Chronic Pain

Question 1

Chronic Pain: Definition

Answer 1

Pain that lasts longer than 3 months

Persists even when acute injury has gone

Question 2

What facilitates the pain response?

Answer 2

Inflammatory Pain Mediators, such as prostaglandins
Histamine
Cytokines
Substance P

Question 3

What inhibits the pain response?

Answer 3

Competing receptors: such as mechanoreceptor or competing pain fibres

Inhibitory neurons activated via CNS via:
Endogenous opioids
Noradrenalin
Serotonin
GABA
Cannaboid receptors

Question 4

Types of Chronic Pain

Answer 4

Visceral
Nociceptive
Mixed
Neuropathic/ Neurogenic

Question 5

Visceral Chronic Pain:

Nature
Possible causes

Answer 5

Dull/ Gnawing

IBS
Pancreatitis
Bladder pain
Non-cardia Chest pain

Question 6

Nociceptive Chronic Pain:

Nature
Possible causes

Answer 6

Sharp/ Burning

OA
RA

Question 7

Mixed Chronic Pain:

Possible causes

Answer 7

Cancer Pain
Lower Back Pain
fibromyalgia

Question 8

Neuropathic/ Neurogenic Chronic Pain:

Nature
Possible causes

Answer 8

Burning/ Tingling/ allodynia

Diabetic Neuropathy
Post-herpetic neuralgia

Question 9

Transduction

Answer 9

Process of converting noxious stimulation from tissue injury to a nociceptive signal

Question 10

Transmission

Answer 10

Sending nociceptive information to CNS

Question 11

Transformation

Answer 11

IN CNS - biological modulation of signal

Question 12

Perception

Answer 12

Interpretation of pain signal by cognitive and emotional responses in brain

Question 13

Nociceptor

Answer 13

Specialised neurone that respond to chemical, mechanical, and heat stimuli.

Promote neurogenic inflammation by neuropeptide release

Question 14

Spontaneous Discharge

Answer 14

Action potential generated without exogenousstimulation

Question 15

Allodynia

Answer 15

Pain in respinse to a non-painful stimuli

Question 16

Hyperalgesia

Answer 16

Increased pain sensation to painful stimuli

Question 17

Peripheral Sensitisation

Answer 17

Process in whichs the threshold for action potentials is lowered

Question 18

First Pain

Answer 18

Sharp and prickly pain generated by activation of rapidly conducting Aδ

Question 19

Second Pain

Answer 19

Dull/ Burning pain caused by activation of slow-conducting C fibres

Question 20

Action of Voltage-gated ion channels on nociceptors during pain

Answer 20

Allow influx of Na and Ca ions which as certain threshold cause and AP

After AP, they allow an efflux of K ion which enable the neurone to re-polarise

Question 21

2x Types of Nociceptor Na Channels

Answer 21

TTX-S - Tetrodotoxin Sensitive: require lower threshold for AP generation

TTX-R - Tetrodotoxin Resistant: can sustain AP secondary to prolonged noxious stimuli

Question 22

3x Primary Nerve classes in pain transmission

Answer 22

Aβ: Largest, fastest, and densely myelinated
Aδ: Lightly myelinated
C: Smallest, unmyelinated