Ch 16- Pain, Temperature Regulation, Sleep, and Sensory Function
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Questions and Answers

Which fibers transmit nerve action potentials generated by nociceptor excitation?

  • B and C fibers
  • A-beta and C fibers
  • A-delta and C fibers (correct)
  • A-delta and A-beta fibers

    • What type of pain sensation is transmitted rapidly by A-delta fibers?

  • Burning pain
  • Dull, aching pain
  • Sharp, well-localized pain (correct)
  • Poorly localized pain

    • Which of the following is a characteristic of pain transmitted by unmyelinated C fibers?

  • Rapid transmission
  • Well-localized sensation
  • Short duration
  • Poorly localized sensation (correct)

    • Which type of stimulus does NOT excite C fibers?

    <p>Vibration stimuli (B)</p> Signup and view all the answers

    Which fibers are responsible for causing reflex withdrawal from a stimulus before pain is perceived?

    <p>A-delta fibers (B)</p> Signup and view all the answers

    Which fibers do not directly transmit pain, but modulate pain transmission?

    <p>A-beta fibers (C)</p> Signup and view all the answers

    What physiological response is associated with increased ventilator rates during hyperthermia?

    <p>Normal pulmonary ventilation providing some heat loss. (C)</p> Signup and view all the answers

    Which of the following is a voluntary mechanism employed to reduce body temperature?

    <p>Stretching out to increase body surface area. (A)</p> Signup and view all the answers

    According to the passage, what structure is NOT directly involved in conscious pain perception?

    <p>Dorsal horn of the spinal cord (C)</p> Signup and view all the answers

    What is the primary cause of heat exhaustion?

    <p>Prolonged vasodilation and profuse sweating leading to dehydration. (B)</p> Signup and view all the answers

    What aspect of pain is the somatosensory cortex primarily responsible for?

    <p>Identification of pain location (B)</p> Signup and view all the answers

    What is the recommended immediate action for an individual experiencing heat exhaustion?

    <p>Ceasing activity to decrease heat production and lying down (A)</p> Signup and view all the answers

    What is an adaptation that occurs when someone moves to a warmer climate?

    <p>An adjustment period that takes days to weeks. (A)</p> Signup and view all the answers

    What is the typical duration criterion for classifying pain as chronic?

    <p>More than 3 to 6 months (C)</p> Signup and view all the answers

    Persistent pain may result in physiological adaptation, leading to which of the following?

    <p>Normal heart rate and blood pressure (C)</p> Signup and view all the answers

    Which of the following is characteristic of neuropathic pain?

    <p>Amplification of pain without stimulation by injury or inflammation (D)</p> Signup and view all the answers

    What is the hallmark characteristic of heat stroke?

    <p>Rectal temperature greater than 41°C (106°F) (B)</p> Signup and view all the answers

    Which physiological process is most directly impaired in heat stroke?

    <p>Function of the thermoregulatory center (A)</p> Signup and view all the answers

    What is allodynia?

    <p>Pain caused by normally nonpainful stimuli (D)</p> Signup and view all the answers

    Peripheral neuropathic pain can be caused by:

    <p>Diabetic neuropathy (B)</p> Signup and view all the answers

    Why does rapid cooling of the skin in heat stroke sometimes need to be avoided?

    <p>Peripheral vasoconstriction prevents core cooling (C)</p> Signup and view all the answers

    Which of the following is a neurological consequence of prolonged heat stroke?

    <p>Cerebral edema and degeneration of the CNS (B)</p> Signup and view all the answers

    Which of the following conditions is a common cause of central neuropathic pain?

    <p>Postherpetic neuralgia (C)</p> Signup and view all the answers

    What type of pain syndrome results from lesions interrupting the spinothalamic pathways?

    <p>Deafferentation pain (D)</p> Signup and view all the answers

    What is the primary function of sleep?

    <p>To provide restorative bodily functions and promote the creation of memories (B)</p> Signup and view all the answers

    Where is the major sleep center located in the body?

    <p>Hypothalamus (A)</p> Signup and view all the answers

    Hemiagnosia pain is typically associated with what condition?

    <p>Stroke (B)</p> Signup and view all the answers

    Phantom limb pain is best described as:

    <p>Pain in an amputated limb after the stump has completely healed (C)</p> Signup and view all the answers

    Approximately what percentage of total sleep time is spent in NREM sleep?

    <p>75-80% (A)</p> Signup and view all the answers

    A patient describes their neuropathic pain as 'burning, shooting, and shock-like.' Which additional symptom is commonly associated with this type of pain?

    <p>Tingling (D)</p> Signup and view all the answers

    What is the approximate duration of each sleep cycle (NREM and REM) in minutes?

    <p>90 - 100 minutes (C)</p> Signup and view all the answers

    Approximately what percentage of total sleep time is spent in N2 sleep stage?

    <p>45-55% (C)</p> Signup and view all the answers

    Which physiological change is characteristic of N3 sleep?

