nociception spinal reflex

CBNS 120 Sensory Transduction II: Chemoreceptors, Thermoreceptors & Nociceptors

Nociceptors

Nociceptive Pain

Central Nervous System White vs gray matter :: Gray = cell bodies (processing); White = myelinated axons (communication) Primary motor cortex, Broca’s, premotor location :: Frontal lobe Innermost meninge :: Pia mater CSF is formed where :: Choroid plexus (ventricles) Ventral horn destruction causes :: Loss of motor output Same hemisphere fibers :: Association fibers Across hemispheres :: Commissural fibers (corpus callosum) Advantage of convolutions :: Increased surface area → more processing power Grooves :: Sulci Folds :: Gyri Groove dividing hemispheres :: Longitudinal fissure Frontal vs parietal lobe :: Central sulcus Parietal vs temporal :: Lateral sulcus Primary motor cortex :: Voluntary movement Premotor cortex :: Plans movement Primary sensory cortex :: Detects touch Somatosensory association :: Interprets sensation Visual area :: Vision Auditory area :: Hearing Prefrontal cortex :: Decision making/personality Broca’s area :: Speech production Controls temp, hunger, ANS :: Hypothalamus Substantia nigra location :: Midbrain Vital centers (heart, breathing) :: Medulla oblongata Sensory relay center :: Thalamus (gray matter) Basal nuclei function :: Initiate/stop movement, smooth motion Cerebellum role :: Coordination, balance, posture Limbic system location/function :: Around brainstem; emotion + memory RAS meaning/function :: Reticular Activating System; alertness STM → LTM factors :: Repetition, sleep, emotion, meaning CNS protection (4) :: Skull/vertebrae, meninges, CSF, BBB CSF formation/drainage :: Produced in ventricles → circulates → reabsorbed into blood Blood-brain barrier :: Tight capillaries + astrocytes Pyramidal tracts :: Motor pathways; cross at medulla Dorsal vs ventral roots :: Dorsal = sensory; Ventral = motor CSF location :: Subarachnoid space Spinal cord organization :: Gray inside; white outside Anterior vs posterior root signals :: Anterior = motor; Posterior = sensory Cervical/lumbar enlargements :: Serve limbs Spinal cord location :: Vertebral foramen Filum terminale :: Anchors spinal cord ⸻ Sensation & Integration Sensation vs perception :: Sensation = detection; Perception = interpretation Sensory modality :: Type of stimulus Mechanoreceptors :: Touch/pressure Thermoreceptors :: Temperature Chemoreceptors :: Chemicals Nociceptors :: Pain Naked nerve endings :: Free endings (pain/temp) Encapsulated endings :: Wrapped (touch/pressure) 3 steps of sensation :: Stimulus → receptor → signal to brain Meissner’s corpuscles :: Light touch receptors Proprioceptor example :: Muscle spindle; detects stretch/body position Pressure receptor :: Pacinian corpuscle (encapsulated) Thermal receptor distribution :: Uneven Touch receptor distribution :: Uneven Referred pain :: Pain felt elsewhere Pain receptors :: Nociceptors Brain maps based on :: Sensitivity (not size) 3-neuron sensory pathway :: 1st: receptor → spinal cord 2nd: spinal cord → thalamus 3rd: thalamus → cortex Motor pathway neurons :: 2 neurons Upper: brain → spinal cord Lower: spinal cord → muscle Ascending pathways :: Sensory to brain Descending pathways :: Motor from brain

I. The Concept of Pain a. Define pain b. Signs & symptoms of pain c. Pathophysiology & etiologies of pain d. Physiological & behavioral responses to pain e. Types of pain i. Nociceptive pain ii. Neuropathic pain iii. Acute vs. chronic pain iv. Idiopathic pain v. Central pain vi. Phantom pain vii. Psychogenic (emotional) pain f. Factors influencing pain g. Assessing pain h. Nursing interventions to manage pain II. The Concept of Oxygenation a. Factors affecting oxygenation b. Hypoxia vs. hypoxemia c. Alterations in respiratory function d. Assessments & diagnostics related to oxygenation e. Oxygen delivery devices i. Indications for which device to use ii. # of liters delivered via each device iii. Percent of oxygen delivered via each device f. Nursing interventions to promote effective oxygenation g. Home oxygen therapy III. The Concept of Infection a. Terms: i. Communicability ii. Virulence iii. Colonization iv. Superinfection b. Localized vs. systemic infections i. Signs & symptoms of each c. Acute infection vs. Chronic infection (know examples of each) d. Factors that increase infection risk e. Stages of infection f. MDRO’s g. MRSA i. VRE h. Chain of infection i. Standard precautions j. Transmission-based precautions (describe the precaution and what PPE are necessary to use) i. Know what transmission-based precautions (if any) might be used for these infections: 1. Varicella Zoster 2. HIV 3. Hepatitis B & C 4. Clostridium difficile 5. MDROs k. Interventions to prevent transmission of infection l. Patient teaching r/t infection IV. Pre-/Intra-/Post-Op Care a. Classifications of Surgery b. Surgical Risk Factors c. Pre-/Intra-/Post-Op Nursing Assessment and Nursing Care d. Roles during Surgery – circulating nurse, scrub nurse/tech, 1st assist, etc. e. Potential Post-Op Complications f. Types of anesthesia, indications for use, and potential complications with each type

Nociception and pain (Alice Whitney lecture 3)

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