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Kine 427 Exam 2
Ruffini's End Organs |
-Tonic (very slow adapting)
-Continuous touch pressure |
Merkel's Disks |
-Tonic
-Light Touch |
Meisner's Corpuscles |
-Phasic
-Touch (Texture)
|
Hair End Organs |
-Phasic (rapid adaption)
-Light touch |
Pacinian Corpuscles |
-Phasic (very rapid adaptation)
-Deep pressure, vibration, proprioception |
Free Nerve Endings |
-Tonic (little-no adaptation)
- Pain, pressure, touch (A: fast)
- Itch, joint movement (C: slow) |
Cold Receptors |
-Tonic (incomplete adaptation)
-cold/cold pain |
Warmth Receptors |
-Tonic (Incomplete adaptation)
-heat/ heat pain |
Temperature Sensation |
-Not well understood
-Mostly transmitted through free nerve endings (thermoreceptors) |
Hot Flashes |
- Hormone signal malfunction "tells" hypothalamus that the body is too hot
- Body responds with temperature reduction mechanisms |
Thermoneutral Environment |
- Point where cold & warmth receptor intersect
~75 degrees normal
~55 degrees Marathon Runners b/c body producing way more heat |
Spacial Resolution Definition |
-The minimum physical distance btw stimuli that results in a two point stimulus being perceived as a two point stimulus. |
Spacial Resolution is a function of... |
-Receptor density
-Sensory fields |
Sensory Fields |
-Convergence of receptor neurons on one brain pathway |
Spatial Resolution Characteristics |
-Smallest for tongue (2 mm)
-Finger tips (4 mm)
-Largest for back (40 mm)
-Indirect relationship to receptive field size |
Tactile Resolution |
-Receptive field size
-Finger tips are better than palm of hand, etc... |
Pain |
-An unpleasant sensory & emotional experience associated with actual or potential tissue damage, or described in terms of such damage.
-Most subjective of our senses |
IASP |
-International Association for the Study of Pain |
Pain influenced by... |
-Past experiences & sleep disturbances
-Emotion
-Individual variation & cultural influences
-Loss of social rank/status |
Pain threshold lowered by... |
-anger
-anxiety
-depression
-isolation
-chronic pain |
Pain threshold raised by... |
-diversion
-empathy
-rest
-sympathy
-medication |
Reflexes involved with activation of nociceptors... |
^ Heart Rate
^ Blood Pressure
^ Respiratory Rate
^ Sweating
^ Pain site blood flow
- Dilated pupils
- Spasm of nearby muscles |
Consequences of unresolved pain |
1) Increasing Physiological Stress
2) Diminishing immune function
3) Reducing mobility & other physical capability
4) Increasing chances of thromboembolism
5) Increasing the work of breathing & myocardial oxygen requirements
6) Sleep disturbances
7) Decline in recreational, social & family activity
8) Causing malnutrition |
CIPA |
-Congenital Insensitivity to Pain w/ Anhidrosis
-Unable to feel pain or sense heat and cold
-Only 34 current cases in the US |
Gated Control Theory |
-Pain shares transducers & neural pathways w/ other sensations (light vs. heavy pressure)
-Transmission of all impulses is "gated" (regulated) at the spinal cord level |
Loesser's Onion Theory |
1st: tissue damage & receptor function
2nd: perception of pain
3rd: suffering
4th: pain behavior
5th: interaction w/ environment
*Only the 4th and 5th layer can be observed |
Contemporary Theory of Pain |
-Pain can be "amplified" or "dampened" at 3 levels:
1) Peripheral (pain sensors & surrounding influences)
2) Spinal Cord (gate mechanism)
3) Brain (emotions, experiences, culture, etc.)
|
5-Hydroxytryptamine (Seratonin) |
-Common pain neurotransmitter |
Bradykinin |
-Common pain neurotransmitter |
Substance P |
-Common pain neurotransmitter
|
Prostaglandulins |
-Enhance the sensitivity of pain receptors
-Recent studies suggest they may also activate the receptor |
Somatic Pain |
-Originates in joints, muscles, skin, or ligaments
-Responds well to NSAID's
-Described as aching, throbbing, stabbing, or pressure |
Visceral Pain |
-Originates in the internal organs or smooth muscle
-Usually requires narcotics |
Superficial Pain |
-Originates in the skin or mucous membranes |
Cancer Pain |
-Pressure from tumor on organs or nerves, fractures, muscle spasms |
Psychogenic Pain |
-Real to the patient but originates from psychological factors |
Referred Pain |
-Pain occurs at an area different from tissue origin
-Heart attack, appendicitis... |
Vascular Pain |
-Originates from vascular pathology
-Inflammation causes change in blood flow |
Migraine Headaches |
-Severe throbbing unilateral pain lasting 4 - 72 hours
-Affects ~ 24 million Americans
-Cause is not completely clear
-Affects woman more than men |
Migraine triggers |
-Barometric pressure change
-Estrogen cycle
-Hunger
-Insomnia
-Stress |
Prophylactic Therapy for Migraines |
-Beta blockers
-Calcium channel blockers
-Antidepressants
-Anticonvulsants (Topomax; Topiramate) |
Abortive Therapy for Migraines |
-Various NSAID's
-5-Hydroxytriptamine (Seratonin) agonist
*Imitrex, Relpax, Frova, Migranal... |
Fast Pain |
-Usually travels a direct route to higher neurocenters
-Localized pain lasting only as long as receptor is stimulated |
Slow Pain |
-Usually travels a multisynaptic route to higher neurocenters
-Usually from visceral sources (cancer or smooth muscle pain) |
Acute Pain |
-Temporary pain resulting from tissue damage, infection, or acute inflammation
-Warning system
-Most often very treatable |
Chronic Pain |
-Continual firing of non-adapting receptors for weeks, months, years...
~86 million Americans (9% - 11% pop)
-More woman than men
-Only about 8,000 MDs that are chronic pain specialists |
Chronic Pain terrible triad |
1) Suffering
2) Sleeplessness
3) Sadness |
Causes of Chronic Pain |
-Displacement of tissues causing ischemia, inflammation, & tissue destruction
-An initial injury or pathology that is not resolved or cured
-Back spasm, ruptured disk in back, unresolved infection, cancer, arthritis...
-Damage or malfunction in the nervous system |
Chronic Pain processing |
-Unlike acute pain, it passes through the hypothalamus & limbic system before reaching the brain
-Hypothalamus releases stress hormone, cortisol
-Limbic System is connected to emotional centers |
Neuropathic Pain |
-Results from damage to CNS fibers or periphery nerve fibers
-Often triggered by past pain or disease, but hard to pinpoint exact cause
-May result from cell content spillage or unresolved inflammation
-Described as tingling, burning, searing, sharp, & shooting sensations |
Allodynia |
-Pain resulting from non-painful stimuli
-Common in neuropathic pain |
Phantom Pain |
-Pain in a limb no longer present
-May dissipate over time
-50%-80% of amputees experience phantom pain |
Causal Theories of Phantom Pain |
-Remaining proximal neurons activated by sensory/pain neurons close by
-Parts of the thalamus continues to send signals to higher centers (cortex)
-Loss of sensory input from amputated limb causes ''crosswiring'' in cortex |