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What types of neurotransmitters inhibit pain and where?

Gamma-aminobutyric acid (GABA) and Glycine -
Both are in the spinal cord and brain.
Norepinephrine and serotonin - medulla and pons

What is chronic pain?

Long lasting pain. Lasts about 3 months

What is psychogenic pain?

physical pain that is caused, increased, or prolonged by mental, emotional, or behavioral factors. Ex: Headache, stomach pain, back pain.

What is phantom pain?

Pain in the limp, but limp is not there.

What is pain threshold?

Pain stimulus. Read page 490 (bottom right)

What is pain tolerance?

duration of time or the intensity of pain that an individual will endure before initiating overt pain responses.

What is visceral pain?

Internal pain. Pain in internal organs. You don't feel it, but you feel it from the symptoms. Ex: "Pain" in liver, you feel the pain in the right shoulder (referred pain)

What are heat cramps?

-Severe spasmodic cramps in the abdomen and extremities that follow prolonged sweating and associated sodium loss.
-Usually affects people who perform strenuous work in very warm climates.
- Fever, rapid pulse, increased BP, (everything goes up)
- Treatment: take dilute salt solutions, electrolytes

What is heat exhaustion?

- "Collapse"
- caused by prolonged high core or environmental temperatures.
- intense vasodilation and profuse sweating
- hypotension, dehydration, tachycardia
- treatment: drink warm water

What is heat stroke?

- lethal result of breakdown in control of an overstressed thermoregulatory center.
- brain cannot tolerate temp. over 40.5C (104.9F)
- high core temp. produce cerebral edema, CNS degeneration, swollen dendrites, renal necrosis, comatose.
- results in death.

What is the drug used for malignant hyperthemia?

definition: rare inherited muscle disorder.
caused by: increased calcium release or decreased calcium uptake with muscle contraction.
- Drug used: Dantrolene Sodium (relaxes muscle), Procainamide (pronestyl), sodium bicarbonate

How does fever help us?

-Kills many organisms
-decrease serum levels of iron ,zinc, and copper
-deprives bacteria of food
-promotes lysosomal breakdown and autodestruction of cells
-increases lymphocytic transformation and phagocyte motility

How does the body respond to hypothermia?

- caused by prolonged exposure to cold.
- produces vasoconstriction, shivering, BP goes up, ischemic tissue damage, coagulation.
- Body's temp goes down to 95F or below.
- accidental (environment- drop in cold water or exposed to cold environment)
-therapeutic (invasion of virus/bacteria. Preserves ATP)
- thinking and coordination increases.

How do we lose body heat?

- sodium loss. Sweating the water out.
- body responds to hyperthermia
- achieved through many mechanisms such as
- Radiation: electromagnetic waves
- Conduction: direct molecule to molecule transfer from one surface to another. (swimming, drinking cold water)
- Convection: transfer of heat through currents of gasses or liquids. (fanning yourself)
- Vasodilation: (control from hypothalamus) diverting core warmed blood to surface of body
- Decreased muscle tone: decreased movement/activity
- Evaporation: Sweating and loss of electrolytes
- Increased respiration : breathe out warm air
- voluntary measures
- adaption to warmer climates

What is REM sleep?

- characterized by desychronized, low-voltage, fast activity that occurs for 5-60 mins
- also referred to as paradoxic sleep because the EEG pattern is similar to the normal awake pattern.
- also characterized by bursts of conjugate rapid eye movement, atonia of antigravity muscles, suppressed temp regulation, alteration in heart rate, BP, and respiration.
- cerebral blood flow to both hemispheres is increased.
- needs hypocretin (makes u awake)

What is Non-REM (slow wave) sleep?

- initiated by the withdrawal of neurotransmitters from the reticular formation and by the inhibition of arousal mechanisms in the cerebral cortex.
- Metabolic rate decreased by 10%-15%
- Temperature, heart rate, respiration, blood pressure, and muscle tone decrease.
- pupils constricted, no knee jerk.

