Chapter 13 - Pain, Temperature, Sleep, and Sensory Function

disorders of initiating and maintaining sleep and disorders of excessive sleepiness
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What pain theory proposes that pain transmission is modulated by balance of impulses conducted to the spinal cord?Gate control theory (1965)What transmission open the spinal gate and increase pain perception?NociceptiveWhat transmission close the gate and decrease pain?Non-nociceptiveWhat theory describes the role of impulse intensity and the repatterning of the central nervous system (CNS)? This one is evolved to provide an explanation for neuropathic painPattern theory (late nineteenth century)What theory propose that the brain produces patterns of nerve impulses drawn from various input?Neuromatrix theory (1999)The perception of pain involves:-Afferent (sensory) pathways- -Interpretive centers in the brain stem, midbrain, diencephalon, and cerebral cortex. -Efferent Pathwayswhat is the processing of the potentially harmful stimuli through the nervous system?Nociception___________________ begins when tissue is damage by exposure to chemical, mechanical, or thermal noxious stimuli. This causes activation of nociceptors.Pain transductionNociceptors: impulses travel through two types of fibers. What are they?A-delta fibers and C fibers(Biggest, fastest) carry information from musclesA delta (Aa)(intermediate size and speed) Carry information about light touch and other skin sensationsAB(smallest and slowest) nerve fibers. Carry pain and temperature information.Aδ myelinated and C unmyelinatedFast, "bright" painslow dull pain uses what fibersC fibers (.5-2 m/sec)A family of morphine-like neuropeptides. This blocks transmission of pain impulses in the spinal cord, brain, and periphery by binding to receptors.Endogenous opioidsProduces the greatest sense of exhilaration and substantial pain reliefB- endorphin________ and ________ are peptide neurotransmitters made by the brainstem and released in the spinal cord.Endorphins and enkephalinsLast seconds to days- sometimes up to 3 monthsTransientLast for more than 3 to 6 monthsChronic painPain that is present in an area removed or distant from its point of originReferred painA temporary "resetting of the hypothalamic thermostat" to a higher level.Fever (febrile response)What is an endotoxins produced by pathogens?Exogenous pyrogensWhat are the benefits of fever?-Kills many microorganijsm and adversely affect their gorwth and replication -Decrease serum levels of iron, zinc, and copper. -Promotes lysosomal breakdown and autodestruction of cells -Increases lymphocytic transformation and phagocyte motility -Augments antiviral interferon production and phagocytosisWhat temperature, a nerve damage produes convulsion in adult41 C or 105.8 FDeath result at what temperature?43 C or 109.4 FWhat is medically induced hyperthermia that is used to destory pathologic microorganisms or tumor cellsTherapeutic hyperthermiaWhat is heat cramps, heat exhaustion, heat stroke, malignant, and hyperthermia?Accidental hyperthermiaFollow prolonged sweating and associated sodium loss Severe spasmodic cramps in the abdomen and extremities Are common in individuals not accustomed to heat or those performing strenuous work in warm climates Fever, rapid pulse, and increased blood pressure often accompany the cramps Diluted salt solutions are administered through oral or parenteral routesHeat CrampsCollapse in response to prolonged high core or environmental temperatures Prolonged vasodilation, profuse sweating ØDehydration, depressed plasma volumes, hypotension, decreased cardiac output, tachycardia Clinical manifestations ØDizziness, weakness, nausea, syncope Treatment ØStop activity, lie down, drink warm fluidsHeat exhaustionIs a potentially lethal result of a breakdown in an overstressed thermoregulatory center The brain cannot tolerate temperatures higher than 40.5° C (104.9° F) ØTemperature is maintained by •Sweat production/evaporation on face and blood flow through the veins in the head and face ØCardiovascular and thermoregulatory centers may cease functioning in high (40° to 43° C) temperatures •Sweating ceases; the skin becomes dry and flushed; the individual may be irritable, confused, stuporous, or comatose; visual disturbances may occur.HeatstrokeWhat is a life-threatening complication of a rare inherited muscular disorder?Malignant HyperthermiaWhat is a disorder of breathing during