Week 4

Question 1

somatic vs. visceral pain

Answer 1

somatic: from skin or bine muscle, conducted by sensory fibers
visceral: from organs, conducted by sympathetic fibers, acute or chronic

Question 2

sensory dimensions

Answer 2

location, intensity, pattern, quality

Question 3

pain threshold

Answer 3

the point at which stimulus is perceived as painful

Question 4

pain tolerance

Answer 4

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

Question 5

Autonomic responses

Answer 5

to protect the individual (eg. moving your hand from a hot stove)

Question 6

Behavioural responses

Answer 6

Learned behaviours as a method to coping with the pain (eg. rubbing a sore leg)

Question 7

Hyperalgesia

Answer 7

an increased sensitivity to pain, which may be the result of damage to nociceptors or peripheral nerves (eg. shingles)

Question 8

neural mechanisms by which pain is perceived (nociception)

Answer 8

transduction, transmission, perception, modulation

Question 9

transduction

Answer 9

The conversion of a mechanical, thermal or chemical stimulus into a neuronal action potential. occurs at free nerve endings

Question 10

transmission

Answer 10

The movement of pain impulses from the site of transduction to the brain

Question 11

the 3 segments involved in nociception signal transmission

Answer 11

Segment 1: Transmission along nociceptor fibers (A & C) to the spinal cord
Segment 2: Dorsal Horn Processing ((includes the release of neurotransmitters (eg. substance P) which may either excite or inhibit the cell.)
Segment 3: Transmission to the thalamus and cortex (pain pathways)

Question 12

perception

Answer 12

Occurs when pain is recognized, defined and responded to.
Conscious awareness of the pain.
Subjective interpretation

Question 13

Modulation

Answer 13

Pathways that integrate nervous system impulses (from nociceptors, peripheral sensory axons, spinal interneurons etc.) (Involves the activation of descending pathways that exert inhibitory or excitatory effects on pain transmission that will either suppress or facilitate pain)

Question 14

Gate control theory

Answer 14

Gates open: Pain impulses transmitted from periphery to brain
Gates closed: Reduces or modifies the passage of pain impulses

Question 15

Increased Intracranial Pressure

Answer 15

Increase in fluid or additional mass causes increase in pressure in the brain. (Ischemia and eventual infarction and death of brain tissue)

Question 16

Increased ICP is common in …

Answer 16

Brain hemorrhage, trauma, cerebral edema, infection, tumors, abnormal circulation of CSF

Question 17

Early signs of increased ICP—if cause is not removed

Answer 17

Decreasing level of consciousness or decreased responsiveness (lethargy)
Severe headache
(From stretching of dura and walls of large blood vessels)
Vomiting
(Often projectile, not associated with food intake)
(Result of pressure stimulating the emetic center in the medulla)
Papilledema
(Caused by increased ICP and swelling of the optic disc)

Question 18

if ICP is not relived it can cause

Answer 18

drop in BP
respiratory controls get destroyed
cheyne-strokes respirations

Question 19

different types of herniation

Answer 19

transtentorial- Cerebral hemispheres, diencephalon, midbrain are displaced downward
uncal- Uncus of the temporal lobe is displaced downward.
infratentorial- Cerebellar tonsils are pushed downward through the foramen magnum.

Question 20

types of seizures

Answer 20

general- Widespread onset with abnormal discharges synchronized throughout all or most of the brain from onset (absence, blank stare or motionless) (myoclonic, brief)(tonic-clonic, MOST COMMON)
partial- Onset in a specific restricted area

Question 21

status epilepticus

Answer 21

Recurring seizures in rapid succession, No break to regain consciousness, Can cause permanent neuronal damage,
May lead to respiratory failure and death

Question 22

treatment for seizures

Answer 22

anticonvulsant drugs

Question 23

what is autonomic dysreflexia

Answer 23

Massive sympathetic reflex response that cannot be controlled from the brain,
often initiated by infection, genital stimulation, or other stimuli (occurs with injury of cervical spine)
leads to:
-Increased blood pressure
-Vasoconstriction below the injury
-Vasodilation above the injury
-Bradycardia

Question 24

complication of spinal cord injury

Answer 24

• Urinary tract infections
• Pneumonia
• Skin breakdown
• Spasm and pain ( resulting in contractions)
• Depression
• Sexual dysfunction and reproductive capacity

Question 25

function of NSAIDS

Answer 25

Block the COX I enzyme and COX II

Question 26

most common adverse effects of NSAIDS

Answer 26

diarrhea and GI upset

Question 27

common drug interactions of NSAIDS

Answer 27

anticoagulants
high dose steroids
antiplatelets

Question 28

MOA of antidepressants

Answer 28

Mechanism of action thought due to neurotransmitter modulation in the brain

Question 29

MOA of anticonvulsants

Answer 29

act centrally via CNS depression

Question 30

what is classified as an opioid

Answer 30

Any any drug, natural or synthetic, that has actions similar to those of morphine

Question 31

what is classified as an opiate

Answer 31

Specific to drugs isolated from opium poppies (ine)

Question 32

MOA of opioids

Answer 32

bind to Mu and Kappa opioid receptors in CNS to reduce pain

Question 33

what is a narcotic

Answer 33

Refers to any medically used controlled substances and in legal settings referred to as illicit or illegal substances

Question 34

tolerance

Answer 34

Once tolerance occurs, a larger dose of opioids is required to maintain the same level of analgesia

Question 35

dependance

Answer 35

Abrupt removal of the drug causes withdrawal

Question 36

addiction

Answer 36

A pattern of compulsive drug use despite harmful consequences

Question 37

what is potency

Answer 37

Potency is a term applied to drugs that all have the same mechanism of action

Question 38

example of potent

Answer 38

If a drug needs ten times the dose to achieve the same effect as another it’s 1/10th as potent

Question 39

symptoms of opioid overdose

Answer 39

• shallow/no breathing
• vomitting
• unresponsive/unconcious
• cold skin/pallor
• pinpoint pupils