Pulmonary/Pain Flashcards by Kristin Godsey

Airway disorder that is worse on expiration (more force is needed to expel the air out of the lungs)

obstructive pulmonary disorders

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examples of obstructive pulmonary disorders

asthma, chronic bronchitis, emphysema

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Clinical Manifestations of \_\_\_\_\_\_\_:
	Dyspnea
	Wheezing
	Work of breathing
	Ventilation/perfusion mismatch
	Decreased forced expiratory volume (FEV1)

obstructive pulmonary disorders

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most common cause for chronic bronchitis and emphysema; contributes to worsening asthma

Smoking

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chronic Inflammatory disorder of airways characterized by bronchial hyperresponsiveness and constriction with intermittent periods of reversible airflow obstruction “attacks” (rarely some degree of obstruction that is always present)

asthma

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Asthma is a _____ disorder

familial

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multiple allergens and microbes may play a role in ________

asthma

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theory of asthma cuase that states low exposure to microbes leads to increased development of asthma and atopic disorders; excessive cleanliness is thought to eliminate the microbial stimulation of the immune system that is needed to prevent atopic asthma

Hygiene Hypothesis

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Risk Factors for \_\_\_\_\_\_:
	Family history
	Allergen exposure
	Urban living (cockroach/dirt)
	Air pollution
	Cigarette smoke
	Recurrent URIs – especially RSV
	Other atopic disorders

Asthma

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50% of children with _________ will have reoccurring wheezing & eventually diagnosed with asthma within 6 years following the infection

RSV bronchitis

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episodic attacks of bronchospasm, bronchial inflammation, mucosal edema, and increased mucus production

patho of asthma

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_______ activates the APCs to present to the CD4 T cells in acute asthmatic response

antigen exposure

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Clinical manifestations of \_\_\_\_\_\_\_\_\_:
	Expiratory wheezing
	Tightness
	Dyspnea
	Prolonged expiration
	Cough- Sometimes (especially in children), cough is the only sign
	Increased constriction (wheezing with both inhalation &amp; exhalation)
	Tachycardia = hypoxemia
	May become status asthmaticus

Asthma

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Diagnosis of ______:
FEV1 before & after a short acting bronchodilator is delivered before and after it is given via inhalation
• Will have improvement in expiratory flow volume after the inhaler is used

Asthma

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Hypersecretion of mucous and chronic productive cough for at least 3 months of each year x 2 consecutive years

Chronic Bronchitis

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Risk Factors for \_\_\_\_\_\_\_:
smoking
occupational dust
chemicals
pollution
any factor that affects fetal/infant lung growth
genetic susceptibility

Chronic Bronchitis

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Airway inflammation with an infiltration of neutrophils, macrophages, and lymphocytes into the bronchial walls lead to bronchial edema, increased goblet cells (mucous cells), thick tenacious mucus, poor ciliary action r/t increased in mucus & increased susceptibility to infection, obstruction d/t mucus plugs

Patho of Chronic Bronchitis

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Clinical Manifestation of \_\_\_\_\_\_\_\_\_:
decreased exercise tolerance
wheezing
SOB
copious productive cough (especially in the AM)
polycythemia
decreased FEV1

Chronic Bronchitis

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abnormal permanent enlargement of gas exchange airways with destruction of alveolar walls without fibrosis; obstruction occurs d/t loss of alveolar elastic recoil that would push the air out of the alveoli

Emphysema

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type of emphysema that is autosomal recessive and inherited deficiency of alpha-1 antitrypsin protein involving A1A inhibiting protolytic breakdown of the alveoli **Pts are usually younger than those with secondary emphysema and tested via cheek swab

Primary Emphysema

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type of emphysema that is more prevalent and caused by cigarette smoking usually or air pollution /childhood URIs may contribute

Secondary Emphysema

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cigarette smoke inhibits antiproteases & stimulates inflammation which increase the protease (enzymes) that attack alveolar walls and diminish elastic recoil which leads to alveoli growing in size and the septa is lost and air is trapped bc it can no longer be squeezed out