sleep, related to an upper airway osbstruction associated with reduct blood oxygen saturation and hypercapnia?Obstructive sleep apnea syndromeWhat is unpleasant sensations (prickling, tingling, crawling) that occur at rest and are worse in the evening or at nightRestless leg syndromeWhat disorder is a rapid time-zone change (jet lag syndrome), changes in sleep schedule with an advance or a delay of 3 hours or more in sleep time, or changes in total sleep time from day to day that desynchronizes rhythm?Circadian ryhthm disorderexcessive daytime sleepinesshypersomniaa primary hypersomnia of cenetral originNarcolepyComplex behaviors related to awakening from REM sleep or partial arousal from NREM sleep and disorders of sleep stage transitionsParasomniasSleep walking (somnambulism), night terrorsArousal disordersSleep talking (somniloquy), nocturnal leg crampsSleep-wake transition ordersSleep paralysis, nightmaresDisorders associated with REM sleepsleep-related alterations in diseases states such as chronic obstructive pulmanory disease (COPD), diabetes, and asthma.Sleep-provoked disordersWhat type of eye movement disorders deviation of one eye from the other? Primary symptom is diplopia (double vision)StrabismusWhat type of eye movement disorder is an involuntary unilateral or bilateral rhymthmic movement of the eyes?NystagmusBack and forth movementPendular nystagmusone phase of the eye movement is faster than the otherJerk nystagmusReducftion or dimness of vision for unknown reasonsAmblyopia or lazy eyeCircumscribed defect of the central field of visionScotomaCloud or opaque area in the ocular lens and leads to visual losscataractsWith age, eye does no adapt as readily to darkdark adaptationIncrease introocular pressures; loss of acuity result from pressure on optic nerveGlaucomaTear or break in retina with accumulation of fluid and separation from underlying tissueRetinal detachmentDrusen or retinal waste products accumulate in the deep retinal layers; wet AMD is the most severe; dry AMD is the most common.Age-related macular degeneration (AMD)What is the process whereby the thickness of the lens changes to adjust for near or distant visionAccommodationLoss of accomodation in older adultsPresbyopiaWhat is the most commen vision problems?RefractionLight rays are focused in front of the retina when the person is looking at a distant objectMyopia (nearsightedness)Light rays are focused behind the retina when a person is looking at the near objectHyperopia (farsightedness)Unequal curvature of the corneaastigmatismwhat is a rare congenital eye tumor of young childrenRetinoblastomaImflammation of the eyelidsBlepharitisInfection of sebaceous gland of the eyelids centered near an eyelashHordeolum (stye)noninfectioous lipogranuloma of the meibomian (oil-secreting) glandChalazionCommon eyelid malposition in which the lid margin turns inward against the eyeballEntropionInflammation of the conjunctivaConjunctivitisOccurs when a change in the outer or middle ear impairs conduction of sound to the inner ear?Conductive hearing lossWhat is caused by impairment of the organ of Corti or its central connections; gradual or sudddenSensorineural hearing lossCaused by a combination of conductive and sensorineural lossesmixed hearing lossThis is rare, the individual does not respond to voice and appears not to hear?Functional hearing lossA disorder of the inner ear (text says middle ear)Meniere diseaseTHe most common inflammation of the outer earOtitis ExternaA common infections of infants and childrenOtitis mediaThe presence of fluid in the middle ear without symptoms of acute infectionOtitis media with effusionwhat are associated with aging, neurodegenerative and nasal/sinus disorders, and head trauma?Hyposmia and Anosmiaarise from hyperactivity in cortical neurons and involve smelling odors that are not really presentOlfactory hallucinationsAbnormal or perverted sense of smallParosmiaDecrease in taste sensationHypogeusiaAbsent of tasteAgeusiaPerversion of taste in which substance possess an unpleasant flavor (a chemotherapy side effect)ParageusiaØDecline in odor sensitivity, usually after age 80 ØLoss of olfactory sensory neurons and cells in the olfactory bulbs ØCauses diminished appetite, food selection, possible malnutrition, and safety issues (inability to smell toxic fumes or gases)OlfactionØHigher concentration of flavors required ØDecline in the number of fungiform papillae ØChanges in taste receptor functiontaste