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Pain (exam 2) Flashcards

1
Q

What are the 2 types of pain?

A

Nociceptive

Neuropathic

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2
Q

What is nociceptive pain?

A

Trigger nociceptors for pain
Somatic- joints, muscle, skin (very specific)
Visceral- organs (tumor/ obstruction) (very broad, referred pain)

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3
Q

What is neuropathic pain?

A

Brain feels pain
CNS or PNS
Don’t always know the stimulus

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4
Q

What type of pain do small C fibers cause?

A

Prolonged, dull, achey, persistent pain

Small C fibers are unmyelinated

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5
Q

What type of pain do large A fibers cause? What other sensations?

A

Immediate, sharp pain
Large A fibers are myelinated
Touch, vibration, thermal

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6
Q

What are natural analgesics?

A

Endorphins
Enkephalin
Dynorphin

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7
Q

What does Transduction in pain pathway do?

A

Nociceptors activated, release substance to activate small C fibers

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8
Q

What does Transmission in pain pathway do?

A

Small C fibers to spinal cord through brain stem to the thalamus to the cerebral cortex

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9
Q

What does Perception in pain pathway do?

A

Once in cerebral cortex we feel and become aware of pain

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10
Q

What does Modulation in pain pathway do?

A

How we inhibit or control pain

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11
Q

What is the gate control theory?

A

Small C fibers open the gate, cause pain

Large A fibers close the pain gate, modulation: touch, thermal, vibration

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12
Q

What is endogenous modulation?

A

Release analgesics (endorphins, serotonin, Neorepinephrine)
Block pain at the level small C fibers came in
Block at spinal cord even though nociceptors are still firing

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13
Q

What is exogenous modulation?

A

Large A fibers doing the modulation and closing gate through touch, vibration and thermal
Nociceptors are still firing, but large A are myelinated and beat to spinal cord so we don’t perceive it

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14
Q

How many months of persistent pain till it is classified as chronic pain?

A

3 months

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15
Q

Intermittent Chronic Pain

A

Comes and goes

Ex: chronic migraines

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16
Q

Persistent Chronic Pain

A

Always present

Ex: lumbago (low back pain)

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17
Q

Neuropathic Pain

A

Brains perception of pain
Characterized by:
Hyperalgesia (over exaggerated pain levels)
Allodynia (feel pain with no present stimulus)

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18
Q

What is perceptual dominance?

A

Second injury is masked by pain of greater injury

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19
Q

What causes a fever? What does fever mean?

A

Pyrogens

Mean infection

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20
Q

What is hyperthemia?

A

High body temp

Overexposure to heat source

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21
Q

What is malignant hyperthermia?

A

Increased body temp caused by anesthetics
Spontaneously, quick progression of body temp
Increase muscle contraction, increase body temp
Stop by removal of anesthetics

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22
Q

What is hypothermia?

A

To low body temp

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23
Q

What are the stages of sleep?

A

REM (dreaming, rapid eye movement)

Non-REM sleep (4 stages, deeper sleep)

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24
Q

What is Hypersomnia and the types?

A

To sleepy
Primary hypersomnia: always over sleepy
Secondary hypersomnia: something inducing it, usually drugs

