Patho Exam 2- S3 Flashcards
Central Nervous System contains what?
Brain and Spinal Cord
Peripheral Nervous System contains what?
Cranial nerves
Spinal Nerves
Pathways (Afferent/Efferent)
Afferent Pathway?
Ascending: Sensory to Spinal Column
Efferent Pathway?
Descending: Innervate effector organs
Peripheral Nervous System Contains what?
Somatic Nervous System
and
Autonomic Nervous System
Somatic Nervous System?
Regulate voluntary control of Skeletal Muscle.
Autonomic Nervous System does what?
Regulate the body’s internal environment through involuntary control of organ systems.
-Sympathetic
-Parasympathetic
What is a Neuron?
Information and Communication Cell
Variable in size and structure throughout.
What are the Cellular constituents of a Neuron?
Microtubules
Neurofibrils
NIssl substances
Microtubules?
Transportation
Neurofibrils?
Structural Support
Nissl Substances?
protein synthesis
3 Primary components of a Neuron?
Cell Body
Dendrites
Axons
Cell Body (Soma)
Located mainly in CNS
Nuclei- densely packed cell bodies in CNS.
Ganglia/Plexuses- groups of cell bodies in PNS.
What are Ganglia/plexuses and where found?
Groups of cell bodies in PNS
Receptor portion of the neuron that sends impulses to the cell body?
Dendrites
Dendritic Zone?
Receptive portion of the neuron that receives a stimulus and continues conduction.
What carries nerve impulses away from the Cell Body?
Axons
Axon Hillock?
Where the axon leaves the cell body
Bundled groups of axons?
Fascicles
Myelin Sheath?
Entire membrane of insulating lipid material. Formed and maintained by Schwann Cells.
What forms the Myelin Sheath?
Schwann Cells
What is the delicate layer of connective tissue around each Axon?
Endoneurium
What is the thin membrane between the myelin sheath and the endoneurium?
Neurilemma (Schwann Sheath)
Order of Neuron insulation?
- Myelin sheath
- Neurolemma
- Endoneurium
Regular interruptions of the myelin sheath are called?
Nodes of Ranvier
Saltatory Conduction?
Faster transmission by allowing ions to flow between segments of myelin.
Ability of branching axons to influence many neurons?
Divergence
Branches of numerous neurons converging on one or a few neurons?
Convergence
Most common Neuron Structure?
Multipolar
What neurons are transmitted via Afferent pathway?
Sensory Neurons
What neurons are transmitted via Efferent pathway?
Motor Neurons
What neurons transmit impulses from peripheral receptors to the CNS
Sensory Neurons via Afferent pathway
What neurons transmit impulses from CNS to organs.
Motor Neurons via efferent pathway
What transmits impulses from neuron to neuron?
Interneurons
What Neuroglia are in the PNS?
Satellite Cells
and
Schwann Cells
What Neuroglia are in the CNS?
Astrocytes
Oligodendroglia
Microglia
Ependymal cells
Which fill the spaces between neurons and surround the blood vessels in the CNS?
Astrocytes
Which deposit myelin within the CNS?
Oligodendrocytes
Which remove debris in the CNS?
Microglia
Which line the CSF filled cavities of the CNS?
Ependymal Cells
Which surround neuron cell bodies in the ganglia and regulate O2/CO2 and neurotransmitter levels?
Satellite Cells
Which surround axons in the PNS and responsible for the myelination of peripheral axons?
Schwann Cells
Also called Neurolemmocytes?
Schwann Cells
What are glial cells that wrap around and cover axons in the PNS?
Schwann Cells
What forms the myelin Sheath?
Schwann Cells
Schwann cells increase what?
Conduction velocity
Wallerian degeneration
Occurs distal to cut
Myelin sheath shrinks/disintegrates
Axon portion degenerates
Proximal end of injured neuron?
- Dispersal of Nissl substance for protein synthesis.
- Increase metabolic and mitochondrial activity.
- New terminal sprouts
- Limited to myelinated axons only in PNS.
- Regeneration
The release of neurotransmitters causes what?
Electrical and chemical impulses to influence nearby neurons.
All or None response?
Action potential response only occurs when the stimulus is strong enough.
What are the regions between adjacent neurons called?
Synapses
Impulses are transmitted across _____ by chemical and electrical conduction?
Synapses
Axoaxonic synapse?
between axons
Axosomatic synapse?
axon to cell body
Axodendritic synpase?
axon to dendrite
Dendrodendritic synapse?
dendrite to dendrite
Neurotransmitters are formed where?
in the Neuron
Impulses are transmitted by?
