PATH 1000 MIDTERM 2 EXAM 2025

Nociceptive Pain - -pain receptors in the PNS being stimulated by mechanical, thermal or chemical means Pain Threshold - -lowest intensity of pain that a person recognizes Pain Tolerance - -greatest intensity of pain that can be endured Acute Pain - -protective mechanism and sudden onset. Warning of an actual or impending tissue injury - Presents as increased HR, HTN, diaphoresis and anxiety Somatic Pain - -occurs in connective tissue, muscle, bone and skin Visceral Pain - -pain in internal organs and lining of body cavities associated with nausea, vomiting and restlessness Referred Pain - -occurs in an area distant from the point of region - Visceral sensory fibers enter the spinal cord along with sensory fibers from another point in the body → fibers converge → carry signals to the cerebral cortex Persistent Pain (Chronic Pain) - -pain lasting longer than 3 months and may be persistent. Onset can be sudden or develop insidiously - Leads to physiological adaptation & behavioural and psychological changes Neuralgia - -pain in the distribution of a nerve Neuropathic Pain - -pain caused by a lesion or dysfunction of the nervous system Phantom Limb Pain - -neuropathic pain from nerve trauma or disease - Occurs in patients who had pain prior to amputation - Cause: • Hyperactivity of peripheral nerves • Scar tissue • Neuroma formation Myofascial Pain - -pain and inflammation in the fascia that covers muscles due to injury and spams (chronic condition) Thermoregulation - -process that allows your body to maintain its core internal temperature mediated by the hypothalamus and endocrine system PATH1000 PATH1000 How does aging affect thermoregulation? - -- Decreased shivering - Slowed BMR - Decreased sweating - Slowed blood circulation - Changes to the skin - Decreased heat producing activities Mechanism of Heat Loss - -- Autonomic Nervous system: • Evaporation & vasodilation - Relation to environmental temperature: • Radiation • Conduction • Convection - transfer liquids/gases through the air from a warmer environment to a cooler environment Mechanism of Heat Conservation - -- Vasoconstriction by sympathetic nervous system Ex: dressing in layers helps with heat conservation as it traps heat in Fever - -temporary response to either endogenous or exogenous pyrogens - Hypothalamus & Brainstem Cause: • Increased heat production & conservation • Peripheral vasoconstriction • Epinephrine release How does fever effect older adults & infants? - -- Older Adults • Limited fever response to infection • May lead to increased morbidity & mortality - Infants • Inability to shiver • High temps can occur in mild infections • May develop febrile seizures Hyperthermia - -increased body temperature without hypothalamus trigger. - Can lead to nerve damage, convulsions & death Heat Cramps - -heat illness due to muscle spasms from loss of large amount of salt and water through exercise Heat Exhaustion - -result of body overheating - S/S: dizziness, headache, heat sweating, paleness, muscle cramps Heat Stroke - -severe heat illness that results in a body temperature greater than 130°F PATH1000 PATH1000 - S/S: throbbing headache, unconsciousness, confusion, rapid/strong pulse, red/hot/dry skin (no sweating) Hypothermia - -core body temperature falls below 35°C - Causes: • Prolonged cold exposure → vasoconstriction, increased blood viscosity, ischemic damage - Clinical Manifestations: • Shivering, increased risk of coagulation, ice crystals form in cells causing them to rupture and die Stages of Sleep - -- Non Rapid Eye Movement (Non-REM) 1. Stage 1: your eyes are closed, but easy to wake you up. Lasts for 5-10 minutes 2. Stage 2: you are in light sleep. Heart rate slows and body temperature drops. Body prepares for deep sleep 3. Stage 3: deep sleep stage. Body repairs and regrows tissues, builds bone and muscle, and strengthens immune system - Rapid Eye Movement (REM): happens 90 minutes after you fall asleep. Heart rate and breathing quickens. Intense dreams occur due to hyperactive brain Insomia - -(sleeplessness) difficulty falling asleep or staying asleep. - Day time sleepiness, low energy, irritability, and depressed mood Obstructive Sleep Apnea Syndrome (OSAS) - -serious sleep disorder where it causes breathing to repeatedly stops and start during sleep Shift Work Sleep Disorder - -trouble sleeping due to working nights or rotating shifts. May also have trouble staying awake or alert during work Restless Leg Syndrome - -uncontrollable urge to move your legs due to an uncomfortable sensation Cataract - -opaqueness of the ocular lens/thickening of lens due to changes in the lens proteins - S/S: decreased visual acuity, blurred vision and decreased color perception Glaucoma - -vision loss due to damage of the optic nerve resulting in increased pressure within the eye (interocular pressure - IOP). Affects peripheral Vision Open Angle Glaucoma - -(most common form) occurs due to blockage of the trabecular network → increased IOP • Progresses slowly PATH1000 PATH1000 • Most