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Neuroanatomy > 4 - Pain > Flashcards

4 - Pain Flashcards

1
Q

an unpleasant sensory and emotional experience associated with actual or potential tissue damage

A

pain

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2
Q

with pain withdrawal reflex, sensory neuron goes through _ root ganglion
motor neuron travels though _ root

A

dorsal

ventral

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3
Q

_ = the perception of pain

A

nociception

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4
Q

nociceptors respond to extreme temps, mechanical and chemical stimuli
they are _ receptors (type)

A

free nerve endings

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5
Q

the cells bodies of nociceptors are located in _ and _

A

spinal ganglia (body) and trigeminal ganglia (face)

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6
Q

nociceptors _ adapt to stimuli

A

DO NOT

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7
Q

continued stimulation of nociceptors _ threshold at which nociceptors respond, this is called _

A

decrease

sensitization

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8
Q

A(delta) fibers
(are/not) myelinated
_ type of pain
_ stimuli

A

are
localized, sharp
mechanical/thermal
(Anitial - bee sting)

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9
Q

C fibers
(are/not) myelinated
_ type of pain
_ stimuli

A

not
poorly localized, diffuse
mechanical, thermal, chemical

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10
Q

3 neurotransmitters used for pain:

A

glutamate, substance P, CGRP

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11
Q

NT are produced in _ and released _ or _

A

spinal ganglion

centrally (CNS) or peripherally (injury site)

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12
Q

peripherally, NT lead to redness, swelling, and tenderness

they inc activation of nociceptors and _ threshold (sensitization)

A

decrease

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13
Q

when “silent” nociceptors are activated, they _

A

expand receptive field area of painful stimulus

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14
Q

activation of nociceptors results in opening on _ channels, leading to depolarization

A

Na+

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15
Q

A(delta) and C fibers can be activated by heat:
_ - hot thermal stimulation
_ - cold thermal stimulation

A

TRPV1 (capsaicin)

TRPM8

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16
Q

A(delta) and C fibers can ALSO be activated by _

A

mechanical stimulation

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17
Q

A(delta) and C fibers can ALSO be activated by mechanical stimulation
-cannot be activated by _,

A

light touch

high threshold, only activated when potential for tissue damage

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18
Q

C fibers are also activate by _

A

wide range of Chemicals

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19
Q

chemicals that activate C fibers include:

A

external irritants and substances released during tissue damage by nociceptors and inflammation

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20
Q

peripheral sensitization:
tissue damage->release of _,
these sensitize _

A

bradykinin & prostaglandins

peripheral nociceptors

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21
Q

noxious stimulus is detected by nociceptor -> free nerve ending releases _ and _

A

substance P and CGRP

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22
Q

substance P and CGRP stimulate _ cells to release histamine and bradykinin, which induce _ and further sensitization

A

mast, vasodilation

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23
Q

heightened response to low-intensity painful stimulus (hot shower hurts)

A

hyperalgesia

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24
Q

pain experienced with normally non-painful stimulus (water hitting your back)

A

allodynia

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25
Q

when silent nociceptors are recruited, there is further amplification in posterior horn, _ temporal and spatial summation of incoming signal

A

increasing

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26
Q

silent nociceptors only respond to molecules secreted by _

A

activated nociceptors

27
Q

synaptic targets in the spinal cord:

A(delta) and C fibers synapse with either _ or _

A

nociceptive-specific cells or Wide Dynamic Range (WDR)

28
Q

nociceptive specific cells synapse with _

A

only A(delta) and C fibers

29
Q

WDR cells synapse with _

A

ALL sensory fibers (including A(beta) nonpainful touch)

30
Q

the synapse in the _ is EXCITATORY

A

posterior horn

31
Q

AMPA and NMDA receptors of _

A

glutamate

32
Q

NK1 receptors of _

A

substance P

33
Q

CGRP receptors of _

A

CGRP

34
Q

Wind Up and Central Sensitization:

WDR cells fire in _ fashion, intensity determined by _

A

graded; frequency of C fiber signaling

35
Q

WDR amplify signal through _

A

windup

36
Q

windup is: chronic bombardment of C fibers in dorsal horn leads to _

A

increased kinase production

37
Q

inc kinase from windup causes:

  1. _ of NMDA receptors
  2. increased _ production
  3. “_” is dorsal horn
A

upregulation
glutamate
sprouting

38
Q

chronic bombardment also leads to _ production in dorsal horn, which travels to periphery via _

A

substance P; C fibers

39
Q

substance P travels via C fibers to periphery to _ threshold and _ receptive fields

A

decrease; increase

40
Q

sensitization serves to _ pain signal to _ behavioral changes

A

amplify, evoke

41
Q

sensitization mechanisms can become maladaptive and lead to _

A

permanent changes in wiring

42
Q

pain modulation:
descending inhibition - _
descending facilitation - _

A

mind/matter, need to be able to function

we don’t want the pain to go away, it protects us

43
Q

Gate Control Theory of Pain
1. balance between nociceptive input (Adelta and C) and touch input (Abeta): rubbing painful area shifts input towards _ and away from _

A

touch (abeta) pain (Adelta and C)

44
Q

Gate Control Theory of Pain
2. inhibitory interneurons that synapse with WDR neurons in posterior horn:
they are inhibited by _, excited by _

A

nociceptive input, touch input

45
Q

Gate Control Theory of Pain (2.)

Adelta and C -> inhibit inhibitory interneurons -> __

A

more signaling = pain

46
Q

Gate Control Theory of Pain (2.)

Abeta - > excite inhibitory interneurons -> __

A

less signaling = less pain

47
Q

descending influences on pain act as _

A

salience filter (how important is this pain)

48
Q

reticular formation: locus coeruleus produces Norepi and modulates _ response to pain

A

physiological

49
Q

Periaqueductal Gray (PAG) receives input from cortex and hypothalm and projects to superior colliculus to:

A

make you look where you feel the pain

50
Q

opiod receptors are found at _ levels of pain system

A

all

51
Q

opioid drugs influence _ pain processing

A

cortical

52
Q

opioid receptors are physiologically active by _ molecules that act as NT including: enkephalins, endorphins, dynorphins

A

endogenous (our body makes them)

53
Q

opioid receptors inhibit _ influx or facilitate _ efflux, hyperpolarizing the cell, less pain perceived

A

Ca++, K+

54
Q

morphine blocks _

A

wound healing

55
Q

chronic pain is experienced by chronic activation of nociceptors; therapy is to _

A

treat underlying inflammation

56
Q

chronic neuropathic pain arises with a lesion to somatosensory system and _

A

persists after the injury has healed (Herpes Zoster)

57
Q

spontaneous tingling

A

paresthesia

58
Q

burning, electric, shooting pain

A

dysesthesia

59
Q

increased pain to low intensity stimulus

A

hyperalgesia

60
Q

painful reaction to innocuous stimuli

A

allodynia

61
Q

repeat small pain = incr pain with brushing hair

A

summation

62
Q

maladaptive peripheral sensitization:
overexpression of TRPV1 receptors = burning sensation
overexpression of Na+ channels=_

A

lower threshold for signaling, spontaneous discharge of signals

63
Q

maladaptive central sensitization

changes _ receptor physiology, increases expression leading to spontaneous activity _ _

A

paresthesias, dysesthesias

64
Q

maladaptive central sensitization

sprouting phenomenon: disruption of _ —-> _

A

spinal cord lamella; allodynia

Neuroanatomy (12 decks)

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