Pain, Temperature Regulation, Sleep, and Sensory Functions

Pain Overview

Pain is a protective mechanism; not weakness leaving the body.
Defined as an unpleasant sensory or emotional experience associated with actual or potential tissue damage.

Specificity Theory: Direct relationship between pain intensity and tissue injury; does not account for psychological factors.
Gate Control Theory: Pain transmission is modulated by impulses conducted to the spinal cord; A-delta and C fibers open pain gate; A-beta fibers can close it.
Neuromatrix Theory: Brain produces nerve impulse patterns from various inputs, illustrating plasticity; pain may originate in the brain independent of external stimuli.

Transduction: Conversion of noxious stimuli into an electrophysiological response.
Transmission: Pain impulse is conducted along A and C fibers to the spinal cord and ascends to the CNS.
Perception: Conscious awareness of pain through sensory, affective, and cognitive systems.
Modulation: Adjustments made to increase or decrease pain signal transmission.

Nociceptive Pain: Normal tissue injury; somatic or visceral.
Neuropathic Pain: Caused by nervous system dysfunction; can be peripheral or central.
Acute Pain: Less than 3 months; protective mechanism.
Chronic Pain: Lasts more than 3 months; dysregulation of pain processes.

Pain tolerance varies among individuals; can be affected by alcohol and distraction.
Hyperalgesia: Increased sensitivity to pain.
Allodynia: Pain response from normally non-painful stimuli.

Excitatory Neurotransmitters: Norepinephrine and serotonin.
Inhibitory Neurotransmitters: GABA, glycine; endogenous opiates (e.g., enkephalins, endorphins) inhibit pain impulses.

Referred Pain: Pain in an area distant from its origin.
Chronic Pain Syndromes include myofascial pain, cancer pain, complex regional pain syndrome, among others.
Pediatric and aging considerations; infants and elderly have altered pain perception and thresholds.

Controlled by the hypothalamus, balancing heat production, conservation, and loss.
Mechanisms include vasodilation, sweating, and behavioral responses.

Sleep has restorative functions; two main phases: REM and non-REM.
Non-REM includes light sleep (N1), moderate sleep (N2), and deep restorative sleep (N3). REM is when vivid dreams occur.
Pediatric sleep patterns differ from adults; elderly have alterations in sleep patterns.