Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
NURS 350 patho pain
Pain, temperature
| Question | Answer |
|---|---|
| 3 aspects of understanding pain | sensory/descriminative, motivational/affective, cognitive/evaluative |
| what mediates sensory/descriminitive aspects of pain | mediated by afferent nerves, spinal cord, brainstem, higher brain centers |
| name 3 types of pain fibers | A-delta, Type C, A-Beta |
| what class of neurons are A-delta and Type C | first order neurons, nociceptive |
| what class is A-Beta fiber | non-nociceptive fiber that INHIBITS A-delta, Type C |
| type of stimuli and physical characteristics of A-Delta | receives mechanical or thermal stimuli and conducts with fast, thick, myelinated axons for intense pain |
| type of stimuli and physical characteristics of Type C | receives chemical, as well as mechanical and thermal bwo polymodal receptors which transmit on small, unmeyelinated fibers--> diffuse, throbbing, burning or chronic pain |
| somatogenic pain | pain witha physical cause |
| psychogenic pain | no KNOWN physical cause, but not imaginary (fibromyalgia) |
| most pain is a mixture of | somatogenic and psychogenic pain |
| types of physical pain | acute or chronic |
| properties of acute pain | protective, begins suddenly-motivates to relieve cause, relieved when chemical mediators removed, associated with anxiety & hope of recovery |
| acute pain may manifest as | somatic, vesceral or referred |
| what type of fibers contribute to acute pain | A-Delta and Type C contribute |
| visceral pain manifests as | poorly localized (except if stretch receptors in viscera activated, then acute), often radiates |
| visceral pain associated with | n/v, hypoTN, restlessness, shock |
| referred pain characteristics | impulse converge on same ascending neuron, brain cant discriminate |
| physiological responses to acute pain | adrenergic response (inc HR, Resp, BP, flushin, diaphoresis, hyperglycemia, mydriasis) |
| physiological response to chronic pain | sympathetic adapts over time --> normal HR, Resp, BP, may have intermittent acute pain episodes. associated with depression |
| pain threshold | point at which stimulus perceived as pain |
| pain tolerance | time or intensity individual will endure pain before initiating overt pain responses |
| pain neuroanatomy involves | afferent pathways, CNS, efferent pathways |
| where do affernt pathways terminate | dorsal horn of spinal cord |
| nociceptors equipped to receive stimuli from these channels | traditional voltage gated, TRP channels = transient receptor potential channels |
| MOA of TRP channels | reside on naked nerve endings and respond to variety of stimuli |
| what class of neurons act as pain gate | 2nd order neurons = projection neuron, excitatory interneuron, inhibitory interneuron |
| what happens once 2nd order neurons gate the pain signal | 2nd order neurons CROSS OVER in from dorsal horn in spinal cord to spinothalamic tract, then transmit to 3rd order -->periacueductal grey matter, thalamus, reticular formation, limbic system, sensory cortex |
| name 5 inflammatory mediators | bradykinin, leukotrienes, prostaglandins, nitric oxide |
| exciatory transmitter | glutamate, and others |
| inhibitory transmitters | endogenous opioids, GABA |
| neuromodulators | serotonin, others |
| name 4 endogenous opioids | endomorphins, endorphins, dynorphins, enkephalins |
| MOA endogenous opioids | inhibit release of excitatory glutamate et al right before gain at 1st order neuron |
| HOA of opiates | bind opiate receptors to enhance natural endorphin response |
| how we increase endogenous opioids to raise pain threshold | sex, stress, physical exertion, acupuncture |
| what disease state may involve circulating endorphins | silent heart attack |
| once signal decussates to spinothalmic tract, how is it processed | either goes to (brain stem OR reticular formation OR hypothalamus,thalamus), limbic, cerebral cortex |
| thalmus role when signal arrives | discriminates and localizes pain |
| limbic and reticular systems functions for pain | alert, arousal and motivating behaviros |
| medulla/hypothalamus functions for pain | coping, flight/fight, cortisol release, CV response |
| what fibers in the efferent pathway are responsible for modulating pain sensation | reticular formation -->midbrain-->sustantia gelantinosa in spinal cord-->taret effector organ |
| how is temperature regulation acheived | balancing of heat production, heat conservation and heat loss |
| what mediates hormonal aspect of temp reg | hypothalamus |
| if temp is low, hypothalamus triggers these responses | heat production --- heat conservation |
| MOA of heat production - endocrine | hypothal ---TSHRH---ant pit---TSH---thyroid---thyroxine---adrenal medulla----epi/norepi |
| heat production when epi/norepi released | vasoCON shunts blood to core, increased glycolysis, increased metabolic rate |
| the chemical reactions of heat production induce | skeletal muscle tone/contraction, chemical thermiogenesis |
| heat conservation MOA | hypothal---sympathetic/adrenergic---shivering/vasocon shunt to core. ALSO relays to cortex, voluntary response to curl up, get blanket, etc. |
| if temp too high, body will | decreased sympathetic response will reverse mechanisms of heat production, heat conservation AND involke mechanism of heat loss |
| 3 mechanisms of heat loss | radiation (off surface), conduction (by direct contact), convection (by gases) |
| other mechanisms of heat loss | vasoDIL gets warm blood to perifpher, dec muscle tone, evaporation, increased resp, voluntary, adaptation to warm climates (increased ECF & plasma) |
| benefits of fever - microorganisms | kills, affects growth, affects replication |
| benefits of fever - elements | decreases serum Fe, Zn, Cu which are needed for bacterial replication |
| benefits of fever - misc | lysosomal breakdown-->autodigestion of infected cells. Increases interferon, enhances phagocytosis |
Created by:
lorrelaws
Popular Nursing sets