AP 4

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Author:
felizdiaz
ID:
45423
Filename:
AP 4
Updated:
2010-10-27 11:23:04
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AP
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Description:
PAIN, TEMP, SLEEP
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  1. PAIN THEORIES
    • SPECIFICITY
    • AMONUT OF PAIN IS RELATED TO AMOUNT OF TISSUS DAMAGE
    • DOES NOT ACOUNT FOR PSYCHOLOGICAL PART OF PAIN

    • GATE CONTROL
    • DEVELOPED TO EXPLAIN THE COMPLEXITIES OF THE PAIN PHENOMENON
    • GATES IN THE SPINE AND THALALMUS
  2. NOCICEPTORS
    • BARE NERVE ENDINGS IN BODY THAT RESPOND TO CHEMICAL, MECHANICAL , AND TEMP
    • THIS NERVES ARE NOT DISTRIBUTED EQUALY IN BODY
    • DEPENDS ON HOMUNCULUS
  3. PAIN FIBERS
    • ALPHA
    • LIGHTLY MYELINATED (FAST AND RAPID)
    • MED SIZED
    • CARRY WELL LOCALIZED PAIN INFO
  4. C FIBERS
    • UNMYELINATED
    • BURNING ACHING
    • SLOW TO RESPONED
    • HARD TO BLOCK
  5. LAMINA
    • ARE LEVELS OF THE DORAL ROOT
    • THERE ARE 10 AREAS
    • THE MOST IMPORTANT FOR PAIN IS LAMINA 2 (PAIN GATE IN SPINE)
  6. LAMINA 2
    • HAS THRESS CLASS
    • 1. PROJECTION CELLS- CARRY INFO TO BRAIN VIA SPINOTHALAMIC TRACT

    • 2. EXCITATORY INTERNEURONS
    • THEY RELAY INFO TO
    • - PROJECTION CELLS
    • - MOTOR CELLS (TO PULLWAY)
    • - OTHER INTERNEURONS

    • INHIBITORY INTERNEURONS
    • WITH WHAT TO HIT THIS IN OR
  7. SPINAL AND EPIDURAL
    • SPIN- BLOCKS ROOT AND LAMINA
    • EPIDURAL- JUST ROOTS
  8. PAIN EXCITATORY NT
    • GLUTAMATE
    • NMDA
    • AMDA
  9. NT PAIN INHIBITORY
    • GABA (BLOCK SUB P)
    • SEROTONIN
    • ENDORPHINS, ENDROMORHINS
  10. PAIN THRESHOLD
    POINT TO WHICH STIMULUS IS PERCEIVED PAIN
  11. PERCERPUTAL DOMINANCE OF PAIN
    • PAIN AT ONE LOCATION MAY CAUSE AN INCREASE IN THE THRESHOLD IN LOCATION
    • AFTER ABD SURG THE PT JUST THINKS ABOUT PAIN OF NG
  12. PAIN TOLERANCE
    • ALL PSYCHO
    • TIME OR LIMIT OF PAIN THAT A PERSON WILL ENDURE BEFORE INITIATION OF PAIN RESPONSES
  13. NEUROPATHIC PAIN
    • FROM THE NERVE SYSTEM (CUTTING, STRECHING, HITTING OF NERVE)
    • PERIPHRAL NERVES
    • CENTERAL (IN BRAIN HARD TO TREAT)
  14. S/S OF ACUTE PAIN
    • ALERT US THAT SOMETHINGS IS IMMEDIATELY HURTING THE BODY
    • SIGNS OF SNS
  15. ACUTE SOMATIC PAIN
    • FROM SKIN CONNECTIVE TISSUE MUSCLE BONE
    • HAS A AND C PAIN FIBERS
  16. ACUTE VISCERAL PAIN
    • PAIN OF INTERNAL ORGANS AND ABDOMEN
    • POORLY LOCALIZED TO THE LESS NUMBER OF NOCIEPTORS
  17. REFERRED PAIN
    • PAIN THAT IS PRESENT IN AREA REMOVED OR DISTANT FROMTHE ITS POINT OF ORIGIN
    • LIKE MI HAVE BACK AND SHOULDER PAIN
  18. REFERRED PAIN PICTURE
  19. CHORNIC PAIN
    • STATE OF EXISTENCE
    • SUDDEN INSIDIOUSLY
    • LASTING AT LEAST 3 MONTHS
    • CHANGE IN BEHAVOIR AND PSYCHOLOGICAL (PAIN REWIRE PT)
  20. MECH OF CHRONIC PAIN
    • PERIPH AND CENTRAL MORE SENSITIVE
    • NEUROPATHIC PAIN
    • ALTERATIONS IN DORSAL ROOT
    • LOSS OF PAIN INHIBITION IN SPINAL CORD
  21. TYPES OF CHRONIC PAIN
    • MOST COMMON LOWER BACK PAIN
    • MYOFASCIAL MUSCLE (NEED DEEP MASSAGE OR MARCAINE TO KILL MUSCLE TO REFORM IT RIGHT)
    • PORT OP CHRONIC PAIN CUTING NERVES, AMPUTATION
    • CANCER PAIN
  22. NEUROPATHIC PAIN
    • FROM TRAUMA OR DISEASE OF NERVE
    • CHRONIC
    • S/S SHOOTING, BURNING, PARETHESIA, STABBING PAIN.