Patho of Emphysema

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Type of Emphysema:
• Associated with smoking
• Occurs with chronic bronchitis (co-diagnosis)
• Destruction of bronchioles & alveolar ducts in upper lobes
• Alveolar sac remains intact

Centriacinar (centrilobular) Emphysema

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Type of Emphysema that is located adjacent to the pleura and septal lines

Paraseptal Emphysema

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cluster of aveoli that look like blackberry clusters

acinus

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Type of Emphysema:
• Involved the entire acinus
• Alveoli damage is more randomly distributed
• Involves lower lobes of the lung

Panacinar (panlobular) Emphysema

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Alveolar Effects of _______:
 Mucus in bronchioles
 Enlarged alveoli
 Fewer capillaries

Emphysema

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90% of these are due to blood clots that arise from the pelvis or lower extremities

Pulmonary Embolism

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Three Causative Factors of PE called ______:
 Venous stasis (sluggish blood flow)
 Hypercoagulability
 Damage to endothelial lining of the vein

Virchow’s Triad

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causes immune response within blood stream that triggers inflammation and coagulation and displaces blood in vessels and leads to wide spread vasoconstriction, atelectasis, pulmonary edema, pulmonary HTN, shock, sometimes death

Amniotic Fluid PE

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Clinical Manifestations of \_\_\_\_\_\_\_:
	Depends on size of embolism
	S/S may be nonspecific 
•	Restless
•	Apprehension
•	Anxiety
•	Dyspnea
•	Tachycardia
	As it worsens:
•	Chest Pain on inspiration
•	Hemoptysis

Pulmonary Embolism

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condition secondary to pulmonary artery HTN that will cause signs of R sided heart Failure with right ventricular enlargement caused by pulmonary HTN creating chronic pressure overload in the R ventricle

Cor Pulmonale

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Clinical Manifestations of _____:
 Heart function appears normal at rest
 With Exercise: decreased CO, chest pain

Cor Pulmonale

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common bacteria of pneumonia

streptococcus pneumoniae

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Risk Factors for \_\_\_\_\_\_:
young
advanced age
immunocompromise
underlying lung disorder
ETOH
smoker

Community Acquired Bacterial Pneumonia

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a very small bacteria and is commonly seen in summer and fall in children and young adults especially in schools, college dorms, barracks and other places where young people congregate

Mycoplasma

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atyplical pneumonia is most commonly caused by ____

mycoplasma

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Causes of ______:
Mycoplasma
Legionnaire’s Disease
Chlamydia

Atypical Pneumonia

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Common Causes of ______:
o Influenza
o RSV

Viral Pneumonia

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immunocompromised people are likely to have __________ pneumonia caused by Pneumocystis or fungal organisms

opportunistic

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this is prevalent among patients with CANCER or HIV or other fungal infections

opportunistic pneumonia

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the most common route of infection for pneumonia

aspiration of oropharyngeal secretions

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Routes of Infection for ________:
aspiration of oropharyngeal secretions
bloodborne (sepsis)

pneumonia

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What causes clinical manifestations of pneumonia? (Dyspnea, V/Q mismatch, hypoxemia)

accumulation of consolidated exudate in alveolar air spaces

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________ pneumonia does not produce exudative fluid like bacteral pneumonia

viral

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pneumonia caused by ______ causes very little mucous production

mycoplasma

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Clinical Manifestations of \_\_\_\_\_\_\_\_:
chills
fever
malaise
cough that is productive
purulent or blood tinged sputum
**Crackles/rales**
bronchial breath sounds via auscultation over the effected lung tissue

Bacterial Pneumonia

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Clinical Manifestations of \_\_\_\_\_\_\_\_:
proceeded by an upper respiratory syndrome
cold symptoms (fever, non-productive 
cough, hoarseness, runny nose)
**wheezing/fine rales**

Viral Pneumonia

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Clinical Manifestations of \_\_\_\_\_\_\_\_:
low grade fever
cough
headache
malaise

