Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Advanced Pathophysiology > Pulmonary/Pain > Flashcards

Pulmonary/Pain Flashcards

1
Q

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

A

obstructive pulmonary disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

examples of obstructive pulmonary disorders

A

asthma, chronic bronchitis, emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q 
Clinical Manifestations of \_\_\_\_\_\_\_:
	Dyspnea
	Wheezing
	Work of breathing
	Ventilation/perfusion mismatch
	Decreased forced expiratory volume (FEV1)
A

obstructive pulmonary disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

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

A

Smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

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)

A

asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Asthma is a _____ disorder

A

familial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

multiple allergens and microbes may play a role in ________

A

asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

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

A

Hygiene Hypothesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q 
Risk Factors for \_\_\_\_\_\_:
	Family history
	Allergen exposure
	Urban living (cockroach/dirt)
	Air pollution
	Cigarette smoke
	Recurrent URIs – especially RSV
	Other atopic disorders
A

Asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

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

A

RSV bronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

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

A

patho of asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

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

A

antigen exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q 
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 & exhalation)
	Tachycardia = hypoxemia
	May become status asthmaticus
A

Asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

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

A

Asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

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

A

Chronic Bronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q 
Risk Factors for \_\_\_\_\_\_\_:
smoking
occupational dust
chemicals
pollution
any factor that affects fetal/infant lung growth
genetic susceptibility
A

Chronic Bronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

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

A

Patho of Chronic Bronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q 
Clinical Manifestation of \_\_\_\_\_\_\_\_\_:
decreased exercise tolerance
wheezing
SOB
copious productive cough (especially in the AM)
polycythemia
decreased FEV1
A

Chronic Bronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

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

A

Emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

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

A

Primary Emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

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

A

Secondary Emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

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

A

Patho of Emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

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

A

Centriacinar (centrilobular) Emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

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

A

Paraseptal Emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

cluster of aveoli that look like blackberry clusters

A

acinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

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

A

Panacinar (panlobular) Emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

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

A

Emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

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

A

Pulmonary Embolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

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

A

Virchow’s Triad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

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

A

Amniotic Fluid PE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q 
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
A

Pulmonary Embolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

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

A

Cor Pulmonale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

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

A

Cor Pulmonale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

common bacteria of pneumonia

A

streptococcus pneumoniae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q 
Risk Factors for \_\_\_\_\_\_:
young
advanced age
immunocompromise
underlying lung disorder
ETOH
smoker
A

Community Acquired Bacterial Pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

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

A

Mycoplasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

atyplical pneumonia is most commonly caused by ____

A

mycoplasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Causes of ______:
Mycoplasma
Legionnaire’s Disease
Chlamydia

A

Atypical Pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Common Causes of ______:
o Influenza
o RSV

A

Viral Pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

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

A

opportunistic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

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

A

opportunistic pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

the most common route of infection for pneumonia

A

aspiration of oropharyngeal secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

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

A

pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

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

A

accumulation of consolidated exudate in alveolar air spaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

________ pneumonia does not produce exudative fluid like bacteral pneumonia

A

viral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

pneumonia caused by ______ causes very little mucous production

A

mycoplasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q 
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
A

Bacterial Pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q 
Clinical Manifestations of \_\_\_\_\_\_\_\_:
proceeded by an upper respiratory syndrome
cold symptoms (fever, non-productive 
cough, hoarseness, runny nose)
**wheezing/fine rales**
A

Viral Pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q 
Clinical Manifestations of \_\_\_\_\_\_\_\_:
low grade fever
cough
headache
malaise
A

Mycoplasma Pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Diagnosis of _______:
H&P
Chest Xray
CBC

A

Pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

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

A

parenchymal infiltrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

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

A

9,200; 2.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q 
Risk Factors for \_\_\_\_\_\_:
malnourishment
immunosuppression
living in overcrowded conditions
incarcerated persons
immigrants
elderly
A

Tuberculosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

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

A

Mycobacterium tuberculosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

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

A

Tuberculosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

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

A

Patho of TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

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

A

TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

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

A

Latent TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q 
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
A

TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

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

A

TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

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

A

Acute Bronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

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

A

Acute Bronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

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

A

Acute Bronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

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

A

Asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

______ and ______ factors influence severity & onset of asthma.

A

Environmental and genetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

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

A

childhood asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

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

A

cough-variant asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Clinical Manifestations of _______:
cough
expiratory wheezing
SOB

