List the 3 systems that are involved in the experience of pain.
Sensory discriminate system
Motivational/affectivce system
Cognitive/evaluation system
Sensory discriminate system
Sensory discriminate system: processes information about the strength, intensity, and temporal and spatial aspects of pain. These sensations are mediated through afferent nerve fibers, the spinal cord, the brain stem, and the higher brain centers, and the
Motivational/affectivce system
Motivational/affectivce system: determines the individual's conditioned or learned approach/avoidance behaviors. These behaviors are mediated through the interaction of the reticular formation, limbic system, and brain stem.
Cognitive/evaluation system
Cognitive/evaluation system: overlies the individual's learned behavior concerning preferences, male and female roles, and life experience, among other ways. The influence of the cognitive/evaluative system may block, modulate, or enhance the perception o
Differentiate among the 3 areas of the nervous system responsible for the sensation and perception of pain.
Afferent pathways: begin in the peripheral nervous system (PNS), travel to the spinal gate in the dorsal horn and then ascend to higher centers in the central nervous system (CNS).
Interpretive centers: located in the brainstem, midbrain, diencephalon, an
nociception
The sensory process leading to the perception of pain is called nociception.
Nociceptors
Nociceptors are free nerve endings and respond to chemical, mechanical, and thermal stimuli. Nociceptors are found under the epidermis and within joint and bone surfaces, the deep tissues, muscles, tendions, and subcutaneous tissue. They are NOT evenly di
Differentiate between C and A fibers .
2 major types of nociceptors, the small unmyelinated (Cfibers) and lightly myelinated (A fibers) afferent neurons.
The small unmyelinated C polymodal nociceptor neurons are responsible for the transmission of diffuse burning or aching sensations. Because
Describe the pathway of pain sensation transmission (See Fig 13-1, p.306)
As the figure illustrates, stimulated nociceptors produce impules that are transmitted through the small, myelinated A fibers and C fibers to the spinal cord. There they form synapses with interneurons primarily in the dorsal horn, cross over to the contr
Excitatory neuromodulators
Excitatory neuromodulators include such substances as substance P, glutamate, somatostain, vasoactive intestinal polypeptied, and calcitonin-gene-related peptide.
Inhibitory neuromodulators
Inhibitory neuromodulators include gamma-aminobutyric acid (GABA), glycine, 5-hydroxtryptamine (serotonin), norepinephrine, and endorphins.
What are endorphins?
Endorphines (endogenous morphines) are a family of neuropeptides that inhibit transmission of pain impulses in the spinal cord and brain by binding to mu, kappa, or delta opiod receptors.
All endorphines attach to opiate receptors on the plasma membrane o
differentiate between somatogenic and psychogenic pain
a. somatogenic pain-with a known physiologic cause
psychogenic pain- without a physiologic cause
somatic, visceral, referred pain
somatic- superficial,
visceral-internal and
referred pain-present in an area distant from its origin
.Differentiate between acute and chronic pain (See Table 13-3, p311).
Acute pain- signal to the person of a harmful stimulus
Chronic pain- persistent pain lasting at least 3 to 6 months and may be related to inflammation or injury to the nervous system or chronic inflammation.
How do infants and children respond to pain in terms of their physiologic
and behavioral responses? (See Table 13-4, p311).
Newborns and young children have the anatomic and functional ability to perceive pain. Older individuals tend to have a slightly higher pain threshold, probably because of changes in the thickness of the skin and peripheral neuropathies. Women appear to b
Glaucoma
Glaucoma- Increased intraocular pressures (above 12 to 20 mm Hg). Loss of acuity results from pressure on the optic nerve, which blocks the flow of nutrients to optic nerve fibers, leading to their death; sixth leading cause of blindness.
Open angle- outf
Cataracts
Cataracts- cloudy or opaque area in ocular lens. Incidence increases with age because most commonly a result of degeneration; other causes are congenital
Retinal detachment
Retinal detachment- a tear or break in the retina with accumulation of fluid and separation from underlying tissue. Seen as floaters, flashes of light, or a curtain over visual field. Risks include extreme myopia, diabetic retinopathy, sickle cell disease
presbyopia
-a condition in which the ocular lens becomes larger, firmer, and less elastic; the major symptom is reduced near vision, causing the individual to hold reading material at arm's length,
myopia
myopia-nearsightedness; light rays are focused in front of the retina when the person is looking at a distant object,
hyperopia
hyperopia-farsightedness; light rays are focused behind the retina when a person is looking at a near object.
presbycusis
Presbycusis is the most common form of sensorineural hearing loss and is especially common in the elderly. Its cause may be atrophy of the basal end of the organ of Corti, loss of auditory receptors, vascular changes, or stiffening of the basilar membrane
Explain otitis media in terms of at risk population, associated factors, causative organisms and clinical manifestations of acute otitis media.
Risk: infants and children.
Associated: allergy sinusitis, immune deficiency.
Causative: streptococcus pneumonia, Haemopilus influenza, moraxella catarrhalis
Clinical: ear pain, fever, inflamed TM, fluid in middle ear.
Differentiate between sensorineural and conductive hearing loss.
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