Mycoplasma Pneumonia

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Diagnosis of _______:
H&P
Chest Xray
CBC

Pneumonia

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white shadows/opacities in involved area of the lungs seen on chest xray in BACTERIAL pneumonia

parenchymal infiltrates

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_____ tuberculosis cases at a rate of ____ cases per 100,000 persons were reported in US in 2016

9,200; 2.9

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Risk Factors for \_\_\_\_\_\_:
malnourishment
immunosuppression
living in overcrowded conditions
incarcerated persons
immigrants
elderly

Tuberculosis

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acid-fast aerobic bacillus that usually effects the lungs, but may infect other organs

Mycobacterium tuberculosis

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Route of Infection for _______:
person to person via AIRBOURNE DROPLETS
by talking, sneezing, coughing, laughing

Tuberculosis

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bacteria will lodge in lungs (usually the upper lobes) & cause a mild pneumonitis
-bacilli will migrate to the lymph nodes where t-lymphocytes contact them and initiate cell-mediated response where neutrophils and macrophages engulf and isolate the bacilli—stopping spread by trapping the bacilli and granulomatous lesions (tubercles or Ghon tubercles)—disease then becomes walled off and dormant with no evidence of disease

Patho of TB

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reactivation of ________ may occur when the individual’s immune system is impaired by age, disease, or poor nutrition or even re-exposure to the organism

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form of TB in which patients do not feel sick and have no symptoms, not infectious and can’t spread to others
BUT is the TB becomes ACTIVE and multiplies that person will develop pulmonary disease at this stage the individual is sick and could spread bacteria to others

Latent TB

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Clinical Manifestations of \_\_\_\_\_\_:
bad cough that lasts 3+ weeks 
pain in chest
coughing up blood or sputum
weakness
fatigue
anorexia
weight loss
chills
diurnal fever
**NIGHT SWEATS

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Diagnosis of ______:
Sputum culture: definitive diagnosis, takes 3 weeks for determination
Chest XR: shows Ghon tubercles or cavitation with infiltrates in apex, infected lymph nodes
Skin Test: Mantoux, MOST RELIABLE but does not differentiate from LATENT OR ACTIVE
Blood tests:
***Interferon-gamma release assays
QuantiFeron-TB GOLD (QFT-GIT)-measures how the immune system reacts to the TB bacteria T-Spot

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an acute infection or inflammation of airways or bronchi that commonly follows a viral illness

Acute Bronchitis

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Clinical Manifestations of ____:
non-productive cough occuring in paroxysms
***aggravated by cold, dry or dusty air

Acute Bronchitis

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________ is caused exactly the same way with the same symptoms as pneumonia except there is no pulmonary consolidation and chest infiltrates on chest XR

Acute Bronchitis

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_______ in children is a chronic inflammatory disease with sensitivity to allergens, bronchial hyperreactivity, and reversible airway obstruction

Asthma

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______ and ______ factors influence severity & onset of asthma.

Environmental and genetic

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_______ is a type 1 hypersensitivity reaction that is mediated by IgE

childhood asthma

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sometimes the only symptom seen in asthma is cough in children and this is called _____

cough-variant asthma

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Clinical Manifestations of _______:
cough
expiratory wheezing
SOB

childhood asthma

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Diagnosis of _______:

pumonary fxn tests- spirometry before and after a short-acting bronchodilator

childhood asthma

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viral, lower respiratory tract infection, seen in infants and young toddlers, typically in winter and spring,

bronchiolitis

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RSV is typical causative agent of ________ (causing 50% of all cases)

bronchiolitis

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Causes of \_\_\_\_\_\_\_:
RSV
influenza
strep
pneumococci

bronchiolitis

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necrosis and destruction of ciliated epithelium cells produces a cell-mediated hypersensitivity to the viral antigen resulting in Inflammation, edema, & thick mucous plugs in the bronchioles which leads to bronchiole spasms and plugs causing narrowed airways, air trapping, and atelectasis

patho of bronchiolitis

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Symptoms of \_\_\_\_\_\_\_:
o	runny nose (rhinorrhea), 
o	tight cough, 
o	fever, 
o	poor feeding, 
o	lethargy, 
o	bronchospasms, and 
o	wheezing, along with 
o	rales, 
o	bronchi, 
o	dyspnea, and 
o	rapid breathing.

