Patho Exam 2- S3 Flashcards
1
Q
Central Nervous System contains what?
A
Brain and Spinal Cord
2
Q
Peripheral Nervous System contains what?
A
Cranial nerves
Spinal Nerves
Pathways (Afferent/Efferent)
3
Q
Afferent Pathway?
A
Ascending: Sensory to Spinal Column
4
Q
Efferent Pathway?
A
Descending: Innervate effector organs
5
Q
Peripheral Nervous System Contains what?
A
Somatic Nervous System
and
Autonomic Nervous System
6
Q
Somatic Nervous System?
A
Regulate voluntary control of Skeletal Muscle.
7
Q
Autonomic Nervous System does what?
A
Regulate the body’s internal environment through involuntary control of organ systems.
-Sympathetic
-Parasympathetic
8
Q
What is a Neuron?
A
Information and Communication Cell
Variable in size and structure throughout.
9
Q
What are the Cellular constituents of a Neuron?
A
Microtubules
Neurofibrils
NIssl substances
10
Q
Microtubules?
A
Transportation
11
Q
Neurofibrils?
A
Structural Support
12
Q
Nissl Substances?
A
protein synthesis
13
Q
3 Primary components of a Neuron?
A
Cell Body
Dendrites
Axons
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.
15
Q
What are Ganglia/plexuses and where found?
A
Groups of cell bodies in PNS
16
Q
Receptor portion of the neuron that sends impulses to the cell body?
A
Dendrites
17
Q
Dendritic Zone?
A
Receptive portion of the neuron that receives a stimulus and continues conduction.
18
Q
What carries nerve impulses away from the Cell Body?
A
Axons
19
Q
Axon Hillock?
A
Where the axon leaves the cell body
20
Q
Bundled groups of axons?
A
Fascicles
21
Q
Myelin Sheath?
A
Entire membrane of insulating lipid material. Formed and maintained by Schwann Cells.
22
Q
What forms the Myelin Sheath?
A
Schwann Cells
23
Q
What is the delicate layer of connective tissue around each Axon?
A
Endoneurium
24
Q
What is the thin membrane between the myelin sheath and the endoneurium?
A
Neurilemma (Schwann Sheath)
25
Order of Neuron insulation?
1. Myelin sheath
2. Neurolemma
3. Endoneurium
26
Regular interruptions of the myelin sheath are called?
Nodes of Ranvier
27
Saltatory Conduction?
Faster transmission by allowing ions to flow between segments of myelin.
28
Ability of branching axons to influence many neurons?
Divergence
29
Branches of numerous neurons converging on one or a few neurons?
Convergence
30
Most common Neuron Structure?
Multipolar
31
What neurons are transmitted via Afferent pathway?
Sensory Neurons
32
What neurons are transmitted via Efferent pathway?
Motor Neurons
33
What neurons transmit impulses from peripheral receptors to the CNS
Sensory Neurons via Afferent pathway
34
What neurons transmit impulses from CNS to organs.
Motor Neurons via efferent pathway
35
What transmits impulses from neuron to neuron?
Interneurons
36
What Neuroglia are in the PNS?
Satellite Cells
and
Schwann Cells
37
What Neuroglia are in the CNS?
Astrocytes
Oligodendroglia
Microglia
Ependymal cells
38
Which fill the spaces between neurons and surround the blood vessels in the CNS?
Astrocytes
39
Which deposit myelin within the CNS?
Oligodendrocytes
40
Which remove debris in the CNS?
Microglia
41
Which line the CSF filled cavities of the CNS?
Ependymal Cells
42
Which surround neuron cell bodies in the ganglia and regulate O2/CO2 and neurotransmitter levels?
Satellite Cells
43
Which surround axons in the PNS and responsible for the myelination of peripheral axons?
Schwann Cells
44
Also called Neurolemmocytes?
Schwann Cells
45
What are glial cells that wrap around and cover axons in the PNS?