Cycles of Sleep - Stage W or 0

Wakefulness with eyes closed and predominated by alpha waves

Cycles of Sleep - Stage 1

Light sleep, with alpha waves interspersed with low-frequency theta waves; slow eye movements

Cycles of Sleep - Stage II

Further slowing of the EEG with the presence of sleep spindles and slow eye movements

Cycles of Sleep - Stage III

Low frequency, high-amplitude delta waves with occasional sleep spindles (slow-wave sleep), no slow eye movements

Cycles of Sleep - Stage IV

Delta waves, slow-wave sleep

What happens in stages I and II?

cerebral blood flow to brainstem and cerebellum is decreased.

What happens in stages III and IV?

cerebral blood flow to the cortex is decreased

What is narcolepsy?

- characterized by hypersomnia (too much sleep) and cataplexy (muscle weakness), Hallucinations, and sleep paralysis
- associated with hypothalamic hypocretin (makes u stay awake) deficiency and may be related to immunemediated destruction of hypocretin-secreting cells.

What's sleep apnea?

- disorder of breathing during sleep related to upper airway obstruction that is associated with reduced blood oxygen saturation and hypercapnea (too much CO2)

Sleep with OLD ppl

- sleep early in the evening. Wake up at night and early in the morning
- REM and NONREM decreases
- changes associated with lifestlyle, chronic diseases, lack of daily routine, jet lag, use of seditives
- sleep cycle 90-100

Sleep with young PPL

- sleep cycle 45-60
- newborns - fall into REM instantly

What is pink eye?

- acute bacterial conjunctivitis
- highly contagious. Caused by gram + organisms
- onset is acute. characterized by mucopurulent drainage from one or both eye. Filled with pus or mucus
- treatment: handwashing. use separate towels. antibiotics
- lasts about 10 to 14 days.

What is glaucoma?

- increased intraocular pressure.
- #1 cause of blindness
- fam history is a risk factor, can be inherited
- see page 510

What is cataract?

- cloudy or opic area in the ocular lense
- increases w/ age as lens enlarges
- develops because of alterations of metabolism and transport of nutrients in lens.
- caused by diabetic mellitus.

What is nsytagmus?

- involuntary unilateral or bilateral rhythmetic movement of the eye
- can occur in infants (congenital) or adults (acquired)
- PENDULAR nystagmus- regular and to-and-pro movement of the eyes in which both phases of the movement are equal in length
- JERK nystagmus- faster movement of one phase of the eye than the other.

What is anosmia?

-complete loss of smell.
-associated with aging, neurodegenerative and nasal/sinus disorders and head trauma.

What is blepharitis?

- inflammation of eyelids caused by stapylaccocus or seborrheic dermatitis.
- symptoms: redness, edema, and itching

What is hordeolum?

- "stye"
- infection of the sebaceous glands of the eyelids

What is chalazion?

-infection of meibomian (oil-secreting) gland

What is keratitis ?

- infection of cornea that can be caused by bacteria or viruses.
- bacterial infections often cause corneal ulceration and require intensive antibiotic treatment
- symptoms: photophobia pain, lacrimation, severe ulcerations w/ residual scarring.

What is papilledema?

- edema and inflammation of the optic nerve at its point of entrance into the eyeball.
- caused by some obstruction to the venous return from the retina (general cause)
- Other causes
1) increases intracranial pressure
2) retrobulbar neuritis
3) changes in the retinal blood vessels

What is AMD?

- age related macular degeneration
- loss of central vision
- major cause of vision loss in individuals over 60 years
- ATROPHIC (DRY)- most prevalent. Loss of retinal pigment epithelium and photoreceptors with overall atrophy of cells
-WET (neovascular)- more severe form and involves proliferation of abnormal choroidal vessels, which leak and bleed, causing retina detachment.

What is Otitis Externa?

- Most common infection of the outer ear.
- Bacterial infection of outer ear (SWIMMERS EAR)

What is Otitis Media?

- inflammation of middle ear.
- Most common in infant and children
- Predisposing factors: allergy, sinusitis, cleft palate, immune deficiency

Cranial nerves for smell?

CN 1 - olfactory nerve
CN V- trigeminal

Cranial nerves for Taste?

CN IX - glossopharyngeal
CN VII - facial nerve

What is proprioception?

-perception and awareness of position of body and its parts.
- depends on impulses from inner ear and receptors in joints and ligaments

What is Meniere's disease?

- idiopathic vestibular disorder that can cause proprioceptive dysfunction.
- individuals can suffer vertigo, hearing loss, tinnitus

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