bronchiolitis

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About 50% of children with _________ by the age of 1 will develop asthma by the time they are 6 years of age.

bronchiolitis

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condition that occurs in children, esp. little boys 6mo-3years of age frequently in fall or early winter caused by viral or bacterial infection most commonly (85%) parainfluenza

Croup

Clinical Manifestations of \_\_\_\_\_\_:
subglottic edema
seal-like barking cough
rhinorrhea
sore throat
low-grade fever.

Croup

Croup is a ______ condition, meaning it gets better on its own although some cases require hospitalization

self-limiting

inflammation of the tonsils most commonly caused by group A beta hemolytic strep that leads to significant swelling of tonsils and posterior pharynx. In some cases, a tenacious membrane will grow and cover the mucosa over the tonsils and sometimes cause an upper airway obstruction…

Tonsillar Infection

_______ can be a complication of infectious mononucleosis, which is caused by the Epstein-Barr virus…also caused by other viruses

Tonsillar Infection

infection behind the tonsil, typically unilateral, pain is usually worse on that same side most commonly caused by streptococcal pharyngitis

Peritonsillar abscess

Complications of ______:

blockage of airway or aspiration pneumonitis.

Peritonsillar abscess

most common potentially life-threatening upper airway infection in children that causes airway edema & copious purulent secretions that lead to airway obstruction that will worsen with the formation of tracheal super membrane and mucosal sloughing.

Bacterial Tracheitis

Causative Organisms of ________:
o streptococcus pneumonia,
o haemophilus influenzae, and
o Moraxella catarrhalis

Bacterial Tracheitis

onset of _______ may be sudden or it may be preceded by viral URI or croup

Bacterial Tracheitis

Clinical Manifestations of \_\_\_\_\_\_\_\_:
o	increased breathing, 
o	stridor, 
o	hoarse voice, 
o	fever, 
o	cough, 
o	increase secretions of mouth/nose

Bacterial Tracheitis

Severe life-threatening infection of the epiglottis caused by Haemophilus type B (have decreased in incidence since we have the HIB vaccine) however, this problem can be cause by other bacteria, especially strep

Acute Epiglottitis

Clinical Manifestations of \_\_\_\_\_\_\_:
high fever
severe sore throat
unable to swallow saliva
inspiratory stridor
severe respiratory distress

Acute Epiglottitis

most common age of SIDS

2-4 months

an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage…it is a protective and complex phenomenon made up of sensory experiences, time, space, intensity, emotion, cognition and motivation

pain

Has to do with the amount of pain is associated with how much tissue damage there is. So checking blood sugar (needle prick) is not as painful as a 3 inch laceration on the arm. Accounts for many types of injuries but does not explain psychologic contribution to pain or chronic pain.

Specificity Theory

This describes the role of impulse intensity and re-patterning of the central nervous system. This is a very limited theory because it does not account for all pain experiences

Patterning Theory

This explains the complexities of pain phenomenon. It proposes that a neuro mechanism in the dorsal horn root of spinal cord acts like a gate that can increase or decrease the perception of pain that comes from the peripheral nerves to the central nervous system. The pain is modulated by this gate. Large myelinated A delta fibers move pain signals very rapidly and the brain perceives these signals as stinging, highly localized pain. Where small unmyelinated C fibers move impulses more slowly. These pain transmissions are poorly localized and are dull and achy in nature. These nerves are within the internal organs. These nociceptive transmissions open the gate. Stimuli from non nociceptive transmissions, such as touch and Larger A beta fibers, close or partially close the gate.