Schwann Cells
46
What forms the myelin Sheath?
Schwann Cells
47
Schwann cells increase what?
Conduction velocity
48
Wallerian degeneration
Occurs distal to cut
Myelin sheath shrinks/disintegrates
Axon portion degenerates
49
Proximal end of injured neuron?
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
50
The release of neurotransmitters causes what?
Electrical and chemical impulses to influence nearby neurons.
51
All or None response?
Action potential response only occurs when the stimulus is strong enough.
52
What are the regions between adjacent neurons called?
Synapses
53
Impulses are transmitted across _____ by chemical and electrical conduction?
Synapses
54
Axoaxonic synapse?
between axons
55
Axosomatic synapse?
axon to cell body
56
Axodendritic synpase?
axon to dendrite
57
Dendrodendritic synapse?
dendrite to dendrite
58
Neurotransmitters are formed where?
in the Neuron
59
Impulses are transmitted by?
Neurotransmitters
60
Where are neurotransmitters stored?
Synaptic knob or bouton
61
Where are Neurotransmitters released?
Across the Synaptic Cleft (space between neurons)
62
Excitatory postsynaptic potentials are?
Depolarized
63
Inhibited postsynaptic potentials are?
Hyperpolarized
64
What determines whether an action potential occurs?
Summation
65
3 Major division of the Brain?
1. Forebrain
2. Midbrain
3. Hindbrain
66
Forebrain contains?
Two cerebral hemispheres
67
Midbrain contains?
Corpora quadrigemina, tegmentum, cerebral peduncles
68
Hindbrain contains?
Cerebellum, pons, medulla
69
Midbrain, medulla, and pons makeup the _____?
Brainstem
70
A network of connected nuclei that regulate vital reflexes such as cardiovascular and respiratory function is?
Reticular Formation
71
What maintains wakefulness?
Reticular Formation
72
The reticular formation and Cerebral cortex are known as the ?
Reticular-activating system
73
The cerebrum, cerebral cortex and basal ganglia makeup what?
Forebrain
74
Gray matter (nuclei) and white matter (numerous tracts) are found where?
Forebrain
75
Goal-oriented behavior, short-term or recall memory is found where?
Prefrontal
(Frontal Lobe)
76
Programs motor movement, basal ganglia and extrapyramidal system are found where?
Premotor
(Frontal Lobe)
77
Primary voluntary motor is referred to as what?
Homunculus (Little man)
78
Is the primary motor area ipsolateral or contralateral movement?
Contralateral
79
Broca speech area controls what?
Motor aspect of speech
Found in Frontal Lobe
80
Which lobe is responsible for somatic sensory input?
Parietal lobe
81
Which lobe is responsible for visual cortex? (vision)
Occipital lobe
82
Which lobe is the primary auditory cortex and responsible for long term memory and reception of speech(wernicke area)?
Temporal Lobe
83
Wernicke area does what?
Reception and interpretation of speech.
Found in Temporal Lobe
84
What connects the two cerebral hemispheres?
Corpus Callosum
(commissural fibers)
85
What controls behavioral responses, emotion, feeding, smell, memory consolidation, and biologic rhythms?
Limbic System
86
What controls the expression of affect (emotional and behavioral states)?
Limbic system and prefrontal cortex
87
Substantia Nigra in the tegmentum does what?
Synthesizes dopamine
88
Cerebral aqueduct (aqueduct of sylvius) does what?
Carries CSF
89
Hindbrain consists of what?
Cerebellum
Pons
Medulla
90
What maintains balance and posture?
Cerebellum
91
Damage to the cerebellum would result in what loss of equilibrium, balance and motor coordination?
(Contralateral or Ipsilateral)
Ipsilateral or same side
92
What controls respirations?
Pons
93
What controls heart rate, respiration, blood pressure, coughing, sneezing, swallowing and vomiting?
Medulla oblongata (myelencecephalon)
94
The end of spinal cord is where?
