Brainscape's Knowledge GenomeTM

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


See full index

Pain Management > Unit 1 > Flashcards

Unit 1 Flashcards

1
Q

what are the 2 aspects of pain

A
  1. pain perception

2. pain reaction

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

what is pain perception

A
  • physical process by which pain is received from stimuli and transmitted by the nervous system (CNS and PNS)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is pain reaction

A
  • a person’s expression of or reaction to the perceived pain

- varies from person to person

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

what does a high pain threshold lead to vs a low pain threshold in reference to pain reaction

A
  • high pain threshold: low pain reaction

- low pain threshold: high pain reaction

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

what 3 factors can a person’s reaction to pain

A
  1. cognitive factors
  2. emotional factors
  3. symbolic factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are cognitive factors for pain

A
  • factors that influence how a person thinks about pain
  • what you say affects how patients thinks/reacts to pain
  • always inform patient of what is happening
  • important to make the patient feel like they are in control
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are emotional factors for pain

A
  • emotional factors, such as anxiety, influences patient’s tolerance to pain
  • increased anxiety decreases pain tolerance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are symbolic factors for pain

A
  • unique to each person. pain may symbolize an attack, damage or threat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are some other factors that may affect pain reactions

A
  • male: higher pain threshold
  • tired: low pain threshold
  • Latin American, European: low pain threshold
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what do neurons do in the physiological generation of pain

A
  • nerve cell which conducts impulses from the skin, mucous membranes and other sense organs to the brain and spinal cord
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the 2 types of nerves

A
  • afferent nerves

- efferent nerves

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

what are afferent nerves

A
  • sensory

- conduct signals from the sensory neurons to the spinal cord or brain (ie receiving a burn)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are efferent nerves

A
  • motor

- conduct signals away from the brain or spinal cord (ie moving hand away from the object causing the burn)

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

what are the functional regions of a sensory neuron

A
  • dendrites (input)
  • cell body
  • axon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what 2 things does a sensory neutron need to be able to do to get a message to the CNS

A
  • sense a message

- move the message

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is excitability

A
  • sensing the message
  • nervous tissue has property of excitability
  • responds to a change in the environment or stimuli (injury, chemical, electrical or temperature)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is conductivity

A
  • moving the message
  • when stimulated, nerve tissue has the property of conductivity, which is the ability to transmit nerve impulses to the CNS
  • messages from the brain are then conveyed back to the various effectors to make adjustments
18
Q

what is the mechanism of the nerve impulse

A
  • a stimulus excites the nerve, leading to the following sequence of events
    1. polarization/resting potential
    2. depolarization and firing potential
    3. repolarization
    4. return to resting state
19
Q

what is polarization

A
  • means that the electrical charge on the outside of the membrane is positive, while the electrical charge on the inside of the membrane is negative
  • nerve membrane is polarized and negatively charged at -70mV
20
Q

how is the charge maintained

A
  • gates of Na+ ion channels are closed, keeping the Na+ outside the cell
  • gates of K+ ion channels are open, but K+ remains mostly inside the cell due to the negative charge
  • Na+ ion channels are kept closed by Ca+ ions bonded onto receptor sits on the cell membrane
  • Na+ ions are in complexes that are too large to fit through K+ channels
  • remember, there are many different electrolytes (ions) in both the cell and extracellular environment
21
Q

what is depolarization

A
  • outer surface of the membrane becomes electronegative
  • inner surface becomes electropositive
  • occurs when stimuli temporarily alter the permeability of the membrane, opening the Na+ channel gates
  • calcium gates move to allow movement of ions
  • sodium ions rush inside the axon
  • potassium ions leave the cell
22
Q

what happens when a stimulus challenges the resting potential

A
  • depolarization is slow at first until it goes from -70mV to -55 mV, but then it picks up to rapid depolarization
23
Q

what is another name for rapid depolarization

A
  • threshold potential or firing potential
24
Q

what will be the electrical charge when the neuron is at threshold potential

A
  • +40mV inside
25
Q

what happens with neuron firing when using local anesthetic

A
  • firing threshold is raised, requiring more current to pass through the membrane to decrease the negativity to the point where depolarization occurs
26
Q

what is repolarization

A
  • occurs once the peak of the firing potential is reached and the membrane potential begins to move back toward the resting potential
  • normal membrane potential is restored to -70mV, and the membrane again becomes impermeable to sodium ions
27
Q

after depolarization occurs, what happens to remaining sodium in the cell

A
  • some can travel out along the concentration gradient
  • sodium pump will help transfer additional sodium which would require lots of energy to go against the concentration gradient
  • potassium is also actively transported back into the cell
28
Q

in summary, what are the events in a successful nerve impulse

A
  • resting state (polarization)
  • depolarization (slow, then rapid)
  • repolarization (return to resting state)
29
Q

what is the absolute refractory period

A
  • immediately after a stimulus has initiated an impulse, the nerve is unable to respond to another stimulus, for a time, regardless of its strength
30
Q

what is the relative refractory period

A
  • this follows the absolute refractory period. a new impulse can be initiated but only by a stronger than normal stimulus
31
Q

why are sodium ions bigger than potassium ions

A
  • because water is attached to sodium ions. this makes them too big to pass through the potassium channels
32
Q

what is action potential

A
  • the rapid sequence of changes in the cell membrane (- to + and + back to -) is termed action potential
33
Q

how is an impulse conducted in an unmyelinated axon

A
  • nerve impulses travel along the fiber
  • impulses move continuously as waves
  • impulses move at a much slower rate compared to myelinated
34
Q

how is an impulse conducted in a myelinated axon

A
  • nerves that are protected against stimulated by a myelin sheath (a lipid covered)
  • impulse jumps from nodes of ranvier
35
Q

what are nodes of ranvier

A
  • weak susceptible area along the myelinated nerve, where there is little or no myelin and the membrane is 500 times more permeable than some non-myelinated nerves
36
Q

what is saltatory conduction

A
  • hop or leap
  • conduction of a nerve impulse via the nodes of ranvier
  • impulse travels down the nerve fibre by jumping from one node to the next, sometimes skipping a node
37
Q

for anesthetic to be effective, how much of the nerve must be covered

A
  • about 8-10 mm or at least 2-3 nodes of ranvier

- this stops saltatory conduction as the message cannot jump that far to be transmitted

38
Q

what are 2 advantages of saltatory conduction

A
  1. increased speed of impulse travel

2. conservation of energy since only nodes depolarize thus causing only minimal work for the sodium and potassium pumps

39
Q

if a nerve fibre is larger, what does this mean for local anesthetic

A
  • the larger the nerve fibre, the thicker the myelin sheath, the more rapid the impulse transmission
  • the larger the diameter of the nerve fibre, the greater the amount of local anesthetic needed (IA and PSA blocks require more anesthetic than infiltration)
40
Q

what is the all or nothing principle

A
  • stimuli must be of a certain magnitude (minimal threshold level) to cause a nerve impulse
  • if a neutron responds at all, it must respond completely = ALL
  • if the stimulus is of insufficient magnitude, nothing happens = NOTHING
41
Q

how does local anesthetic work

A
  • mainly inhibit sodium influx through sodium ion channels in the neutron cell membrane
  • LA agents work by displacing the calcium ions that block sodium ion channels
  • LA agents bond more tightly to the receptors than the calcium, which means that the sodium ion channels will remain closed
  • LA agents decrease the rate of depolarization
42
Q

in NB, what is necessary for a hygienist to deliver anesthetic

A
  • a specific written order, signed by a licensed dentist or a physician
  • changes to HH require a new signature

Pain Management (4 decks)

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