    <p>Low-frequency, high-amplitude delta waves (D)</p> Signup and view all the answers

    What part of the brain controls REM sleep?

    <p>Pontine and reticular formation (A)</p> Signup and view all the answers

    During which sleep stage is respiration dependent and controlled by metabolic processes?

    <p>NREM sleep (D)</p> Signup and view all the answers

    Which of the following physiological events occurs during REM sleep?

    <p>Atonia of antigravity muscles (D)</p> Signup and view all the answers

    Which factor is increased during REM sleep?

    <p>Cerebral blood flow to both hemispheres (B)</p> Signup and view all the answers

    What is the effect of losing REM sleep?

    <p>Impaired memory and learning (C)</p> Signup and view all the answers

    Which of the following decreases during NREM sleep?

    <p>All of the above (D)</p> Signup and view all the answers

    A common symptom shared by both keratitis and inflammatory response is:

    <p>Photophobia (B)</p> Signup and view all the answers

    Which organism commonly causes acute bacterial conjunctivitis?

    <p>Staphylococcus (D)</p> Signup and view all the answers

    What is the primary cause of trachoma?

    <p>Chlamydia trachomatis (D)</p> Signup and view all the answers

    Which of the following is a typical symptom of allergic conjunctivitis?

    <p>Ocular itching (D)</p> Signup and view all the answers

    What is the most common cause of bacterial keratitis?

    <p>Staphylococcus aureus (B)</p> Signup and view all the answers

    A patient presents with conjunctivitis and pharyngitis. Which type of infection is most likely the cause?

    <p>Viral (A)</p> Signup and view all the answers

    What strategy does the WHO recommend for trachoma treatment?

    <p>SAFE (B)</p> Signup and view all the answers

    What is a potential consequence of chronic conjunctivitis if left untreated?

    <p>Persistent inflammation (C)</p> Signup and view all the answers

    Flashcards

    C fibers

    Unmyelinated polymodal fibers; transmit dull, aching pain.

    A-delta fibers

    Lightly myelinated fibers; transmit sharp, localized pain quickly.

    Nociceptors

    Free nerve endings that respond to pain stimuli.

    Pain transmission

    Conduction of pain impulses via A-delta and C fibers.

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    Pain perception

    Conscious awareness of pain occurring in the CNS.

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    Sensory-discriminative system

    Identifies the presence, character, location, and intensity of pain.

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    Polymodal fibers

    Fibers that respond to multiple types of stimuli (C fibers).

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    Dorsal horn

    Part of the spinal cord where pain signals enter the CNS.

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    Increased pulmonary ventilation

    Exchange of air that results in minimal heat loss, especially faster at higher body temperatures.

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    Voluntary heat loss mechanisms

    Behavioral actions like stretching out and wearing light clothing to increase heat loss.

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    Heat adaptation

    Adjustment period of the body transitioning from cooler to warmer climates lasting several days to weeks.

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    Heat exhaustion

    Common heat injury due to prolonged high temperatures, leading to dehydration and hypotension.

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    Management of heat exhaustion

    Encouraging rest and warm fluid intake to recover from heat-related symptoms.

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    Chronic Pain

    Persistent pain lasting beyond normal healing time, often over 3-6 months.

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    Neuropathic Pain

    Chronic pain caused by nerve dysfunction, leading to abnormal sensory processing.

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    Peripheral Neuropathic Pain

    Pain caused by trauma or diseases affecting peripheral nerves.

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    Central Neuropathic Pain

    Pain from lesions or dysfunction in the central nervous system.

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    Hyperalgesia

    Increased sensitivity to a painful stimulus; normally painful stimuli feel worse.

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    Allodynia

    Induction of pain by typically non-painful stimuli.

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    Phantom Limb Pain

    Pain perceived in an amputated limb after healing.

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    Deafferentation Pain Syndromes

    Pain resulting from lesions that disrupt sensory pathways in the nervous system.

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    Chronic Neuropathic Pain

    Long-lasting changes in pain processing along somatosensory pathways.

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    Hemiagnosia Pain

    Central pain associated with stroke, causing hypersensitivity on one body side.

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    Acute bacterial conjunctivitis

    Highly contagious eye infection often seen in children, resolves spontaneously in 10-14 days.

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    Symptoms of acute bacterial conjunctivitis

    Mucopurulent drainage from one or both eyes; associated with redness and pain.

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    Viral conjunctivitis

    Contagious inflammation of the conjunctiva caused by adenovirus; symptoms include watering and redness.

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    Symptoms of viral conjunctivitis

    Watering, redness, photophobia; milder than bacterial.

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    Allergic conjunctivitis

    Ocular inflammation due to allergens, causing itching and a gritty feel in the eyes.

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    Treatment for allergic conjunctivitis

    Includes antihistamines, corticosteroids, and mast cell stabilizers.

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    Trachoma

    Chlamydial conjunctivitis caused by Chlamydia trachomatis; leads to blindness if untreated.

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    Keratitis

    Inflammation of the cornea possibly caused by infection; severe cases may require transplantation.

