SUMMARY Nociceptive information is transmitted from the spinal cord to the brain via several different pathways. Consequently, multiple regions of the brain are activated during the complex experience of pain. Cortical regions activated during pain include the limbic, paralimbic, and…
SUMMARY Clinically relevant forms of pain cannot be fully understood without appreciating the various forms of plasticity that develop in the spinal dorsal horn after injury or with disease. All major components of the spinal cord nociceptive network are subject…
SUMMARY The spinal dorsal horn receives input from a wide variety of primary afferent axons, including nociceptors , which respond to tissue-damaging stimuli from the skin, muscles, joints, and viscera. The patterns of termination of primary afferents within the spinal…
SUMMARY Neuron–glial interactions are increasingly recognized as being key for physiological and pathological processes in the central nervous system. Microglia in the spinal dorsal horn respond to injury to peripheral nerves by adopting a specific response state characterized by up-regulation…
SUMMARY Disease and injury frequently result in pain and hyperalgesia. These abnormal sensory events arise in part from the action of inflammatory mediators on the peripheral terminals of nociceptive neurons. In this chapter we begin by reviewing the different ways…
SUMMARY The perception of pain arising from a noxious stimulus starts with conversion of the energy of the stimulus into an electrical signal in the primary afferent neurons innervating the site of the stimulus. This process of energy conversion is…
SUMMARY Nociceptors are a specialized class of primary afferents that respond to intense, noxious stimuli. Unmyelinated nociceptors signal the burning pain from intense heat stimuli applied to the glabrous skin of the hand, as well as the pain from sustained…
Specialty and category within specialty Critical care medicine Mechanical support for refractory respiratory and cardiac failure Before procedure Indications Venovenous extracorporeal membrane oxygenation (ECMO) Acute severe respiratory failure with high mortality risk, reversible and nonresponsive to optimal conventional therapy. ECMO…
Before the procedure Indications A need for estimating energy expenditure (EE) in critically ill patients in whom the EE is highly variable and difficult to predict by simple equations, such as: Patients with liver disease Obese patients Trauma patients Patients…
Before procedure Indications Common Traumatic brain injury (TBI) Subarachnoid hemorrhage Intracranial hemorrhage (ICH) Hydrocephalus Uncommon Meningitis/encephalitis/brain abscess Acute liver failure Pseudotumor cerebri Postoperative Contraindications Absolute Anticoagulation Bleeding diathesis Relative Scalp infection Lack of specialized healthcare personnel You’re Reading a Preview…