L1-L2
95
The end of the spinal cord is called what?
Conus Medullaris
96
Nerve bundle at the end of the spinal cord?
Cauda equina
97
How many nerves are in the spinal cord?
31pairs
98
How many nerves are in the?
Cervical
Thoracic
Lumbar
Sacral
Coccygeal
C-8
T-12
L-5
S-5
C-1
99
Which horn is pain transmitting?
Dorsal horn
100
Which horn is composed primarily of interneurons and axons from sensory neurons whose lie in the dorsal root ganglion?
Posterior or dorsal horn
101
Which horn contains cell bodies involved with the ANS?
Lateral Horn
102
Which horn contains nerve cell bodies for efferent pathways?
Anterior or ventral horn
103
Substantia gelatinosa?
Pain transmission
Located Lamina II
104
Substantia gelatinosa is where?
Lamina II in the Dorsal horn
pain transmission
105
Label (sensory or motor)function?
Posterior/dorsal horn?
Lateral Horn?
Anterior/ventral horn?
Dorsal horn- sensory
lateral horn- motor
Ventral horn- motor
106
Horns are
(White or Gray)
Gray
107
Columns are
(White or Gray)
White
108
White matter forms ascending and descending pathways where?
Spinothalamic tract
109
Motor effects from the _____ generally occur before the perception of the event in the higher centers of the brain?
Reflex arc
110
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)
111
Destruction of these neurons = partial recovery?
Upper motor neurons
112
These neurons have direct influence on muscles and destruction = permanent paralysis?
Lower motor neurons
113
Destruction of these neurons = permanent paralysis?
Lower motor neurons
114
Anterior spinothalamic tract senses what?
Vague touch
115
Lateral spinothalamic tract senses what?
Pain and temperature
116
Posterior (dorsal) column senses what?
Fine touch
two point discrimination
proprioception
117
What space reduces pressure in the cranium?
Subgaleal space
118
Cranium consists of how many bones?
8 bones
119
Meninges layer order?
1. Periosteum
2. Meningeal. Both 1&2 belong to Dura
3. Arachnoid
4. Pia
120
Outter most layer of meninges?
Dura mater which consists of periosteum and meningeal
121
Inner most layer of meninges?
Pia matter
122
What space is located between the dura and arachnoid matter?
Subdural
123
What space is between the arachnoid and pia matter and contains CSF?
Subarachnoid
124
What space is located between the dura mater and skull/bone?
Epidural
125
Spinals are done in which space?
Subarachnoid space (intrathecal)
126
What is the order of spaces for blocks? from outer to inner
1. Epidural
2. Subdural
3. Subarachnoid
127
CSF should not contain what?
no WBCs
128
CSF is produced by what?
The choroid plexuses in the lateral, third and fourth ventricles.
129
CSF is reabsorbed through what?
Arachnoid villi
130
How many vertebrae are there?
33
131
How many vertebrae in each?
Cervical
Thoracic
Lumbar
Sacral
Coccygeal
C-7
T-12
L-5
S-5
C-4
132
What is the primary regulator for CNS blood flow?
Carbon dioxide CO2
133
What vessel supplies the greatest amount of blood flow to the brain?
Internal carotid
134
Artery of Adamkiewitz?
only major arterial supply to the anterior spinal artery along the lower thoracic, lumbar and sacral segments of the spinal cord.
135
The 31 spinal nerves arise from the what?
Anterior and posterior horn cells of the spinal cord
136
How many cranial nerves are there?
12 pairs
137
The 12 pairs of cranial nerves arise from where?
Brain and brainstem
138
A network of nerve fibers are called what?
Plexuses
139
What maintains a steady state among visceral organs in the body?
Autonomic Nervous System
140
Preganglionic neurons are?
(Myelinated or unmeylinated)?
Myelinated
141
Postganglionic neurons are?
(Myelinated or unmeylinated)?