Gate Control Theory (1965)

This expands out of the Gate Control Theory. It says that the brain produces patterns of nerve impulses drawn from various inputs, including genetic, physiologic and cognitive experiences. Pain is described as multidimensional. Whole body, mind, spirit experience that recognizes past experiences, culture factors, emotional state, stress regulation, immune system and the immediate sensory input all effect pain perception. For example, labor pain is less intense in a quiet, warm, safe, controlled environment with someone always in attendance. In addition, prenatal education and a birth plan that includes movement, massage and music can greatly enhance the labor experience. This theory illustrates the placidity (adaptable change in structure and function of the brain). Further it proposes that sensory input to the brain produce patterns of pain, but the stimuli may independently originate in the brain with no external input.

Neuromatrix Theory

These begin in the periphery and travel to the spinal gate in the dorsal horn and then ascend to higher centers in the CNS.

Afferent pathways

necessary system for pain located in the brain stem, mid brain and cerebral cortex

interpretive centers

pain pathways that descend from CNS back to the dorsal horn and modulate pain.

efferent pathways

phase of pain response that begins when tissue is damaged by exposure to chemical, mechanical, or thermal noxious stimuli and is converted to electrophysiological activity leading to stimulation of nociceptors

transduction

phase of pain response that involves conduction of the pain impulses moving via sensory A and C fibers into the dorsal horn of the spinal cord and to the brain stem, thalamus and cortex
o “fast” via A delta fibers-skin, muscles
o “Slow” via C fibers-internal organs

Transmission

“fast” pain sensory fibers of the skin and muscles

A delta

“slow” pain sensory fibers of the internal organs

C fibers

phase of pain response which is the conscious awareness of pain involving the sensory discriminating system, effective motivational system, and cognitive evaluative system. This is the awareness and interpretation of meaning of pain

Perception

phase of pain response that is the physiological process of suppressing pain or facilitating pain in an attempt to decrease perception of pain

Modulation

Primary order of nociception of pain consisting of bare nerve endings in the skin, muscle, joints, arteries, and viscera that respond to chemical, mechanical and thermal stimuli

First-order neurons-nociceptors

interneurons in the dorsal horn of the spinal column made up of projection cells that are excitatory or inhibitory interneurons and function as a pain gate to regulate pain transmission, crossover the cord and ascend

Second-order neurons

Afferent neurons in the spinothalamic tract that carry information to the sensory cortex and reticular and limbic system to process and interpret pain

Third-order Neurons

nociceptor fibers for assigned to a particular area of the body surface

sensory dermatomes

The brain is able to localize pain sensation because nociceptor transmission pathways are in anatomical order in the ________ and _______

spinal cord and somatosensory cortex

pain located in the pattern of a dermatome that occurs with spinal nerve injury or area of infection like herpes

radiculopathy

_______ pain does not follow a dermatomal pattern

peripheral neuropathy

physical process of suppressing or facilitating pain

pathways of modulation

This closes the gate, low threshold, mechanical information such as touch, vibration and pressure. For instance, massage will trigger A-Beta fibers to close the gate to more intense C fiber pain felt during the first stages of labor

Segmental inhibition

cerebral cortex, top down, control pathways

Modulation even occur even in the absence of painful stimuli.

Descending Modulation of Pain

spinal medullary pathways that are activated when peripheral pain stimulation remotes from the pain site. This is counter irritation. For example: Sterile water injections on either side of the sacrum as a counter irritant for the first stages of labor.

Diffuse noxious inhibitory controls

Cognitive expectation, the placebo or the non-placebo effect can cause real measurable, powerful, physiological effects that share pathways with pain modulation systems. These modularly pathways modify, dampen or augment nociceptive transmission depending on all the factors effecting the individual, internally and externally.

