10.24 Pain Flashcards

1
Q

pain receptors are _____ nerve endings

A

free

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2
Q

do nociceptors adapt?

A

no

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3
Q

what is the axon reflex?

A

peripheral release of NT from the nociceptor (efferent function)

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4
Q

a non-noxious stimulus now begins to produce pain

A

allodynia

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5
Q

A noxious stimulus produces a larger response due to sensitization of nociceptors

A

hyperalgesia

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6
Q

what are the three types of pain nociceptors can sense?

A

mechanical
thermal
chemical

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7
Q

what types of pain do C fibers respond to? which one is unique?

A

mechanical
thermal
CHEMICAL

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8
Q

what types of pain do A-delta fibers respond to?

A

mechanical

thermal

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9
Q

what fibers correspond to the initial, sharp, well localized pain? what is this called?

A

“first pain”

A-delta fibers

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10
Q

what fibers correspond to the dull, diffuse, poorly localized pain that follows after? what is this called?

A

“second pain”

C fibers

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11
Q

axons of the pain and temperature enter the dorsal root entry zone more ________, while the touch and proprioception fibers are more _________

A

lateral

medial

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12
Q

the A-delta and C fibers branch into a fiber tract in the spinal cord called _________. What does this tract allow?

A

Lissauer’s tract

for the fibers to travel rostral or caudal for a few spinal cord segments

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13
Q

sensitization of sensory pain fibers means ________ thresholds

A

lower

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14
Q

____________ ___________ is when second order sensory neurons get sensitized. What does this contribute to?

A

central sensitization

hyperalgesia, allodynia

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15
Q

what are the two NTs associated with pain?

A

substance P

glutamate

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16
Q

what are the two endogenous peptides that produce pain relief?

A

endorphins

enkephalins

17
Q

opioid receptors are found on ___________ fibers (in general)

A

nociceptive

18
Q

what are the two thing opioid receptors do?

A
  1. open VG K+ channels, letting K+ leave the cell and thus hyper polarizing
  2. block VG Ca++ channels, preventing calcium entry into cell and blocking NT release
19
Q

the descending fibers of the supraspinal descending system project along a tract called the:

A

dorsolateral funiculus

20
Q

what is the descending modulatory system that originates in the periaqueductal gray (PAG)?

A

supraspinal descending system

21
Q

where do neurons project in the descending pain modulatory system after the PAG?

A
locus ceruleus (pons)
medullary reticular formation (medulla)
22
Q

inhibition of a tonically active GABA neuron is called _____________. (this is what ______ receptors do in the descending modulating pain pathway)

A

disinhibition

opioid

23
Q

what do the descending pain modulatory neurons release? what do they indirectly release?

A

5HT and NE

enkephalins and endorphins

24
Q

mechanism of steroidal anti-inflammatory drugs

A

release lipocortin which inhibits PLA2, not allowing arachidonic acid to be mobilized from the lipid bilayer

25
side effects of steroidal anti-inflammatory drugs
Cushing's syndrome (central obesity, moon face, hyperglycemia, osteoporosis, muscle weakness/wasting) Increase in susceptibility to pathogens and infection
26
mechanism of non-steroidal anti-inflammatories (NSAIDS)
reversible and irreversible COX inhibition (stops conversion of arachidonic acid to prostaglandins, etc)
27
side effects of NSAIDs:
GI effects, GERD, ulcers, renal damage
28
what side effects occur with the use of opioids?
constipation, urinary retention, respiratory depression, vomiting, dizziness, confusion, potential for abuse
29
A noxious stimulus produces a larger response.
hyperalgesia
30
a non-noxious stimulus now begins to produce pain
allodynia
31
what is the plasticity on the level of seconds to minutes
synaptic plasticity
32
what is the plasticity on the level of hours to days
cellular plasticity
33
what is the plasticity on the level of months to years
systems plasticity
34
systems plasticity is:
reorganization of cellular connectivity
35
cellular plasticity:
transcriptional/translational alterations (up or down regulated, making something new) changing composition of a channel remodeling of membranes
36
synaptic plasticity:
increases or decreases in NT release or NT response | changes in processes of transmission and transduction
37
what are three other types of drugs used for chronic pain?
Gabapentinoids Norep/5HT reuptake inhibitors Local analgesics