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Ane Class Practice > Patho Exam 2- S3 > Flashcards

Patho Exam 2- S3 Flashcards

1
Q

Central Nervous System contains what?

A

Brain and Spinal Cord

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2
Q

Peripheral Nervous System contains what?

A

Cranial nerves
Spinal Nerves
Pathways (Afferent/Efferent)

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3
Q

Afferent Pathway?

A

Ascending: Sensory to Spinal Column

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4
Q

Efferent Pathway?

A

Descending: Innervate effector organs

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5
Q

Peripheral Nervous System Contains what?

A

Somatic Nervous System
and
Autonomic Nervous System

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6
Q

Somatic Nervous System?

A

Regulate voluntary control of Skeletal Muscle.

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7
Q

Autonomic Nervous System does what?

A

Regulate the body’s internal environment through involuntary control of organ systems.
-Sympathetic
-Parasympathetic

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8
Q

What is a Neuron?

A

Information and Communication Cell
Variable in size and structure throughout.

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9
Q

What are the Cellular constituents of a Neuron?

A

Microtubules
Neurofibrils
NIssl substances

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10
Q

Microtubules?

A

Transportation

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11
Q

Neurofibrils?

A

Structural Support

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12
Q

Nissl Substances?

A

protein synthesis

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13
Q

3 Primary components of a Neuron?

A

Cell Body
Dendrites
Axons

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14
Q

Cell Body (Soma)

A

Located mainly in CNS
Nuclei- densely packed cell bodies in CNS.
Ganglia/Plexuses- groups of cell bodies in PNS.

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15
Q

What are Ganglia/plexuses and where found?

A

Groups of cell bodies in PNS

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16
Q

Receptor portion of the neuron that sends impulses to the cell body?

A

Dendrites

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17
Q

Dendritic Zone?

A

Receptive portion of the neuron that receives a stimulus and continues conduction.

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18
Q

What carries nerve impulses away from the Cell Body?

A

Axons

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19
Q

Axon Hillock?

A

Where the axon leaves the cell body

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20
Q

Bundled groups of axons?

A

Fascicles

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21
Q

Myelin Sheath?

A

Entire membrane of insulating lipid material. Formed and maintained by Schwann Cells.

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22
Q

What forms the Myelin Sheath?

A

Schwann Cells

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23
Q

What is the delicate layer of connective tissue around each Axon?

A

Endoneurium

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24
Q

What is the thin membrane between the myelin sheath and the endoneurium?

A

Neurilemma (Schwann Sheath)

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25
Q

Order of Neuron insulation?

A
  1. Myelin sheath
  2. Neurolemma
  3. Endoneurium
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26
Q

Regular interruptions of the myelin sheath are called?

A

Nodes of Ranvier

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27
Q

Saltatory Conduction?

A

Faster transmission by allowing ions to flow between segments of myelin.

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28
Q

Ability of branching axons to influence many neurons?

A

Divergence

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29
Q

Branches of numerous neurons converging on one or a few neurons?

A

Convergence

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30
Q

Most common Neuron Structure?

A

Multipolar

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31
Q

What neurons are transmitted via Afferent pathway?

A

Sensory Neurons

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32
Q

What neurons are transmitted via Efferent pathway?

A

Motor Neurons

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33
Q

What neurons transmit impulses from peripheral receptors to the CNS

A

Sensory Neurons via Afferent pathway

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34
Q

What neurons transmit impulses from CNS to organs.

A

Motor Neurons via efferent pathway

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35
Q

What transmits impulses from neuron to neuron?

A

Interneurons

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36
Q

What Neuroglia are in the PNS?

A

Satellite Cells
and
Schwann Cells

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37
Q

What Neuroglia are in the CNS?

A

Astrocytes
Oligodendroglia
Microglia
Ependymal cells

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38
Q

Which fill the spaces between neurons and surround the blood vessels in the CNS?

A

Astrocytes

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39
Q

Which deposit myelin within the CNS?

A

Oligodendrocytes

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40
Q

Which remove debris in the CNS?