Expectancy-related cortical activation

these control the emotional and affective responses to pain

Reticular formation and Limbic System

pain excitatory neurotransmitters of pain modulation

glutamate

aspartate

pain inhibitory neurotransmitters of pain modulation

serotonin
GABA
glycine
endorphins
enkephalins
dynorphins
endomorphins

inflammatory (usually excitatory) neurotransmitters of pain modulation

TNF alpha
prostaglandins
bradykinins

threshold of pain

hyperalgesia

neurotransmitters of pain that will lower the threshold of pain

Inflammatory

As tissue heals, this will diminish or continue on as chronic pain

hyperalgesia

threshold depolarization from direct stimuli, like heat, chemicals or tissue trauma

direct excitation

from inflammatory mediators after tissue injury such as loss of oxygen supply or infection.

indirect excitation

Increase excitability of neurons… when normally non painful stimuli causes pain

Central sensitization

when light touch stimulates nociceptors

allodynia

The point at which a stimulus is perceived as pain **Does NOT significantly vary among people or the same person over time.

pain threshold

Duration of time or intensity of pain that an individual will endure before initiating overt pain response
**Very individualized and varies among people or the same person over time.

pain tolerance

Intense pain at one location may cause an increase in the pain threshold in another location. In an individual with many painful sites, may only report the most painful. After the dominant pain is diminished the individual may identify other painful areas.

Perceptual Dominance

this pain treatment stimulates A-beta fibers thereby preventing pain signals from reaching the brain and closes the gate to the C fiber pain of labor.
It can be set to different frequencies, and some will stimulate A-Delta fibers to stimulate the release of endorphins. A counter irritant effect that is not always well tolerated.

TENS Unit

pain treatment that sets up a very painful impulse across A-Delta fibers, rapid stinging pain to the dorsal root quickly, essentially closing the gate to the slower C fiber transmitted pain of first stage of contraction of labor. This counter irritant distracts the patient from the pain and release endorphins. Can last up to 2 hours in patients.

sterile water injections over the sacrum

these decrease the perception of pain by acting like opioids binding with opioid receptors producing sedation and euphoria

endogenous opiate peptides

These are all _______:

Enkephalins, Endorphins, Dynorphins, Endomorphins.

endogenous opiate peptides

these endogenous opiate peptides reside in the hypothalamus and pituitary and are released during times of stress, pain, emotion, while eating chocolate, when laughing, by massage or acupuncture and are called “stress induced analgesia”

Beta Endorphins

strong mu receptor agonists that provide natural pain relief

endorphins

Pain is always a _______ symptom

subjective

pain from tissue injury and will resolve when healed; <3 months (lecture says can last 3-6 months); poorly localized resulting in fewer nociceptors and may be recurrent; a protective mechanism that alerts the body of immediate danger to the body.

acute pain

Clinical Manifestations of \_\_\_\_\_\_ Pain:
tachycardia
diaphoretic
dilated pupils
hypertension
elevated blood sugar
decreased gastric acid secretion
decreased gastric motility

Acute

o Pain felt in an area other than the site of injury… in an area that is removed or distant from it’s point of origin… supplied by the same spinal segment.
o Areas of the body share sensory dermatomes
o Embryonic development
o Patterns are predictive-help in diagnosis.
o Can be acute or chronic

Referred Pain

decreased pain threshold and increased response of nociceptors seen in chronic pain

peripheral sensitization

pain that does not respond to usual therapy, and does not serve as a protective purpose…thought to be caused by dysregulation of nociception and pain regulation process

chronic pain

with ______ pain, there will be no sympathetic signs or symptoms-physiologic adaptation occurs and there will be normal pulse and B/P

chronic

injuries to the muscle, tendons and fascia that have occurred that cause spasms, tenderness, and stiffness

Myofascial pain syndromes

these are changes in the PNS and CNS that contribute to allodynia and hypersensitivity.

Chronic Postoperative pain

this is due to growing cancer within an organ or compression of structures by tumor, radiation or chemotherapy tissue destruction

Cancer Pain

very complex type of pain in which nerves become damaged or dysfunctional…may result from trauma or disease to the PNS or CNS and is most often chronic

neuropathic pain

pain caused by injured nerves becoming hyper excitable.

peripheral neuropathic pain

type of pain caused by a lesion or dysfunction in the brain or spinal cord

central neuropathic pain

Clinical Manifestations of \_\_\_\_\_\_ Pain:
burning/shooting/tingling sensation of pins and needles
stabbing sensation
gnawing
being miserable