people are diagnosed once they have lost vision Closed Angle Glaucoma - -area between the cornea and iris has closed, leading to forward displacement of iris towards cornea • Fluid unable to drain → increased IOP • Abrupt onset, painful • Requires immediate medical attention Retinal Detachment - -tear or break in retina, which causes fluid accumulation in the space between retina & epithelial pigment - Vitreous gel becomes more liquefied - Separation deprives retina of oxygen & nutrients - S/S: floaters, flashes of light Macular Degeneration - -degeneration of the retinal macula - Usually age related (ARMD) - Affects central vision Dry (atrophic) Acute Macular Degernation - -(most common type) atrophy of retinal epithelial layer • Drusen thins and dries out macula • Loss of photoreceptors → loss of central vision • Can progress to Wet AMD Wet (exudative) Acute Macular Degeneration - -abnormal blood vessel growth • Vessels are leaky and weak → scarring • Fluid lifts and damages the macula • Causes rapid loss of vision if untreated and can lead to retinal detachment Conjunctivitis - -inflammation or swelling of the conjunctiva ("pink eye") Otitis Externa - -inflammation (redness and swelling) of the external ear canal - Common cause is bacteria (E.coli) - Occurs after prolonged exposure to moisture Otitis Media - -infection of the middle ear caused by bacteria - Common in children - Can be acute or chronic - Causes ear pain Reticular Activating System (RAS) - -regulates attention & information processing - Maintains wakefulness/attention (arousal) and helps maintain posture/balance - Location starts at the top of the spinal cord PATH1000 PATH1000 Alterations of Arousal - -- Structural - infections/tumours/injuries - Metabolic - hypoxia/electrolytes imbalances/hypoglycaemia - Psychogenic - drugs/psychiatric disorders Five Categories of Neurological Function - -1. LOC - determines nervous system function (awareness of person, place, time and arousal) 2. Pattern of Breathing - - Ex: Cheyne-Stokes Respirations 3. Pupil Changes - indicates level of brainstem dysfunction (fixed, dilated, pinpoint, sluggish) 4. Oculomotor Response - eye movements & reflexes change with brain dysfunction (abnormal movements/absent movements indicate what part of the brain is involved) - Ex: Doll's Eyes Phenomenon 5. Motor Response - evaluates level of brain dysfunction (determines which side of the brain is damaged) Cheyne-Stokes Respirations - -abnormal breathing pattern characterized by progressively deeper, sometimes faster, followed by gradual decrease that results in a temporary stop in breathing (apnea) - Pattern repeats each cycle taking 30 seconds to 2 minutes Cerebral Death - -death of cerebral hemisphere causing irreversible coma - Brainstem and cerebellum still function to maintain homeostasis - Permanent brain damage - Person does not follow commands, speak or have voluntary movement Brain Death - -brain cannot maintain body's internal homeostasis causing irreversible brain damage - Absence of cerebral hemisphere function - Absence of brainstem's vital centers Coma - -deep state of prolonged unconsciousness in which a person cannot be awakened - Fails to response to painful stimuli, light or sound - Does not initiate voluntary actions Vegetative State - -unawareness of self or environment - Arousal returns but is sluggish - Loss of cognitive function - BP & breathing are maintained - Brainstem reflexes intact Locked-in Syndrome - -patient is aware but cannot move or communicate verbally due to complete paralysis of nearly all voluntary muscles except for vertical eye movements and blinking PATH1000 PATH1000 Acute Confusional State (Delirium) - -acute transient disorder of awareness that affects attention, sleep-wake cycle, and behaviours - Causes: • Drug intoxication, ETOH/drug withdrawal, fever, trauma, electrolyte imbalances, head injury, etc. - Clinical Manifestations: • Confusion, delusions, hallucinations, loss of concentration, restlessness, irritability, insomnia, poor appetite Dementia - -progressive deterioration of brain function leading to impaired of intellect, memory, language and behaviour - Clinical Manifestations: • Memory loss, impaired judgement/learning, hallucinations, sleep disorders, depression, apathy, falls, anxiety Alzheimer's Disease - -(leading cause of dementia) brain has neurotic plaques & neurofibrillary tangles in the cerebral cortex & hippocampus - Unknown cause - Loss of acetylcholine - Results in loss of neurons & brain atrophy - Clinical Manifestations: • Progression from mild short term memory loss to total loss of cognition, disorientation/confusion, inability to problem solve, dyspraxia (loss of coordination of a learned skill), behavioural changes - Treatment: • Use of memory aids, improving hygiene/nutrition/health, use of cholinesterase inhibitors to stop breakdown of acetylcholine Parkinson's Disease - -chronic neurodegenerative disorder that degenerates the basal ganglia (affects extrapyramidal system) - Causes tremors and stiffness/slowing of movement