens

62
Q

Glaucomas

A

Intraocular pressure >12-20

Degeneration of peripheral vision followed by central vision

63
Q

Retinal detachment

A

Fluid separates photoreceptors from retinal pigment epithelium
Deprives outer retina of O2 and nutrients

64
Q

Age related macular degeneration

A

Severe and irreversible loss of vision

Due to age, htn, smoking, diabetes, family hx

65
Q

Presbyopia
(Nearsightedness)

A

Ocular lens becomes larger, firmer, less elastic
Occurs >45 years old
Decrease in near vision

66
Q

Myopia

A

Nearsightedness

67
Q

Hyperopia

A

Farsightedness

68
Q

Astigmatism

A

Unequal curvature of corna

Light rays bent unevenly

69
Q

Presbycusis

A

Loss of hearing in increased age

Loss of hearing high frequency common

70
Q

Conductive hearing loss

A

Due to change in outer or middle ear

71
Q

Sensorineural hearing loss

A

Impairment of organ of corti

Due to noise exposure, aging, meniere disease, ototoxicity, systemic disease

72
Q

Risk factor for otitis externa

A

Swimming

73
Q

Otitis media due to

A

HIB most commonly in children

74
Q

Hyposmia

A

Impaired sense of smell

75
Q

Hypoguesia

A

Impaired taste sensation

76
Q

When does nocturnal angina occur

A

REM sleep

77
Q

Visceral pain transmitted by

A

Sympathetic afferent nerves

78
Q

Diabetic neuropathy causes

A

Chronic, peripheral pain

Due to damaged nerves–become hyper excitable and fire even when absence of pain signals

NRP511 (23 decks)

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