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pain and temp regulation Flashcards

1
Q

pain?

A

unpleasant sensory and emotional experience with actual or potential tissue damage

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2
Q

specificity theory of pain?

A

amt of pain is related to the amount of tissue injury; does NOT explain psychologic contributions

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3
Q

gate control theory?

A

explains complexities of pain phenomenon; says why some patients may experience pain without tissue damage

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4
Q

name some excitatory NT

A

glutamate and aspartate

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5
Q

name some inhibitory NT

A

serotonin, GABA, endorphins

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6
Q

what is direct excitation

A

threshold depolarization from direct stimuli

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7
Q

what is indirect excitation example

A

sunburn

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8
Q

endorphins?

A

pain reducer

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9
Q

pain threshold?

A

point at which stimulus is perceived as pain

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10
Q

perceptual dominance

A

pain at one location may cause an increase in threshold in another location

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11
Q

pain tolerance?

A

duration of time or intensity of pain that a person will endure before initiating pain responses

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12
Q

does pain threshold vary among ppl or in the same person over time

A

no

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13
Q

what is it called when someone with many painful sites only reports the post painful one

A

perceptual dominance

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14
Q

what is pain tolerance influenced by

A

cultural perceptions, expectations, role behaviors, physical and mental health

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15
Q

when is pain tolerance decreased?

A

repeated pain, fatigue, anger, boredom, apprehension, sleep deprivation

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16
Q

when is pain tolerance increased?

A

alcohol consumption, main meds, hypnosis, warmth, distracting activities, strong beliefs/faith

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17
Q

what varies greatly among ppl and in the same person over time

A

pain tolerance

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18
Q

2 types of pain

A

nociceptive pain and non-nociceptive pain

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19
Q

nociceptive pain?

A

pain with normal tissue injury; can be somatic or visceral

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20
Q

non-nociceptive pain?

A

neuropathic pain; peripheral and central

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21
Q

protective mechanism?

A

alerts a person that a condition or experience is immediately harmful to the body

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22
Q

3 types of acute pain

A

acute somatic, acute visceral, and referred

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23
Q

what does acute somatic pain arise from

A

CT, muscle, bone, and skin

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24
Q

2 types of acute somatic fibers?

