Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Semester 3 - Mind and movement > Case 2 - Back pain and addiction > Flashcards

Case 2 - Back pain and addiction Flashcards

1
Q

what is neuropathic pain?

A

pain arising as a direct consequence of a lesion or disease affecting the somatosensory system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is allodynia?

A

pain triggered by non-noxious stimuli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is hyperalgesia?

A

increased pain from a noxious stimuli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is central pain?

A

damage to modulation of ascending pathways within brain or spinal cord. traumatic or degenerative injury to spinothalamic pathways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

common causes of central pain?

A 
stroke
MS
Cancer
Epilepsy
Parkinsons
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

symptoms of neuropathic pain?

A

spontaneous pain - shooting, burning, numbness, pins and needles
allodynia
hyperalgesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is paraesthesia?

A

an abnormal sensation: e.g. numbness, pins and needles, crawling ants etc. can be evokes or constant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are some of the mechanisms of central neuropathic pain?

A 
enhancement of facilitatory pathways
diminished inhibitory pathway
central sensitisation
neuronal plasticity
genetic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what sensory modalities does the dorsal column pathway carry?

A

proprioception
fine touch
vibration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

spinothalamic tract has two divisions - what are they and what sensory modalities do they carry?

A

lateral - pain and temperature

anterior - crude touch and pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

the faciculus gracilis transmits information coming from where?

A

proprioception, fine touch and vibration from lower limbs - inferior to T6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

the faciculus cuneatus

A

transmits information coming from above T6 - upper limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the three pairs of corticospinal tracts?

A

lateral, anterior and corticobulbar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

where do corticospinal fibres decussate?

A

at the pyramids in the medulla - most decussate and form the lateral tract - some remain and are called the anterior tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the 4 subconscious motor tracts?

A

vestibulospinal tract
tectospinal tract
reticulospinal tract
rubrospinal tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the role of the vestibulospinal tracts?

A
  • information is sent from the inner ear to monitor position of the head
  • vestibular nuclei respond by altering muscle tone, neck muscle contraction and limbs for posture and balance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the role of tectospinal tract?

A
  • sends information to the head, neck and upper limbs in response to bright and sudden movements and loud noises
  • the tectum area consists of the superior and inferior colliculi
  • -superior colliculi - receives visual information
  • -inferior colliculi receives auditory information
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what structures modify and coordinate movements so that they are performed in a smooth manner?

A

basal nuclei and cerebellum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are some of the treatments of neuropathic pain?

A
    • antidepressants - TCA e.g. amitriptyline, amoxapine trimipramine
    • anticonvulsants - gabapentin or pregabalin
    • opiate painkillers - morphine, tramadol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the MOA of TCAs?

A

blockage of sertonin and noradrenalin reuptake transporters (SERT) increasing levels of seratonin and noradrenalin available in the synaptic cleft

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are some of the side effects of TCAs?

A 
dry mouth 
blurred vision
weight gain
constipation
cardiotoxicity and neurotoxicity are related to overdose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what receptor do opiates act on?

A

agonists of Mu opioid receptors in the CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

influx of which ions causes the depolarisation of neurons during an action potential?

A

Na+ influx depolarises neruone
K+ efflux causes repolarisation
Na/K co transporter restores membrane potential

24
Q

what are the two main types of receptor?

A

Ionotropic

metabotropic

25
Q

how is dopamine synthesised?

A

tyrosine –tyrosine hydroxylase–> L-DOPA –dopa decarboxylase (DDC) –> dopamine

26
Q

what is the rate determining step in the synthesis of dopamine?

A

tyrosine hydroxylase is the rate determining step in DA synthesis - it is usually saturated by a substrate

27
Q

what are the Dopamine receptor subtypes?

A

D1 family - D1 and D5 - excitatory

D2 - D2,3,4 - inhibitory

28
Q

what two enzymes metabolise catecholamines?

A

COMT -catechol-O-methyl transferase

MAO (A and B) - Monoamine oxidase

29
Q

what are the 4 steps for acute pain?

