Unit 5 Chapter 13 & 14 Flashcards
Astrocytes with joined endothelial cells of the capillaries in the CNS contribute to the
blood brain barrier
with out myelin the axon will
die
neurotransmitters
small molecules that incorporate positively charged nitrogen atom
neural tube develops during the ___-___ week
3rd-4th
most congenital abnormalities of SC result from
defective closure of the neural tube (spina bifida)
vertebral column and spinal dura grow faster than
spinal cord
cord usually terminates at ___ in adults
L1
___-___ has pocket of CSF= spinal tap
L2-S2
what will enter the brain with ease
water, carbon dioxide, oxygen
do water soluble or lipid soluble readily enter the blood brain barrier
lipid soluble
what are some examples of substances that are lipid soluble
alcohol, nicotine, heroin
what would increase peremeability
trauma, infection, birth
if there is an infection in the brain what soluble antibiotic must we use
lipid
the blood brain barrier is more permeable at birth which would cause risk for _____________ from _________
kernicterus, bilirubin
what philosopher thought about pain
Descartes
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 ______
nociceptors, occurs
peripheral fibers are ______ ______ _________
free nerve endings
peripheral fibers are widely distributed in
skin, dental pulp, periosteum, meninges, internal organs
first order neurons detect stimuli that threaten the
integrity of innervated tissues
second order neurons are located in
spinal cord
second order neurons process ___________ information and transmit it to the brain stem ___________ formation and _________
nociceptive, reticular, thalamus
third order neurons project pain information from the _________ to the ____________ _______
thalamus, somatosensory cortex
why might a paper cut be more painful than an abdominal mass why
there are more nerve endings in the skin than the internal organs
neospinothalamic tract pain
bright, sharp, stabbing
paleospinothalamic tract pain
diffuse, dull, aching, unpleasant sensations
fast pain is will what fibers
A fibers
are A fibers myelinated or not
myelinated
A fibers are incited by what stimuli
mechanical or thermal
slow eave pain is what fibers
C fibers
are C fibers myelinated or not
unmyelinated
C fibers are incited by what stimuli
chemical/persistent mechanical/thermal
opioid peptides
Enkephalins, endorphins, dynorphins
what do prostaglandins do
enhance sensitivity of pain endings
what do aspirin/nonsteroidals do
block the enzyme needed for prostaglandin synthesis which results in pain control
pain perception
information about pain is received and processed by the higher centers in the brain, ___________, __________, and the individual perceives pain
thalamus, cerebral cortex
endogenous analgesia is located in the
PAG
the PAG has what receptors highly concentrated there
opioid
PAG is connected to what system
limbic
what is a pain neurotransmitter
serotonin
PAG has a dense population of
cells
pain threshold
point at which a stimulus is perceived as painful
is threshold uniform or specific to the person
uniform
pain tolerance
maximum intensity or duration of pain that a person is willing to endure before the person wants something done about the pain
is pain tolerance uniform or specific to the person
specific to the person
what does pain intolerance depend on
psychological, familial, cultural, environmental factors
3 types of pain
cutaneous, deep somatic, visceral
cutaneous pain
superficial such as skin and subcutaneous structures
cutaneous pain feels like
sharp stabing
deep somatic
periosteum, muscles, tendons, joints and blood vessels; radiation may occur
visceral has its origin in
visceral organs
visceral feels like
cramping
referred pain
pain perceived at a site different from its point of origin but innervated by the same spinal segment
how are sites of referred pain determined by
embryologically and where the structure originated from
you might get liver and lung/diaphragm pain where
shoulders
which will require less medications acute or chronic
acute
less medication is needed when the drug is given before pain becomes
severe and pathways are sensitized
chronic is classified as
abnormal lengths of pain, greater than 6 months
some examples of chronic pain
back pain, sickle cell pain, migraine, cancer, neuropathy
neuropathic pain presents as
burning, numbness, tingling, touch, sensitivity, sharp and shooting sensations
who might develop neuropathic pains
DM, HIV/AIDS, postherapeutic neuralgia, cancer induced syndrome like chemotherapy neuropathies, and phantom limb pain
allodynia and hyperalgesia
greater perception of pain in higher centers
neuropathic pain is caused by
lesions
percent of amputees that experience phantom pain
70%
10% of caucasians do not have the enzyme to metabolize codeine which leads to
all the symptoms like nausea and vomiting but no pain relief
can we or can we not do placebos
cannot
why can we not do placebos anymore
not ethical, harms relationship with patient and nurse
what are some examples that can lead to pain relief
foot/hand massages and music
is cancer pain chronic or acute
chronic
NSAIDS decrease the sensitivity of blood vessels to ___________ and __________ and the result is reverse vasodilatation and decrease the release of inflammatory mediators
bradykinin, histamine
what enzyme do ASA and NSAIDS inhibit for the process of prostaglandins
cycloxygenase
prostaglandins affect sensation of pain by sensitizing __________ to chemical mediators such as bradykinin and histamine
nociceptors
adjutant pain medications help what medication work better
opiods
examples of adjuvant pain medications
tricyclic antidepressants, anticonvulsants, corticosteroids
anticonvulsants supress
spontantous neuronal firing
corticosteroids help with
inflammation
what is the acupressure spot on the hand called
L4
pain pathways are developed and functional by the
last trimester of pregnancy
for infants and noncommunicating children ____________ symptoms must be used for assessment
physiological
older adults do not tell when their are in pain because they believe the pain comes with being older but actually
pain does not come from being odler
children experience and remember
pain
can you give a child opiods
yes
3 types of classifications of headaches
primary headaches, headaches secondary to other medical conditions, cranial neuralgias and facial pain
migraine headache affects mainly men or women
women
migraine patients could or could not present with this prior to getting the migrane
aura
migrane could be caused by what factors
genetic, enviromental
migrane activation of the ___________ system, _________ spreading depression, distinct activity of brainstem nuceli
trigeminal, cortical
migraine may present with what 2 phobias
photophobia, phonophobia
photophobia
light
phonophobia
noise
diagnosis: when any two symptoms occur
unilateral head pain (whole head), pulsating pain, pain worsening with activity, moderate or severe pain
fever results from _________ induced increase in the set point of thermostatic center in _______________
cytokine, hypothalamus
fever non specific response mediated by ____________ _________ released from host cells in response to infectious or non infectious disorder
endogenous pyrogens
fever normally presents with _____cardia
tachy
two types of fever that will cause bradycardia
legionnaire and drug fever
what age group will have same heart rate with a fever
elderly
in elderly slight elevations in temp may indicate
serious infection