A

Microglia

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41
Q

Which line the CSF filled cavities of the CNS?

A

Ependymal Cells

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42
Q

Which surround neuron cell bodies in the ganglia and regulate O2/CO2 and neurotransmitter levels?

A

Satellite Cells

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43
Q

Which surround axons in the PNS and responsible for the myelination of peripheral axons?

A

Schwann Cells

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44
Q

Also called Neurolemmocytes?

A

Schwann Cells

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45
Q

What are glial cells that wrap around and cover axons in the PNS?

A

Schwann Cells

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46
Q

What forms the myelin Sheath?

A

Schwann Cells

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47
Q

Schwann cells increase what?

A

Conduction velocity

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48
Q

Wallerian degeneration

A

Occurs distal to cut
Myelin sheath shrinks/disintegrates
Axon portion degenerates

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49
Q

Proximal end of injured neuron?

A
  1. Dispersal of Nissl substance for protein synthesis.
  2. Increase metabolic and mitochondrial activity.
  3. New terminal sprouts
  4. Limited to myelinated axons only in PNS.
  5. Regeneration
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50
Q

The release of neurotransmitters causes what?

A

Electrical and chemical impulses to influence nearby neurons.

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51
Q

All or None response?

A

Action potential response only occurs when the stimulus is strong enough.

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52
Q

What are the regions between adjacent neurons called?

A

Synapses

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53
Q

Impulses are transmitted across _____ by chemical and electrical conduction?

A

Synapses

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54
Q

Axoaxonic synapse?

A

between axons

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55
Q

Axosomatic synapse?

A

axon to cell body

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56
Q

Axodendritic synpase?

A

axon to dendrite

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57
Q

Dendrodendritic synapse?

A

dendrite to dendrite

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58
Q

Neurotransmitters are formed where?

A

in the Neuron

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59
Q

Impulses are transmitted by?

A

Neurotransmitters

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60
Q

Where are neurotransmitters stored?

A

Synaptic knob or bouton

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61
Q

Where are Neurotransmitters released?

A

Across the Synaptic Cleft (space between neurons)

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62
Q

Excitatory postsynaptic potentials are?

A

Depolarized

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63
Q

Inhibited postsynaptic potentials are?

A

Hyperpolarized

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64
Q

What determines whether an action potential occurs?

A

Summation

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65
Q

3 Major division of the Brain?

A
  1. Forebrain
  2. Midbrain
  3. Hindbrain
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66
Q

Forebrain contains?

A

Two cerebral hemispheres

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67
Q

Midbrain contains?

A

Corpora quadrigemina, tegmentum, cerebral peduncles

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68
Q

Hindbrain contains?

A

Cerebellum, pons, medulla

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69
Q

Midbrain, medulla, and pons makeup the _____?

A

Brainstem

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70
Q

A network of connected nuclei that regulate vital reflexes such as cardiovascular and respiratory function is?

A

Reticular Formation

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71
Q

What maintains wakefulness?

A

Reticular Formation

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72
Q

The reticular formation and Cerebral cortex are known as the ?

A

Reticular-activating system

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73
Q

The cerebrum, cerebral cortex and basal ganglia makeup what?

A

Forebrain

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74
Q

Gray matter (nuclei) and white matter (numerous tracts) are found where?

A

Forebrain

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75
Q

Goal-oriented behavior, short-term or recall memory is found where?

A

Prefrontal
(Frontal Lobe)

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76
Q

Programs motor movement, basal ganglia and extrapyramidal system are found where?

A

Premotor
(Frontal Lobe)

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77
Q

Primary voluntary motor is referred to as what?

A

Homunculus (Little man)

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78
Q

Is the primary motor area ipsolateral or contralateral movement?

A

Contralateral

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79
Q

Broca speech area controls what?

A

Motor aspect of speech
Found in Frontal Lobe

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80
Q

Which lobe is responsible for somatic sensory input?

A

Parietal lobe

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81
Q

Which lobe is responsible for visual cortex? (vision)

A

Occipital lobe

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82
Q

Which lobe is the primary auditory cortex and responsible for long term memory and reception of speech(wernicke area)?