Neurotransmitters
Where are neurotransmitters stored?
Synaptic knob or bouton
Where are Neurotransmitters released?
Across the Synaptic Cleft (space between neurons)
Excitatory postsynaptic potentials are?
Depolarized
Inhibited postsynaptic potentials are?
Hyperpolarized
What determines whether an action potential occurs?
Summation
3 Major division of the Brain?
- Forebrain
- Midbrain
- Hindbrain
Forebrain contains?
Two cerebral hemispheres
Midbrain contains?
Corpora quadrigemina, tegmentum, cerebral peduncles
Hindbrain contains?
Cerebellum, pons, medulla
Midbrain, medulla, and pons makeup the _____?
Brainstem
A network of connected nuclei that regulate vital reflexes such as cardiovascular and respiratory function is?
Reticular Formation
What maintains wakefulness?
Reticular Formation
The reticular formation and Cerebral cortex are known as the ?
Reticular-activating system
The cerebrum, cerebral cortex and basal ganglia makeup what?
Forebrain
Gray matter (nuclei) and white matter (numerous tracts) are found where?
Forebrain
Goal-oriented behavior, short-term or recall memory is found where?
Prefrontal
(Frontal Lobe)
Programs motor movement, basal ganglia and extrapyramidal system are found where?
Premotor
(Frontal Lobe)
Primary voluntary motor is referred to as what?
Homunculus (Little man)
Is the primary motor area ipsolateral or contralateral movement?
Contralateral
Broca speech area controls what?
Motor aspect of speech
Found in Frontal Lobe
Which lobe is responsible for somatic sensory input?
Parietal lobe
Which lobe is responsible for visual cortex? (vision)
Occipital lobe
Which lobe is the primary auditory cortex and responsible for long term memory and reception of speech(wernicke area)?
Temporal Lobe
Wernicke area does what?
Reception and interpretation of speech.
Found in Temporal Lobe
What connects the two cerebral hemispheres?
Corpus Callosum
(commissural fibers)
What controls behavioral responses, emotion, feeding, smell, memory consolidation, and biologic rhythms?
Limbic System
What controls the expression of affect (emotional and behavioral states)?
Limbic system and prefrontal cortex
Substantia Nigra in the tegmentum does what?
Synthesizes dopamine
Cerebral aqueduct (aqueduct of sylvius) does what?
Carries CSF
Hindbrain consists of what?
Cerebellum
Pons
Medulla
What maintains balance and posture?
Cerebellum
Damage to the cerebellum would result in what loss of equilibrium, balance and motor coordination?
(Contralateral or Ipsilateral)
Ipsilateral or same side
What controls respirations?
Pons
What controls heart rate, respiration, blood pressure, coughing, sneezing, swallowing and vomiting?
Medulla oblongata (myelencecephalon)
The end of spinal cord is where?
L1-L2
The end of the spinal cord is called what?
Conus Medullaris
Nerve bundle at the end of the spinal cord?
Cauda equina
How many nerves are in the spinal cord?
31pairs
How many nerves are in the?
Cervical
Thoracic
Lumbar
Sacral
Coccygeal
C-8
T-12
L-5
S-5
C-1
Which horn is pain transmitting?
Dorsal horn
Which horn is composed primarily of interneurons and axons from sensory neurons whose lie in the dorsal root ganglion?
Posterior or dorsal horn
Which horn contains cell bodies involved with the ANS?
Lateral Horn
Which horn contains nerve cell bodies for efferent pathways?
Anterior or ventral horn
Substantia gelatinosa?
Pain transmission
Located Lamina II
Substantia gelatinosa is where?
Lamina II in the Dorsal horn
pain transmission
Label (sensory or motor)function?
Posterior/dorsal horn?
Lateral Horn?
Anterior/ventral horn?
Dorsal horn- sensory
lateral horn- motor
Ventral horn- motor
Horns are
(White or Gray)
Gray
Columns are
(White or Gray)
White
White matter forms ascending and descending pathways where?
Spinothalamic tract
Motor effects from the _____ generally occur before the perception of the event in the higher centers of the brain?
Reflex arc
Motor pathways are completely in the CNS, efferent pathways relay information from the cerebrum to the brainstem.
Destruction = partial recovery?
Upper motor neurons (Corticospinal tract)
Destruction of these neurons = partial recovery?
