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505 Ch 15 - Anjum's Delivery of Pain
Anjum Knocked these out today!
71
Nursing
Graduate
12/05/2011

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Term
Nociception
Definition
sensory process leading to pain perception
Term
Nociceptors
Definition
Bare nerve endings in skin, connective tissue, muscle, joints, arteries, viscera
Term
nociceptors respond to
Definition
chemical, mechanical and thermal stimuli, starts functioning @ 24 weeks gestation :)
Term
Pain fibers= A delta
Definition
Myelinated and fast
Term
Pain fibers = C fibers
Definition
Unmyelinated and slow…most common related with pain transmision
Term
pain theories
Definition
Specificity, gate and nueromatrix
Term
Specificity theory of pain
Definition
amount of pain = amount of tissue injury
Term
Gate theory of pain
Definition
pain modulated between A delta and C fibers
Term
Neuromatrix
Definition
Brain produces patterns of nerve impulses, e.g. phantom limb pain, neuropathies
Term
Pain is inhibited by which chemicals?
Definition
Endorphins, enkephalins, serotonin, norepinephrine, GABA(gamma aminobutyric acid)
Term
Endorphins and enkephalins are…..
Definition
body's endogenous opioids
Term
Pain's excitatory chemicals are
Definition
Glutamate, aspartate, PGs, bradykinin, lymphokines
Term
Bradykinins and PGs released by
Definition
tissue injury
Term
lymphokines released associated with
Definition
chronic inflammation
Term
Acute pain is
Definition
sudden and protective
Term
Acute pain can also cause
Definition
Anxiety, increased heart rate, BP, temperature, blood sugar level, sweating AND decreased intestinal motility, gastric acid secretion and blood flow
Term
Somatic pain
Definition
Superficial, Sharp and carried by Sensory fibers
Term
Visceral
Definition
Deep, poorly localized, carried by sympathetic fibers and ass. With nausea, vomiting, restlessness and hypotention
Term
Referred pain
Definition
Distant from original location DUE to the same spinal supply, e.g non-cardiac pain location for MI/angina
Term
Chronic pain
Definition
persistent/intermittent, lasting for 3-6 months, e.g. cancer pain, backache, myofascial pain syndrome
Term
Neuropathic pain
Definition
chronic pain, due to nerve injury or disease, e.g. diabetic neuro,. Phantom, complex regional pain syndrome, post-herpetic neuralgia
Term
pain threshold
Definition
lowest point @ which pain stimulus is perceived/pain is felt
Term
pain tolerance
Definition
Amount of time or intensity of pain that can be endured before responding to pain
Term
perceptual dominance
Definition
pain @ one location may cause an increase in the threshold in another location, e.g. hip/back pain
Term
All above 3 vary by
Definition
CULTURE
Term
pain tolerance
Definition
decreased in older adults, with increase or no change of threshold
Term
temp. regulated by
Definition
hypothalamus
Term
body produces heat through
Definition
muscle contraction, vasoconstriction, metabolic reactions, chemical thermogenesis,
Term
body loses heat through
Definition
decreased muscle tone, vasodil., radiation, conduction, convection,evaporation, increased respirations, adapt. To warmer climates
Term
fever is due to the temporary
Definition
reset of hypothalamic thermostat due to pyrogens(extogenous=endotoxins by pathogens/endogenous)
Term
T/F: fever should always be treated?
Definition
F: fever kills many micro-org., causes lysosomal breakdown and autodestruction of cella so virus can't replicate
Term
Fever increases…
Definition
lymphocytic transformation for immune response
Term
Fever decreases…
Definition
iron, zinc and copper (that are important for bacterial division) WOW
Term
fever enhances
Definition
phagocytosis and interferon production
Term
hyperthermia
Definition
excessive core warming
Term
T/F: hyperthermia caused by pyrogens
Definition
F: it is most due to excessive heat, e.g. heat cramps, heat exhaustion, heat stroke
Term
at 105.8 F
Definition
nerve damage, cell proteins' coagulation, fits
Term
At body temperature 109.4 F, what will happen?
Definition
death
Term
heat cramps are due to
Definition
strenous exercise in warmer climate and in people who r not used to such temperatures
Term
what happens in heat cramps
Definition
severe episodes of abdmonial or extremities cramping followed by excess sweating AND LOSS OF SODIUM
Term
what should u do when you experience heat cramps?
Definition
drink plenty of water WITH added salt or I/V saline fluids
Term
symptoms of heat cramps
Definition
increased temperature, pulse and BP
Term
untreated heat cramps can lead to
Definition
heat exhaustion
Term
heat exhaustion is
Definition
prolonged high core temperature, causing vasodil. And excessive sweating
Term
symptoms of heat exhaustion
Definition
dehydration, decreased plasma vol., decreased cardiac output, decreased BP, increased heart rate, dizziness, weakness, nausea, syncope
Term
untreated heat exhaustion can lead to
Definition
heat stroke=lethal due to overstressed thermoreg. Center..stops working @ 104.9 F
Term
symptoms of heat stroke
Definition
cerebral edema, CNS degeneration, renal tubular necrosis(acute renal failure) and death
Term
who suffer more with hyperthermia?
Definition
kids, due to more surface area and less sweating capacity and more metabolic heat production
Term
malignant hyperthermia is a rare inherited disorder of _________
Definition
muscles associated with certain inhaled anesthetics and neuromusc. Blockers
Term
what happens in malig. Hyperthermia?
Definition
muscual Calcium alters=sustained muscular contraction->increased O2 consumption->lactic acidosis->cardiac arrest
Term
HYPOthermia occurs below what temp?
Definition
95 F
Term
what happens in hypothermia
Definition
vasoconstriction, increased bld. Viscosity,slow micocirculation,more bld. Coagulation,ischemic tissu damage,ince crystal in cells, cell rupture and death
Term
Accidental hypothermia
Definition
frost bite
Term
therapeutic hypothermia
Definition
in surgery, limb reimplantation= to preserve ischemic tissue by slowing tissue metabolism
Term
side effects of therapeutic hypothermia
Definition
vent. Fibrillation and cardia arrest
Term
T/F: major trauma can affect tempertaure control
Definition
T: e.g. with CNS trauma, hemorrhagic shock, thermal burns, major surgery, increased intracranial pressure, accidental injuries
Term
T/F: sleeping is a passive process
Definition
F: it is an active process important for restoring function and memory improvement(doesn't work for me;)
Term
major sleep center
Definition
Dear hypothalamus
Term
NREM:REM
Definition
75:25 %
Term
rREM
Definition
after 1-2 hr of sleeping, occurs every 90 minutes
Term
Sleep stages
Definition
I - IV stages ..measured thru EEG
Term
do infants sleep for 15-17 hours?
Definition
Yeah, so lucky!
Term
who has more REM, adults or infants?
Definition
Infants= 53% of 17 hours…
Term
infants' sleep is like
Definition
immediate REM=10-45 min. + NREM=20 min. Whole sleep cycle=60 min.
Term
older adults' sleep
Definition
take longer to fall asleep + awaken more often= less total sleep time (due to circadian rhythm changes, meds., pee etc
Term
Insomnia
Definition
difficulty in initiating sleep
Term
obstructive sleep apnea also known as
Definition
upper airway resistance syndrome
Term
obese people are @ risk of …
Definition
obesity hypoventilation syndrome
Term
enuresis is defined as . . .
Definition
bed wetting during sleep
Term
somnambulism
Definition
sleep walking/any complex act during sleeping…no recall later….these sleep-wake disturbances are called parasomnias
Term
secondary causes for sleep disorders
Definition
pain, depression, altered thyroid hormones
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