A

Temporal Lobe

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83
Q

Wernicke area does what?

A

Reception and interpretation of speech.
Found in Temporal Lobe

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84
Q

What connects the two cerebral hemispheres?

A

Corpus Callosum
(commissural fibers)

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85
Q

What controls behavioral responses, emotion, feeding, smell, memory consolidation, and biologic rhythms?

A

Limbic System

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86
Q

What controls the expression of affect (emotional and behavioral states)?

A

Limbic system and prefrontal cortex

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87
Q

Substantia Nigra in the tegmentum does what?

A

Synthesizes dopamine

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88
Q

Cerebral aqueduct (aqueduct of sylvius) does what?

A

Carries CSF

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89
Q

Hindbrain consists of what?

A

Cerebellum
Pons
Medulla

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90
Q

What maintains balance and posture?

A

Cerebellum

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91
Q

Damage to the cerebellum would result in what loss of equilibrium, balance and motor coordination?
(Contralateral or Ipsilateral)

A

Ipsilateral or same side

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92
Q

What controls respirations?

A

Pons

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93
Q

What controls heart rate, respiration, blood pressure, coughing, sneezing, swallowing and vomiting?

A

Medulla oblongata (myelencecephalon)

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94
Q

The end of spinal cord is where?

A

L1-L2

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95
Q

The end of the spinal cord is called what?

A

Conus Medullaris

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96
Q

Nerve bundle at the end of the spinal cord?

A

Cauda equina

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97
Q

How many nerves are in the spinal cord?

A

31pairs

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98
Q

How many nerves are in the?

Cervical
Thoracic
Lumbar
Sacral
Coccygeal

A

C-8
T-12
L-5
S-5
C-1

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99
Q

Which horn is pain transmitting?

A

Dorsal horn

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100
Q

Which horn is composed primarily of interneurons and axons from sensory neurons whose lie in the dorsal root ganglion?

A

Posterior or dorsal horn

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101
Q

Which horn contains cell bodies involved with the ANS?

A

Lateral Horn

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102
Q

Which horn contains nerve cell bodies for efferent pathways?

A

Anterior or ventral horn

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103
Q

Substantia gelatinosa?

A

Pain transmission
Located Lamina II

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104
Q

Substantia gelatinosa is where?

A

Lamina II in the Dorsal horn
pain transmission

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105
Q

Label (sensory or motor)function?

Posterior/dorsal horn?
Lateral Horn?
Anterior/ventral horn?

A

Dorsal horn- sensory

lateral horn- motor

Ventral horn- motor

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106
Q

Horns are
(White or Gray)

A

Gray

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107
Q

Columns are
(White or Gray)

A

White

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108
Q

White matter forms ascending and descending pathways where?

A

Spinothalamic tract

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109
Q

Motor effects from the _____ generally occur before the perception of the event in the higher centers of the brain?

A

Reflex arc

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110
Q

Motor pathways are completely in the CNS, efferent pathways relay information from the cerebrum to the brainstem.
Destruction = partial recovery?

A

Upper motor neurons (Corticospinal tract)

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111
Q

Destruction of these neurons = partial recovery?

A

Upper motor neurons

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112
Q

These neurons have direct influence on muscles and destruction = permanent paralysis?

A

Lower motor neurons

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113
Q

Destruction of these neurons = permanent paralysis?

A

Lower motor neurons

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114
Q

Anterior spinothalamic tract senses what?

A

Vague touch

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115
Q

Lateral spinothalamic tract senses what?

A

Pain and temperature

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116
Q

Posterior (dorsal) column senses what?

A

Fine touch
two point discrimination
proprioception

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117
Q

What space reduces pressure in the cranium?

A

Subgaleal space

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118
Q

Cranium consists of how many bones?

A

8 bones

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119
Q

Meninges layer order?

A
  1. Periosteum
  2. Meningeal. Both 1&2 belong to Dura
  3. Arachnoid
  4. Pia
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120
Q

Outter most layer of meninges?