A

childhood asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Diagnosis of _______:

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

A

childhood asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

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

A

bronchiolitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

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

A

bronchiolitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q 
Causes of \_\_\_\_\_\_\_:
RSV
influenza
strep
pneumococci
A

bronchiolitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

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

A

patho of bronchiolitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q 
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.
A

bronchiolitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

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

A

bronchiolitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

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

A

Croup

77
Q 
Clinical Manifestations of \_\_\_\_\_\_:
subglottic edema
seal-like barking cough
rhinorrhea
sore throat
low-grade fever.
A

Croup

78
Q

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

A

self-limiting

79
Q

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…

A

Tonsillar Infection

80
Q

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

A

Tonsillar Infection

81
Q

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

A

Peritonsillar abscess

82
Q

Complications of ______:

blockage of airway or aspiration pneumonitis.

A

Peritonsillar abscess

83
Q

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.

A

Bacterial Tracheitis

84
Q

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

A

Bacterial Tracheitis

85
Q

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

A

Bacterial Tracheitis

86
Q 
Clinical Manifestations of \_\_\_\_\_\_\_\_:
o	increased breathing, 
o	stridor, 
o	hoarse voice, 
o	fever, 
o	cough, 
o	increase secretions of mouth/nose
A

Bacterial Tracheitis

87
Q

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

A

Acute Epiglottitis

88
Q 
Clinical Manifestations of \_\_\_\_\_\_\_:
high fever
severe sore throat
unable to swallow saliva
inspiratory stridor
severe respiratory distress
A

Acute Epiglottitis

89
Q

most common age of SIDS

A

2-4 months

90
Q

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

A

pain

91
Q

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.

A

Specificity Theory

92
Q

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

A

Patterning Theory

93
Q

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.

A

Gate Control Theory (1965)

94
Q

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.

A

Neuromatrix Theory

95
Q

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

A

Afferent pathways

96
Q

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

A

interpretive centers

97
Q

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

A

efferent pathways

98
Q

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

A

transduction

99
Q

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

A

Transmission

100
Q

“fast” pain sensory fibers of the skin and muscles

A

A delta

101
Q

“slow” pain sensory fibers of the internal organs

A

C fibers

102
Q

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

A

Perception

103
Q

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

A

Modulation

104
Q

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

A

First-order neurons-nociceptors

105
Q

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

A

Second-order neurons

106
Q

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

A

Third-order Neurons

107
Q

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

A

sensory dermatomes

108
Q

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

A

spinal cord and somatosensory cortex

109
Q

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

A

radiculopathy

110
Q

_______ pain does not follow a dermatomal pattern

A

peripheral neuropathy

111
Q

physical process of suppressing or facilitating pain

A

pathways of modulation

112
Q

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

A

Segmental inhibition

113
Q

cerebral cortex, top down, control pathways

Modulation even occur even in the absence of painful stimuli.

A

Descending Modulation of Pain

114
Q

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.

A

Diffuse noxious inhibitory controls

115
Q

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.

A

Expectancy-related cortical activation

116
Q

these control the emotional and affective responses to pain

A

Reticular formation and Limbic System

117
Q

pain excitatory neurotransmitters of pain modulation

A

glutamate

aspartate

118
Q

pain inhibitory neurotransmitters of pain modulation

A 
serotonin
GABA
glycine
endorphins
enkephalins
dynorphins
endomorphins
119
Q

inflammatory (usually excitatory) neurotransmitters of pain modulation

A

TNF alpha
prostaglandins
bradykinins

120
Q

threshold of pain

A

hyperalgesia

121
Q

neurotransmitters of pain that will lower the threshold of pain

A

Inflammatory

122
Q

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

A

hyperalgesia

123
Q

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

A

direct excitation

124
Q

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

A

indirect excitation

125
Q

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

A

Central sensitization

126
Q

when light touch stimulates nociceptors

A

allodynia

127
Q

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

A

pain threshold

128
Q

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.

A

pain tolerance

129
Q

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.

A

Perceptual Dominance

130
Q

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.

A

TENS Unit

131
Q

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.

A

sterile water injections over the sacrum

132
Q

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

A

endogenous opiate peptides

133
Q

These are all _______:

Enkephalins, Endorphins, Dynorphins, Endomorphins.

A

endogenous opiate peptides

134
Q

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”

A

Beta Endorphins

135
Q

strong mu receptor agonists that provide natural pain relief

A

endorphins

136
Q

Pain is always a _______ symptom

A

subjective

137
Q

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.

