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Neuroscience Exam 3 > 3 Pain Neuroscience > Flashcards

3 Pain Neuroscience Flashcards

1
Q

research demonstrates the direct connection between ___ and___

A

Persistent/chronic pain and neuroplasticity

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2
Q

susceptibility to pain and development of persistent/chronic pain is determined by interaction between:

A
  1. genetic predisposition
  2. environmental factors (epigenetic)
  3. lifestyle factors (epigenetic)
  4. physiologic response
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3
Q

what epigenetic factors are most modifiable? least modifiable?

A

most: habits (e.g. smoke/alcohol), physical activity, and diet

least: (early-) life stress

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4
Q

T/F: a musculoskeletal injury such as an ankle sprain will result in pain receptors conveying the afferent pain signal to your brain

A

FALSE

no such thing as pain pathways

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5
Q

what would happen if a speeding truck was headed straight for you immediately after you severely sprained your ankle while stepping off a curve?

A

brain tells you to move!!

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6
Q

T/F: pain only occurs if there is tissue damage

A

FALSE

There were a bunch of people who had disc problems and no pain. There is only a 50% correlation between knee pain complaints and findings of arthritic/degenerative changes on radiograph

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7
Q

what should you do before you consider potentially harmful interventions such as surgery?

A

physical findings corroborate/support imaging findings

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8
Q

Can individuals suffer from significant pain, and yet no tissue damage occurred or is healed and no disease process can be identified/

A

YES

the work boot example

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9
Q

what is an example of somatisation or somatic symptom disorder

A

work boot example, where physical symptoms occur that can’t be explained by tissue damage

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10
Q

T/F: the CNS/brain determines when you will experience pain

A

TRUE

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11
Q

The ___ can amplify the signal, turn it down, or tell the nerves how much of a signal to send up

A

brain

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12
Q

___ can be set by the brain, and/or by conditions right in the tissue. Even the structure of the nerves can and does change.

A

Nerve sensitivity

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13
Q

T/F: the resting level of a neuron can vary (it becomes more or less excitable)

A

TRUE

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14
Q

___ in the neuron axonal membrane control sensitiivity to depolariizatiion (sensitization of the PNS and/or CNS)

A

ion channels

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15
Q

normal function of nociception

A

3 in thru primary afferent

to dorsal horn neurons

3 out thru secondary afferent

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16
Q

modulation of nociception for incoming danger messages

A

3 in thru primary afferent

to dorsal horn neurons

5 out thru secondary afferent (happens in situations where there is potential for significant tissue damage)

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17
Q

modification of nociception for patient with peristent/chronic pain

A

ALLODYNIA

1 in thru primiary afferent

to dorsal horn neurons

5 our thru secondary efferent (can result in sensitization, producing way larger signal than expected)

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18
Q

T/F: for individuals with chronic pain, hormones/chemicals associated with stress can directly activate nociception pathways

A

TRUE

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19
Q

Basic stress or threat response is sympathetic nervous system mediated (fight or flight). This promotes stress hormone release of:

A

adrenaline/epinephrine AND cortisol

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20
Q

what hormone suppresses the immune system and its long term circulation can result in pro-inflammatory effects?

A

CORTISOL

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21
Q

nociception is the neuronal response to ___

A

intense stimuli

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22
Q

what type of pain arises from nociceptive afferent signals arising from tissue damage/irritation/deformation

A

nociceptive pain (acute)

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23
Q

does nociceptive pain have a mechanical and/or chemical component? if so, give examples.

A

BOTH

Mechanical - tissue deformation/damage
Chemical - inflammatory process, inflammatory cascade of cytokines

24
Q

what is the most common nociceptive pain that is musculoskeletal system related

A

somatic

25
Q

what type of pain is related to hollow organs and smooth muscle related (highly sensitive to distention/stretch, ischemia, and inflammation)

A

visceral nociceptive pain

26
Q

what type of pain is reported by autonomic afferent fibers thru dual sensory innervation? what tracts do they come from?

A

visceral nociceptive from spinothalamic and spinoreticular tracts

27
Q

what type of pain is vague and not well localized and is usually pressure like, deep squeezing, dull or diffuse, and often referred to more superficial locations on the body

A

visceral nocicecptive pain

28
Q

what occurs when noxious stimulation of viscera triggers somatiic afferent input and the brain translates the input as pain occurring at a somatic site

A

REFERRED visceral pain

29
Q

what is reported to the brain by the somatic afferent nervous system? what tract?