A

Dura mater which consists of periosteum and meningeal

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121
Q

Inner most layer of meninges?

A

Pia matter

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122
Q

What space is located between the dura and arachnoid matter?

A

Subdural

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123
Q

What space is between the arachnoid and pia matter and contains CSF?

A

Subarachnoid

124
Q

What space is located between the dura mater and skull/bone?

A

Epidural

125
Q

Spinals are done in which space?

A

Subarachnoid space (intrathecal)

126
Q

What is the order of spaces for blocks? from outer to inner

A
  1. Epidural
  2. Subdural
  3. Subarachnoid
127
Q

CSF should not contain what?

A

no WBCs

128
Q

CSF is produced by what?

A

The choroid plexuses in the lateral, third and fourth ventricles.

129
Q

CSF is reabsorbed through what?

A

Arachnoid villi

130
Q

How many vertebrae are there?

A

33

131
Q

How many vertebrae in each?

Cervical
Thoracic
Lumbar
Sacral
Coccygeal

A

C-7
T-12
L-5
S-5
C-4

132
Q

What is the primary regulator for CNS blood flow?

A

Carbon dioxide CO2

133
Q

What vessel supplies the greatest amount of blood flow to the brain?

A

Internal carotid

134
Q

Artery of Adamkiewitz?

A

only major arterial supply to the anterior spinal artery along the lower thoracic, lumbar and sacral segments of the spinal cord.

135
Q

The 31 spinal nerves arise from the what?

A

Anterior and posterior horn cells of the spinal cord

136
Q

How many cranial nerves are there?

A

12 pairs

137
Q

The 12 pairs of cranial nerves arise from where?

A

Brain and brainstem

138
Q

A network of nerve fibers are called what?

A

Plexuses

139
Q

What maintains a steady state among visceral organs in the body?

A

Autonomic Nervous System

140
Q

Preganglionic neurons are?
(Myelinated or unmeylinated)?

A

Myelinated

141
Q

Postganglionic neurons are?
(Myelinated or unmeylinated)?

A

Unmyelinated

142
Q

2 Division of the Autonomic nervous system are?

A

Sympathetic
Parasympathetic

143
Q

Which system mobilizes energy storage in times of need and receives innervation from cell bodies in the Thoracolumar division?

A

Sympathetic (SNS)

144
Q

Which system releases epinephrine (vasodilation) and norepinephrine (vasoconstriction)?

A

Sympathetic (SNS)

145
Q

Which system functions to conserve and restore energy?

A

Parasympathetic (PNS)

146
Q

Which system receives innervation from cell bodies in the craniosacral division?

A

Parasympathetic (PNS)

147
Q

Sympathetic PRE-ganglionic fibers
Neurotransmitter?
Receptor?

A

Acetylcholine

Cholinergic

148
Q

Sympathetic Post-ganglionic fibers
Neurotransmitter?
Receptor?

A

Norepinephrine

Adrenergic

149
Q

Parasympathetic pre and postganglionic fibers
Neurotransmitter?
Receptor?

A

Acetylcholine

Cholinergic

150
Q

Alpha-1 adrenergic receptor?

A

Excitation or stimulation
Most common

151
Q

Alpha-2 adrenergic receptor?

A

Relaxation or inhibition

152
Q

Beta-1 adrenergic receptor?

A

Increase HR and Contractility
Release of Renin in kidneys

153
Q

Beta-2 adrenergic receptor?

A

Facilitates all other beta-adrenergic receptors.

154
Q

Beta-3 adrenergic receptor?

A

Mediates lipolysis and thermogenesis
It is upregulated in CAD

155
Q

Decreased peristalsis
Increased blood sugar
Increased temperature
Increased blood pressure
Vasomotor tone

What stimulation?

A

Sympathetic nervous system stimulation

156
Q

Promotes rest and tranquility
Reduced heart rate
Enhanced digestion
Pupil constriction
Tear secretion
Increased salivation
Contracted urinary bladder

What stimulation?

A

Parasympathetic nervous system stimulation

157
Q

Most accepted theory of pain?

