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D1 Fall - Biochem > 11/29: Pain, Analgesia, and Anesthesia COPY > Flashcards

11/29: Pain, Analgesia, and Anesthesia COPY Flashcards

1
Q

What is pain?

A

An unpleasant sensory and emotional experience associated with actual or
potential damage

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2
Q

What feelings are associated with higher intensity/moderate pain?

A

Anxiety and feelings to escape

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3
Q

What is is nociception?

A

Unconscious activity induced by a harmful stimulus to sense receptors

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4
Q

What are are noxious stimuli?

A

Harmful, poisonous and unpleasant stimuli

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5
Q

What is hyperalgesia?

A

Exaggerated response to a noxious stimulus

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6
Q

What is allodynia?

A

Sensation of pain in response to a normal stimulus that does not cause pain
i. I.E hot shower after being in cold weather

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7
Q

Does the threshold lower when intense stimuli are repeated or prolonged?

A

Yes

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8
Q

Does being exposed to the same stimulus cause a higher frequency of firing for all stimulus activities?

A

Yes

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9
Q

What inflammatory mediators contribute to the increased frequency and lowered stimulus?

A

Bradykinin
Nerve growth factor Prostaglandins
Leukotrienes

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10
Q

What do hyperalgesia and allodynia signify an increased sensitivity to?

A

Nociception
i. Essentially, both let body know you are doing something you were not aware of that is hurting you

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11
Q

What is analgesia?

A

Inability or reduced ability to feel pain

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12
Q

What substances reduces ability to feel pain?

A

Analgesics

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13
Q

What is insensitivity to pain called?

A

Anesthesia

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14
Q

What substances produce general insensitivity to pain?

A

Anesthetics

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15
Q

What general anesthetic is used often by dentist to perform surgery?

A

Nitrous

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16
Q

What local anesthetic is used by dentist to perform surgery?

A

Lidocaine

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17
Q

What are the 3 classes of receptors found in the body?

A
  1. Mechanoreceptors
  2. Thermoreceptors
  3. Chemoreceptors
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18
Q

What are the two transient receptor potential channels found in the body?

A
  1. TRPV1
  2. TRPA1
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19
Q

What protein does TRPV1 use?

A

Vanilloids

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20
Q

What do TRPV1 receptors respond to?

A

Heat
Acids
Chemicals

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21
Q

What protein does TRPA1 respond to?

A

Ankyrin

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22
Q

What is ankyrin used for?

A

Attaching cytoskeletal proteins together

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23
Q

What does TRPA1 respond to?

A

Mechanical
Cold
Chemical

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24
Q

What receptors are though to be the main ones dealing with acid induced pain?

A

ASIC receptors

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25
Q

What receptor does cold sensations activate?

A

TRPM8
i. “M for methanol”
1. Not really but helps remember it

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26
Q

What receptor does mechanical sensations activate?

A

TRPA1

27
Q

What receptor does heat sensations activate?

A

TRPV1

28
Q

What two receptors are used when ATP is released to cause pain?

A

P2X
P2Y

29
Q
  1. Is P2X an ionotropic or G-protein receptor?
A

a. Ionotropic

30
Q
  1. Is P2Y an ionotropic or G-protein receptor?
A

G-protein

31
Q

What 6 molecules act on G-protein coupled receptors to cause pain?

A

(BHPSSC)
Bradykinin
Histamine
Prostaglandins
Serotonin
Substance P
Calcitonin-gene related protein

32
Q

What receptor does NGF act on?

A

Tyrosine Kinase A

33
Q

What does NGF singaling through a tyrosine kinase receptor A cause?

A

Gene transcription

34
Q
  1. What does ATP cause once it has bound to either P2X or P2Y?
A

a. Immediate depolarization with P2X
b. Gene expression or Immediate depolarization with P2Y

35
Q
  1. Can all three types of receptors cause sensitization of nociceptive neurons?
A

Yes

36
Q
  1. What nerve type is the primary type used for pain transmission?
A

a. Sensory afferent neurons

37
Q
  1. What are the two types of sensory afferent neurons?
A

a. A-Beta
b. A-Delta/C axons

38
Q
  1. How do A-Delta and C-axons differ
A

a. A-delta is myelinated while C-Axons are not

39
Q
  1. What type of stimuli does A-Beta nerves respond to?
A

a. Light touching and moving stimuli

40
Q
  1. What type of stimuli does A-delta nerves respond to?
A

a. Extremely painful stimuli

41
Q
  1. Where do these axons cross within the spinal cord?
A

Ventrolateral quadrant within the ventrolateral spinothalamic tract

42
Q

What parts of the somatosensory cortex are activated by pain?

A

Primary and secondary

43
Q

What laminae do the unmyelinated C-fibers project to within the dorsal horn?

A

Superficial laminae 1 and 2

44
Q

What laminae do the myelinated A and Delta fibers project to in the dorsal horn?

A

Superficial laminae 1 and 5

45
Q
  1. Where are somatosensory ganglia located at within the body?
A

a. Peripheral ganglia like DRG and Trigeminal ganglia

46
Q
  1. Where do the spinothalamic tract axons ascend to?
A

Thalamus

47
Q
  1. Where do the thalamic projections go to?
A

a. Somatosensory cortex

48
Q
  1. What does the somatosensory cortex mediate?
A

Purely sensory aspect of pain
i. This is locations, intensity, quality

49
Q
  1. Where do thalamic neurons project to?
A

a. Cortical regions

50
Q
  1. What does the cortical regions of the brain link pain with?
A

Emotional responses
i. Why you remember painful events

51
Q

Does visceral sensation travel along the same central pathway as somatic sensation in
the spinothalamic tract and thalamic radiation?

A

Yes

52
Q

Are the cortical receiving areas for visceral sensation intermixed with somatic receiving areas?

A

Yes

53
Q

What does this mixing between cortical receiving areas for visceral sensation and somatic receiving areas create?

A

Referred pain

54
Q

What is the gate control mechanism for pain modulation?

A

Pain from nociceptive pathways can be interrupted by the addition of new stimulus to the site where the nerve is receiving the injury at
i. This is why rubbing shin after hitting it helps as new stimulus are generated and they use the same nerves

55
Q

What do interneurons within the superficial regions of the dorsal horn contain receptors for?

A

Endogenous opioid peptides

56
Q

What does activation of the postsynaptic opioid receptor do to the dorsal horn interneuron?

A

Hyperpolarizes it causing an uptake in K

57
Q

What does activation of the presynaptic opioid receptor do to the dorsal horn?

A

Decrease in Ca so glutamate and substance P are decreased

58
Q

What do these two actions do to EPSPs within the dorsal horn?

A

Reduce its duration

59
Q

What is the main opioid used by dentists?

A

Morphine

60
Q

What is the mechanism of action of an opioid?

A
  1. Bind to receptors located on neurons
  2. Decrease intracellular calcium causing reduced NT
  3. Increase intracellular potassium causing hyperpolarization decreasing action potential propagation
61
Q

What are the two non-opioid analgesics used

A

Aspirin
Acetaminophen

62
Q
  1. How do NSAIDs and aspirin work?
A

By inhibiting cyclooxygenase which causes a reduced production of
prostaglandins leading to a reduced inflammatory-mediated pain signaling and
nociceptor sensitivity

63
Q
  1. What two components of an NSAID’s reduce inflammatory mediated pain signaling?
A

a. Histamine
b. Serotonin

D1 Fall - Biochem (29 decks)

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