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Patho- > Pain > Flashcards

Pain Flashcards

1
Q

What is pain?

A

an unpleasant sensation but important for injury awareness/protection

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2
Q

What is the specificity theory?

A
  • Sensations of touch, warmth, cold and pain involve specific receptors and pathways
  • Amt of pain is related to the amt of tissue injury
  • Accounts for many types of injuries but doesn’t explain psychologic contributions to pain/chronic pain
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3
Q

What is the pattern theory?

A

Describes the role of impulse intensity and re-patterning of the CNS.

  • Pain is experienced due to pattern of nerve impulses (but not specific receptors/nerves)
  • Doesn’t account for all pain experiences
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4
Q

What is the Gate-control theory?

A

-Explains the complexities of the pain phenomenon.
◦ Stimulation of the large Type A beta and alpha inhibitory fibers “close the gate” at the substantia gelatinosa and inhibiting pain conduction along Type A delta and C fibers
◦ Stimuli thought to close the gate include electrical stimulation, massage, scratching or rubbing of the skin

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5
Q

What serves as the gate control system and regulates the transmission of pain impulses

A

The substantia gelatinosa

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6
Q

What closes the gate in the Gate-control theory?

What does this do?

A
  • Stimulation of the large Type A beta and alpha inhibitory fibers at the substantia gelatinosa
  • inhibits pain conduction along Type A delta and C fibers
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7
Q

What is the Neuromatrix theory?

A

Widely distributed neural network in the brain that integrates multiple sources of input resulting in the cognitive, affective and sensory perceptions of pain

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8
Q

What influences variations in the neuromatrix?

A

genetic, emotional, cultural, past experience and stress regulation influences

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9
Q

What induces sensation patterns in the neuromatrix theory?

A

absence of a sensory trigger (may explain phantom and chronic pain)

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10
Q

What are the phases of nociception?

A

Transduction, transmission, perception, modulation

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11
Q

What is the transmission phase of nociception?

A

Conduction of pain impulses along the

A and C fibers into the spinal cord and to the brainstem, thalamus, and cortex

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12
Q

What is the perception phase of nociception?

A

Is the conscious awareness of pain

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13
Q

What is the transduction phase of nociception?

A

Begins when tissue is damaged by exposure to chemical, mechanical, or thermal noxious stimuli and is converted to electrophysiologic activity

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14
Q

What is the modulation phase of nociception?

A

Is the physiologic process of suppressing or facilitating pain

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15
Q

What is nociceptors?

A

Are bare nerve endings in the skin, muscle, etc that respond to chemical, mechanical, and thermal stimuli

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16
Q

What are mylenated A-delta fibers?

A

Transmission is fast and conveys mechanical and thermal, sharp, and localized pain

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17
Q

What is pain threshold?

A
  • the point at which a stimulus is perceived as pain

- Doesn’t significantly vary among people or in the same person over time

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18
Q

What is pain tolerance?

A
  • duration of time or intensity of pain that an individual will endure before initiating overt pain responses
  • varies greatly among people and in the same person over time.
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19
Q

What are unmylenated C fibers?

A

Transmission is slower and conveys diffuse burning and aching sensations

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20
Q

What is Nociceptive pain?

A

Pain with normal tissue injury from a known cause

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21
Q

What is Nonnociceptive pain?

A

Neuropathic pain

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22
Q

What is acute pain?

A

-protective mechanism

Alerts to a condition or experience that is immediately harmful to the body.

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23
Q

What is acute somatic pain?

A

Arises from connective tissue, muscle, bone, and skin

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24
Q

What is acute Visceral pain?

A
  • Pain arises from the internal organs and lining of body cavities.
  • Pain is poorly localized (result of the fewer number of nociceptors)
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25
Q

What are the two types of Nociceptive pain?

A

Somatic and visceral

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26
Q

What are the two types of Nonnociceptive pain?

A

peripheral and central

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27
Q

How long does acute pain last?

A

Less than 3 months

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28
Q

What are the clinical manifestations of acute pain?