A

Gate Control Theory

158
Q

Pain is modulated by a “gate” in the cells of the _____ in the spinal cord?

A

Substantia Gelatinosa

159
Q

A-delta fibers are ?

A

Large and myelinated
Acute

160
Q

C fibers are?

A

Small and unmyelinated
Chronic

161
Q

Which fibers “close” the gate?

A

Larger A-beta fibers

162
Q

When there is no stimulation gates are?

A

Closed

163
Q

Large diameter fibers ____ the gate?

A

Close

164
Q

Small diameter fibers ____ the gate?

A

Open

165
Q

Which theory illustrates the plasticity and produces patterns of pain, but with independent stimuli?

A

Neuromatrix theory

166
Q

These pathways begin in the PNS and travel to the spinal gate in the dorsal horn up to the CNS?

A

Afferent pathways

167
Q

These pathways descend from the CNS back to the dorsal horn of the spinal cord and modulate pain?

A

Efferent pathways

168
Q
  1. Site of injury
  2. Spinal Cord
  3. Brainstem
  4. Cerebrum
A

Pain pathway

169
Q

Which sensation?
Noxious pain
High Threshold
Conducted by smaller myelinated A-delta and unmyelinated C nerve fibers?

A

Protopathic

170
Q

Protopathic sensation?

A

Noxious pain
high threshold
Small and large nerve fibers

171
Q

Which sensation?
Non-noxious
Light touch, pressure, proprioception, temperature
Low threshold
Conducted by Large myelinated nerve fibers?

A

Epicritic Sensation

172
Q

Epicritic Sensation

A

nonnoxious
light touch, temperature. proprioception
low threshold
large myelinated

173
Q

Which requires more intense stimulation for an action potential?
(Protopathic or Epicritic)

A

Protopathic

174
Q

Which sensation is more precise and more sensitive?
(Protopathic or Epicritic)

A

Epicritic

175
Q

Allodynia

A

Perception of an ordinarily nonnoxious stimulus as pain

176
Q

Abscense of all sensation is?

A

Anesthesia

177
Q

Bone/Muscle/Visceral caused by activation or sensitization of peripheral nociceptors is what?

  1. Nociceptive
  2. Neuropathic
  3. Psychogenic
A
  1. Nociceptive
178
Q

Burning/tingling/pins/needles sensation caused by injury or abnormalities is what?

  1. Nociceptive
  2. Neuropathic
  3. Psychogenic
A
  1. Neuropathic
179
Q

Psychological mechanism or environmental factors. Produce chronic pain is what?

  1. Nociceptive
  2. Neuropathic
  3. Psychogenic
A
  1. Psychogenic
180
Q

What are the four phases or processes of pain?

A
  1. Transduction
  2. Transmission
  3. Perception/Interpretation
  4. Modulation
181
Q

Transduction?

A

Begins when tissue is damaged by exposure to chemical, mechanical or thermal noxious stimuli.

(local anesthesia can block this)

182
Q

Transmission?

A

Conduction of pain impulses along the A and C fibers into the dorsal horn of spinal cord.

183
Q

Perception/Interpretation?

A

Conscious awareness of pain.

184
Q

Modulation?

A

Physiologic process of suppressing or facilitating pain. Convergence on spinal dorsal horn.

185
Q

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?

A

Transduction

186
Q

In which phase is the impulse carried throughout the nervous system?

A

Transmission

187
Q

What is the most important pathway for transmission?

A

Spinothalamic Tract

188
Q

In which phase is the subjective interpretation of pain or “how it feels to the patient”?

A

Perception or interpretation

189
Q

In which phase is the pain either suppressed or aggravated by release of mediators and chemical messages?

A

Modulation

190
Q

Prostaglandins
histamine
bradykinin
serotonin
acetycholine
lactic acid
hydrogen ions
potassium ions

are what?

A

Endogenous mediators of inflammation

191
Q

Prostaglandins are ?