Unmyelinated
142
2 Division of the Autonomic nervous system are?
Sympathetic
Parasympathetic
143
Which system mobilizes energy storage in times of need and receives innervation from cell bodies in the Thoracolumar division?
Sympathetic (SNS)
144
Which system releases epinephrine (vasodilation) and norepinephrine (vasoconstriction)?
Sympathetic (SNS)
145
Which system functions to conserve and restore energy?
Parasympathetic (PNS)
146
Which system receives innervation from cell bodies in the craniosacral division?
Parasympathetic (PNS)
147
Sympathetic PRE-ganglionic fibers
Neurotransmitter?
Receptor?
Acetylcholine
Cholinergic
148
Sympathetic Post-ganglionic fibers
Neurotransmitter?
Receptor?
Norepinephrine
Adrenergic
149
Parasympathetic pre and postganglionic fibers
Neurotransmitter?
Receptor?
Acetylcholine
Cholinergic
150
Alpha-1 adrenergic receptor?
Excitation or stimulation
Most common
151
Alpha-2 adrenergic receptor?
Relaxation or inhibition
152
Beta-1 adrenergic receptor?
Increase HR and Contractility
Release of Renin in kidneys
153
Beta-2 adrenergic receptor?
Facilitates all other beta-adrenergic receptors.
154
Beta-3 adrenergic receptor?
Mediates lipolysis and thermogenesis
It is upregulated in CAD
155
Decreased peristalsis
Increased blood sugar
Increased temperature
Increased blood pressure
Vasomotor tone
What stimulation?
Sympathetic nervous system stimulation
156
Promotes rest and tranquility
Reduced heart rate
Enhanced digestion
Pupil constriction
Tear secretion
Increased salivation
Contracted urinary bladder
What stimulation?
Parasympathetic nervous system stimulation
157
Most accepted theory of pain?
Gate Control Theory
158
Pain is modulated by a "gate" in the cells of the _____ in the spinal cord?
Substantia Gelatinosa
159
A-delta fibers are ?
Large and myelinated
Acute
160
C fibers are?
Small and unmyelinated
Chronic
161
Which fibers "close" the gate?
Larger A-beta fibers
162
When there is no stimulation gates are?
Closed
163
Large diameter fibers ____ the gate?
Close
164
Small diameter fibers ____ the gate?
Open
165
Which theory illustrates the plasticity and produces patterns of pain, but with independent stimuli?
Neuromatrix theory
166
These pathways begin in the PNS and travel to the spinal gate in the dorsal horn up to the CNS?
Afferent pathways
167
These pathways descend from the CNS back to the dorsal horn of the spinal cord and modulate pain?
Efferent pathways
168
1. Site of injury
2. Spinal Cord
3. Brainstem
4. Cerebrum
Pain pathway
169
Which sensation?
Noxious pain
High Threshold
Conducted by smaller myelinated A-delta and unmyelinated C nerve fibers?
Protopathic
170
Protopathic sensation?
Noxious pain
high threshold
Small and large nerve fibers
171
Which sensation?
Non-noxious
Light touch, pressure, proprioception, temperature
Low threshold
Conducted by Large myelinated nerve fibers?
Epicritic Sensation
172
Epicritic Sensation
nonnoxious
light touch, temperature. proprioception
low threshold
large myelinated
173
Which requires more intense stimulation for an action potential?
(Protopathic or Epicritic)
Protopathic
174
Which sensation is more precise and more sensitive?
(Protopathic or Epicritic)
Epicritic
175
Allodynia
Perception of an ordinarily nonnoxious stimulus as pain
176
Abscense of all sensation is?
Anesthesia
177
Bone/Muscle/Visceral caused by activation or sensitization of peripheral nociceptors is what?
1. Nociceptive
2. Neuropathic
3. Psychogenic
1. Nociceptive
178
Burning/tingling/pins/needles sensation caused by injury or abnormalities is what?
