Chapter 3- Pain Modulation and Sensitization: Part 1

Question 1

What is Pain Modulation?

Answer 1

Turning the volume (AKA nociception) UP or DOWN

Question 2

What is delayed onset muscle soreness?

Answer 2

Neutropic factors are released after actual threat of muscle damage –> e.g. with fatigue but no damage/inflammation

Question 3

What is the process of how muscle fatigue occurs? What are the 2 pathways in which muscle fatigue can happen?

Answer 3

1. Muscle fatigue –> fatigue metabolites (ATP (P2X4) + Lactic Acid (ASIC3) –> M1 –> Inflammatory Cytokines –> inhibits nociceptor –> PAIN
2. Muscle Fatigue –> fatigue metabolites (ATP (P2X4) + Lactic Acid (ASIC3) –> M2–> Anti-Inflammatory Cytokines –> inhibit nociceptor –> Analgesia

Question 4

What are the 4 elements of peripheral sensitization for nocicpetors?

Answer 4

1- Increased size of nociceptors
2- Increased responsiveness
3- Reduced threshold to stimulation
4- Activation of silent nociceptors (approx 1/3 of nociceptors innervating the joint, visceral or skin are silent)

Question 5

How does the Gate Control Theory Work?

Answer 5

Low intensity stimulation activates large diameter sensory afferents (L) which reduce noxious input of nociceptors (via S aka small sensory afferents) by activation of inhibitory neurons in SG

Question 6

What activates the hypothalamus and is activated when fear is present?

Answer 6

Amygdala

Question 7

What hormone is mainly responsible for fight or flight response?

Answer 7

Cortisol

Question 8

What is pain neurotag? (aka neurosginature)

Answer 8

Network of brain areas invovled in processing inputs

Question 9

True or False
There is not just one dedicated “pain area” in the brain?

Answer 9

TRUE

Question 10

What are the 4 characteristics for central sensitization for nocicpetion?

Answer 10

1. Increased responsiveness in CNS
2. Increased size of receptive fields in nociceptive spinal dorsal horn neurons
3. Reduced threshold spinal dorsal horn neurons
4. Temporal summation of pain = progressively increasing pain to the same stimulus administered repetively or over a long duration