Term
| at are the 3 components in pain |
|
Definition
afferent
affective
efferent |
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|
Term
| what seperates pain from other sensations? |
|
Definition
|
|
Term
| what is the sensaiton that signals a threat for pain |
|
Definition
|
|
Term
the physiologicla recptors for pain are called?
what do they conist of? |
|
Definition
nociceptors
-simple nerve endings |
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|
Term
| what are the 3 modalities that pain can be detected as |
|
Definition
| thermal, mechnical, chemical |
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|
Term
the sensory neurons that are specific for a modality are called?
what if there go to all 3? |
|
Definition
|
|
Term
mechanorecptors are activated by -
also called? |
|
Definition
defromaiton of nerve endings
-stretch receptors |
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|
Term
| chemorecptors contain _ at thier ending that respond to things in the damaged tissue |
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Definition
|
|
Term
| thermoreceptors contain _ that open in response to heat or cold (>45 celcius <10 |
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Definition
|
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Term
| *bc pain depends on emotion an physiological factors the neuroal pathways can be modifed person to person |
|
Definition
|
|
Term
| nocicpetive neurons have their cell bodies where? |
|
Definition
| root ganglia along spinal cord |
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Term
| nocicpetive neurons are bipolar with one axon _ and the other _ |
|
Definition
spinal cord (spinal root)
second order neurons in dorsal horn |
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Term
| bc the neurons synapse at spinal cord instead of straight in brain, this means processing occurs? |
|
Definition
|
|
Term
neurons from the spinal root innervate a defined region in tissue called the-
other neurons innervate - |
|
Definition
dermatone
specific region in each dermatone |
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|
Term
| the nociceptors are innervated where? |
|
Definition
| skin, periosteum, arterial walls, joints, viscera |
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|
Term
where are nociceptors most innervated?
leasT? |
|
Definition
|
|
Term
| what tissues dont have nocicpectors and relay on the vessels that supply them to have them? |
|
Definition
| brain, liver, lung aveoli |
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Term
| sharp pricking pain is caused by what fibers |
|
Definition
|
|
Term
| fast pain has what type of fibers? |
|
Definition
| A delta / small mylinated |
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|
Term
| whcih are faster proprioceptive or fast fibers? |
|
Definition
|
|
Term
| _ rectpors usually mediate fast pain |
|
Definition
|
|
Term
| bursting, aching pain is caused by what pain |
|
Definition
|
|
Term
the neurons of slow pain are -modal
they are also good for detecting - |
|
Definition
polymodal
tissue destruction |
|
|
Term
| what are examples of the products activating slow pain fibers-5 |
|
Definition
| BRADYKININ, pge2, 5HT, adenosine, histamine |
|
|
Term
| what fibers are for slow pain |
|
Definition
| un mylinated small C fibers |
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|
Term
| the action compenent of slow pain is- |
|
Definition
| immoblization (do no more harm) |
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|
Term
| the action compoenet of fast pain is- |
|
Definition
| withdrawl (get away formt he pain) |
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|
Term
| tickelt and itch are also on whcih fibers? |
|
Definition
|
|
Term
pain can be due to what -2
examples: |
|
Definition
pathophysiology
physiological response
inflammatory (tissue) neuropathic (nervous system) |
|
|
Term
pain signals are trasmited thru _ pathway?
also called? |
|
Definition
anterolateral pathway
spinothalmic tract |
|
|
Term
| the pain fiber tract is found where? |
|
Definition
| ventral and lateral part of ventral horns |
|
|
Term
| what are the 2 subpathways for pain? |
|
Definition
neospinothalmic
paleospinothalmic |
|
|
Term
| the neospinothalmic fibers are found- |
|
Definition
| lateral part of fiber tract |
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|
Term
| the paleopsinothalmic fibers are founf- |
|
Definition
| ventral part of fiber tract |
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|
Term
| neospinothalmic tramsits mainly what kind of fibers |
|
Definition
| unimodal Adelta fibers (fast pain) |
|
|
Term
| first order affervents in the neospin synase where? |
|
Definition
|
|
Term
second order fibers ascend to _ in neospin?
collaterals innervate the? |
|
Definition
ventrobasal part of thalmus
RAS |
|
|
Term
| 3rd order thalmic neurons of the neospin project to |
|
Definition
|
|
Term
| the somatosesory cortex is required for loacilzaiton of -2 |
|
Definition
| pain stimulus and cognitive interpretation |
|
|
Term
| does damage to the somatosensory cortex prevent pain? |
|
Definition
|
|
Term
| what fibers are in the paleospin ? |
|
Definition
| C fibers (burning, chronic pain) |
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|
Term
afferent fibers for paleospin synpase where?
what is the NT released at this synapsE? |
|
Definition
2nd order neurons in layer II/III of dorsal horn
substance P |
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|
Term
what gives rise to a slow EPSP?