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    Heat Stroke

    A lethal condition from the breakdown of thermoregulation due to high body temperature.

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    Rectal Temperature for Heat Stroke

    A critical indicator of heat stroke; greater than 41°C or 106°F.

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    Symptoms of Heat Stroke

    Includes dry skin, confusion, irritability, and loss of consciousness.

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    Treatment for Heat Stroke

    Immediate cooling, removing from heat, using water or ice packs strategically.

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    Children and Heat Stroke

    Children are more susceptible due to higher metabolic heat and lower sweating capacity.

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    Sleep Phases

    Normal sleep consists of cyclic phases: NREM and REM.

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    NREM Sleep

    Non-REM sleep makes up 75-80% of sleep time with varying depths.

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    Major Sleep Center

    The hypothalamus regulates the sleep-wake cycle.

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    N2 Sleep Stage

    A sleep stage characterized by slowed EEG, sleep spindles, and slow eye movements; lasts 30-60 min and comprises 45-55% of sleep time.

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    N3 Sleep Stage

    Known as slow-wave sleep, it features low-frequency high-amplitude delta waves, no slow eye movements, and accounts for 13-23% of sleep time.

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    Sleep Spindles

    Bursts of oscillatory brain activity that occur in N2 sleep, associated with memory consolidation.

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    Atonia

    Muscle relaxation during REM sleep, leading to temporary paralysis of antigravity muscles.

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    Effects of REM Sleep Loss

    Impairment of memory and learning processes due to the absence of REM sleep.

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    Cerebral Blood Flow in Sleep

    Changes in cerebral blood flow during different sleep stages impact brain function and metabolic processes.

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    Conjunctivitis

    Inflammation of the conjunctiva, the mucous membrane covering the eyeball.

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    Study Notes

    Gate Control Theory of Pain

    • Integrates other theories (specificity, pattern) to explain pain perception and modulation
    • Pain transmission is regulated by a "gate" in the spinal cord's substantia gelatinosa
    • Nociceptive transmission (mechanical, thermal, chemical) opens the gate; perception of pain occurs
    • Non-nociceptive stimulation (touch, rubbing) closes or partially closes the gate, reducing pain perception
    • Larger A-beta fibers are involved in the closure or partial closure of the spinal gates

    Nerve Fibers and Pain Transmission

    • Nociceptors (primary order neurons) are free nerve endings in the PNS
    • Respond to chemical, mechanical, and thermal stimuli
    • Lateral spinothalmic spinal tract carries nociceptive information, causing pain
    • Categorized by stimulus type and axon properties
    • Nociception has four phases: transduction, transmission, perception, and modulation

    Types of Nerve Fibers

    • A-delta fibers: lightly myelinated, medium-sized
      • Stimulated by severe mechanical or thermal stimuli
      • Transmit "fast" pain sensations
      • Cause rapid reflex withdrawal
    • C fibers: unmyelinated, small
      • Stimulated by mechanical, thermal, and chemical stimuli
      • Transmit "slow" pain sensations, often dull, aching, or burning
      • Poorly localized and longer-lasting

    Pain Perception in the CNS

    • Conscious pain awareness occurs in the reticular and limbic systems and the cerebral cortex
    • Interactions of three systems (sensory-discriminative, affective-motivational, cognitive-evaluative) determine pain perception and responses

    Clinical Descriptions of Pain

    • Pain threshold: the point at which a stimulus is perceived as painful. Relatively consistent between people and over time, but intense pain in one area can increase the threshold in other areas.

    • Pain tolerance: the duration or intensity of pain an individual will endure before responding. Typically decreases with repeated pain exposure. Can be affected by culture, expectations, physical and mental health, and gender.

    • Acute pain: normal protective mechanism, temporary, lasts seconds to days, or up to 3 months. Stimulated by chemical mediators.

    • Chronic pain: lasts significantly longer than expected normal healing; often out of proportion to any tissue injury; associated with anxiety and depression.

    • Neuropathic pain: caused by damage or dysfunction in the nervous system; characterized by burning, shooting, shock-like pain and hyperalgesia/allodynia

      • Central neuropathic pain: results from lesions or dysfunction in the CNS (e.g., spinal cord injury, stroke)
      • Peripheral neuropathic pain: caused by damage to peripheral nerves (e.g., diabetes, injuries).

    Endogenous Opioids

    • Family of morphine-like neuropeptides that inhibit pain transmission
    • Types include enkephalins, endorphins, dynorphins, and endomorphins
    • Act on specific receptors in the CNS, GI system, immune system, and others

    Temperature Regulation and Epinephrine

    • Heat production is regulated by the hypothalamus and endocrine system (thyroid stimulating hormone, thyroxine)
    • Epinephrine causes vasoconstriction, increasing metabolic rate and heat production

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    Description

    Test your knowledge on the mechanisms of pain transmission, including the roles of different nerve fibers such as A-delta and C fibers. This quiz also covers physiological responses to heat and temperature regulation. Perfect for students studying neuroanatomy and physiology.

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