1. Nociceptive
2. Neuropathic
3. Psychogenic
2. Neuropathic
179
Psychological mechanism or environmental factors. Produce chronic pain is what?
1. Nociceptive
2. Neuropathic
3. Psychogenic
3. Psychogenic
180
What are the four phases or processes of pain?
1. Transduction
2. Transmission
3. Perception/Interpretation
4. Modulation
181
Transduction?
Begins when tissue is damaged by exposure to chemical, mechanical or thermal noxious stimuli.
(local anesthesia can block this)
182
Transmission?
Conduction of pain impulses along the A and C fibers into the dorsal horn of spinal cord.
183
Perception/Interpretation?
Conscious awareness of pain.
184
Modulation?
Physiologic process of suppressing or facilitating pain. Convergence on spinal dorsal horn.
185
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
186
In which phase is the impulse carried throughout the nervous system?
Transmission
187
What is the most important pathway for transmission?
Spinothalamic Tract
188
In which phase is the subjective interpretation of pain or "how it feels to the patient"?
Perception or interpretation
189
In which phase is the pain either suppressed or aggravated by release of mediators and chemical messages?
Modulation
190
Prostaglandins
histamine
bradykinin
serotonin
acetycholine
lactic acid
hydrogen ions
potassium ions
are what?
Endogenous mediators of inflammation
191
Prostaglandins are ?
1.Potent Vasodilators
2. cause increased permeability of blood vessels
3. intensify effects of histamine, serotonin, and bradykinins
192
What is produced following tissue damage?
Prostaglandins
193
Which enzyme is stimulated by tissue damage?
Phospholipase A2 enzyme
194
Activation of phospholipase A2 causes the release of arachidonic acid which leads to what two enzyme reactions?
Cyclooxygenase and Lipoxygenase
195
Cyclooxygenase converts arachidonic acid to ______ and ______ which potentiates the edema from bradykinin?
Prostaglandins and Prostacyclins
196
What inhibits the action of Cyclooxygenase?
ASA, NSAIDS and COX inhibitors
197
Lipoxygenase pathway converts arachidonic acid to ______ which increases vascular permeability and releases leukocytes?
Leukotrienes
198
What are the 3 major functions of the Spinal cord?
1. Conduit for Ventral (motor) information which travels down.
2. Conduit for Dorsal (sensory) information that travels up.
3. Center for coordinating reflexes
199
The ventral (motor) and Dorsal (sensory) roots combine to form what on each side of the spinal cord?
Spinal nerves
200
Pain is conducted along which 3 neuron pathways?
1. First-order neurons in dorsal root
2. Second-order neurons in dorsal horn
3. Third-order neurons in inner chamber of thalamus
201
First order neurons are located where?
Dorsal root ganglia
202
Second order neurons are located where?
Dorsal horn
203
Third order neurons are located where?
Inner chamber of the thalamus
204
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)
205
Myelinated A-delta fibers
Transmission is_____?
Pain is described as_____?
Fast
mechanical, thermal, sharp, and localized pain.
206
Unmyelinated C fibers
Transmission is_____?
Pain is described as_____?
Slow
Burning and aching sensation.
207
Both Myelinated A-delta fibers and Unmyelinated C fibers terminate on?
Second order neurons
208
Are Nociceptors Afferent or Efferent nerve endings?
Afferent
209
Afferent ______?
Ascending
or
Arrives
210
Efferent______?
Exits
(Away)
211
What responds to mechanical stimulation such as pressure, vibration or movement?
Mechanonociceptors
212
What type of receptors responds to inflammation?
Silent Nociceptors
213
What responds to excessive pressure, excessive temperature and alogens(chemical) ?
Polymodal mechanoheat nociceptors (Thermoreceptors)
214
Most prevalent type of nociceptor?
Polymodal mechanoheat nociceptors
215
Which nociceptors are located in the Epidermis?
Meissner corpuscles (touch)
216
Which nociceptors are located in the Dermis?