A

A delta and C

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25
what do A delta fibers sense
pain is sharp and well localized
26
what do C fibers sense
dull, aching, and poorly localized pain
27
where is acute visceral pain
pain in the internal organs and abdomen
28
why is acute visceral pain poorly localized
lesser number of nociceptors (sometimes dont feel pain even when its occurring)
29
where is referred pain
pain in an area removed or distant from its point of origin
30
where is referred pain supplied by
same spinal segment as the actual site
31
chronic pain?
misinterpretation of nociceptive input due to an imbalance of neuromodulatoin controls
32
what are some examples of chronic pain
dec endorphins and predominance of C neuron stimulation
33
cause of chronic pain
usually unknown
34
does chronic pain respond to usual therapy
no
35
how long must pain occur for it to be chronic
at least 3 months
36
name some common types of chronic pain
back pain, myofacial pain syndromes, chronic postoperative pain, cancer pain
37
mc type of chronic pain
back pain
38
what are myofacial pain syndromes
pain to the muscles and fascia that cause tenderness, stiffness, and spasms
39
how do endorphins regulate pain?
bind to opiate receptors
40
what pain is an imbalance of neuromodulation controls?
chronic pain
41
neuropathic pain a result of?
result of trauma or disease of nerves
42
what type of pain is neuropathic pain
chronic
43
neuropathic pain examples
diabetic neuropathy (due to untreated diabetes) and postherpetic neuralgia (reactivation of viruses within nerves)
44
types of neuropathic pain
deafferentiation pain, sympathetically maintained pain, complex regional pain syndrome (CRPS), central pain, phantom limb pain
45
what is important to consider in neuropathic pain?
psychological components (like depression and anxiety), sleep disturbances, work related issues, trmt expectations, social support
46
when is the nococeptor system functional in infants
24 weeks
47
how do babies express pain
crying, facial expressionsss, body language
48
how does pain change as we age
increased pain threshold, dec pain tolerance, changes in metabolism of drugs or other metabolites
49
what does temp regulation vary based on
location, activity, environment, circadian rhythm, gender
50
what regulates our temp
peripheral thermoreceptors, hypothalmic control, heat production and conservation
51
how is heat produced and conserved
metabolism, muscle contraction, chemical thermogenesis, vasoconstriction, voluntary mechanisms
52
how is temp regulation different in peds
they produce body heat but cant maintain it; small body size and high body surface to weight ratio, thin subcutaneous layer
53
how is temp regulation different in old ppl
slow blood circulation, vasoconstrictive response, and metabolic rate dec sweating and perception of heat/cold
54
what is a fever
resetting of hypothalamic thermostat
55
febrile response of a fever?
raise temp, immunologic changes (inc B lymphocytes), endocrine changes (inc. catecholamines), physiologic changes (anorexia)
56
acute phase response of a fever?
inc c reactive protein, dec albumin, inc circulating neutrophils
57
benefits of fever?
kills many organisms, increases lymphocytes and phagocyte motility
58
fever dec. serum levels of what elements
iron, zinc, and copper
59
how does fever kill organisms
dec. serum iron, zinc, and copper, deprives bacteria of toos, and promotes lysosomal breakdown and autodestruction of cells
60
hyperthermia?
not mediated by pyrogens; NO resetting of hypothalamic thermostat
61
what does a temp over 41 C or 105.8F cause
nerve damage and convulsions
62
what does a temp over 43 C or 109.4F cause
death
63
forms of hyperthermia
heat cramps, heat exhaustion, and heat stroke
64
heat cramps?
severe spasmodic cramps in the abdomen and extremities followed by prolonges sweating and Na loss
65
who are heat cramps common in
ppl not used to heat or ppl doing hard work in warm temps
66
what often accompanies heat cramps
fever, rapid pulse, inc. BP
67
heat exhaustion?
collapse due to prolonged high core or environmental temps; also get prolonged vasodilation and sweating
68
manifestations of heat exhaustion?
dizziness, weakness, nausea, syncope
69
what does prolonged vasodilation and profuse sweating lead to
dyhydration, dec. plasma volumes, hypotension, sec. cardiac output, and tachycardia
70
what can the brain not regulate temps over
40.5C or 104.9F
71
heat stroke?
potentially lethal result of a break down in an overstressed thermoregulatory center
72
what is temp in the brain maintained by
blood flow through veins in the head and face
73
what may happen to CV and thermoregulatory centers in too high of temps
they may stop functioning
74
manifestations of a heat stroke?
cerebral edema, degeneration of CNS, swollen dendrites, renal tubular necrosis
75
what does rapid peripheral cooling cause in a heat stroke
peripheral vasoconstriction and limits core cooling
76
who are more susceptible to heat strokes
children
77
why are children more susceptible to heat strokes
they produce more heat when exercising, greater surface area to mass ratio, sweating capacity is less in adults
78
malignant hyperthermia?
complication of an inherited muscular disorder precipitated by administration of volatile anesthetics and neuromuscular blocking agents
79
what occurs with calcium in malignant hyperthermia?
increased Ca release or dec Ca uptake with muscle contraction
80
what does malignant hyperthermia cause?
sustained muscle contractions which increase O2 consumption and lactic acid production
81
hypothermia?
body temp less than 35C or 95F
82
what does hypothermia produce?
vasoconstriction, changes in microcirculation, coagulation, ischemic tissue damage
83
what do ice crystals do in hypothermia
form in cells and cause them to rupture and die
84
what does tissue hypothermia do
slows chemical rxns, increases blood viscosity, slows circulation of blood, facilitaties blood coagulation, and stimulates vasoconstriction
85
accidental hypothermia?
result of sudden immersion in cold water or prolonged exposure to cold
86
therapeutic hypothermia?
used to slow metabolism and preserve ischemic tissue during surgery, but may lead to ventricular defibrillation and cardiac arrest
87
trauma induced temp change?
CNS trauma, accidental injuries, hemorrhagic shock, major surgery, burns

Pathophysiology (17 decks)

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