A

1.Potent Vasodilators
2. cause increased permeability of blood vessels
3. intensify effects of histamine, serotonin, and bradykinins

192
Q

What is produced following tissue damage?

A

Prostaglandins

193
Q

Which enzyme is stimulated by tissue damage?

A

Phospholipase A2 enzyme

194
Q

Activation of phospholipase A2 causes the release of arachidonic acid which leads to what two enzyme reactions?

A

Cyclooxygenase and Lipoxygenase

195
Q

Cyclooxygenase converts arachidonic acid to ______ and ______ which potentiates the edema from bradykinin?

A

Prostaglandins and Prostacyclins

196
Q

What inhibits the action of Cyclooxygenase?

A

ASA, NSAIDS and COX inhibitors

197
Q

Lipoxygenase pathway converts arachidonic acid to ______ which increases vascular permeability and releases leukocytes?

A

Leukotrienes

198
Q

What are the 3 major functions of the Spinal cord?

A
  1. Conduit for Ventral (motor) information which travels down.
  2. Conduit for Dorsal (sensory) information that travels up.
  3. Center for coordinating reflexes
199
Q

The ventral (motor) and Dorsal (sensory) roots combine to form what on each side of the spinal cord?

A

Spinal nerves

200
Q

Pain is conducted along which 3 neuron pathways?

A
  1. First-order neurons in dorsal root
  2. Second-order neurons in dorsal horn
  3. Third-order neurons in inner chamber of thalamus
201
Q

First order neurons are located where?

A

Dorsal root ganglia

202
Q

Second order neurons are located where?

A

Dorsal horn

203
Q

Third order neurons are located where?

A

Inner chamber of the thalamus

204
Q

What are bare nerve endings in the skin, muscles joints, arteries and viscera that respond to chemical, mechanical and thermal stimuli?

A

Nociceptors
(primary order neurons)

205
Q

Myelinated A-delta fibers

Transmission is_____?

Pain is described as_____?

A

Fast

mechanical, thermal, sharp, and localized pain.

206
Q

Unmyelinated C fibers

Transmission is_____?

Pain is described as_____?

A

Slow

Burning and aching sensation.

207
Q

Both Myelinated A-delta fibers and Unmyelinated C fibers terminate on?

A

Second order neurons

208
Q

Are Nociceptors Afferent or Efferent nerve endings?

A

Afferent

209
Q

Afferent ______?

A

Ascending
or
Arrives

210
Q

Efferent______?

A

Exits
(Away)

211
Q

What responds to mechanical stimulation such as pressure, vibration or movement?

A

Mechanonociceptors

212
Q

What type of receptors responds to inflammation?

A

Silent Nociceptors

213
Q

What responds to excessive pressure, excessive temperature and alogens(chemical) ?

A

Polymodal mechanoheat nociceptors (Thermoreceptors)

214
Q

Most prevalent type of nociceptor?

A

Polymodal mechanoheat nociceptors

215
Q

Which nociceptors are located in the Epidermis?

A

Meissner corpuscles (touch)

216
Q

Which nociceptors are located in the Dermis?

A

Merkel cell neurite (touch)
Ruffini endings (heat)

217
Q

Which nociceptors are located in the subcutis(layer beneath the dermis)?

A

Pacinian corpuscles (pressure)

218
Q

Kinesthetic receptors sense what?

A

Where limbs are located in space and movement

219
Q

Muscle spindles are sensory receptors that sense tension

A

Muscle memory?

220
Q

First Order Neurons are located in the ?

A

Dorsal root ganglia

Sensory is Afferent is Dorsal= SAD

221
Q

SAD means?????

A

Sensory is Afferent is Dorsal

222
Q

Why might patients still have pain after a rhizotomy?

A

Some unmeylinated fibers enter spinal cord via ventral root (40%) instead of dorsal root

223
Q

What procedure is used in children to relieve symptoms of Cerebral palsy?

A

Rhizotomy, severs problematic nerve roots in the spinal cord

224
Q

What is a rhizotomy used for with adult patients?

A

Treat chronic back pain, degenerative disc disease or sciatica

225
Q

Which order neurons function as a pain gate and regulate pain transmission?

