NURS
549
/
Final Review Questions With Correct Answers
/ / / / / /
4 /steps /of /pain /pathway /- /verified /answer(s)-
✔✔transduction, /transmission, /perception, /modulation
Transduction /- /verified /answer(s)-✔✔Stimulus /converted /to /nerve /impulse
Travels /from /most /distal /nerve /ending /toward /CNS
Transmission /- /verified /answer(s)-✔✔Impulse /carried /to /brain/CNS
Through /Neospinothalamic /tract /(fast) /or /Paleospinothalamic /tract /(slow)
Perception /- /verified /answer(s)-✔✔message /from /periphery /interpreted /by /brain
Alterations /in /neural /circuitry /in /brain /can /cause /change /in /pain /perception
--> /Mood, /stress, /rest
Modulation /- /verified /answer(s)-
✔✔Brain /sends /signals /that /cause /pain /signals /from /periphery /to /be /suppressed /or /amplified
Fast /pain /receptors /- /verified /answer(s)-✔✔Type /A-delta /fibers
Felt /<0.1 /second /of /stimulus: /sharp, /acute
Mechanical, /acute /thermal /pain
Not /in /deep /tissues
,Slow /pain /receptors /- /verified /answer(s)-✔✔Type /C /fibers
Felt /1+ /second /of /stimulus: /aching, /throbbing, /burning
Chemical /pain
Neospinothalamic /tract /- /verified /answer(s)-✔✔Type /A-delta /fibers
Mechanical /and /thermal /pain
Spine /--> /Thalamus /fibers, /pain /localized /precisely
Paleospinothalamic /tract /- /verified /answer(s)-✔✔Type /C /fibers
Chemical /pain
Terminates /in /brain /stem, /only /10-25% /terminate /in /thalamus, /cannot /localize /pain
Endogenous /pain /modulation/suppression /- /verified /answer(s)-
✔✔Serotonergic /and /enkephalin /neurons /BLOCK /pain
Analgesia /signals /can /block /pain /from /peripheral /neurons /- /from /both /Type /A-
delta /and /C /fibers
NSAIDS: /COX /inhibitors /- /verified /answer(s)-✔✔Inhibit /transduction /of /TYPE /C /pain /fibers
COX-1: /constitutive /(occurs /all /the /time) /
COX-2: /induced /by /cytokines /in /presence /of /inflammation /--> /localized /to /pain
NSAIDS /Side /Effects /- /verified /answer(s)-
✔✔GI /ulceration /and /bleeding /d/t /decreased /platelet /aggregation
Decreased /renal /function, /not /good /for /CKD /or /ARF /pts
Acetaminophen /- /verified /answer(s)-✔✔COX /inhibitor /(COX-
3?), /better /for /fever /than /inflammation /or /pain
, Opioids /- /verified /answer(s)-✔✔Block /transmission /of /pain, /binds /to /Mu /receptors
S/
S:
/suppresses
/respiratory
/center
/of /brain /stem, /Chemoreceptor /Trigger /Zone /(CTZ) /- /N/V, /constipation, /urinary /retention
Tramadol /(Ultram) /- /verified /answer(s)-✔✔Selective, /weak /mu-opioid /receptor /agonist
Increases /risk /of /SEIZURE
Antidepressants /for /pain /- /verified /answer(s)-✔✔SNRIs /(Duloxetine/Cymbalta) /or /tricyclics
Good /for /chronic /neuropathy /or /chronic /musculoskeletal /pain
Antiepileptics /for /pain /- /verified /answer(s)-✔✔Pregablin/Lyrica, /Gabapentin
Often /need /increased /dose /for /pain /management
Good /for /chronic /neuropathy /or /chronic /musculoskeletal /pain
Goals /of /pulmonary /meds /- /verified /answer(s)-✔✔Reduce /inflammation
Stimulate /bronchodilation
Block /bronchoconstriction
Control /cough /(may /be /more /than /one /goal)
Cough /- /verified /answer(s)-✔✔Protective /mechanism, /not /always /safe /to /stop /cough
Cough /receptors /in /trachea
