ADVANCED PATHOPHYSIOLOGY EXAM QUESTIONS AND ANSWERS |RATED A+|

ADVANCED PATHOPHYSIOLOGY EXAM QUESTIONS AND ANSWERS |RATED A+| Peripheral thermoreceptors in - ---ANSWER--- the skin and central thermoreceptors in the hypothalamus, spinal cord, and abdominal organs provide the hypothalamus with information about skin and core temperatures. Heat is produced through chemical reactions of metabolism - ---ANSWER--- skeletal muscle contraction (shivering) and brown fat (nonshivering) thermogenesis. Heat is lost through - ---ANSWER--- radiation, conduction, convection, vasodilation, decreased muscle tone, evaporation of sweat, increased ventilation, and voluntary mechanisms. Heat conservation is accomplished through - ---ANSWER--- vasoconstriction and voluntary mechanisms. Infants and older adults require special attention to - ---ANSWER--- maintenance of body temperature. Because of their greater body surface area to mass ratio and decreased subcutaneous fat infants - ---ANSWER--- do not conserve heat well. Older individuals have poor responses to - ---ANSWER--- environmental temperature extremes as a result of slowed blood circulation structural and functional changes in skin and an overall decrease in heat-producing activities. Three classes of second-order neurons modulate pain transmission: - --- ANSWER--- projection cells, excitatory interneurons and inhibitory interneurons. The second-order neurons are located: - ---ANSWER--- in the spinal cord laminae The second-order neurons function as - ---ANSWER--- a pain gate to regulate pain transmission. Second-order neurons cross over the cord and ascend primarily in - ---ANSWER--- the lateral the spinothalamic tract to projection centers including the thalamus reticular formation, and PAG matter. Third-order neurons carry information to the - ---ANSWER--- sensory cortex and reticular and limbic systems for pain processing and interpretation. Efferent pathways from the PAG are responsible for modulation or inhibition of afferent pain signals. - ---ANSWER--- The thalamus cortex, and postcentral gyrus perceive, describe, and localize: - --- ANSWER--- Pain The reticular formation and limbic system control the - ---ANSWER--- emotional and affective response to pain. Pain threshold is the point at which pain is perceived. Pain threshold does not vary significantly among people or within the same person over time. - ---CORRECT ANSWER--- Pain tolerance is the duration of time or the intensity of pain that an individual will ensure before initiating overt pain response. - ---ANSWER--- Tolerance varies widely among individuals and in the same individual over time and in the same individual over time. - ---ANSWER--- Descending inhibitory or facilitatory pathways facilitate pain. - ---ANSWER--- Segmental inhibition is the peripheral stimulation of nociceptors by touch nuclei, and neurotransmitter inhibit or vibration or pressure resulting in closure of the spinal cord pain gate. - ---ANSWER--- The higher brain centers also can - ---ANSWER--- influence painful stimuli (heterosegmental control of nociception) as well as inhibition from the caudal medulla (diffuse noxious inhibitory controls). Thus pain can be modulated with: - ---ANSWER--- Stimulation from the periphery or by descending impulses from the brain Cognitive expectation can attenuate or intensify pain and this is known as the: - --- ANSWER--- Placebo and nocebo effects. Pain neurotransmitters can be classified as inflammatory excitatory, and inhibitory modulators of pain. - ---ANSWER--- Inflammatory neurotransmitters are usually excitatory. Gammaaminobutyric acid (GABA) and glycine are inhibitors of pain. - ---ANSWER--- Endogenous opioids are a family of morphine-like neuropeptides that inhibit transmission of pain by acting on: - ---ANSWER--- specific opiod receptors (mu [μ] kappa [κ], and delta [δ]). Classifications of pain include - ---ANSWER--- A: nociceptive pain (with a known physiologic cause) B: nonnociceptive pain (neuropathic pain) Acute pain - ---ANSWER--- signal to the person of a harmful stimulus Chronic pain - ---ANSWER--- Persistence of pain of unknown cause or unusual response to therapy. Acute pain may be - ---ANSWER--- (a) somatic (superficial) (b) visceral (internal) (c) referred (present in an area distant from its origin). Somatic pain arises from - ---ANSWER--- connective tissue, muscle, bone, and skin and is sharp and localized. Visceral pain is from - ---ANSWER--- internal organs and is transmitted by sympathetic afferents and is poorly localized. Referred pain usually arises from the viscera and terminates - ---ANSWER-- - in an area of the spinal cord that is conjoined with fibers originating in the skin and other areas and thereby produces the perception of pain at the referred site. that is conjoined with fibers originating in the skin and other areas and thereby produces - ---ANSWER--- the perception of pain at the referred site. - ---ANSWER--- Physiologic responses to acute pain include - ---ANSWER--- increased heart rate, respiratory rate, and blood pressure; pallor or flushing; dilated pupils; and diaphoresis. Blood glucose level is elevated; gastric secretion and motility are decreased; and blood flow to the viscera and skin is decreased. Chronic pain generally lasts - ---ANSWER--- at least 3 months and may be persistent. for example, low back pain myofascial pain syndromes, chronic postoperative pain, and chronic pain associated with cancer.