A

Second order neurons in the dorsal horn

226
Q

First-order neurons synapse with second-order neurons in the ____ of the dorsal horn?

A

Gray matter

227
Q

The spinal cord gray matter is divided into how many lamina?

A

10

228
Q

Lamina 1-6 make up the _____ and are where all afferent stimuli come from the spinal cord?

A

Dorsal horn

229
Q

Lamina 1-6 represent the principle site of ____?

A

Modulation of pain

230
Q

The substantia Gelatinosa is what laminae?

A

Laminae II
2

231
Q

Which is the major site of action for opiods?

A

Laminae II or Substantia Gelatinosa

232
Q

The substantia Gelatinosa is the major site of action for?

A

Opiods

233
Q

Lamina III, IV and VI do what?

A

Receive non-nociceptive sensory input

234
Q

Lamina VII does what?

A

The intermediiolateral column, contains preganglionic sympathetic neurons

235
Q

Lamina VIII and IX do what?

A

Anterior horn, MOTOR

236
Q

Lamina X?

A

Very small, involved in pain, temperature and visceral sensations

237
Q

Third order neurons are?

A

Afferent neurons that carry information to the sensory cortex and limbic systems to process and interpret pain.

238
Q

Second order neurons synapse with third order neurons in the ?

A

Thalamus

239
Q

Somatosensory areas are responsible for___ _____?

A

Evoked potentials or electrical signals generated

240
Q

SSEPs or Somatosensory evoked potentials purpose is to?

A

Evaluate the integrity of the brain and spinal cord ascending pathways.

241
Q

Segmental inhibition does what?

A

Closes the gate

Low threshold mechanical information, touch, vibration, pressure

242
Q

All pathways of modulation converge on the?

A

Spinal dorsal horns

243
Q

Segmental inhibition
Descending modulation of pain
Diffuse noxious inhibitory controls
Expectancy related cortical activation

are all pathways of what?

A

Modulation

244
Q

Thalamus, cortex and postcentral gyrus are responsible for what with pain?

A

Perceiving, describing, and localizing pain.

245
Q

What controls the emotional and affective responses to pain?

A

Reticular formation and Limbic system

246
Q

Glutamate and Aspartate are pain
(Excitatory or Inhibitory) ?

A

Excitatory

247
Q

Serotonin, GABA, glycine, endorphins, enkephalins are pain
(Excitatory or Inhibitory) ?

A

Inhibitory

248
Q

Allodynia is?

A

Normally nonpainful stimuli induces pain

249
Q

A normally nonpainful stimuli that induces pain is called?

A

Allodynia

250
Q

The point at which a stimulus is perceived as pain is the ?

A

Pain threshold

251
Q

The duration of time or intensity of pain will endure before a response is the ?

A

Pain tolerance

252
Q

Which varies greatly among people: pain threshold or pain tolerance?

A

Pain tolerance

253
Q

Pain with normal tissue injury from a known cause: Somatic and Visceral is?

A

Nociceptive pain

254
Q

Pain less than 3 months is?

A

Acute

255
Q

Neuropathic pain, peripheral and central is ?

A

Nonnociceptive pain

256
Q

Pain more than 3 months is ?

A

Chronic

257
Q

Which type of pain is a protective mechanism?

A

Acute, affects all body systems

258
Q

Which pain arises from connective tissue, muscle, bone and skin?

A

Acute Somatic

259
Q

Which pain arises from the internal organs and lining of body cavities and poorly localized?

A

Acute Visceral

260
Q

A-delta fibers pain is?

A

Acute, sharp, well localized

261
Q

C- fibers pain is?

A

Chronic, dull, aching, throbbing.

262
Q

Which pain leads to physiologic adaption of pulse and blood pressure?

A

Chronic

263
Q

Which neuropathic pain is caused by a lesion or dysfunction in the brain or spinal cord?

A

Central neuropathic pain

264
Q

Which Neuropathic pain syndrome results of lesions in the PNS?

