Ch1 BB AALA Flashcards
1
Q
- What is the IASP?
A
International Association for the Study of Pain
2
Q
- What is the IASP definition of pain?
A
- “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage”
3
Q
- What is a more animal specific definition of pain?
A
- “an aversive sensory, emotional experience representing an awareness by the animal of damage or threat to the integrity of its tissues; it changes the animal’s physiology and behavior to reduce or avoid damage, reduce the likelihood of recurrence, and to promote recovery; non-functional pain occurs when the intensity or duration of the experience is not appropriate for the damage sustained and when physiological and behavioral responses are unsuccessful in alleviating it.”
4
Q
- What is acute pain?
A
- Acute pain- has proximate cause, often serves as an essential protective function by associating potentially damaging noxious stimuli with an unpleasant sensation
5
Q
- Acute pain can be further characterized as _________ or __________.
A
- physiologic or clinical
6
Q
- Differentiate between the two classifications of acute pain.
A
- physiologic- early-warning system that aids in protecting body from tissue damage by physical, thermal, or chemical threats, initiated by activation of high-threshold nociceptive neurons, highly localized, transient, initiates physiologic and avoidance behaviors accompanied by protective reflexes; clinical- prolonged unpleasant sensations arising from significant tissue damage, induces augmented or abnormal signal processing, may be spontaneous, may be characterized by hypersensitivity, hyperalgesia, & allodynia, & pain surrounding noninjured tissues
7
Q
- What is chronic pain?
A
- “pain which persists past the normal time of healing”, pain continues beyond the stage where it is useful to protect the region, or is persistent and may not have a clearly identifiable cause
8
Q
- The IASP regards _____ months of pain as the most expedient point at which transition from acute to nonmalignant pain can be defined.
A
3 months
9
Q
- What is pain threshold?
A
- least experience of pain an individual can recognize
10
Q
- True or False: Sex has been demonstrated to influence pain thresholds in animals.
A
- False- has not been conclusively demonstrated
11
Q
What is pain tolerance?
A
- the greatest level of pain an individual is willing to tolerate
12
Q
- _____________ is an exaggerated response to a stimulus that would normally be painful.
A
- hyperalgesia
13
Q
- _____________ refers to reduced threshold to noxious stimuli.
A
- hypersensitivity
14
Q
- What is allodynia?
A
- pain induced by a non-noxious stimulus
15
Q
- What is analgesia?
A
- absence of pain in response to stimulation that would normally be painful
16
Q
- _____________ is the sensation of noxious stimuli.
A
nociception
17
Q
- What is the important distinction between nociception and pain?
A
- nociception includes neurobiological processes by which noxious stimuli are encoded as neural impulses and sent to the brain; pain is the cognitive and emotive interpretation of the sensation as a hurtful or unpleasant experience
18
Q
- ___________ is the process of converting noxious thermal, mechanical, or chemical stimuli into an action potential
A
transduction
19
Q
- True or False: The frequency and duration of the action potential is proportional to the intensity and duration of the stimulus.
A
True
20
Q
- True or False: Most nociceptors are unimodal.
A
- False- polymodal
21
Q
- What are “silent” nociceptors?
A
- nociceptors that express transducers with such high activation thresholds that they are only activated when sensitized by tissue injury
22
Q
- List the major transducer types.
A
- transient receptor potential ion channels, ATP-gated ion channels, and acid-sensing ion channels
23
Q
- _______ respond to thermal, chemical, and possibly mechanical stimuli.
A
transient receptor potential ion channels
24
Q
- _________ are released in response to mechanical forces, inflammation, and nerve damage.
A
ATP-gated ion channels
25
25. _________ transduce innocuous mechanical stimuli such as touch.
acid-sending ion channels
26
26. What is transmission?
26. the process by which primary afferent sensory neurons propagate action potentials to the spinal cord
27
27. What 5 things are nociceptive neurons characterized by?
27. size, myelination, peptide content, receptive characteristics, and site of termination in the spinal cord
28
28. _______ fibers are thinly myelinated, have intermediate velocities, punctate receptive fields, and respond to thermal and mechanical stimuli.
28. Aδ
29
29. _______ fibers constitute the majority of peripheral nociceptive fibers, have small unmyelinated axons, wide receptive fields, and are polymodal.
C
30
30. ______ fibers are large, myelinated, and have fast conduction velocities.
30. Aβ
31
31. True or False: All neurons express voltage-gated sodium ion channels.
True
32
32. What is projection, and where does it start?
32. process of conveying information through the spinal cord to the brain, starts in the dorsal horn
33
33. Primary afferent nociceptive neurons connect with interneurons where in the dorsal spinal cord?
a. lamina I
b. substantia gelatinosa (II, IIa)
c. lamina V
d. all of the above
e. none of the above
33. d- all of the above
34
34. What type of neurons do dorsal horn projections code into?
nociceptive-specific
wide dynamic range
non-nociceptive
35
35. ____________ neurons are innervated by Aδ and C fibers and code localizing and qualitative information about noxious stimuli.
35. nociceptive-specific
36
36. __________ neurons are innervated by C, Aδ, and Aβ fibers and convey the intensity of noxious and innocuous mechanical, thermal, and chemical stimuli.
36. wide dynamic range
37
37. ________ fibers code innocuous thermal and mechanical information from Aβ and Aδ fibers.
37. non-nociceptive
38
38. What may be the four most important spinal tracts involved in pain?
38. spinothalamic, spinoreticular, spinomesencephalic, and spinohypothalamic tracts
39
39. True or False: In contrast to humans and NHP, other animals do not have a bilateral, diffuse and multisynaptic nociceptive pathway in the spinal cord.