Merkel cell neurite (touch)
Ruffini endings (heat)
217
Which nociceptors are located in the subcutis(layer beneath the dermis)?
Pacinian corpuscles (pressure)
218
Kinesthetic receptors sense what?
Where limbs are located in space and movement
219
Muscle spindles are sensory receptors that sense tension
Muscle memory?
220
First Order Neurons are located in the ?
Dorsal root ganglia
Sensory is Afferent is Dorsal= SAD
221
SAD means?????
Sensory is Afferent is Dorsal
222
Why might patients still have pain after a rhizotomy?
Some unmeylinated fibers enter spinal cord via ventral root (40%) instead of dorsal root
223
What procedure is used in children to relieve symptoms of Cerebral palsy?
Rhizotomy, severs problematic nerve roots in the spinal cord
224
What is a rhizotomy used for with adult patients?
Treat chronic back pain, degenerative disc disease or sciatica
225
Which order neurons function as a pain gate and regulate pain transmission?
Second order neurons in the dorsal horn
226
First-order neurons synapse with second-order neurons in the ____ of the dorsal horn?
Gray matter
227
The spinal cord gray matter is divided into how many lamina?
10
228
Lamina 1-6 make up the _____ and are where all afferent stimuli come from the spinal cord?
Dorsal horn
229
Lamina 1-6 represent the principle site of ____?
Modulation of pain
230
The substantia Gelatinosa is what laminae?
Laminae II
2
231
Which is the major site of action for opiods?
Laminae II or Substantia Gelatinosa
232
The substantia Gelatinosa is the major site of action for?
Opiods
233
Lamina III, IV and VI do what?
Receive non-nociceptive sensory input
234
Lamina VII does what?
The intermediiolateral column, contains preganglionic sympathetic neurons
235
Lamina VIII and IX do what?
Anterior horn, MOTOR
236
Lamina X?
Very small, involved in pain, temperature and visceral sensations
237
Third order neurons are?
Afferent neurons that carry information to the sensory cortex and limbic systems to process and interpret pain.
238
Second order neurons synapse with third order neurons in the ?
Thalamus
239
Somatosensory areas are responsible for___ _____?
Evoked potentials or electrical signals generated
240
SSEPs or Somatosensory evoked potentials purpose is to?
Evaluate the integrity of the brain and spinal cord ascending pathways.
241
Segmental inhibition does what?
Closes the gate
Low threshold mechanical information, touch, vibration, pressure
242
All pathways of modulation converge on the?
Spinal dorsal horns
243
Segmental inhibition
Descending modulation of pain
Diffuse noxious inhibitory controls
Expectancy related cortical activation
are all pathways of what?
Modulation
244
Thalamus, cortex and postcentral gyrus are responsible for what with pain?
Perceiving, describing, and localizing pain.
245
What controls the emotional and affective responses to pain?
Reticular formation and Limbic system
246
Glutamate and Aspartate are pain
(Excitatory or Inhibitory) ?
Excitatory
247
Serotonin, GABA, glycine, endorphins, enkephalins are pain
(Excitatory or Inhibitory) ?
Inhibitory
248
Allodynia is?
Normally nonpainful stimuli induces pain
249
A normally nonpainful stimuli that induces pain is called?
Allodynia
250
The point at which a stimulus is perceived as pain is the ?
Pain threshold
251
The duration of time or intensity of pain will endure before a response is the ?
Pain tolerance
252
Which varies greatly among people: pain threshold or pain tolerance?
Pain tolerance
253
Pain with normal tissue injury from a known cause: Somatic and Visceral is?
Nociceptive pain
254
Pain less than 3 months is?
Acute
255
Neuropathic pain, peripheral and central is ?
Nonnociceptive pain
256
Pain more than 3 months is ?
Chronic
257
Which type of pain is a protective mechanism?
Acute, affects all body systems
258
Which pain arises from connective tissue, muscle, bone and skin?
