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Patho Final > Somatosensory Modalities, chap 35 > Flashcards

Somatosensory Modalities, chap 35 Flashcards

(48 cards)

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1
Q

Tactile

A

pressure/vibration

Initial response often total adaptation. Put shirt on but get used to it

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2
Q

Thermal

A

Initial response partial adaptation. Go into the sun and feel it stronger at first, but still feel it

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3
Q

Position

A

(proprioception)

Sense of limb /body movement without using vision

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4
Q

Somatic Nervous system:

A

Provides awareness of the body, both conscious and autonomic

  1. Tactile
  2. Thermal
  3. Position
  4. Pain
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5
Q

Pain

A

An unpleasant sensory and emotional sensation associated with actual or potential tissue damage.

  1. warns of impeding injury
  2. motivates to seek help
  3. motivates avoidance of future injury
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6
Q

Two main pathways of pain:

A

A and B: “fast pain”-

    • large myelinated fibers
    • Pressure/touch…… cold, mechanical/heat pain.

C: “slow pain”

    • small non-myelinated fibers
    • Warm/hot, chemical…… mechanical/ heat/cold pain
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7
Q

3 levels of neurons involved in somatic sensation:

A

1st order- transmit sensory info from perifery to CNS

2nd- communicate sensory paths in spinal cord to thalamus

3rd- from thalamus to cerebral cortex

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8
Q

Dermatome

A

region of body wall supplied by single pair of dorsal root ganglia

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9
Q

Pain Theories: 4

  1. specificity theory
A

pain is a separate modality caused by activity of a specific receptor (nociceptor)

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10
Q

Pain Theories: 4

  1. Pattern theory
A

Pain receptors share pathways and/or nerve endings with other sensory modalities

ex. light touch may not cause pain, but heavy touch might cause pain in that same area

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11
Q

Pain Theories: 4

  1. Gate control theory
A

combined specificity and pattern.

Neural gate mechanisms in spinal cord can block pain info from going to brain by involving brain fibers that sense touch

Research: simplistic approach

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12
Q

Pain Theories: 4

  1. Neuromatrix
A

Multifactorial: genetic, cognitive, sensory influences of the neural network

helps explain phantom pain

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13
Q

Pain threshhold

A

point at which a nociceptive stimulus is perceived as painful

uniform from person to person

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14
Q

Pain tolerance

A

Maximum intensity or duration of pain a person is willing to endure 3/10?

Variable: psychological, familial, cultural, environmental

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15
Q

Acute Pain

A

short term duration

serves as a warning

  1. Early wave: activates nociceptive stimuli at site of injury and hyperexcites the neurons in the CNS
  2. Second wave: longer lasting
    - -> inflam reaction to tissue injury ex. papter cut hurts at first but goes away bc of inflam process
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16
Q

Chronic Pain

A

when pain persists longer than normal ex ca

Highly variable- often not usual pain characteristics

  1. Peripheral: musculoskeletal
  2. Peripheral-Central: neuralgias, phantom, limb pain
  3. Central: CNS disease/injury
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17
Q

Possible negative consequences of chronic pain

A
  1. Physiological: loss appetite, sleep
  2. Psychological: depression
  3. Familial: everyone suffers
  4. Economic
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18
Q

Cutaneous pain

A

> skin/sc tissue

> sharp, burning, abrupt/slow

> usually localized

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19
Q

Deep Somatic pain

A

> from deep structures: muscle, tendon, bone

> diffuse, radiation

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20
Q

Visceral Pain

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A

> from activation of nociceptors of thoracic, pelvic, abd vescera. Very deep!

    • highly sensitive to distension, ischemia, inflam
    • not to cutting and burning
21
Q

Reffered Pain

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A

> Originating in viscera: experienced as oain more near body surface ex. heart attach and pain felt in arm

> alone or concurrent with localized pain from source

WHY?
> the visceral and peripheral neurons converge
> structures develop as embryo and stay connected