Upper motor neurons
These neurons have direct influence on muscles and destruction = permanent paralysis?
Lower motor neurons
Destruction of these neurons = permanent paralysis?
Lower motor neurons
Anterior spinothalamic tract senses what?
Vague touch
Lateral spinothalamic tract senses what?
Pain and temperature
Posterior (dorsal) column senses what?
Fine touch
two point discrimination
proprioception
What space reduces pressure in the cranium?
Subgaleal space
Cranium consists of how many bones?
8 bones
Meninges layer order?
- Periosteum
- Meningeal. Both 1&2 belong to Dura
- Arachnoid
- Pia
Outter most layer of meninges?
Dura mater which consists of periosteum and meningeal
Inner most layer of meninges?
Pia matter
What space is located between the dura and arachnoid matter?
Subdural
What space is between the arachnoid and pia matter and contains CSF?
Subarachnoid
What space is located between the dura mater and skull/bone?
Epidural
Spinals are done in which space?
Subarachnoid space (intrathecal)
What is the order of spaces for blocks? from outer to inner
- Epidural
- Subdural
- Subarachnoid
CSF should not contain what?
no WBCs
CSF is produced by what?
The choroid plexuses in the lateral, third and fourth ventricles.
CSF is reabsorbed through what?
Arachnoid villi
How many vertebrae are there?
33
How many vertebrae in each?
Cervical
Thoracic
Lumbar
Sacral
Coccygeal
C-7
T-12
L-5
S-5
C-4
What is the primary regulator for CNS blood flow?
Carbon dioxide CO2
What vessel supplies the greatest amount of blood flow to the brain?
Internal carotid
Artery of Adamkiewitz?
only major arterial supply to the anterior spinal artery along the lower thoracic, lumbar and sacral segments of the spinal cord.
The 31 spinal nerves arise from the what?
Anterior and posterior horn cells of the spinal cord
How many cranial nerves are there?
12 pairs
The 12 pairs of cranial nerves arise from where?
Brain and brainstem
A network of nerve fibers are called what?
Plexuses
What maintains a steady state among visceral organs in the body?
Autonomic Nervous System
Preganglionic neurons are?
(Myelinated or unmeylinated)?
Myelinated
Postganglionic neurons are?
(Myelinated or unmeylinated)?
Unmyelinated
2 Division of the Autonomic nervous system are?
Sympathetic
Parasympathetic
Which system mobilizes energy storage in times of need and receives innervation from cell bodies in the Thoracolumar division?
Sympathetic (SNS)
Which system releases epinephrine (vasodilation) and norepinephrine (vasoconstriction)?
Sympathetic (SNS)
Which system functions to conserve and restore energy?
Parasympathetic (PNS)
Which system receives innervation from cell bodies in the craniosacral division?
Parasympathetic (PNS)
Sympathetic PRE-ganglionic fibers
Neurotransmitter?
Receptor?
Acetylcholine
Cholinergic
Sympathetic Post-ganglionic fibers
Neurotransmitter?
Receptor?
Norepinephrine
Adrenergic
Parasympathetic pre and postganglionic fibers
Neurotransmitter?
Receptor?
Acetylcholine
Cholinergic
Alpha-1 adrenergic receptor?
Excitation or stimulation
Most common
Alpha-2 adrenergic receptor?
Relaxation or inhibition
Beta-1 adrenergic receptor?
Increase HR and Contractility
Release of Renin in kidneys
Beta-2 adrenergic receptor?
Facilitates all other beta-adrenergic receptors.
Beta-3 adrenergic receptor?
Mediates lipolysis and thermogenesis
It is upregulated in CAD
Decreased peristalsis
Increased blood sugar
Increased temperature
Increased blood pressure
Vasomotor tone
What stimulation?
Sympathetic nervous system stimulation
Promotes rest and tranquility
Reduced heart rate
Enhanced digestion
Pupil constriction
Tear secretion
Increased salivation
Contracted urinary bladder
What stimulation?
Parasympathetic nervous system stimulation
Most accepted theory of pain?
Gate Control Theory
Pain is modulated by a “gate” in the cells of the _____ in the spinal cord?
Substantia Gelatinosa
A-delta fibers are ?
Large and myelinated
Acute
C fibers are?
Small and unmyelinated
Chronic
Which fibers “close” the gate?
Larger A-beta fibers
When there is no stimulation gates are?
Closed
Large diameter fibers ____ the gate?
