12 Flashcards
Dimensions of pain
sensory-discrimination
motivational-affective
cognitive-evaluative
dimensions of sensory-discrimination
location
magnitude
duration
quality
dimensions of motivational affective
emotions
anxiety
depression
dimensions of cognitive evaluative
post experience
possibility of outcomes
increased sensitivity to noxious stimulus
hyperalgesia
feeling of pain from a non-noxious stimulus
allodynia
pain perceived outside the area of injury
referred pain
increased responsiveness or decreased threshold of neurons
sensitization
dysfunction in PNS; primary hyperalgesia
peripheral sensitization
dysfunction in neurons in SC or brain; secondary hyperalgesia; allodynia
central sensitization
ascending pain pathways
1st order neurons =primary afferent
2nd order neurons = spinothalamic
3rd order neurons = thalamocortical neurons
transmit sharp pain, noxious mechanical, thermal stimulation; low-threshold; fast pain
A alpha
transmit dull pain, noxious mechanical, thermal and chemical stimulation; high-threshold; slow pain
C
immediate sharp sensation following an injury that indicates location of pain, transmitted via a alpha/GIII; processed via lateral pain system
fast pain
dull, burring, throbbing ache followed by sharp pain that is not well localized; transmitted by C fibers/IV; processed via medial pain system
Slow pain
a sensory receptor that transduce pain stimulus
nociceptor
peripheral mechanisms for pain
unimodal neurons
Polymodal neurons
receptors
chemicals
func of primary afferent neurons
transduction
transmission
detection of noxious or damaging stimuli
transduction
passage of the resulting sensory input from peripheral terminals to spinal cord
transmission
tissue damage resulting in release of chemicals
binding of substances and activation of ion channels and receptors
inflammation
symptoms of inflammation
constant pain/pain form a normal stimulus
heat
edema
chemicals released by primary afferents are
glu
substance p
spinal pain mechanisms
chemicals released by primary afferents
NMDA receptors, NK receptors, Ca ion channels
3 classifications of DH neurons
projection
interneurons
wide dynamic range
Integrate painful and non-painful info
receive info from both sides and multiple sites
response to noxious and non-noxious stimuli
contributes to chronic pain
wide dynamic range neurons
convergence of input from various tissues and misinterpretation by cortex
referred pain
lateral pain system
lat spinothalamic
medial pain system
ant spinothalamic tract
spinolimbic tract
sensory discrimination pain tract
Lateral spinothalamic tract
motivational-affective pain pathway
ant spinothalamic tract
ant spinothalamic tract projection to brainstem
spinoreticular tract
ant spinothalamic tract projection to midbrain
spinomesencephalic tract
these fibers mediate visceral, emotional and autonomic reactions to pain
spinolimbic tract
spinolimbic pathway
nociceptors SC (lamina II, V) multisynaptic/bilateral medial and intralaminar thalamic nuleus anterior cingulate, insular cortex, DLPFC, amygdala
descending pain pathways
Cingulate cortex insular cortex amygdala periaqueductal grey (PAG) Rostroventromedial medulla (RVM) dorsolateral pontine tegmentum
main descending pain pathway
PAG-RVM
descending pain inhibitory output
electrical stimulation
exercise
opioid medication
descending pain excitatory output
increase glu release
tissue injury
brain regions that process and regulate pain information
pain matrix
sensory discrimination in the brain
thalamus (VPL and VPM) SSC
affective motivational in the brain
cerebral: insula, cingulate and prefrontal cortex
amygdala and hypothalamus
thalamus: intralaminar nuclei
cognitive pain in the brain
prefrontal cortex (DLPFC)
descending pain control in the brain
midbrain and brainstem
ANS, SNS pain factor
contibutes to emergency analgesia
key command center in brainstem - locus ceruleus
types of pain
somatic
psychological
neuropathic
skin and deep tissues (superficial or deep pain)
somatic
pain associated with anxiety or depression
psycological
pain that results from disturbances in neural and non-neural cells that leads to maladaptive changes in the neurons of the sensory system
neuropathic