    CAUSES DIABETIC NEUROPATHY, DEAFFERENTATION (CUT NERVE), SYPATHICTICALLY (LOSE BLOOD FLOW AND REPERFUSTION, CENTRAL PAIN, PHANTOM LIMB PAIN)
  23. PEDS PAIN
    • BABYS HAVE PAIN
    • EXPRESSION OF PAIN; FACIAL, CRYING, BODY LANG
    • KEEP RR > 20
  24. TEMP REGULATION
    • PERIPHERAL THERMORECEPTORS
    • SKIN
    • SPINE
    • EAR

    • HYPOTHALAMIC CONTROL
    • RELEASE TSH-RE -TSH- T4-EPI TO INCREASE META THAT INCREASE HEAT PRODUCTION
  25. HOW IS HEAT PRODUCTED AND CONSERVED
    • MAKE HEAT
    • META
    • CONTRACTIONS (SHIVERING)
    • CHEM THERMOGENESIS (BROWN FAT)
    • CONSERVE
    • VASOCONTR
    • FETAL POSTIONS

    PEOPLE ARE SHORTER IN COLD AREAS AND TALLER IN HOT AREAS
  26. RADIATION
    • MOST COMMON
    • TRANEFER OF HEAT FROM AN OBJECT THROUGH SPACE (LOST TO AIR) TILL ABSORBED BY OTHER OBJECT
    • LOSES 80% OF HEAT VIA HEAD
  27. CONDUCTION
    TRANSFER OF HEAT FORM SOLID TO SOLID
  28. CONVECTION
    TRANSFER OF HEAT BY CIRCULATION OR MOVEMENT OF LIQ (VASODIL)
  29. EVAPORATION
    LOSS OF HEAT BY EVAPORATION OF WATER
  30. BENEFITS OF FEVER
    • KILLS MANY ORGANISMS
    • DECREASE SERUM IRON, COPPER, ZINC
    • DEPRIVES BAC OF FOOD
    • PROMOTES LYSOSOMAL BREAKDOWN AND AUTODESTRUCTION OF CELL
    • INCREASE LYMPHOCYTIC TRANSFORMATION AND PHAGOCYTE MOTILITY
  31. HYPERTHERMIA
    • 41C NERVE DAMAGE
    • 43C DEATH
    • FORMS HEAT CRAMPS, EXHAUSTION, STROKE
    • MALE HOTTER THAN FEMALES
  32. HEAT CRAMPS
    • HEAT CRAMPS ABD AND EXTREMITIES
    • PROLONG SWEATING AND LOSS OF NA
    • PEOPLE NOT USE TO HEAT
    • INCREASE HR BP AND FEVER
    • TX WITH FLUIDS AND COOL DOWN SLOWY
  33. HEAT EXHAUSTION
    • COLLAPSE DT LONG HIGH CORE OR EXTERNAL TEMP
    • PROLONG VASODIL LED TO DEHYDRATION, LOW PLASMA VOL, LOW BP AND CO AND UP HR
    • S/S DIZZINESS, WEAK , NV
  34. HEATSTORK
    • TEMP OF >40.5
    • CAN'T SWEAT
    • GET CEREBRAL EDEMA, DEGENERATION OF THE CNS, SWOLLEN DENDRITES, AND RENAL TUBE NECROSIS