A

Deafferentation pain syndrome

265
Q

Produces paralysis and a hypersensitivity or allodynia on one half of the body?

A

Hemiagnosia pain

266
Q

Phatom limb pain?

A

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

267
Q

CRPS Type I

A

No nerve injury

268
Q

CRPS Type II

A

Nerve injury with high velocity

269
Q

Newborn nociceptor system functional by what week old?

A

20-24 weeks gestation

270
Q

Normal temperature range?

A

36.2-37.7 celsius or 97.2-99.9 F

271
Q

Thermoregulation is controlled by the?

A

Hypothalamus

272
Q

Benefits of FEVER

A
  1. aids infectious response
  2. Kills organisms
  3. Deprives bacteria of food
  4. decreases serum iron, zinc, and copper
  5. Promotes Lysosomal Breakdown and Autodestruction of cells
273
Q

Older adults vs Children fever response?

A

Older adults- decreased or no response.

Child- higher temps than adults for minor infections, febrile seizures.

274
Q

Fever of Unknown Origin (FUO) ?

A

Higher than 38C or 101F, undiagnosed after 3 days of hospital investigation.

275
Q

41C or 105.8F =

A

Nerve Damage, Convulsions

276
Q

43C or 109.4F =

A

Death

277
Q

Therapeutic hyperthermia?

A

Medically induced, used to destroy pathologic microorganisms or tumor cells.

278
Q

Accidental hyperthermia?

A

Heat cramps, heat exhaustion, heat stroke, malignant hyperthermia.

279
Q

Prolonged vasodilation, profuse sweating. Dehydration, hypotension, decreased CO, tachycardia. Treatment is to stop activity, lie down and drink fluids.

A

Heat Exhaustion

280
Q

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.

A

Heat Stroke

281
Q

MH caused by ?

A

Volatile anesthetics and NMBA.

282
Q

MH caused by excessive _____ release?

A

Calcium due to ryanodine receptor.

283
Q

MH treatment drug?

A

Dantrolene 2.5mg/kg IV q6h

284
Q

What is the major sleep center?

A

Hypothalamus

285
Q

Two phases of sleep?

A

REM- 20-25%
NREM- 75-80%

286
Q

What controls the timing of the sleep-wake cycle?

A

Suprachiasmatic nucleus (SCN)

287
Q

What neuropeptides promote wakefulness and REM sleep?

A

Hypocreatins

288
Q

What EEG stage is Light sleep, 3-8% of time?

A

N1

289
Q

What EEG stage is longest stage, 45-55% of sleep time?

A

N2

290
Q

What EEG stage is slow wave sleep, 15-20% of sleep time?

A

N3

291
Q

REM sleep or paradoxic sleep?

A

Dreams, controlled by hypothalamus, occurs every 90 mins beginning after 1-2 hours of sleep.

292
Q

Meissner and Pacinian corpuscles sense?

A

light touch and pressure.

293
Q

Merkel disks and Ruffini endings sense?

A

touch, sustained pressure and temperature.

294
Q

What is responsible for equilibrium and maintaining balance?

A

The inner ear.

295
Q

CN I and V sense what?

A

Olfaction or smell

296
Q

CN VII and IX sense what?

A

Taste

297
Q

RYR1 mutation

A

Encodes a protein that regulates calcium movement. MH is caused by reduction in the reuptake of Ca.

298
Q

Which drugs increase MH?

A

Volatile anesthetics and NMBA (Succ)

299
Q

Late signs of MH?

A

Extreme hyperthermia
Acidosis
Rhabdomyolysis

300
Q

Most common cause of death from MH?

A

V-fib

301
Q

Thalamus, cortex and post central gyrus do what?

A

Perceive, describe and localize pain

302
Q

Reticular formation and limbic system do what?

A

Control emotional and affective response to pain.

303
Q

Pain excitatory neurotransmitters?

A

Glutamate, aspartate

304
Q

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

A

Perceptual dominance

305
Q

Pain in an area is removed or distant from its point of origin, can be acute or chronic?

A

Referred pain

Ane Class Practice (26 decks)

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