Acute Somatic
259
Which pain arises from the internal organs and lining of body cavities and poorly localized?
Acute Visceral
260
A-delta fibers pain is?
Acute, sharp, well localized
261
C- fibers pain is?
Chronic, dull, aching, throbbing.
262
Which pain leads to physiologic adaption of pulse and blood pressure?
Chronic
263
Which neuropathic pain is caused by a lesion or dysfunction in the brain or spinal cord?
Central neuropathic pain
264
Which Neuropathic pain syndrome results of lesions in the PNS?
Deafferentation pain syndrome
265
Produces paralysis and a hypersensitivity or allodynia on one half of the body?
Hemiagnosia pain
266
Phatom limb pain?
Pain is felt in an amputated limb after the stump has healed.
267
CRPS Type I
No nerve injury
268
CRPS Type II
Nerve injury with high velocity
269
Newborn nociceptor system functional by what week old?
20-24 weeks gestation
270
Normal temperature range?
36.2-37.7 celsius or 97.2-99.9 F
271
Thermoregulation is controlled by the?
Hypothalamus
272
Benefits of FEVER
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
Older adults vs Children fever response?
Older adults- decreased or no response.
Child- higher temps than adults for minor infections, febrile seizures.
274
Fever of Unknown Origin (FUO) ?
Higher than 38C or 101F, undiagnosed after 3 days of hospital investigation.
275
41C or 105.8F =
Nerve Damage, Convulsions
276
43C or 109.4F =
Death
277
Therapeutic hyperthermia?
Medically induced, used to destroy pathologic microorganisms or tumor cells.
278
Accidental hyperthermia?
Heat cramps, heat exhaustion, heat stroke, malignant hyperthermia.
279
Prolonged vasodilation, profuse sweating. Dehydration, hypotension, decreased CO, tachycardia. Treatment is to stop activity, lie down and drink fluids.
Heat Exhaustion
280
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
281
MH caused by ?
Volatile anesthetics and NMBA.
282
MH caused by excessive _____ release?
Calcium due to ryanodine receptor.
283
MH treatment drug?
Dantrolene 2.5mg/kg IV q6h
284
What is the major sleep center?
Hypothalamus
285
Two phases of sleep?
REM- 20-25%
NREM- 75-80%
286
What controls the timing of the sleep-wake cycle?
Suprachiasmatic nucleus (SCN)
287
What neuropeptides promote wakefulness and REM sleep?
Hypocreatins
288
What EEG stage is Light sleep, 3-8% of time?
N1
289
What EEG stage is longest stage, 45-55% of sleep time?
N2
290
What EEG stage is slow wave sleep, 15-20% of sleep time?
N3
291
REM sleep or paradoxic sleep?
Dreams, controlled by hypothalamus, occurs every 90 mins beginning after 1-2 hours of sleep.
292
Meissner and Pacinian corpuscles sense?
light touch and pressure.
293
Merkel disks and Ruffini endings sense?
touch, sustained pressure and temperature.
294
What is responsible for equilibrium and maintaining balance?
The inner ear.
295
CN I and V sense what?
Olfaction or smell
296
CN VII and IX sense what?
Taste
297
RYR1 mutation
Encodes a protein that regulates calcium movement. MH is caused by reduction in the reuptake of Ca.
298
Which drugs increase MH?
Volatile anesthetics and NMBA (Succ)
299
Late signs of MH?
Extreme hyperthermia
Acidosis
Rhabdomyolysis
300
Most common cause of death from MH?
V-fib
301
Thalamus, cortex and post central gyrus do what?
Perceive, describe and localize pain
302
Reticular formation and limbic system do what?
Control emotional and affective response to pain.
303
Pain excitatory neurotransmitters?
Glutamate, aspartate
304
Intense pain at one location may cause an increase in pain threshold in another location?
Perceptual dominance
305
Pain in an area is removed or distant from its point of origin, can be acute or chronic?
Referred pain