Close
Small diameter fibers ____ the gate?
Open
Which theory illustrates the plasticity and produces patterns of pain, but with independent stimuli?
Neuromatrix theory
These pathways begin in the PNS and travel to the spinal gate in the dorsal horn up to the CNS?
Afferent pathways
These pathways descend from the CNS back to the dorsal horn of the spinal cord and modulate pain?
Efferent pathways
- Site of injury
- Spinal Cord
- Brainstem
- Cerebrum
Pain pathway
Which sensation?
Noxious pain
High Threshold
Conducted by smaller myelinated A-delta and unmyelinated C nerve fibers?
Protopathic
Protopathic sensation?
Noxious pain
high threshold
Small and large nerve fibers
Which sensation?
Non-noxious
Light touch, pressure, proprioception, temperature
Low threshold
Conducted by Large myelinated nerve fibers?
Epicritic Sensation
Epicritic Sensation
nonnoxious
light touch, temperature. proprioception
low threshold
large myelinated
Which requires more intense stimulation for an action potential?
(Protopathic or Epicritic)
Protopathic
Which sensation is more precise and more sensitive?
(Protopathic or Epicritic)
Epicritic
Allodynia
Perception of an ordinarily nonnoxious stimulus as pain
Abscense of all sensation is?
Anesthesia
Bone/Muscle/Visceral caused by activation or sensitization of peripheral nociceptors is what?
- Nociceptive
- Neuropathic
- Psychogenic
- Nociceptive
Burning/tingling/pins/needles sensation caused by injury or abnormalities is what?
- Nociceptive
- Neuropathic
- Psychogenic
- Neuropathic
Psychological mechanism or environmental factors. Produce chronic pain is what?
- Nociceptive
- Neuropathic
- Psychogenic
- Psychogenic
What are the four phases or processes of pain?
- Transduction
- Transmission
- Perception/Interpretation
- Modulation
Transduction?
Begins when tissue is damaged by exposure to chemical, mechanical or thermal noxious stimuli.
(local anesthesia can block this)
Transmission?
Conduction of pain impulses along the A and C fibers into the dorsal horn of spinal cord.
Perception/Interpretation?
Conscious awareness of pain.
Modulation?
Physiologic process of suppressing or facilitating pain. Convergence on spinal dorsal horn.
In which phase are nociceptors stimulated by a noxious, painful or damaging stimuli in the peripheral nerve ending causing depolarization and generation of electrical impulse?
Transduction
In which phase is the impulse carried throughout the nervous system?
Transmission
What is the most important pathway for transmission?
Spinothalamic Tract
In which phase is the subjective interpretation of pain or “how it feels to the patient”?
Perception or interpretation
In which phase is the pain either suppressed or aggravated by release of mediators and chemical messages?
Modulation
Prostaglandins
histamine
bradykinin
serotonin
acetycholine
lactic acid
hydrogen ions
potassium ions
are what?
Endogenous mediators of inflammation
Prostaglandins are ?
1.Potent Vasodilators
2. cause increased permeability of blood vessels
3. intensify effects of histamine, serotonin, and bradykinins
What is produced following tissue damage?
Prostaglandins
Which enzyme is stimulated by tissue damage?
Phospholipase A2 enzyme
Activation of phospholipase A2 causes the release of arachidonic acid which leads to what two enzyme reactions?
Cyclooxygenase and Lipoxygenase
Cyclooxygenase converts arachidonic acid to ______ and ______ which potentiates the edema from bradykinin?
Prostaglandins and Prostacyclins
What inhibits the action of Cyclooxygenase?
ASA, NSAIDS and COX inhibitors
Lipoxygenase pathway converts arachidonic acid to ______ which increases vascular permeability and releases leukocytes?
Leukotrienes
What are the 3 major functions of the Spinal cord?
- Conduit for Ventral (motor) information which travels down.
- Conduit for Dorsal (sensory) information that travels up.
- Center for coordinating reflexes
The ventral (motor) and Dorsal (sensory) roots combine to form what on each side of the spinal cord?
Spinal nerves
Pain is conducted along which 3 neuron pathways?
- First-order neurons in dorsal root
- Second-order neurons in dorsal horn
- Third-order neurons in inner chamber of thalamus
First order neurons are located where?
Dorsal root ganglia
Second order neurons are located where?
Dorsal horn
Third order neurons are located where?
Inner chamber of the thalamus
What are bare nerve endings in the skin, muscles joints, arteries and viscera that respond to chemical, mechanical and thermal stimuli?
