Stress & Pain

Question 1

neuro sx of stress

Answer 1

anxiety

difficulty concentrating

depression

irritability

mind fog

Question 2

CV sx of stress

Answer 2

high cholesterol

HTN

↑ risk for heart attack, CVA

Question 3

GI sx of stress

Answer 3

affects nutrient absorption

diarrhea

constipation

indigestion

bloating

discomfort

Question 4

integ sx of stress

Answer 4

hair loss

dull hair

brittle nails

dry skin

acne

delayed tissue repair

Question 5

MS sx of stress

Answer 5

inflammation

tension

aches and pains

Question 6

immune sx of stress

Answer 6

↓ functioning

Question 7

reproductive sx of stress

Answer 7

↓ hormone production

↓ libido

↑ PMS sx

Question 8

impact of stress on lymphocytes

Answer 8

reduces T-cell cytotoxicity & B-cell function

Question 9

when is coping adaptive?

Answer 9

when problem-focused

when social support is sought

Question 10

flight, fight, freeze arises from…

Answer 10

limbic system

Question 11

interprets danger

Answer 11

amygdala

Question 12

amygdala activates…

Answer 12

sympathetic NS (#1)

hypothalamus-pituitary-adrenal axis (#2)

Question 13

what happens when amygdala triggers SNS?

Answer 13

Autonomic nerves to adrenals trigger release of epinephrine (adrenalin)

↑ HR, BP, RR, airway dilation, alertness, sensory acuity, glucose and fats

blood shunted to muscles and brain

Question 14

what happens when amygdala triggers HPA?

Answer 14

releases corticotropin-releasing hormone (CRH)

triggers release of adrenocortiocropic hormone (ACTH)

triggering adrenals to release cortisol - potent anti-inflammatory, shuts off immune system; increases SNS response

Question 15

function of catecholamines

Answer 15

serve as neurotransmitters OR hormones which regulate physiologic functions such as breathing & HR

Question 16

catecholamines’ affect on immune system

Answer 16

↑ proinflammatory cytokine production

Question 17

cortisol affect on lymphocytes

Answer 17

T-cell apoptosis

Question 18

elevated levels of cortisol complications

Answer 18

↓ innate immunity and ↑ risk for autoimmune disorders

linked to obesity, sleep deprivation, lipid abnormalities, HTN, DM, atherosclerosis, bone density loss

Question 19

physiological complications of stress

Answer 19

• Enlargement of adrenals
• ↓ lymphocytes, immune functioning
• GI ulcers

Question 20

3 stages of general adaptation syndrome

Answer 20

alarm

resistance vs adaptation

exhaustion

Question 21

events of alarm stage

Answer 21

• Stressor triggers HPA axis
• Activates SNS
• Arousal of body defenses

Question 22

events of adaption vs resistance stage

Answer 22

• Begins with actions of adrenal hormones
• Mobilization contributes to fight or flight
• Adaptation resolves stress; resistance leads to exhaustion of all adaptogens, and individual enters exhaustion stage

Question 23

events of exhaustion stage

Answer 23

• Occurs if stress continues & adaptation is unsuccessful
• Leads to stress-related disorders

Question 24

allostatic overload

Answer 24

exhaustion stage of GAS

Question 25

function of A-delta myelinated fibers

Answer 25

transmit pain quickly

deal with acute pain

Question 26

function of unmyelinated C-polymodal fibers

Answer 26

transmit pain slowly

deal with chronic pain

diffuse, vague pain

Question 27

facilitation or inhibition of transmission before, during or after pain perception

Answer 27

pain modulation

Question 28

pain at one location may cause ↑ threshold at another location

Answer 28

perceptual dominance

Question 29

INTRACTABLE PAIN DISEASE

explanation

complication

Answer 29

severe, constant, relentless & debilitating pain not curable by any known means

causes house-bound or bedbound state

Question 30

SOMATIC PAIN

activated by…

2 forms

characteristics

duration

Answer 30

• Form of nociceptive pain
• Activated by force, temp, vibration, swelling
• Superficial (skin) or deep (muscles, bones, joints, tendons, ligaments, fascia, blood vessels)
• Characteristics - well localized; aching, gnawing, throbbing, cramping
• May be intermittent or constant

Question 31

VISCERAL PAIN

location

causes

characteristics

examples

Answer 31

• Activation of nociceptors of organs
• Viscera are highly sensitive to distension, ischemia & inflammation
• Characteristics - diffuse; difficult to localize; referred; n/v; changes in vital signs; emotional manifestations
• Ex - kidney stone, hydronephrosis

Question 32

cause of referred pain

Answer 32

Pain travels along dermatomes - usually a “mirror” location

Question 33

NEUROPATHIC PAIN

cause

characteristics

2 forms + etiology, examples

Answer 33

• Amplification of pain w/o stimulation
• Characteristics - burning, shooting, tingling, shocklike
• Peripheral neuropathic pain
  
  • Etiology - peripheral nerve lesions
  • Ex - trigeminal neuralgia; postherpatic neuralgia (shingles)
• Central neuropathic pain
  
  • Etiology - lesion/dysfunction in CNS
  • Ex - MS; spinal cord injury

Question 34

cause of phantom pain

Answer 34

the brain still has the “map” of that organ/limb - it knows something is meant to be there

Question 35

acute pain tract

Answer 35

neospinothalamic tract

Question 36

chronic pain tract

Answer 36

paleospinothalamic tract

Question 37

complication of chronic pain

Answer 37

↓ ability to tolerate/adapt to additional pain

Question 38

RICE

Answer 38

rest, ice, compression, elevation

Question 39

increases sensory stimulation at site, blocking pain transmission

Answer 39

transcutaneous electrical nerve stimulation

Question 40

function of endogenous opioids

examples

Answer 40

block pain conduction to CNS

enkephalins, endorphins, dynorphins, endomorphins

Question 41

what can cause thymus atrophy?

Answer 41

exhaustion stage of GAS