39. False- other animals DO have bilateral, diffuse, multisynaptic pathway in contrast to humans and NHP
40
40. The ________ has long been considered the key relay for receiving and integrating spinal nociceptive input and projecting that information to cortical and subcortical areas of the brain.
40. thalamus
41
41. What is modulation?
41. the process by which nociceptive information from primary afferents is inhibited or augmented
42
42. True or False: Most dorsal horn neurons are inhibitory interneurons.
True
43
43. What happens when inhibitory interneurons are activated?
44
44. What is the primary excitatory neurotransmitter release by nociceptive terminals?
glutamate
45
45. Glutamate preferentially binds to what receptor(s)?
kainate
AMPA
NMDA
46
46. What is the principal inhibitory neurotransmitter in the nervous system?
GABA
47
47. GABA’s actions are mediated by _______ and _______ receptor subtypes.
48
48. What happens when these receptors are activated?
48. GABAA- hyperpolarizes cell, decreasing excitation; GABAB- reduces release of glutamate, substance P, and calcitonin gene-related product
49
49. What neurotransmitter(s) is/are most critical to descending antinociception?
Serotonin
Norepinephrine
50
50. True or False: Norepinephrine stimulates the release of GABA and glycine, reduces glutmate release from primary afferents and reduces excitation of projection neurons.
True
51
51. True or False: Both noxious and non-noxious stimuli elicit the same type of unlocalized body responses in altricial rats.
True
52
52. True or False: In rats, the descending inhibitory systems that help fine-tune responses are mature and functional at birth.
52. False- immature at birth and not functional until 3 wks after birth
53
53. The _______________ is the primary system affecting the neuroendocrine response to pain.
53. hypothalamic-pituitary-adrenal axis
54
54. True or False: Responses to pain are the mirror images of those elicited by restraint or other stressors.
54. False- are not mirror image
55
55. The neuroendocrine and sympathetic nervous system responses to pain are initiated by:
a. neuronal stimulation through direct and indirect connection with nociceptive pathways
b. IL-1
c. TNF
d. All of the above
e. None of the above
55. d- all of the above
56
56. Activation of the hypothalamic-pituitary-adrenal axis by acute pain results in the release of:
corticotrophin-releasing hormone
antidiuretic hormone
prolactin & adrenocorticoropic hormone
β-endorphins
glucocorticoids
57
57. True or False: Pain causes increased heart rate, blood pressure, cardiac output, and systemic vascular resistance.
True
58
58. True or False: Pain in human thoracic surgery patients, has been shown to decrease tidal volume, functional residual capacity, and cause ventilation-perfusion mismatch.
True
59
59. Name 3 miscellaneous effects of pain
glucose intolerance
ileus
sleep disturbance
60
60. What does neural plasticity refer to?
60. when neurons alter their structure/function in response to stimulation or activation
61
62. True or False: Prostaglandin E2, Histamine, and Nerve growth factor are algogens and cause sensitization.
62. False- sensitization, not algogens
62
63. What is “wind-up”?
63. progressive increase in action potential frequency generated by closely repeated constant pulses of electricity
63
64. True or False: Wind-up is necessary and sufficient for central sensitization to occur.
64
65. ________________ contributes to primary hyperalgesia, and is the only mechanism by which secondary hyperalgesia and secondary allodynia occur.
65
66. Central sensitization is not a completely neuronal event, and may depend upon _____________ activation.
66. glial cell
66
67. The glial model of central sensitization suggests that the CNS synapses have a tetrapartite structure, comprised of:
microglia
astrocytes
pre-synaptic neurons
post-synaptic neurons
67
68. True or False: Over a period of hours-days, central sensitization switches from transcription-and-translation-dependent processes to activity-dependant processes.
68. False- switches from activity-dependent to transcription-and-translation dependent
68
69. What are the cardinal signs of chronic pain?
69. allodynia, hyperalgesia, and spontaneous pain
69
70. True or False: Once astrocytes are activated, inhibiting microglial cells has no effect on pain.
True
70
71. Which voltage-gated sodium channels have been implicated in the pathogenesis of both neuropathic and inflammatory chronic pain?
1.3, 1.7, and 1.8
71
72. Altered expression and distribution of sodium ion channels leads to the generation of _________________ in the absence of stimuli.
72. spontaneous (ectopic) impulses
72
73. Voltage gated _______________ (sodium or calcium, choose one) channels appear to regulate neurotransmitter release.
calcium
73
74. True or False: Loss of inhibitory interneurons appears to be mediated by glutamate receptor 5 and caspase-3 activity.
True
74
75. What is phenotypic switching?
induced expression of nociceptive-related ion channels, molecules, and receptors not normally found in non-nociceptive sensory neurons, and novel up-or down regulation of similar molecules in nociceptive neurons
75
76. True of False: Most chronic pain encountered in veterinary medicine is likely neuropathic, inflammatory, or neoplastic in origin
True
76
What are definitions of neuropathic pain?
77. “pain initiated or caused by a primary lesion or dysfunction of the nervous system”, “pain caused by a lesion of the peripheral or central nervous system (or both) manifesting with sensory symptoms and signs”
77
78. Which of the following is NOT an etiology responsible for neuropathic pain?
a. chemotherapy induced polyneuropathy
b. diabetes
c. herpes virus
d. multiple sclerosis
e. osteoarthritis
78. e- osteoarthritis
78
79. How does chronic inflammatory pain develop?
79. from chemicals (algogens, sensitizers, immunomodulators) released by immunocytes infiltrating injured or diseased tissue
79
80. Which of the following is NOT an example of a disease associated with chronic inflammatory pain?
a. herpes virus
b. osteoarthritis
c. endometriosis
d. feline lower urinary tract disease
e. ulcerative dermatitis
80. a- herpes virus
80