Nociceptors
(primary order neurons)
Myelinated A-delta fibers
Transmission is_____?
Pain is described as_____?
Fast
mechanical, thermal, sharp, and localized pain.
Unmyelinated C fibers
Transmission is_____?
Pain is described as_____?
Slow
Burning and aching sensation.
Both Myelinated A-delta fibers and Unmyelinated C fibers terminate on?
Second order neurons
Are Nociceptors Afferent or Efferent nerve endings?
Afferent
Afferent ______?
Ascending
or
Arrives
Efferent______?
Exits
(Away)
What responds to mechanical stimulation such as pressure, vibration or movement?
Mechanonociceptors
What type of receptors responds to inflammation?
Silent Nociceptors
What responds to excessive pressure, excessive temperature and alogens(chemical) ?
Polymodal mechanoheat nociceptors (Thermoreceptors)
Most prevalent type of nociceptor?
Polymodal mechanoheat nociceptors
Which nociceptors are located in the Epidermis?
Meissner corpuscles (touch)
Which nociceptors are located in the Dermis?
Merkel cell neurite (touch)
Ruffini endings (heat)
Which nociceptors are located in the subcutis(layer beneath the dermis)?
Pacinian corpuscles (pressure)
Kinesthetic receptors sense what?
Where limbs are located in space and movement
Muscle spindles are sensory receptors that sense tension
Muscle memory?
First Order Neurons are located in the ?
Dorsal root ganglia
Sensory is Afferent is Dorsal= SAD
SAD means?????
Sensory is Afferent is Dorsal
Why might patients still have pain after a rhizotomy?
Some unmeylinated fibers enter spinal cord via ventral root (40%) instead of dorsal root
What procedure is used in children to relieve symptoms of Cerebral palsy?
Rhizotomy, severs problematic nerve roots in the spinal cord
What is a rhizotomy used for with adult patients?
Treat chronic back pain, degenerative disc disease or sciatica
Which order neurons function as a pain gate and regulate pain transmission?
Second order neurons in the dorsal horn
First-order neurons synapse with second-order neurons in the ____ of the dorsal horn?
Gray matter
The spinal cord gray matter is divided into how many lamina?
10
Lamina 1-6 make up the _____ and are where all afferent stimuli come from the spinal cord?
Dorsal horn
Lamina 1-6 represent the principle site of ____?
Modulation of pain
The substantia Gelatinosa is what laminae?
Laminae II
2
Which is the major site of action for opiods?
Laminae II or Substantia Gelatinosa
The substantia Gelatinosa is the major site of action for?
Opiods
Lamina III, IV and VI do what?
Receive non-nociceptive sensory input
Lamina VII does what?
The intermediiolateral column, contains preganglionic sympathetic neurons
Lamina VIII and IX do what?
Anterior horn, MOTOR
Lamina X?
Very small, involved in pain, temperature and visceral sensations
Third order neurons are?
Afferent neurons that carry information to the sensory cortex and limbic systems to process and interpret pain.
Second order neurons synapse with third order neurons in the ?
Thalamus
Somatosensory areas are responsible for___ _____?
Evoked potentials or electrical signals generated
SSEPs or Somatosensory evoked potentials purpose is to?
Evaluate the integrity of the brain and spinal cord ascending pathways.
Segmental inhibition does what?
Closes the gate
Low threshold mechanical information, touch, vibration, pressure
All pathways of modulation converge on the?
Spinal dorsal horns
Segmental inhibition
Descending modulation of pain
Diffuse noxious inhibitory controls
Expectancy related cortical activation
are all pathways of what?
Modulation
Thalamus, cortex and postcentral gyrus are responsible for what with pain?
Perceiving, describing, and localizing pain.
What controls the emotional and affective responses to pain?
Reticular formation and Limbic system
Glutamate and Aspartate are pain
(Excitatory or Inhibitory) ?
Excitatory
Serotonin, GABA, glycine, endorphins, enkephalins are pain
(Excitatory or Inhibitory) ?
Inhibitory
Allodynia is?
Normally nonpainful stimuli induces pain
A normally nonpainful stimuli that induces pain is called?
Allodynia
The point at which a stimulus is perceived as pain is the ?
Pain threshold
The duration of time or intensity of pain will endure before a response is the ?
Pain tolerance
Which varies greatly among people: pain threshold or pain tolerance?