A

Physiological responses: Tachycardia, hypertension, diaphoresis, dilated pupils, outward pain behaviors, elevated blood sugar levels, decreased gastric acid secretion and intestinal motility, general decrease in blood flow

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29
Q

What is referred pain?

A
  • Pain in an area is removed or distant from its point of origin.
  • Area of referred pain is supplied by the same spinal segment as the actual site
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30
Q

Is referred pain acute or chronic?

A

Both

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31
Q

What is though to cause chronic pain?

A

dysregulation of nociception and pain modulation processes

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32
Q

How long does chronic pain last?

A

at least 3 months

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33
Q

What are complications of chronic pain?

A

behavioral and psychologic changes, such as depression, difficulty eating, and difficulty sleeping

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34
Q

What are Myofascial pain syndrome?

A
  • Injury to the muscle and fascia and tendons has occurred.

- Spasm, tenderness, and stiffness

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35
Q

What are examples of chronic pain syndromes?

A

Myofascial pain syndrome, cancer pain, chronic post-operative pain, neuropathic pain, phantom limb pain, complex regional pain syndrome

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36
Q

What is neuropathic pain the result of?

A
  • Is the result of trauma or disease to the PNS or CNS

- Is most often chronic

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37
Q

What are the two types of neuropathic pain

A

Central and peripheral

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38
Q

What causes central neuropathic pain?

A

caused by a lesion or dysfunction in the brain or spinal cord

39
Q

What is phantom limb pain?

A

Pain is felt in an amputated limb after the stump has completely healed

40
Q

What is complex regional injury syndrome?

A

Develops 1 to 2 weeks after an extremity injury or an injury to the brachial plexus or the median, sciatic, or other peripheral nerves

41
Q

What are the clinical manifestations of neuropathic pain?

A
  • Include paroxysmal with hyperesthesia and paresthesia (tingling sensations of pins and needles), burning, shooting, or stabbing sensations
  • “gnawing” and miserable
42
Q

T or F: Pathways associated with pain are functional in preterm and newborn infants

A

T

43
Q

How do infants express pain?

A

Facial expression
Crying
Body language
Lack of consolability

44
Q

T or F: children ages 5-18 have a lower pain threshold than adults

A

T

45
Q

T or F: Pain threshold decreases as you age

A

F

46
Q

T or F: Pain tolerance decreases as you age

A

T

47
Q

What occur in terms of drug metabolism as you age?

A

alterations

48
Q

How is temperature regulation achieved?

A

precise balancing of heat production, heat conservation, and heat loss

49
Q

What is normal temperature range?

A

36.2° to 37.7° C (97.2° to 99.9° F)

50
Q

Variable temperature are based on

A
  • Location
  • Activity
  • Environment
  • Circadian rhythm
  • Gender
51
Q

What part of the brain control temperature regulation?

A

hypothalamus

52
Q

What controls heat production and conservation?

A
  • Chemical reactions of metabolism
  • Skeletal muscle contraction
  • Chemical thermogenesis
  • Vasoconstriction
  • Voluntary mechanisms
53
Q

Can infants conserve body heat?

A

No

54
Q

Can infants produce body heat?

A

Yes

55
Q

Why can’t infants conserve body heat?

A
  • Small body size and high body surface–to-weight ratio
  • Inability to shiver
  • Thin subcutaneous layer
56
Q

Why can’t older adults regulate body temperature?

A
  • Blood circulation and vasoconstrictive responses are slowed
  • Metabolic rate is decreased
  • Shivering is decreased and ineffective.
  • Sweating and the perceptions of heat and cold are decreased
57
Q

What are Exogenous pyrogens?

A

Endotoxins produced by pathogens

58
Q

What are Endogenous pyrogens?

A

Prostaglandin-E2, interleukin-1, IL-6, tumor necrosis factor–alpha (TNF-α), interferon-γ

59
Q

What causes temporary resetting of the hypothalamic thermostat

A
  • Endogenous pyrogens
  • Exogenous pyrogens
  • Endogenous cryogens or antipyretics
60
Q

What are benefits of fever?