Neuropathic

nociceptor system is functional by _____ weeks gestation

20-24

Children, ages 5-18, have a _____ pain threshold than adults

lower

Signs of \_\_\_\_\_\_\_ Pain:
lowered, drawn together brows
bulge between brows
vertical furrows
tightly closed eyes
raised cheeks
broadened bulging nose
open/squarish mouth

Pediatric

Signs of \_\_\_\_ Pain:
increased Pain threshold
Peripheral neuropathies
Skin thickness changes 
Cognitive impairment
Decreased Pain tolerance-women more than men
Alterations in the metabolism of drugs and metabolites
Impaired renal and liver function

Adult

poor perfusion of a well-ventilated lung

high V/Q

bullae and blebs are associated with ______

emphysema

sterile water injections during labor uses the _______ Theory of Pain

Gate Control

_____ closes or partially closes the spinal gate to pain preception

massage

large myelinated fibers that transmit touch and vibration sensation

A beta fibers

_____ will result in respiratory alkalosis

hyperpnea

allergic asthma due to response to antigen

extrinsic

non-allergic, adult-onset of asthma

intrinsic

COPD patient is cyanotic, they likely have ____

chronic bronchitis

consolidation area of pneumonia will cause auscultation of ________

expiratory crackles/rales

in chronic bronchitis, what causes the JVD and swollen ankles?

R sided heart failure

smoking contributes to bronchial damage in emphysema by

inflammatory release of proleatic enzymes that damage alveolar lining

emotional responses to pain are mediated through ______ and ______

lymbic system and brainstem

what type of nerve fiber transmits dull or achey sensations?

C fibers

In aging, _______ _____________ decreases, and residual _____________ ____________.

vital capacity

volume increases

What kind of V/Q mismatch occurs in asthma?

shunting

reduced oxygenation of arterial blood (PaO2) caused by respiratory alterations

hypoxemia

ischemia- reduced oxygenation of cells in tissues

hypoxia

hypoventilation will show _______ in blood gas

acidosis (too much CO2)

Inflammation from vocal cords to bronchial lumina

patho of croup

Pulmonary System Changes That Occur with \_\_\_\_\_\_:
loss of elastic recoil
stiffening of the chest wall
changes in gas exchange
increases in flow resistance

Aging

With aging, lung _______ _______ decreases, _______ ______ increases while lung _______ remains the same.

vital capacity
residual volume
capacity

Alveolar Changes That Occur with \_\_\_\_\_\_
alveolar size increases
alveolar surface area available for gas diffusion
diminishes
airway support decreases

Aging

Respiratory muscle strength/endurance decreases by ___ % by age ___

20% by age 70

Decrease in vital capacity seen with aging leads to decrease in ______ ________ and decreased _______ - _______ ______

ventilary reserve

ventilation-perfusion ratio

Older adults have a decreased compesatory response to _______ and _______

hypercapnia

hypoxemia

Perception of _____ remains the same and can even be enhanced in older adults

dyspnea

PaO2

partial pressure of oxygen in alveoli

With aging, \_\_\_\_\_ declines due to:
loss of alveolar surface area
thickening of plural septa
loss of lung elasticity
increase in ventilation-perfusion mismatch

PaO2

Older adults are at greater risk for respiratory depression caused by _______

medications

mucous secreting single-celled exocrine glands in the epithelial lining of the bronchi

goblet cells

respirations with slightly increased ventilatory rate, very large tidal volume, and no expiratory pause caused by strenuous exercise or repiratory acidosis

Kussmaul respirations

alternating periods of deep and shallow breathing with apnea caused by decreased blood flow to the brain stem

Cheyne-Sokes respirations

increased CO2 concentration in arterial blood caused by hypoventilation of the alveoli

hypercapnia

reduced oxygenation of tissue cells

hypoxia (ischemia)

inadequate gas exchange (hypoxemia) with PaO2 < 50 mmHg or hypercapnia with PaO2 > 50 mmHg and pH < 7.25

acute respiratory failure

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Pulmonary/Pain Flashcards

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