    • DON'T COOL SKIN TO RAPIDLY SINCE IT WILL CAUSE VASOCON LIMITING CORE COOLING
  35. MALIGNANT HYPERTHERMIA
    • GENETIC (BLONDE HAIR BLUE EYES)
    • PERCIPITATED BY VOLATILE GAS
    • UP CA RELEASE OR LOW CA UP TAKE WITH CAUSE UP IN MUSCLE CONTRACTIONS
    • LEADING TO UP META= CO2, AND LACTIC ACID
    • TREAT WITH DANDROLIN 2.5 MG, (INHIBIT CA, HAS BICARB IN IT, AND MANNITOL) VENT, AND VENT
  36. HYPOTHERMIA
    • TEMP BELOW 35C
    • PRODUCE VASOCON, COAGULATION, TISSUE DAMAGE, ICE IN CELL, INCREASE BLOOD VISCOSITY,
    • ACCIDENTAL HYPO- FALL IN COLD WATER
    • THERAPEUTIC- FOR SURGERY TO LOW META
  37. NREM SLEEP
    • 75-80% OF SLEEP TIME
    • HAVE 4 STAGES
  38. REM SLEEP
    • 20-25% OF SLEEP TIME
    • PARADOXIC SLEEP
    • OCCURS Q 90 MINS AFTER 1-2 HOURS OF SLEEP
  39. SLEEP DISORDERS
    INSOMINIA

    • BREATHING
    • UPPER AIRWAY
    • OBSTRUCTIVE SLEEP APNEA
    • OBESITY HYPOVENT SYNDROME

    • SLEEP/WAKE
    • PARASOMNIAS- SLEEP WALKING
    • SOMINAMBULISM
    • NIGHT TERRORS
    • ENURESIS
  40. BLEPHARITIS
    INFECTION OF EYELIDS
  41. HORDEOLUM
    • STYE
    • INFECTIONS OF SEBACEOUS GLAND OF EYELID
  42. CHALAZION
    INFECTION OF OIL SECRETING GLAND
  43. KERATITIS
    • INFECTION OF CORNEA
    • NOT WEAR CONTACTS IN OR
  44. CONJUNCTIVITIS
    • INFECTION OF CONJUNCTIVA
    • PINKEYE
  45. CUT OPTIC NERVE
  46. VISUAL DYSFUNCTIONS
    • PAPILLEDEMA (UP ICP) NO NO FOR SPINAL AND EPIDURALS
    • GLAUCOMA
    • MACULAR DEGENERATION
    • STRABISMUS (FIX EARLY)
    • COLORBLINDNESS (X LINKED TRAIT)
  47. MYOPIA
    NEARSIGHTED
  48. HYPEROPIA
    FARSIGHTED
  49. OTITIS EXTERNA
    • INFECTION OF OUTTER EAR
    • SWIMMERS EAR
  50. OTITIS MEDIA
    PRESSURE OF MEMBRANE THAT CAN CAUSE SCARING
  51. OLFACTION
    • CN 1 AND 5
    • MOST OF TASTE (SOUR, SWEET, SALTY, BITTER)
  52. PROPRIOCEPTION
    • WHERE BODY IS AT DEPENDS ON INNER EAR, VISION, RECEPTORS OF JOINTS AND LIGAMENT
    • CAUSE VESTIBULAR NYSTAGMUS. VETIGO, MENIERE DISEASE

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