A
  • Aids infectious response and kills organisms
  • Decreases the serum levels of iron, zinc, and copper
  • Deprives bacteria of food
  • Promotes lysosomal breakdown and autodestruction of cells
  • Increases lymphocytic transformation and phagocyte motility
61
Q

Fever response in older adults

A

Have a decreased or no fever response to infection

62
Q

Fever response in children

A
  • Develop higher temperatures than adults for relatively minor infections
  • May have febrile seizures
63
Q

What are heat cramps?

A

severe cramps in the abdomen and extremities

64
Q

What are some other symptoms of heat cramps?

A

Fever, rapid pulse, and increased blood pressure often accompany the cramps

65
Q

How do you treat heat cramps?

A

Diluted salt solutions are administered

66
Q

In who are heat cramps common?

A

people unaccustomed to heat or performing strenuous work in warm climates.

67
Q

When do heat cramps usually occur?

A

prolonged sweating and associated sodium loss

68
Q

What is heat exhaustion?

A

Collapse in response to prolonged high core or environmental temperatures

69
Q

What are the clinical manifestations of heat exhaustion?

A

Dizziness, weakness, nausea, syncope

70
Q

What is the treatment of heat exhaustion?

A

Stop activity, lie down, drink warm fluids

71
Q

What happens during heat exhaustion?

A
  • Prolonged vasodilation, profuse sweating

- Dehydration, hypotension, decreased cardiac output, tachycardia

72
Q

What is heat stroke?

A

Is a potentially lethal result of a breakdown in an overstressed thermoregulatory center

73
Q

At what temperature can the brain not tolerate?

A

higher than 40.5° C (104.9° F)

74
Q

What are the clinical manifestations of heat stroke?

A

Cerebral edema, degeneration of the CNS, renal tubular necrosis, ceased sweating

75
Q

How do you treat heat stroke?

A

Remove from the warm environment

-use cooling blanket or cool water bath or ice packs on the head, neck, groin, and axilla

76
Q

Who is most susceptible to heat stroke?

A

Children

77
Q

What is considered hypothermia?

A

lower than 35°C (95°F)

78
Q

What reaction does hypothermia produce?

A
  • Vasoconstriction, alterations in the microcirculation, coagulation, ischemic tissue damage
  • Ice crystals, which form inside the cells, cause cells to rupture and die
79
Q

What happens during accidental hypothermia?

A
  • Adenosine triphosphate (ATP) is depleted

- Passive or active rewarming can be used

80
Q

What is usually the cause of accidental hypothermia?

A

sudden immersion in cold water or prolonged exposure to cold

81
Q

Which happens during therapeutic hypothermia?

A
  • ATP is preserved.

- used to slow metabolism and preserve ischemic tissue during surgery, especially brain surgery, or limb reimplantation

82
Q

What is sleep considered and what does it provide?

A
  • an active, multiphase process

- Provides restorative functions, and promotes memory consolidation.

83
Q

What are the two phases of sleep

A
  • Rapid eye movement (REM) sleep

- Non–rapid eye movement (NREM) sleep

84
Q

Where is the sleep center located

A

Hypothalamus

85
Q

How many hours to newborns sleep a day?

What kind of sleep is this?

A
  • 16-17 hours

- REM (entered immediately)

86
Q

At what age do children assume adult sleep patterns?

A

during the first 2-5

87
Q

Why is sleep important in children?

A

for growth and development

88
Q

What happens with sleep as you age

A

total sleep time decrease because more time is needed to fall asleep and awaken more during the night

89
Q

What part of sleep decreases as you age?

A

REM sleep

90
Q

What are the causes for change in sleep cycles?

A
  • Physical ailments
  • Lack of daily routine
  • Circadian rhythm changes
  • Medications
91
Q

How many classification of sleep disorders are there?

A

4

92
Q

What is dyssomnia

A

-Intrinsic and extrinsic sleep disorders and circadian rhythm sleep disorders

93
Q

What is parasomnia

A

Arousal and sleep-wake transition disorders and REM sleep disorders

94
Q

What are the 4 classification of sleep disorders?

A

dyssomnia, parasomnia, sleep disorders associated with mental, neurologic, or other medical disorders, proposed sleep disorders

Patho- (5 decks)

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