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Neuro > 5 - Sensory Receptors; Pain Science > Flashcards

5 - Sensory Receptors; Pain Science Flashcards

1
Q

1st order neuron pathway?

A

info from sensory receptors to SC or brainstem

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2
Q

2nd order neuron pathway?

A

info from SC or brainstem to thalamus

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3
Q

3rd order neuron pathway?

A

info from thalamus to cerebral cortex

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4
Q

___: when applied to a receptor, it triggers a graded membrane potential in receptor

A

stimulus

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5
Q

___: converts stimulus energy into action potential

A

receptor

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6
Q

___: of impulse over sensory pathway to CNS

A

conduction

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7
Q

___: CNS receives impulse/s, integrates info and may prepare response

A

translation

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8
Q

___ determines types of receptors that are activated and pattern of signal transmission

A

stimulation

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9
Q

___ ___: specialized peripheral element of sensory neuron where sensation and perception begin

A

sensory receptors

  • each receptor type is specialized and responds only to specific type and intensity of stimulus
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10
Q

what receptors are neurons with free nerve endings?

A

simple receptors

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11
Q

what receptors have nerve endings enclosed in connective tissue capsules?

A

complex neural receptors

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12
Q

what receptors are cells that release neurotransmitter onto sensory neurons, initiating an action potential?

A

special senses receptors

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13
Q

2 types of general senses and what falls under each?

A
  1. somatic: tactile, thermal, pain, proprioceptive
  2. visceral: conditions with internal organs
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14
Q

examples of specialized senses?

A

smell, taste, vision, hearing, balance and equilibrium

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15
Q

Exteroceptors- location? detect what?

A
  • at or near body surface (superficial, cutaneous)
  • detect external stimuli (light, heat, chemicals, pressure)
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16
Q

Interoceptors - location? detect what?

A
  • deep
  • react to stimuli coming from internal body/organs (BP, blood pH)
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17
Q

___: sensory receptors for mechanical pressure of touch, pressure, stretch, or vibration causes receptor to respond

A

mechanoreceptors

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18
Q

___: receptors for chemicals released cells (including ones damaged by injury or disease) cause it to respond; includes smell, taste

A

chemoreceptors

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19
Q

___: receptors detect changes in temperature

A

thermoreceptros

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20
Q

each type of receptor has subset of _____ that are sensitive to stimuli that either damage or have potential to damage tissues

A

nociceptors

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21
Q

__ receptors: respond continuously as long as stimulus is present

A

tonic

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22
Q

tonic receptors are ___ acting

A

slow

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23
Q

tonic receptors detect what type of sensory imput?

A

detect object pressure and form (static)

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24
Q

___ receptors: adapt to continuous stimulus and then stop responding, even while stimulus is present

A

phasic

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25
Q

phasic receptors are ___ acting

A

fast

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26
Q

phasic receptors detect what type of sensory imput?

A

detect motion, vibration and rate of change

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27
Q

what is a sensory neuron receptive field?

A

area of skin innervated by 1 afferent neuron

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28
Q

Sensory neuron receptive fields have smaller receptive fields ____ and larger receptive fields ___.

A

distally, proximally

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29
Q

2 superficial cutaneous receptors?

A
  1. meisners corpuscles
  2. merkels disks
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30
Q

what do meisners corpuscles detect?

A

light touch, vibration

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31
Q

what do merkels disks detect?

A

pressure

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32
Q

2 subcutaneous receptors?

A
  1. pacinian corpusle
  2. ruffinis ending
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33
Q

what do pacinian corpuscles detect?

A

touch, vibration

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34
Q

what do ruffinis endings detect?

A

stretch of skin

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35
Q

mechanoreceptros (cutaneous) are ___ fibers

A

alpha beta (AB)

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36
Q

what do mechanoreptors detect?

A

light touch, vibration, skin stretch, skin pressure

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37
Q

free nerve endings (cutaneous) are ___ and ___ fibers

A

Alpha gamma and C

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38
Q

what do free nerve endings detect?