22
Q

Analgesia

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A

Absence of pain

23
Q

Hyperalgesia

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A

increased sensitivity to pain

24
Q

Hypoalgesia

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A

Decreased sensitivity to pain

25
Hyperpathia
Unpleasant, prolonged, response to pain. Explosive. An overreaction Pain threshold is elevated
26
Hyperesthesia
Abnormally increase in sensitivity to sensation ex. hearing, smells, touch
27
Hypoesthesia
Abnormal decrease in sensitivity to sensation ex, hearing, smells, touch
28
Paresthesia
Abnormal touch sensation without external stimuli; tingling, pins/needles
29
Allodynia
Pain produced by stimuli that do not normally cause pain. A mild touch that hurts someone
30
Neuropathic pain
Causes: > pressure on nerve > physical/chemical injury to neuron > infection/ischemia/inflammation of neuron Focal: trauma/disease of neuron Global: endocrine disease (DM), neurotoxic meds, chronic alcoholism 1. unexplainable pain 2. occurring without evidence of provocation 3. widespread pain 4. sensory deficits (paresthesia/numb) 5. occurring with light touch (allodyna) 6. burning/stabbing ect. 7. persistent/intermittent
31
Neuralgias
> severe, brief, repetitive attacks of lightening-like throbbing pain along spinal cranial nerve > usually percipitation by stimulation of cutaneous region supplied by nerve 1. Trigeminal neuralgia (5th)-face and jaw 2. postheraputic neuralgia (after shingles)
32
Trigeminal Neuralgia (Tix Douloureux)
*most common, most severe* Facial spasms ``` Triggers: > light touch >movement >drafts > eating ``` possibly d/t trigem nerve damage
33
Postherpetic Neuralgia
> chronic pain after shingles (herpes zoster) - -dormant in dorsal root ganglia - - variable pain types >Triggers: - -light touch - - cold wind - - clothing can hurt
34
Complex Regional Pain Syndrome (CRPS)
1. rare, has variable changes 2. Autonomic and vasomotor instability more sensitive than associated injury warrants 3. begins with one limb then expands 4. severe pain or hyperalgesia 5. edema, skin blood flow change 6. abnormal sensory motor activity CRPS-1: no definable injury, allodynia CRPS-2: allodynia/hyperalgesia after injury
35
Headaches Primary: Secondary:
P: >migraine/tension-type/cluster/chrinic daily S: >with/following serious disease --meningitis, cerebral tumor or aneurysm > triggered by disturbed sleep or over-exertion >accompanied by neurologic symptoms -- mentation changes, visual or limb disturbances
36
Migraine Headache: Without aura:
> thought to be inherited > Pulsatile, throbbing, unilateral >lasts 1-2 days >aggravated by physical activity > accompanied by - - N/V - - Light/sound sensitivity - - Visual hallucinations (sparks, flashes, ect) - -some ppl without aura may have prodromal symptoms such as fatigue, irritable for hrs or days bfr
37
Migraine Headache: With aura:
> similar symptoms plus pre-symptoms (aura) >aura develops over 5-20 min, lasts up to one hr -- characteristics vary but are fully reversible > visual symptoms --flickering light/spots, loss of vision > sensory symptoms -- pins/needles, numbness > speech or neurological disturbances
38
Retinal Migraine
Rare > recurrent, fully reversible scintillations (flash or spark of light), scotomata (area or alteration in feild of vision), blindness in one eye
39
Chronic migraine
15 days/month x 3 months
40
Transformed Migraine
> similar symptoms to tension-type or sinus ha > possibly d/t parasympathetic activation. > increase in frequency
41
Childhood Periodic Syndrome Migraine
>often r/t a serious disease process*** > 3 of the following to be diagnosed 1. abd pain 2. N/V 3. throbbing ha 4. unilateral location ha 5. aura 6. relief with sleep 7. positive family hx
42
Patho of migraines
>not well understood > trigeminal cranial nerve activation is common > altered hormonal levels --estrogen thought to be related > possible triggers -- monosodium glutamate, cheese, chocolate
43
Cluster Headache
1. uncommon 2. possibly hereditary 3. activation of trigeminal nerve and ANS*** 4. possible hypothalamus involvement 5. Men > women 6. 30-70 yo 7. last for weeks/months --> then remission 8. rapid onset pain, lasting 15-18min 9. severe, constant, unilateral 10. orbital most common area 11. can radiate to temple, cheeks, gums Accompanied by: 1. restless/aggitation 2. conjunctival redness, lacrimation 3. nasal congestion, rhinorrhea 4. facial sweating 5. Miosis (excessive constricting of pupil), ptosis (lid drooping), eyelid edema
44
Tension headache
``` > usually dont interfere with daily activities >dull, aching, diffuse > not associated with N/V > possible type of migraine > Associated with: -- scalp/neck muscle tension -- oromandibular dysfunction -- stress/anxiety/depression ```
45
Chronic Daily Headache (CDH)
1. 15+ days/month 2. no known cause 3. often resembles other ha types
46
TMJ pain
> imbalanced joint movement** --poor bite, bruxism (teeth grinding), inflam, trauma, degeneration > pain: face, neck, ears, head
47
Children and pain
> respond to nociceptive stimuli as neonates > demonstrate pain memory as infants >reliable/accurate reporters of pain at young age
48
Older adults and pain
Common types: 1. musculoskeletal 2. Rheumatologic- joints, CT disorders, autoimmune 3. Neurologic Unrelieved pain can result can result in: 1. gait disturbances, muscle waisting 2. impaired appetite 3. sleep disturbances 4. decreased cognition 5. economic impact

Patho Final (4 decks)

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