A

somatic nociceptive pain frmo spinothalamic tract

30
Q

what type of pain results from noxious insults or injury of tissues such as skin, muscles, joints, tendons or bones

A

somatic nociceptiive

31
Q

what type of pain is often sharp and well localized, and it aggravated by activity and relieved by rest

A

somatic nociceptive pain

32
Q

what type of pain is initiated or caused by primary lesion or disease affecting the nervous system (signal transmission)

A

neuropathic pain - ACUTE and may develop into persistent/chronic condition

33
Q

what type of pain ranges from deficits perceived as numbness and paratheia (tingling) to hypersenitivity (hyperalgesia or allodynia)

A

neuropathic paiin

34
Q

what is an exaggerated reponse to a noxious stimuluss resultant from peripheral nervous system change (sensitization - often locally mediated by inflammatory chemicals)

A

hyperalgesia

35
Q

what is the perception of pain from normally innocuous stimuli resultant from PNS and CNS changes (sensitization = neuroplastic changes)

A

allodynia

36
Q

is facial pain a typical symptom of facial nerve neuropathy (Bells Palsy)?

A

NO. Facial does not do sensory. Trigeminal does sensory.

37
Q

what type of pain are neuroplasticity based changes

A

“other” pain (persistent/chronic)

38
Q

___ is the amplification of danger signaling in any part of the nervous system (PNS or CNS)

A

sensitizatioin

39
Q

what is a proposed phyisological phenomenon where neuron plasticity is maladaptive, resulting in neuronal hyperexcitability/hypersensitivity to both noxious and non-nonxious stimuli

A

sensitization

40
Q

neuron sensitization is associated with

A
  1. allodynia
  2. hyperalgeisa
  3. expansion of receptive field
  4. unusually prolonged pain after a painful stimulus has been removed
41
Q

what is pain resulting from non-painful stimuluss

A

allodynia

42
Q

what is excessive sensitivity to a normally painful stimulus

A

hyperalgesia

43
Q

Cartesian Model of Pain

A

ALL PAIN results from injury. Increased pain means greater tissue damage

nociception and pain are synonymous

44
Q

Gate Control Theory

A

nociceptive signals can be blocked or changed based on other signals

nociception and pain are synonymous

45
Q

what is the processs by which info about noxious stimuli is conveyed by the brain and is the total sum of neural activity

A

nociception in neuromatrix theory

46
Q

Neuromatrix theory

A

pain is a conscious experience that results from brain activity in response to a NOXIOUS stimuli and engages sensory, emotional and cognitive processes of the brain.

47
Q

what are the 2 components of pain in relation to the neuromatrix theory

A
  1. sensory-discriminative (perceived intensity, location, and quality of pain)
  2. affective-emotional (perceived unpleasantness of painful event)
48
Q

acute nociception is caused by

A

mechanical, temperature, or acid/chemical substance

49
Q

inputs for neuromatrix theory

A

cognitive, emotion, and sensory (nociceptive input)

50
Q

outputs for neuromatrix theory

A

pain, motor, stress, emotion

51
Q

what is homeostatic neuroplasticity

A

learning and memory

(excitatory/inhibitory BALANCE)

52
Q

what is maladaptive neuroplasticity

A

persistent pain, addiction

(excitatory/inhibitory IMBALANCE)

53
Q

what is is any physiologic change in neuron structure or function that is observed either directly from measures of individual neurons or inferred from measures taken across populations of neurons that correlate with behavioral change.

A

neuroplasticity

54
Q

what is the brain’s ability to reorganize itself by forming new
neural connections throughout life. ____
allows the neurons (nerve cells) in the brain to
compensate for injury and disease and to adjust their
activities in response to new situations or to changes
in their environment.

A

neuroplasticity

55
Q

where can neuroplasticity occur

A

peripherally or centrally with both afferent and efferent neurons

56
Q

do nociceptive neurons have positive feedback loops

A

yes

57
Q

how can neuroplasticity be used for emotional and cognitive areas

A

changing words and exercise based treatment

Neuroscience Exam 3 (7 decks)

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