549
/
Final Review Questions With Correct Answers
/ / / / / /
4 /steps /of /pain /pathway /- /verified /answer(s)-
✔✔transduction, /transmission, /perception, /modulation
Transduction /- /verified /answer(s)-✔✔Stimulus /converted /to /nerve /impulse
Travels /from /most /distal /nerve /ending /toward /CNS
Transmission /- /verified /answer(s)-✔✔Impulse /carried /to /brain/CNS
Through /Neospinothalamic /tract /(fast) /or /Paleospinothalamic /tract /(slow)
Perception /- /verified /answer(s)-✔✔message /from /periphery /interpreted /by /brain
Alterations /in /neural /circuitry /in /brain /can /cause /change /in /pain /perception
--> /Mood, /stress, /rest
Modulation /- /verified /answer(s)-
✔✔Brain /sends /signals /that /cause /pain /signals /from /periphery /to /be /suppressed /or /amplified
Fast /pain /receptors /- /verified /answer(s)-✔✔Type /A-delta /fibers
Felt /<0.1 /second /of /stimulus: /sharp, /acute
Mechanical, /acute /thermal /pain
Not /in /deep /tissues
,Slow /pain /receptors /- /verified /answer(s)-✔✔Type /C /fibers
Felt /1+ /second /of /stimulus: /aching, /throbbing, /burning
Chemical /pain
Neospinothalamic /tract /- /verified /answer(s)-✔✔Type /A-delta /fibers
Mechanical /and /thermal /pain
Spine /--> /Thalamus /fibers, /pain /localized /precisely
Paleospinothalamic /tract /- /verified /answer(s)-✔✔Type /C /fibers
Chemical /pain
Terminates /in /brain /stem, /only /10-25% /terminate /in /thalamus, /cannot /localize /pain
Endogenous /pain /modulation/suppression /- /verified /answer(s)-
✔✔Serotonergic /and /enkephalin /neurons /BLOCK /pain
Analgesia /signals /can /block /pain /from /peripheral /neurons /- /from /both /Type /A-
delta /and /C /fibers
NSAIDS: /COX /inhibitors /- /verified /answer(s)-✔✔Inhibit /transduction /of /TYPE /C /pain /fibers
COX-1: /constitutive /(occurs /all /the /time) /
COX-2: /induced /by /cytokines /in /presence /of /inflammation /--> /localized /to /pain
NSAIDS /Side /Effects /- /verified /answer(s)-
✔✔GI /ulceration /and /bleeding /d/t /decreased /platelet /aggregation
Decreased /renal /function, /not /good /for /CKD /or /ARF /pts
Acetaminophen /- /verified /answer(s)-✔✔COX /inhibitor /(COX-
3?), /better /for /fever /than /inflammation /or /pain
, Opioids /- /verified /answer(s)-✔✔Block /transmission /of /pain, /binds /to /Mu /receptors
S/
S:
/suppresses
/respiratory
/center
/of /brain /stem, /Chemoreceptor /Trigger /Zone /(CTZ) /- /N/V, /constipation, /urinary /retention
Tramadol /(Ultram) /- /verified /answer(s)-✔✔Selective, /weak /mu-opioid /receptor /agonist
Increases /risk /of /SEIZURE
Antidepressants /for /pain /- /verified /answer(s)-✔✔SNRIs /(Duloxetine/Cymbalta) /or /tricyclics
Good /for /chronic /neuropathy /or /chronic /musculoskeletal /pain
Antiepileptics /for /pain /- /verified /answer(s)-✔✔Pregablin/Lyrica, /Gabapentin
Often /need /increased /dose /for /pain /management
Good /for /chronic /neuropathy /or /chronic /musculoskeletal /pain
Goals /of /pulmonary /meds /- /verified /answer(s)-✔✔Reduce /inflammation
Stimulate /bronchodilation
Block /bronchoconstriction
Control /cough /(may /be /more /than /one /goal)
Cough /- /verified /answer(s)-✔✔Protective /mechanism, /not /always /safe /to /stop /cough
Cough /receptors /in /trachea