A

course touch (pleasant touch/pressure, tickle, itch)
pain
temperature

39
Q

T or F - natural stimuli typically activate >1 type of receptor

A

T

40
Q

4 attributes to conduction?

A
  1. modality
  2. location
  3. intensity
  4. duration
41
Q

output signal (transmitter release) increases as ___ and/or ___ increases

A

duration, amplitude

42
Q

Signal processing for integration occurs at what 3 levels in somatosensory system?

A
  1. receptor level
  2. circuit level
  3. perceptual level
43
Q

Speed of information is determined by:
- axon ___
- amount of axon ____
- # of ____ in pathways

A

diameter
myelination
synapses

44
Q

___ ___: graded membrane potential in receptors

A

receptor potential

45
Q

__: synapses can spread action potentials to several areas of CNS

A

divergence

46
Q

___: synapses can focus action potentials from several sensory neurons onto narrowed areas of CNS

A

convergence

47
Q

T or F - sensory nerve tracts carry impulses to respective region of brain

A

T

  • remember the sensory map of homunculus
48
Q

what test electrical stimulation to peripheral nerve, comparing results to normal?

A

nerve conduction velocity testing (NCV/NCS)

49
Q

what 3 things does a nerve conduction velocity test look for?

A
  1. distal latency - time from stim to distal recording site
  2. amplitude - # axons conducting
  3. conduction velocity - indication of myelination
50
Q

what test is done to test peripheral and central pathways? Done by stimulation at distal site recording more proximally and cerebral cortex

A

somatosensory evoked potentials (SSEP)

51
Q

pathology of peripheral nerve is ____

A

neuropathy

52
Q

Nerve compression impacts what nerves first and what nerves last?

A

nerve compression impacts large myelinated axons first and smaller nociceptive thermal and autonomic axons last

53
Q

Order of sensory loss?

A
  1. conscious proprioception and light touch
  2. cold
  3. fast, sharp, stinging pain
  4. heat
  5. slow, aching pain
54
Q

what injuries can cause sensory ataxia?

A

injury to peripheral sensory nerves, dorsal roots, dorsal columns of SC or medial lemnisci

55
Q

patients with ____ ataxia will have similar motor performance eyes open/closed

A

cerebellar

56
Q

proprioception/kinesthesia will be intact with ____ ataxia and impaired/absent with ____ ataxia

A

cerebellar, sensory

57
Q

SHINGLES OR HERPES ZOSTER:
- painful skin rash with blisters following a ___ pattern
- caused by: varicella zoster virus causes chicken pox and infects __ ___ __
- virus remains latent in sensory ganglia for many years
- virus breaks out of nerve cells and travels distally causing painful eruptions on skin
- treatment: antiviral drugs within 72 hrs post onset

A

dermatome
dorsal root ganglion

58
Q

T or F - nociceptors are free nerve endings that respond to noxious stimuli

A

T

  • located within skin, muscle, joints
  • fast and slow pain carried by Alpha gamma or C fibers to SC
59
Q

____ pain: acute or chronic tissue injury stimulates nociceptors to cause events that become perception of pain

A

nociceptive

60
Q

_____ pain: malfunction of neural pain regulating processes causes pain without the presence of tissue injury

A

non-nociceptive

  • includes neuropathic pain, central sensitivity syndromes, pain syndromes
61
Q

___ and ___ ___ can sensitize free nerve endings in the periphery

A

edema, endogenous chemicals

62
Q

Pain inhibition occurs thru ___ ___ pathways and ___ ___ system

A

descending analgesic
endogenous opiod

63
Q

central processing: ___ and ___ areas activated during perception of pain

A

cingulate, insular

64
Q

3 examples of endorphins? (endogenous opiods)

A

enkephalins, dynorphin and B-endorphins

65
Q

brain regions that have opiate receptors that bind with both endorphins and opiates?

A
  • rostral ventromedial medulla
  • periqueductal gray in midbrain
  • locus coeruleus in pons
66
Q

SC has inhibtory neurons - which 2?

A

enkephalin and dynorphin

67
Q

5 locations of pain inhibition?

A
  1. periphery
  2. dorsal horn
  3. brainstem
  4. hormonal system
  5. cortical level
68
Q

periphery pain inhibition?

