Analgesia

Question 1

What is pain?

Answer 1

• An unpleasant sensory and emotional experience associated with actual or potential tissue damage
• Pain is a subjective experience and may not be directly proportional to the amount of tissue injury

Question 2

What is physiological pain?

Answer 2

• Is a protective mechanism
• Causes avoidance
• Little to no tissue injury
• Pain stops once the stimilus is removed

Question 3

What is pathological pain?

Answer 3

• Results from tissue injury
• Inflammation occurs in the area
• Nerve damage
• Release of NT with ongoing stimulation of nociceptors
• Can lead to hyperalgesia
• Persist after the stimulus is removed

Question 4

What is the PNS split into?

Answer 4

• Sensory (afferent division)

- Motor (efferent division)

Question 5

The nerve endings in Nociceptors are pain receptors/ TRUE OR FALSE?

Answer 5

TRUE

Question 6

Nocicpetors are high in concentration in skin, pleural and peritoneal membranes. TRUE OR FALSE?

Answer 6

TRUE

Question 7

Nociceptors have high stimulation threshold. TRUE OR FALSE?

Answer 7

TRUE

Question 8

Nociceptors only generate nerve signal under conditions of tissue damage e.g physical disruption, heat, cold, chemical and pH. TRUE OR FALSE?

Answer 8

TRUE

Question 9

What are the most important channels to pain?

Answer 9

• TRPV1, TRPM8, TRPA1

Question 10

which of these send rapid signal transmission myelinated or non myelinated fibres?

Answer 10

• Myelinated

Question 11

Myelinated send immediate pain and reflex withdrawal. TRUE OR FALSE?

Answer 11

TRUE

Question 12

Non-myelinated C fibres have much slower signal transmission, longer term and diffusion of pain and they protect damaged tissue to allow repair. TRUE OR FALSE?

Answer 12

TRUE

Question 13

Provide examples of pain recpetors which detect specific stimuli?

Answer 13

• Bradikinin and histamine
• Transit receptor potential channel
• P2X and P2Y receptors
• ASIC - acid sensitive ion channels

Question 14

Myelinated sensory fibres form direct synapse to ascedning fibres which enter contralateral spino-thalamic tract. TRUE OR FALSE?

Answer 14

TRUE

Question 15

Non-myelinated C fibres connect to ascending fibres via connecting interneurons. TRUE OR FALSE?

Answer 15

TRUE

Question 16

In somatosensory cortex: The brain does not know when the body is in pain. TURE OF FALSE?

Answer 16

FALSE

Question 17

In the limbic system: Pain alters emotions. TRUE OR FALSE?

Answer 17

TRUE

Question 18

In the reticular formation: Pain does not prevent sleep. TRUE OR FALSE?

Answer 18

FALSE

Question 19

Describe the physiology of pain, how pain occurs?

Answer 19

• Noxious stimuli active the nociceptors
• Nociceptors become sensistised with stimulation
• Resulting in lowered stimulation threshold
• Damaged cells release substances which stimulate nociceptors and inflammation
• Afferent nerves in the spinal cord send signals to the brain
• Leading to the perception of pain

Question 20

What is the difference between pain and Nociception?

Answer 20

• Pain:
  is a product of higher brain center processing signals it has received

Nociception:
Refers to the peripheral nervous system processing information recieved from stimulation of nociceptors

Question 21

Nociception can occur in the absence of pain. TRUE OR FALSE?

Answer 21

TRUE

Question 22

what is pathological pain?

Answer 22

• It is a state of disease caused by damaged nervous system or by its abnormal function
• Pain processing mechanism functions abnormally

Question 23

Nociception is sustained by chronic injury. TRUE OR FLASE?

Answer 23

TRUE

Question 24

What is analgesia?

Answer 24

• The abscence of decrease in pain even in the presence of the stimuli

Question 25

Analgesics prevent pain inducing pathways and promote pain supressing pathways. TRUE OR FALSE?

Answer 25

TRUE

Question 26

What are the different target sites for pain therapies and dsecribe each target?

Answer 26

TTP - Transduction: the translation of the noxiuos stimuli into electrical activity at the peripheral nociceptors - Transmission: The propagation of nerve impulses through the nervous system - Perception: The final conscious subjective and emotional experience of pain

Question 27

What are the 5 classes of analgesics?

Answer 27

- Opiods - NSAIDS - Local anasthetics - Alpha2 adrenoceptor agonists - Miscellaneous drugs

Question 28

What is the pain control system also known as?

Answer 28

- The endogenous analgesic system

Question 29

What does The endogenous analgesic system consist of?

Answer 29

- Areas in the brain and spinal cord, which when activated reduce pain sensations

Question 30

What are the key NT in the descending analgesic pathway?

Answer 30

- Endogenous opiod receptors agonists | - Noradrenaline and 5HT