A
  1. Transduction
  2. Transmission
  3. Perception
  4. Modulation
30
Q

for each or the mechanoreceptors of somatosensation state what stimuli they transduce:

  1. free nerve endings
  2. mechanoreceptors (merkel’s disc)
  3. Raffini’s corpuscle
  4. Meissner’s corpuscle
  5. Pacinian corpuscle
  6. muscle spindle
  7. golgi tendon organ
A
  1. pain, temperature, mechanical deformation
  2. low frequency vibration
  3. stretch (joint, skin)
  4. light touch
  5. deep pressure
  6. muscle contraction and stretch
  7. stretch of tendons
31
Q

what is peripheral sensitisation?

A

reduction in threshold and an increase in responsiveness of the peripheral ends of nociceptors

32
Q

what is central sensitisation?

A

increase in the excitability of the neurones within the CNS - normal inputs begin causing abnormal responses

33
Q

what is an example of central sensitisation?

A

hyperalgeasia

34
Q

What is a pain management programme?

A

a psychologically based rehabilitation programme delivered in a group setting by an interdisciplinary team.

35
Q

What neurotransmitter is central to the neurochemistry of reward? and where are increases in levels noted?

A

Dopamine

nucleus accumbans

36
Q

how to stimulants like cocaine work?

A

directly increase dopamine by blocking DA reuptake transporter

37
Q

Opiates increase dopamine by…

A

acting on Mu receptors on GABAergic neurons inhibiting GABA release onto DA neurones

38
Q

what are two main pathways to addiction?

A

Self medication - negative reinforcement to negative reinforcement
sensation seeking - positive reinforcement to negative reinforcement

39
Q

drug abuse is…

A

taking of a substance in a manner that does not conform to social norms

40
Q

drug dependance (physical) is…

A

an individual depends on a drug for normal physiological functioning - abstinence produces withdrawal symptoms

41
Q

drug dependance (psychological) is…

A

compulsive use of a drug

42
Q

Drug addiction is…

A

not a clinical diagnosis - typically used to emphasise psychological dependance

43
Q

describe the cell body, myelination, nerve conduction and function of:

  1. Aalpha/Abeta
  2. Adelta
  3. C fibres
A
  1. large cell body, myelinated, fast conduction, proprioception and low threshold mechanoreception
  2. small/medium cell body, thinly myelinated, medium conduction, high threshold mechanoreception
  3. small, unmyelinated, slow, pain and temperature, high threshold mechanoreception
44
Q

what primary afferent receptor does heat and capsaicin activate?

A

TRPV1

45
Q

TRPM8 is activated by what?

A

cold and mint

46
Q

what causes secondary hyperalgesia?

A

mast cell activation and degranulation

47
Q

what are nociceptors?

A 
pain sensing nerve cells
A delta (sharp pain) and C fibres (dull pain)
48
Q

what is substance P?

A

pain neurotransmitter - from 1st to 2nd order neurone

49
Q

what substances are produced in response to injury which initiates the ascending pain pathway

A

prostaglandins

50
Q

descending pain pathway arises from?

A

anterior cingulate gyrus, amygdala and hypothalamus and are relayed to the spinal cord

51
Q

what are the inhibitory neurotransmitters involved in the descending modulation of pain?

A

noradrenalin, seratonin and opioids (enkephalin, endorphins)

52
Q

where is sympathetic outflow along the spinal cord?

A

T1-L2

53
Q

where are sympathetic nerve cell bodies of the preganglionic neurones located?

A

lateral horn of grey matter

54
Q

what is the MOA of ibuprofen?

A

non-selective COX-inhibitor

55
Q

what is the MOA of lidocaine?

A

blockage of Na+ channels prevent depolarisation along axons - prevent propagation of pain signals

56
Q

what is the gate control theory of pain?

A
  • A synaptic gate lies between peripheral nerves and neurons of the spinal cord
  • Pain signals from peripheral nerves compete with other neural signals to get through the gate
  • The gate may be opened or closed by physical factors, (e.g. counter stimulation of other peripheral nerves, endogenous opioids) or by psychological factors, (e.g. attention, downward stimulation from the brain, moods)
  • The theory provides a basis on which to understand the interplay between physical and psychological factors in pain
  • Also accounts for the phenomenon of pain being reduced through touch
  • Can help people understand that their mental attitudes and behaviour can influence their pain

Semester 3 - Mind and movement (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions