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Pathophysiology > Unit 5 Chapter 13 & 14 > Flashcards

Unit 5 Chapter 13 & 14 Flashcards

1
Q

Astrocytes with joined endothelial cells of the capillaries in the CNS contribute to the

A

blood brain barrier

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2
Q

with out myelin the axon will

A

die

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3
Q

neurotransmitters

A

small molecules that incorporate positively charged nitrogen atom

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4
Q

neural tube develops during the ___-___ week

A

3rd-4th

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5
Q

most congenital abnormalities of SC result from

A

defective closure of the neural tube (spina bifida)

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6
Q

vertebral column and spinal dura grow faster than

A

spinal cord

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7
Q

cord usually terminates at ___ in adults

A

L1

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8
Q

___-___ has pocket of CSF= spinal tap

A

L2-S2

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9
Q

what will enter the brain with ease

A

water, carbon dioxide, oxygen

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10
Q

do water soluble or lipid soluble readily enter the blood brain barrier

A

lipid soluble

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11
Q

what are some examples of substances that are lipid soluble

A

alcohol, nicotine, heroin

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12
Q

what would increase peremeability

A

trauma, infection, birth

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13
Q

if there is an infection in the brain what soluble antibiotic must we use

A

lipid

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14
Q

the blood brain barrier is more permeable at birth which would cause risk for _____________ from _________

A

kernicterus, bilirubin

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15
Q

what philosopher thought about pain

A

Descartes

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16
Q

at low levels of intensity, these stimuli may activate _________, but are typically not perceived as painful until the intensity reaches a level where tissue damage ______

A

nociceptors, occurs

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17
Q

peripheral fibers are ______ ______ _________

A

free nerve endings

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18
Q

peripheral fibers are widely distributed in

A

skin, dental pulp, periosteum, meninges, internal organs

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19
Q

first order neurons detect stimuli that threaten the

A

integrity of innervated tissues

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20
Q

second order neurons are located in

A

spinal cord

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21
Q

second order neurons process ___________ information and transmit it to the brain stem ___________ formation and _________

A

nociceptive, reticular, thalamus

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22
Q

third order neurons project pain information from the _________ to the ____________ _______

A

thalamus, somatosensory cortex

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23
Q

why might a paper cut be more painful than an abdominal mass why

A

there are more nerve endings in the skin than the internal organs

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24
Q

neospinothalamic tract pain

A

bright, sharp, stabbing

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25
Q

paleospinothalamic tract pain

A

diffuse, dull, aching, unpleasant sensations

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26
Q

fast pain is will what fibers

A

A fibers

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27
Q

are A fibers myelinated or not

A

myelinated

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28
Q

A fibers are incited by what stimuli

A

mechanical or thermal

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29
Q

slow eave pain is what fibers

A

C fibers

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30
Q

are C fibers myelinated or not

A

unmyelinated

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31
Q

C fibers are incited by what stimuli

A

chemical/persistent mechanical/thermal

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32
Q

opioid peptides

A

Enkephalins, endorphins, dynorphins

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33
Q

what do prostaglandins do

A

enhance sensitivity of pain endings

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34
Q

what do aspirin/nonsteroidals do

A

block the enzyme needed for prostaglandin synthesis which results in pain control

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35
Q

pain perception
information about pain is received and processed by the higher centers in the brain, ___________, __________, and the individual perceives pain

A

thalamus, cerebral cortex

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36
Q

endogenous analgesia is located in the

A

PAG

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37
Q

the PAG has what receptors highly concentrated there

A

opioid

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38
Q

PAG is connected to what system

A

limbic

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39
Q

what is a pain neurotransmitter

A

serotonin

40
Q

PAG has a dense population of

A

cells

41
Q

pain threshold

A

point at which a stimulus is perceived as painful

42
Q

is threshold uniform or specific to the person

A

uniform

43
Q

pain tolerance

A

maximum intensity or duration of pain that a person is willing to endure before the person wants something done about the pain

44
Q

is pain tolerance uniform or specific to the person

A

specific to the person

45
Q

what does pain intolerance depend on

A

psychological, familial, cultural, environmental factors

46
Q

3 types of pain

A

cutaneous, deep somatic, visceral

47
Q

cutaneous pain

A

superficial such as skin and subcutaneous structures

48
Q

cutaneous pain feels like

A

sharp stabing

49
Q

deep somatic

A

periosteum, muscles, tendons, joints and blood vessels; radiation may occur

50
Q

visceral has its origin in

A

visceral organs

51
Q

visceral feels like

A

cramping

52
Q

referred pain

A

pain perceived at a site different from its point of origin but innervated by the same spinal segment

53
Q

how are sites of referred pain determined by

A

embryologically and where the structure originated from

54
Q

you might get liver and lung/diaphragm pain where

A

shoulders

55
Q

which will require less medications acute or chronic

A

acute

56
Q

less medication is needed when the drug is given before pain becomes

A

severe and pathways are sensitized

57
Q

chronic is classified as

A

abnormal lengths of pain, greater than 6 months

58
Q

some examples of chronic pain

A

back pain, sickle cell pain, migraine, cancer, neuropathy

59
Q

neuropathic pain presents as

A

burning, numbness, tingling, touch, sensitivity, sharp and shooting sensations

60
Q

who might develop neuropathic pains

A

DM, HIV/AIDS, postherapeutic neuralgia, cancer induced syndrome like chemotherapy neuropathies, and phantom limb pain

61
Q

allodynia and hyperalgesia

A

greater perception of pain in higher centers

62
Q

neuropathic pain is caused by

A

lesions

63
Q

percent of amputees that experience phantom pain

A

70%

64
Q

10% of caucasians do not have the enzyme to metabolize codeine which leads to

A

all the symptoms like nausea and vomiting but no pain relief

65
Q

can we or can we not do placebos

A

cannot

66
Q

why can we not do placebos anymore

A

not ethical, harms relationship with patient and nurse

67
Q

what are some examples that can lead to pain relief

A

foot/hand massages and music

68
Q

is cancer pain chronic or acute

A

chronic

69
Q

NSAIDS decrease the sensitivity of blood vessels to ___________ and __________ and the result is reverse vasodilatation and decrease the release of inflammatory mediators

A

bradykinin, histamine

70
Q

what enzyme do ASA and NSAIDS inhibit for the process of prostaglandins

A

cycloxygenase

71
Q

prostaglandins affect sensation of pain by sensitizing __________ to chemical mediators such as bradykinin and histamine

A

nociceptors

72
Q

adjutant pain medications help what medication work better

A

opiods

73
Q

examples of adjuvant pain medications

A

tricyclic antidepressants, anticonvulsants, corticosteroids

74
Q

anticonvulsants supress

A

spontantous neuronal firing

75
Q

corticosteroids help with

A

inflammation

76
Q

what is the acupressure spot on the hand called

A

L4

77
Q

pain pathways are developed and functional by the

A

last trimester of pregnancy

78
Q

for infants and noncommunicating children ____________ symptoms must be used for assessment

A

physiological

79
Q

older adults do not tell when their are in pain because they believe the pain comes with being older but actually

A

pain does not come from being odler

80
Q

children experience and remember

A

pain

81
Q

can you give a child opiods

A

yes

82
Q

3 types of classifications of headaches

A

primary headaches, headaches secondary to other medical conditions, cranial neuralgias and facial pain

83
Q

migraine headache affects mainly men or women

A

women

84
Q

migraine patients could or could not present with this prior to getting the migrane

A

aura

85
Q

migrane could be caused by what factors

A

genetic, enviromental

86
Q

migrane activation of the ___________ system, _________ spreading depression, distinct activity of brainstem nuceli

A

trigeminal, cortical

87
Q

migraine may present with what 2 phobias

A

photophobia, phonophobia

88
Q

photophobia

A

light

89
Q

phonophobia

A

noise

90
Q

diagnosis: when any two symptoms occur

A

unilateral head pain (whole head), pulsating pain, pain worsening with activity, moderate or severe pain

91
Q

fever results from _________ induced increase in the set point of thermostatic center in _______________

A

cytokine, hypothalamus

92
Q

fever non specific response mediated by ____________ _________ released from host cells in response to infectious or non infectious disorder

A

endogenous pyrogens

93
Q

fever normally presents with _____cardia

A

tachy

94
Q

two types of fever that will cause bradycardia

A

legionnaire and drug fever

95
Q

what age group will have same heart rate with a fever

A

elderly

96
Q

in elderly slight elevations in temp may indicate

A

serious infection

Pathophysiology (44 decks)

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