this can be a reason for it causing? |
|
Definition
|
|
Term
most paleospin neurons terminate where?
there they project to -2; what is added here? |
|
Definition
brainstem
hypothalmus and limbic; aversive overtones |
|
|
Term
| why is it difficult to sleep when in pain? |
|
Definition
| bc pain neurons activate RAS which does attention and arousal |
|
|
Term
| what two pathways synapse on entry to spinal cord? |
|
Definition
|
|
Term
a few neurons after entering spinal cord go up or down in the -
these _ before ascending in the brain |
|
Definition
Tract of Lissauer
decussate |
|
|
Term
| what can block pain before tactile afferent and motor efferent |
|
Definition
|
|
Term
| local anesthetics inhibit - |
|
Definition
| voltage gates Na channels to prevent action potential |
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|
Term
| which is more sensitive to local anesthetics, propriception or pain sensation? |
|
Definition
the small fibers are first to fail
longer AP duration (which anesthetic bind to open state more) |
|
|
Term
| as anesthetic conc increases it inhibits fibers in what order |
|
Definition
|
|
Term
activation of afferents thats perceived as pain elswehere is termed?
ex: |
|
Definition
referred pain
angina where heart pain is perceived as left shoulder pain |
|
|
Term
| brain doesnt percieve pain when it comes from? so what happens? |
|
Definition
viscera
it interepts it as coming from peripheral receptors |
|
|
Term
why doesnt damage to the brain cause pain?
what does contain them? |
|
Definition
bc no nociceptros
meninges and blood vessels |
|
|
Term
| headaches are caused by nococeptor activation where? |
|
Definition
| meneinges and blood vessels |
|
|
Term
| the differenc ein pain threshold for people (an deven in smae person at diff times) is due to |
|
Definition
| cortical controle of pain pathways |
|
|
Term
|
Definition
| condition leading to enhanced pain sensation (suburn) |
|
|
Term
|
Definition
| a stimulus normally that doesnt produce pain but does one time |
|
|
Term
| can humans block out pain? |
|
Definition
|
|
Term
| in inflamaotry pain, unimodal can -> polymodal* |
|
Definition
|
|
Term
| inflammatory pain has modulators that initation depolarization thru channels, what is a big one? |
|
Definition
| TRPV1 (transient receptor potential vanilloid Type 1) |
|
|
Term
what does TRPV1 mediate? -2
what 2 cations does it favor |
|
Definition
heat response at 45C, acidic pH
Na and Ca |
|
|
Term
| what is a type of vanilloid? |
|
Definition
|
|
Term
phosphorylation can activate the TRPV1, what are susbtances that do this? -2
if phosphorylated what can the receptor become? |
|
Definition
bradykinin, protein kinase A
polymodal (now mechnicala or chemical + the heat can activate it) |
|
|
Term
capscain excessively stimulation TRPV1 can down regulate it, if activated too long what can happen?
who does this happen to a lot? |
|
Definition
C fibers damaged by too muhc Ca
small children |
|
|
Term
| what are some things that cause neuropathic pain-5 |
|
Definition
nococeptors become mechansensitive
nociceptors senstive to NE
Nocicpetors lose tuning and crossifre
denervated neruons spontaneously fire
synaptic plasticity |
|
|
Term
| what therapies stimulate sensory fibers to inhibit chronic pain (like when you rub a sore spot aactivates tactile stimuli) |
|
Definition
dorsal column stimulation
TENS |
|
|
Term
| the brain has 3 mechanisms for endogenous analgesia |
|
Definition
PAG/perventricle neurons of midbrain
Raphe magnus/nucleus reticularis
dorsolateral horns |
|
|
Term
| electrical stimualtion of RAG or Raphe magnus suppresses pain by releasing - |
|
Definition
|
|
Term
| PAG projects to the raphe nuclei, and the _ neurons here stop the pain |
|
Definition
| 5HT (in tissue it activates pain, but in brain is analgesic) |
|
|
Term
| presynaptic inhibition invovles 5HT releasing enkepahlin whihc then inhibits what-2 |
|
Definition
| substance P and glutamate |
|
|
Term
| post synaptic inhibiton is when enkepahlin binds and elecits- and inhibits- |
|
Definition
| IPSP and inhibits seocnd order neurons |
|
|
Term
| what is stress induced analgesia MOA |
|
Definition
| increase ACTH-> increase B-endorphin-> increase enkephalin |
|
|
Term
what is responsible for WARMTH (not hot) detection?
what is the range for this to be normal?
if temp goes above 45 do the recpt increase of decrease? |
|
Definition
TRPV3
(25-45)
decrease (so the nocicpectors recieve sitmualtion of pain) |
|
|
Term
what is the pathway for temp?
-what brain parts are invovled |
|
Definition
anterolateral
brainstem and hypothalmus |
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|