A

decrease synthesis of prostaglandins

69
Q

dorsal horn pain inhibition?

A

release of enkephalin and dynorphin

70
Q

brainstem pain inhibition?

A

neuronal descending system - periaqueductal gray, rostral VM medulla, locus coeruleus

71
Q

hormonal system pain inhibition?

A

periaqueductal gray and pituitary gland

72
Q

cortical level pain inhibition?

A
  • prefrontal lobe, insular lobe, cingulate cortex
  • spinolimbic, spinomesencephalic and spinoreticular tracts
73
Q

nociceptors that are excessively reactive to stimuli demonstrate ___ ___

A

peripheral sensitization

74
Q

__ ___: pain that is perceived as coming from site distinctly different from actual origin site

A

referred pain

  • usually referred from visceral tissue to skin
  • occurs due to convergence of nociceptive and somatic information
75
Q

chronic pain as disease: ____ pain: neural dysfunction creates pain without evidence of tissue damage

A

primary

76
Q

examples of primary pain?

A
  1. fibromyalgia
  2. complex regional pain syndrome
  3. chronic nonspecific low back pain
  4. migraine HA’s
77
Q

___ ___: central neurons respond excessively/disproportionately to continuing nociceptive input, with the central neuronal activity lasting longer than actual tissue injury

A

central sensitization

78
Q

___: abnormal sensation that is painless with no nociceptor stimulation
- dysfunction of neurons anywhere along the pathway
- typically tingling sensation
- different from neuropathic pain

A

parasthesia

79
Q

___ ___: pain that arises as a direct result of a lesion or disease that affects the somatosensory system

A

neuropathic pain

80
Q

central sensitazation characterized by ____: unpleasant abnormal sensation that can occur on its own or with stimulation
- burning, shooting or electrical sensation like hitting your “funny bone”

A

dysesthesias

81
Q

4 types of dysesthesias?

A
  1. allodynia
  2. hyperalgesia
  3. spontaneous pain
  4. temporal summation
82
Q

___: pain that is caused by something that normally wouldn’t cause pain

A

allodynia

  • “cross-talk” hypothesized between light touch and nociceptor pathways
  • microglia abnormal activation may be implicated
83
Q

___ ___: stimuli that are normally mildly painful in injured tissue are causing excessive sensitivity

A

primary hyperalgesia

84
Q

___ ___: pain spreads to uninjured areas close to injury site

A

secondary hyperalgesia

85
Q

__ __: pain unrelated to external stimulus

A

spontaneous pain

86
Q

___ ___: increased pain due to repeated stimulus or continued presence of single stimulus
- “wind up” occurs at cellular level due to heightened output of 2nd order neurons within dorsal horn or trigeminal spinal nucleus

A

temporal summation

87
Q

___ __ are locations that are outside of the nociceptor or soma that trigger action potentials

A

ectopic foci

88
Q

___ ___:
- also called cross talk
- lack of insulation due to demyelination allows an action potential in 1 neuron to cause an action potential in another neuron

A

ephaptic transmission

89
Q

Long lasting central sensitization facilitates rewiring of CNS connections. New synapses between ___ fibers and 2nd order neurons replace ___ fiber connections so that AB fibers now carry nociceptive information

A

AB, C

  • cerebral cortex also shows signs of reorganization
90
Q

Neuropathic pain: ___ ___: caused by lesion to CNS, localized to area of body deafferented by the lesion

  • burning, shooting, aching, freezing, tingling pain
A

central pain

91
Q

__ ____ ___ is due to absence of sensory inputs causing neurons in central nociceptive pathways to be overly active

A

phantom limb pain

  • adaptive stuctural reorganization is seen in periphery with altered membrane channels and hyperexcitability of neurons, degenreation of dorsal root ganglion and dorsal horn of SC, thalamus and cerebral cortex
  • amount of cerebral cortex reorganization is correlated to amount of phantom pain
92
Q

therapists need to address the “3 D’s” of chronic pain which are?

A
  1. distress
  2. disuse
  3. disability
93
Q
A

Neuro (10 decks)

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