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25
What sleep disorders affect breathing?
Obstructive sleep apnea syndrome (usually overweight or obese) Nocturnal paroxysmal dyspnea (CHF patients, overwork heart laying down, SOB)
26
What is insomnia?
Inability to fall or stay asleep
27
What is strabismus?
Deviation from center of eye | Lazy eye
28
What is nystagmus?
Eye shaking, twitching
29
What is diplopia? What is it a symptom of?
Double vision | Strabismus symptom
30
What is myopia?
Nearsightedness Long eyeball Focus in front of retina
31
What is hyperopia?
Farsightedness Fat eyeball Focus behind retina
32
What is astigmatism?
Uneven corneal curvature | No single retinal focus
33
What is an otitis externa ear infection?
Outside the tympanic membrane | Swimmers ear
34
What is an otitis media infection? Most common in who?
Eustachian tube infection | Children and infants
35
What is vestibular nystagmus?
proprioceptive dysfunction | Eyeball movement secondary to overstimulation of semicircular canals
36
What is vertigo?
Feel like you are spinning | Spinning sensation secondary to inflammation of semicircular canals
37
What is the primary cause of aphasia?
Stroke
38
What is anomic/ amnesia aphasia?
Without a name for person, place, thing
39
What is receptive aphasia?
Damage to wernicke's area | Difficulty understanding spoken or written language
40
What is expressive aphasia?
Damage to Broca's area | Difficulty in conveying thoughts speech or writing
41
What is global aphasia?
Damage to wernicke and broca areas | Loss of almost all language function
42
What is decorticate?
Hands stuck up on chest Lower on brain stem Corticospinal damage: opposite side
43
What is decerebrate?
Hands stuck down Higher on brainstem Ipsilateral damage: same side
44
What happens with both decorticate and decerebrate damage?
Brain damage is to straight are side
45
What is Brain Stem Death?
Lack of brain function | Vegetative state, living by machines
46
What is cerebral death?
Death exclusive of brain stem and cerebellum | Brain maintains internal homeostasis
47
What is a partial seizure?
Part of brain | Focal and unilateral
48
What is an absence seizure?
Spacing out, zoning out for a couple minutes
49
What is a tonic clonic seizure?
Convulsions (rigid and relax, repeat) | Grand mal seizures
50
What is an epileptic?
Chronic tonic clonic seizures
51
What is hydrocephalaus?
Big head Excess CSF within cranial vault, subarachnoid space or both Increased ICP
52
What is a coup and counter- coup injury?
Coup is injury where hit on brain | Counter-coup is brain bouncing off opposite side of head, secondary injury
53
Cerebral Concussion
``` Most common type of traumatic brain injury Chemical injury with loss of ATP Confusion, Amnesia, Fatigue, Dizziness Loss of consciousness not needed No major broken blood vessels ```
54
Epidural Hematoma
``` Blunt force trauma/ motor vehicle accident Between skull and dura mater Increase ICP Arterial bleed, fast bleed Lucid intervals= think you are fine Progressive Don't break blood brain barrier ```
55
Subdural Hematoma
``` Elderly/ alcoholics/ shaken baby syndrome Increase ICP (highest of all) Below dura, above pia Venous bleed, slow bleed Most common, most fatal Brain becomes hypoxic then necrosis Break blood brain barrier Inflammation and macrophage in brain Liquifactic necrosis ```
56
Intracerebral Hematoma
``` Stroke causes Inside brain tissue Small arteries or veins, slow bleed Fastest to produce symptoms Break blood brain barrier Liquifactic necrosis Forms penumbra, walling off area Little to no change in ICP ```
57
Quadrapelegia
Complete paralysis | Damage to T1 or above
58
Paraplegia
Lower half | T2 and below
59
Hemiplegia
Half the body | Stroke
60
What is the circle of willis?
Colateral flow | If get a blockage in part, then should still get bloodflow to brain
61
Hemorrhagic Stroke
Bleeding into brain tissue Poor oxygenation Necrosis
62
Ischemic Stroke
Lack of bloodflow Hypoxia Permanent necrosis
63
Meningitis
Inflammation of the meninges Bacterial: skull fractures, antibiotics Aseptic (Viral) Fungal: Super fatal and rare
64
Encephalitis
Inflammation of the brain
65
Senility
Physiologic | Decrease cognitive function due to age
66
Dementia
Severe short term memory loss
67
Alzheimer's Disease
``` Initial symptom: memory loss Secondary: motor function loss Strong genetic component Tau tangles and Amyloid plaques Severe atrophy of brain ```
68
Parkinson's Disease
Initial symptom: motor function loss Secondary: Memory loss Loss of dopamine production/ release Loss of inhibition of dopamine causes more Ach= muscle tremors
69
Amyotrophic Lateral Sclerosis (ALS)
Primary symptom: Muscle weakness Degeneration of somatic motor neurons Rapidly prgressive
70
Multiple Sclerosis
Primary Symptom: Muscle weakness Demyelination of CNS neurons Autoimmune disease (type 4): cyto T's attack oligos Females more prone
71
Guillan barre
Primary symptom: Muscle weakness Demyelination of PNS neurons (schwann cells) From infection Can recover
72
Muscular Dystrophy
``` Primary symptom: muscle weakness Muscle protein (dystrohpin) problem Duchenne MD= most common in kids Myotonic MD= most common in adults ```
73
Myasthenia Gravis (MG)
Primary symptom: muscle weakness | Autoimmune disease: Ab to Ach receptors- block/ destroy- low muscle function

Patho (17 decks)

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