Physiological Adaptation Q 85
Which of the following systems is the most likely origin of pain the client describes as knifelike chest pain that increases in intensity with inspiration?
A. Cardiac
B. Gastrointestinal
C. Musculoskeletal
D. Pulmonary
Correct Answer: D. Pulmonary
Pulmonary pain is generally described by these symptoms. Pain may originate from several different structures within the chest, including the skin, ribs, intercostal muscles, pleura, esophagus, heart, aorta, diaphragm, or thoracic vertebrae. The pain may be transmitted by intercostal, sympathetic, vagus, and phrenic nerves. The innervations of the deep structures of the thorax follow common pathways to the central nervous system, making it difficult to localize the source of pain.
Option A: In cardiac pain, respirations are usually unaffected. Various schemes have been used to classify the etiologies of chest pain, but the most useful is to distinguish between acute and chronic patterns of pain. Patients with acute pain include those whose episodes are of recent onset or those who have had a recent increase in the intensity or frequency of recurrent pain. Patients with chronic pain include those who have recurrent episodes of pain occurring in a relatively stable pattern.
Option B: GI pains don’t change with respiration. The findings suggest that pain influences respiration by increasing its flow, frequency, and volume. Furthermore, paced slow breathing is associated with pain reduction in some of the studies, but evidence elucidating the underlying physiological mechanisms of this effect is lacking.
Option C: Musculoskeletal pain only increases with movement. The SNS is concerned with the regulation of vascular tone, blood flow, and blood pressure, as sympathetic nerves have stimulating effects on the heart (improving circulation) and respiratory system (increasing oxygen intake). Pain, therefore, increases heart rate, blood pressure, and respiratory rate.