Chapter 4: Pain, Exam 2 Patho

List the CAUSES of pain

inflammation, infection, ischemia, tissue necrosis, stretching of tissue, chemicals, burns

Differentiate between somatic and visceral pain

somatic: nociceptive. skin, tissue, or muscle pain

visceral: nociceptive. result from the activation of nociceptors of the thoracic, pelvic, and abdomen

Name the three chemical compounds produced by the body that will initiate pain

bradykinin, histamine, and prostagianin

Describe the steps involved in the perception of pain, from the stimulus to interpretation. include all the anatomical structures that are involved in the pathway

afferant pain stimilil i --> dorsal root then to spinal cord sensory muscle --> cord synapse --> spinothalmatic tract for acute, paleospinothalmatic for chronic dull pain --> reticular formation

Explain the mechanism by which endorphin can block pain impulses

endorphin are released by inter-neurons on the spinal cord; they then attach to opiate receptors and block the release of substance P

What is meant by referred pain? Explain how it occurs. Describe an example of referred pain

occurs when pain is perceived at a site distant from the source.

Ex: having a heart attack and having right arm pain

Differentiate between acute and chronic pain

acute: sudden, severe, and short term

chronic: difficult to treat and prognosis is less certain

Outline measures used to control pain, including the rationale for each

most common: analgesic meds to relieve pain. sedatives and anti-anxiety drugs. severe pain can be self managed with PCA. stress reduction, relaxation

Identify factors that may influence an individual's response to pain

age, culture, tradition, prior experience

Functions of skin

Protection, Thermoregulation, Sensory perception, Vitamin D synthesis, Excretion and Absorption of fluid.

Layers of the epidermis (superficial to deep)

corneum, lucidum, granulosum, spinosum, basale

Innermost layer of epidermis, squamous cells by mitosis

stratum basale (bsae layer)

epidermis layer composed of desmosomes (irregular shaped) that is rich in RNA and keratin

starum spinosum (spiny layer)

epidermis layer that has keratine-protein, keratine prevents fljiud loss/entry

startum graanulsom (granular layer)

epidermis composed of degernating kerancytes, thicker skin

stratum luciderm (clear layer)

epidermis layer made of dead cell, intrior filled with keraatin fibers formed from eledin (waterproof)

stratum corenum (horny layer)

layers of dermis

papillary layer and reticular layer

papillary layer

outer layer of the dermis, directly beneath the epidermis

outer layer of the dermis, directly beneath the epidermis

papillary layer

Deeper layer of the dermis that supplies the skin with oxygen and nutrients

reticular layer

Appendages of the skin

Hair, nails, sweat glands, and oil glands

Glands all over the body except the soles of feet and palms of hands

Merocrine

the other type of sweat gland, which are larger than eccrine glands and produce fatty acids and proteins

apocrine glands

What is a condition characterized by red patches and silvery scales, dry skin, swollen joints ?

Psoriasis

What are some treatments for psoriasis?

Glucosteroids, UV light, antimetabolic methotrexate

What is the condition characterized by shallow ulcers or fragile blisters in the mouth?

Pemphigus

What causes pemphigus?

Autoantibodies operating on the layers of the epidermis

What is a common treatment for pemphigus?

Prednisone

Condition that hardens the skin from increased colagen deposits tht cause deposits in the vessels restrcting blood flow

scerloderma

treatment for scleroderma

NSAIDs, vasodilaters immunosuppressants

Infection of the dermisa subcutaneous tissue caused by staphlocuccus auereas or streaptococcus spp

cellulitis

simpelx virus that causes (vesicles) that are painful and are treated by topical antivirals

Herpes

Condition of small red vesicles that will rupture cuased by straphylocci, treated by topical antibiotics

impetico

condition of flesh eating thaat causess reduced blood flow and tissue death

acute necrotizing fascitis

two types of necrotizing bacteria

anerobic and aerboic bavcter

streaptococcus or stapihlyococcus auerus

Condition of warts occuring on soles, face and rough surfaces along with papules and are caused by human papillomarines virus

verrucae

treatment for verrucae

laser, freezing, topical agents.

conditon of circular fungal infection causing redness and scalling caused by microsprum (animals) and tichophyton tonsurans (humans)

tinea

Benign lesions casued by aging or skin damage

keratoses

malignant tumor of the epidermis

suamous cell carcinoma

cancer that devlopes from the melanocytes in the basal layer of epidermis

malignant melanoma

skin lesion that is flat, colored spot on the skin (freckle), cicurcsribed

macule

skin lesion that is solid, raised clump of skin cells, firm and deep

nodule

skin lesion that is small, solid elevation

papule

skin lesion that is riased, often with a "head" filled with exudate or pus

pustule

skin lesion that has a thin waall, raised, fluid filled (blister)

vesicle

skin lesion that is elevated, flat and scale like

plaque

skin lesion that is a cavity in the tissue

ulcer

skin lesion that is a crack in the tissue

fissure

Body's first line defense

skin, mucous membrane, body scretions

Body's second line of defense

phagocytosis and inflammation

body's third line of defense

antibodies, senstive lymphocytes

What is inflammation?

when the body reacts to injury, irritation, or infection.

some causes of inflammation

-elimate cause of cell injury

-remove damaged cells

inflammaorty response to pain and its causes

damaged cells send signals

cause of the cardinal sign of heat

extra blood flow

causes of the inflammatory reponse of swelling

increased capillary permability

causes of the inflammatory response of loss of function

swelling causes blokage of nerves

causes of inflammatory reponse of redness

increased blood flow

sequence of inflammatory response

relese bradykins --> activazte pain receptors --? stimulates basophhils to release histamine --> causes capillary dilation --> breaks in tissue --> baccteria enters --> neutrophils and monocytes phagosize bacteria

inflmation that is short term with exudation of fluid and plasma

cells involed leukocytes, neutrophils, EC fluid

acute

inflammation that is longer

cells involved are lympocutes, macrophages, fibrosis, necrosis

chronic

involved in cell-mediated immunity

T lymphocytes

elevated during allergic responses

eosinophils

secretes histamine

basophils

the first cells to migrate to an injured area

neutrophils

involved in antibody production

B lymphocytes

elevated during chronic infection

macrophages

a source of macrophages

monocytes

phagocytizes microorganisms and other substances

neutrophil

involves minimal damage, cells return to normal

resolution

involes damaged tissues capable of mitosis

regerneration

potential complications during healing process with scar formation

loss function and normal cells, contractions and obstruction, scar tissue non-elastic and shrinks, adhesions of other scar tisssue

what degree of burn damages epidermis superficially

first degree

what burn degree is partial thickness, destrcution of epiermis and part of dermis

second degree

what degree of burn is full thickness and disctrution of all skin layers

third