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  1. (gate theory) small unmyelinated C polymodal nociceptors responsible for transmission of
    diffuse burning or aching sensations (slow pain)
  2. (gate theory) Medium-sized A-delta fibers carry what kind of pain?
    localized, sharp pain; important in initiating rapid reactions to stimuli (fast pain)
  3. (gate theory) "gate" in the spinal chord regulates transmission of pain impulses that proceed _______ for further processing and interpretation in the ______

  4. (gate theory) stimulation of ________________________ (which synapse in the dorsal horn of spinal cord along with their nociceptive Alpha-delta and C fiber counterparts) can close pain gates
    large, fast, heavy myelinated Alpha-beta fibers
  5. (gate therapy) what contributes to pain modulation (inhibition) in medulla and pons
    norepi and epi
  6. Endogenous opioids
    morphine-like neuropeptides act as neurotransmitters by binding to one or more opioid receptors
  7. _________ inhibit transmission of pain impulses in spinal cord and brain
    endogenous opioids
  8. 4 types of endogenous opioids
    • enkephalins
    • endorphins
    • dynorphins
    • endomorphins
  9. Acute pain
    somatic, visceral or referred
  10. Somatic pain
    skin or close to surface, sharp and localized
  11. Visceral pain
    internal organs, abdomen, skeleton
  12. Referred pain
    area removed or distant from point of origin
  13. in referred pain, the area is supplied by the
    same segment as actual site of injury (i.e. upper adbomen-
  14. example of referred pain
    upper abdomen-- T8, L1, L2
  15. In referred pain, ___________________ converge on same ascending neuron and brain cannot distinguish between origin of the two
    cutaneous and visceral neurons
  16. Steps of thermoregulation (5)
    • 1. heat production begins in hypothalamus with release of TSH-RH
    • 2. Results in release of TSH from anterior pituitary
    • 3. TSH causes release of thyroxine from thyroid
    • 4. Thyroxine causes release of epinephrine from adrenal medulla which causes vasoconstriction, glycolysis and increased metabolic rates
  17. Fever
    failure of normal thermoregulatory mechanism
  18. Fever begins with introduction of
    exogenous pyrogens or endotoxins
  19. In a fever, ______________ produced and released as exogenous bacteria are destroyed and absorbed by phagocytic cells in host. This raises the set point of the _________
    Interleukin 1 (IL-1), IL-6, interferons and TNF

  20. heatstroke
    potentially lethal consequence of thermoregulation
  21. During heat stroke, ________________ center is overstressed
  22. Brain cannot tolerate temperatures of more than
  23. In heatstroke, the regulatory center may
    cease to function
  24. Sweating ________ during heatstroke because

    core temp rises rapidly
  25. The skin is dry and flushed during heatstroke because of
    vascular collapse
  26. the person becomes irritable, confused, stuporous and comatose during heatstroke due to
    cerebral edema, degeneration of CNS, renal tubular necrosis
  27. hypothermia
    • slows chemical reactions
    • increases blood viscosity¬†
    • slows blood flow
    • facilitates blood coagulation
    • stimulates profound vasoconstriction
  28. body temp during hypothermia
    less than 95
  29. Hypothermia is secondary to
    • hypothyroidism
    • hypopituitarism
    • malnutrition
    • Parkinson's Disease
    • rheumatoid arthritis
  30. symptoms of of hypothermia
    • shivering
    • thinking becomes sluggish
    • decreased coordination
    • stuporous
    • decreased HR and RR
    • decreased cardiac output
    • Moderate to severe acidosis
  31. Consciousness
    alertness with orientation to person, place and time
  32. confusion
    alteration of perception of stimuli
  33. Confusion progresses in what steps
    • time
    • place
    • person
  34. Lethargy
    oriented x3 but slow vocalization, decreased motor skills
  35. Obtundation
    awakens in response to stimulation, continuous stimulation needed for arousal, eyes usually closed
  36. Stupor
    arouses only to painful stimuli
  37. Coma
    no arousal to any stimulus but brainstem reflexes intact
  38. Progression of Nonresponsiveness:
    1. Diencephalon (thalamus/hypothalamus):

    dull, lethargic, obtundation, pupils respond briskly, full-range eye movements only on "doll's eyes"- none in direction of rotation on or after injection of hot or cold water in ear canal (caloric posturing)

    2. Midbrain:

    • stupor or coma
    • neurogenic hyperventilation
    • midposition fixed pupils (MPF)
Card Set:
2014-12-02 01:19:12
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