Pain tolerance
Pain with normal tissue injury from a known cause: Somatic and Visceral is?
Nociceptive pain
Pain less than 3 months is?
Acute
Neuropathic pain, peripheral and central is ?
Nonnociceptive pain
Pain more than 3 months is ?
Chronic
Which type of pain is a protective mechanism?
Acute, affects all body systems
Which pain arises from connective tissue, muscle, bone and skin?
Acute Somatic
Which pain arises from the internal organs and lining of body cavities and poorly localized?
Acute Visceral
A-delta fibers pain is?
Acute, sharp, well localized
C- fibers pain is?
Chronic, dull, aching, throbbing.
Which pain leads to physiologic adaption of pulse and blood pressure?
Chronic
Which neuropathic pain is caused by a lesion or dysfunction in the brain or spinal cord?
Central neuropathic pain
Which Neuropathic pain syndrome results of lesions in the PNS?
Deafferentation pain syndrome
Produces paralysis and a hypersensitivity or allodynia on one half of the body?
Hemiagnosia pain
Phatom limb pain?
Pain is felt in an amputated limb after the stump has healed.
CRPS Type I
No nerve injury
CRPS Type II
Nerve injury with high velocity
Newborn nociceptor system functional by what week old?
20-24 weeks gestation
Normal temperature range?
36.2-37.7 celsius or 97.2-99.9 F
Thermoregulation is controlled by the?
Hypothalamus
Benefits of FEVER
- aids infectious response
- Kills organisms
- Deprives bacteria of food
- decreases serum iron, zinc, and copper
- Promotes Lysosomal Breakdown and Autodestruction of cells
Older adults vs Children fever response?
Older adults- decreased or no response.
Child- higher temps than adults for minor infections, febrile seizures.
Fever of Unknown Origin (FUO) ?
Higher than 38C or 101F, undiagnosed after 3 days of hospital investigation.
41C or 105.8F =
Nerve Damage, Convulsions
43C or 109.4F =
Death
Therapeutic hyperthermia?
Medically induced, used to destroy pathologic microorganisms or tumor cells.
Accidental hyperthermia?
Heat cramps, heat exhaustion, heat stroke, malignant hyperthermia.
Prolonged vasodilation, profuse sweating. Dehydration, hypotension, decreased CO, tachycardia. Treatment is to stop activity, lie down and drink fluids.
Heat Exhaustion
Potentially lethal result of a breakdown in the overstressed thermoregulatory center. Cerebral edema, swollen dendrites, renal tubular necrosis. Treat with cool ice packs on body. Children more susceptible.
Heat Stroke
MH caused by ?
Volatile anesthetics and NMBA.
MH caused by excessive _____ release?
Calcium due to ryanodine receptor.
MH treatment drug?
Dantrolene 2.5mg/kg IV q6h
What is the major sleep center?
Hypothalamus
Two phases of sleep?
REM- 20-25%
NREM- 75-80%
What controls the timing of the sleep-wake cycle?
Suprachiasmatic nucleus (SCN)
What neuropeptides promote wakefulness and REM sleep?
Hypocreatins
What EEG stage is Light sleep, 3-8% of time?
N1
What EEG stage is longest stage, 45-55% of sleep time?
N2
What EEG stage is slow wave sleep, 15-20% of sleep time?
N3
REM sleep or paradoxic sleep?
Dreams, controlled by hypothalamus, occurs every 90 mins beginning after 1-2 hours of sleep.
Meissner and Pacinian corpuscles sense?
light touch and pressure.
Merkel disks and Ruffini endings sense?
touch, sustained pressure and temperature.
What is responsible for equilibrium and maintaining balance?
The inner ear.
CN I and V sense what?
Olfaction or smell
CN VII and IX sense what?
Taste
RYR1 mutation
Encodes a protein that regulates calcium movement. MH is caused by reduction in the reuptake of Ca.
Which drugs increase MH?
Volatile anesthetics and NMBA (Succ)
Late signs of MH?
Extreme hyperthermia
Acidosis
Rhabdomyolysis
Most common cause of death from MH?
V-fib
Thalamus, cortex and post central gyrus do what?
Perceive, describe and localize pain
Reticular formation and limbic system do what?
Control emotional and affective response to pain.
Pain excitatory neurotransmitters?
Glutamate, aspartate
Intense pain at one location may cause an increase in pain threshold in another location?
Perceptual dominance
Pain in an area is removed or distant from its point of origin, can be acute or chronic?
Referred pain