A

acute pain

138
Q 
Clinical Manifestations of \_\_\_\_\_\_ Pain:
tachycardia
diaphoretic
dilated pupils
hypertension
elevated blood sugar
decreased gastric acid secretion
decreased gastric motility
A

Acute

139
Q

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

A

Referred Pain

140
Q

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

A

peripheral sensitization

141
Q

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

A

chronic pain

142
Q

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

A

chronic

143
Q

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

A

Myofascial pain syndromes

144
Q

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

A

Chronic Postoperative pain

145
Q

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

A

Cancer Pain

146
Q

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

A

neuropathic pain

147
Q

pain caused by injured nerves becoming hyper excitable.

A

peripheral neuropathic pain

148
Q

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

A

central neuropathic pain

149
Q 
Clinical Manifestations of \_\_\_\_\_\_ Pain:
burning/shooting/tingling sensation of pins and needles
stabbing sensation
gnawing
being miserable
A

Neuropathic

150
Q

nociceptor system is functional by _____ weeks gestation

A

20-24

151
Q

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

A

lower

152
Q 
Signs of \_\_\_\_\_\_\_ Pain:
lowered, drawn together brows
bulge between brows
vertical furrows
tightly closed eyes
raised cheeks
broadened bulging nose
open/squarish mouth
A

Pediatric

153
Q 
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
A

Adult

154
Q

poor perfusion of a well-ventilated lung

A

high V/Q

155
Q

bullae and blebs are associated with ______

A

emphysema

156
Q

sterile water injections during labor uses the _______ Theory of Pain

A

Gate Control

157
Q

_____ closes or partially closes the spinal gate to pain preception

A

massage

158
Q

large myelinated fibers that transmit touch and vibration sensation

A

A beta fibers

159
Q

_____ will result in respiratory alkalosis

A

hyperpnea

160
Q

allergic asthma due to response to antigen

A

extrinsic

161
Q

non-allergic, adult-onset of asthma

A

intrinsic

162
Q

COPD patient is cyanotic, they likely have ____

A

chronic bronchitis

163
Q

consolidation area of pneumonia will cause auscultation of ________

A

expiratory crackles/rales

164
Q

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

A

R sided heart failure

165
Q

smoking contributes to bronchial damage in emphysema by

A

inflammatory release of proleatic enzymes that damage alveolar lining

166
Q

emotional responses to pain are mediated through ______ and ______

A

lymbic system and brainstem

167
Q

what type of nerve fiber transmits dull or achey sensations?

A

C fibers

168
Q

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

A

vital capacity

volume increases

169
Q

What kind of V/Q mismatch occurs in asthma?

A

shunting

170
Q

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

A

hypoxemia

171
Q

ischemia- reduced oxygenation of cells in tissues

A

hypoxia

172
Q

hypoventilation will show _______ in blood gas

A

acidosis (too much CO2)

173
Q

Inflammation from vocal cords to bronchial lumina

A

patho of croup

174
Q 
Pulmonary System Changes That Occur with \_\_\_\_\_\_:
loss of elastic recoil
stiffening of the chest wall
changes in gas exchange
increases in flow resistance
A

Aging

175
Q

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

A

vital capacity
residual volume
capacity

176
Q 
Alveolar Changes That Occur with \_\_\_\_\_\_
alveolar size increases
alveolar surface area available for gas diffusion
diminishes
airway support decreases
A

Aging

177
Q

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

A

20% by age 70

178
Q

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

A

ventilary reserve

ventilation-perfusion ratio

179
Q

Older adults have a decreased compesatory response to _______ and _______

A

hypercapnia

hypoxemia

180
Q

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

A

dyspnea

181
Q

PaO2

A

partial pressure of oxygen in alveoli

182
Q 
With aging, \_\_\_\_\_ declines due to:
loss of alveolar surface area
thickening of plural septa
loss of lung elasticity
increase in ventilation-perfusion mismatch
A

PaO2

183
Q

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

A

medications

184
Q

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

A

goblet cells

185
Q

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

A

Kussmaul respirations

186
Q

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

A

Cheyne-Sokes respirations

187
Q

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

A

hypercapnia

188
Q

reduced oxygenation of tissue cells

A

hypoxia (ischemia)

189
Q

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

A

acute respiratory failure

Advanced Pathophysiology (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions