Brainscape's Knowledge GenomeTM

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


See full index

P2 Head, Neck and Neuro > Chronic pain, brain anatomy, signalling in the NS > Flashcards

Chronic pain, brain anatomy, signalling in the NS Flashcards

1
Q

Which lobe is the precentral gyrus part of?

A

Frontal

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

What lobe is the postcentral gyrus part off?

A

Parietal

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

Where is Broca’s area?

A

On the inferior frontal gyrus

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

Which hemisphere is Broca’s more commonly found in?

A

The left

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

Which gyri is the auditory complex found on?

A

Superior temporal gyri

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the function of Broca’s area?

A

Motor aspect of speech - speech associated gestures

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

What does damage to Broca’s area do?

A

Expressive aphasia- non-fluent and slow speech

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

Where is wernicke’s area found?

A

Within the auditory association cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the function of Wernicke’s?

A

Sensory language areas, lexical processing

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

What can damage to Wernicke’s area cause?

A

Receptive aphasia - extremely poor comprehension

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

What are the most anterior and posterior parts of the corpus callosum called?

A

Genu (anterior)

Splenium (posterior)

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

What is the rostrum of the corpus callosum?

A

The part that projects inferiorly and posteriorly from the Genu

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

Where is CSF made?

A

Choroid plexus within the ventricular system of the brain

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

How much CSF is produced per day, and what happens to it when it’s been used?

A

500ml produced per day 140ml circulates through the subarachnoid space

Reabsorbed into the venous drainage system

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

What is the function of CSF?

A

Affords mechanical and immunological protection to the brain and spinal cord

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

How does CSF pass from the lateral ventricles to the third ventricle?

A

Interventricular foramen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How does CSF pass from the third ventricle to the fourth ventricle?

A

Through the aqueduct of midbrain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which structures make up the lentiform nucleus?

A

Putamen

Globus palidus

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

What are the three borders of the lentiform nucleus?

A

Claustrum

Anterior limb

Posterior limb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which motor axons pass by the Genu of the lentiform nucleus?

A

Corticobulbar axons

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

Which axons pass by the posterior boundary of the lentiform nucleus?

A

Corticospinal axons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the three main pairs of arteries given off by the circle of Willis?

A

Anterior cerebral arteries

Middle cerebral arteries

Posterior cerebral arteries

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

Roughly what areas of the brain does the anterior, middle and posterior cerebral arteries supply?

A

Anterior - frontal and parietal

Middle - temporal

Posterior - occipital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which eight, fused bones make up the cranial cavity?

A

Frontal

Occipital

Sphenoid

Ethmoid

2 x parietal

2 x temporal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the red flags of lower back pain?

A

Previous history of malignancy

Younger than 16, older than 50 with new pain

Weight loss

Prolonged steroid use

Recent serious illness

Recent significant infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

List some mechanical causes of lower back pain below.

A

Trauma

Muscular and ligament pain

Pustular back pain

Facet joint syndrome = ostearthritis

Lumbar disk prolapse

Lumbar spondylosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Describe the anatomy of an intervertebral disk.

A

Soft gelatinous centre called nucleus pulposus, encircled by a strong, ring-like collar of fibrocartilage called the annulus fibrosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the main function of an intervertebral disk?

A

Shock absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What happens in an intervertebral disk prolapse?

A

Nucleus pulposus is squeezed out of place and herniated through the annulus fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Name some reasons an IV disk would become damaged?

A

Trauma

Effects of ageing

Degenerative disorders of the spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Briefly describe pathology involved once an IV disk herniation has occurred?

A

Posterior protrusion of the nucleus pulposus towards the intervertebral foramen and its contained spinal root. Annulus fibrosis becomes thin and poorly supported by posterior or anterior ligaments at this point

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Which regions of the spine are most commonly involved in disk herniations?

A

Cervical and lumbar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Where are the signs and symptoms of a disk herniations seen?

A

Localised to the area of the body innervated by the affected spinal nerve roots- includes motor and sensory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

If the nerve roots L4, L5, S1, S2 and S3 are damaged, what condition arises?

A

Sciatica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Describe where the pain is felt in sciatica?

A

Spreads down the back of the leg and over the sole of the foot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are the most common sensory effects from spinal root compression?

A

Paraesthesia and numbness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What are the most common motor effects from spinal root compression?

A

Knee and ankle reflexes may be absent or diminished

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are the symptoms of severe spinal disease?

A

Pain worse at rest

Thoracic pain

Fever

General malaise

Urinary retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What signs and symptoms of cauda equina compression occur in severe spinal disease?

A

Bilateral leg pain

Back pain

Urinary retention

Perinatal sensory loss

Erectile dysfunction

Reduced anal tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are the layers of protection for the spinal cord?

A

Vertebrae

Vertebral ligaments

Fat and connective tissue in epidural space

Meninges

CSF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

At what point do the spinal nerves stop being covered in meninges?

A

Once they exit the spinal column through the intervertebral foramen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the epineurium?

A

The outer covering of spinal and cranial nerves - continuous with dura mater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Which meningeal layer contain blood vessels? (At least in the spine :/)

A

Pia mater and dura mater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Describe the connective tissues of the dura mater.

A

Thick, strong, dense and irregular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Where does the spinal cord arise and terminate in adults and babies?

A

-Arises in the medulla oblongata

Terminates:

  • superior border of 2nd lumbar vertebrae in adults
  • L3,4 in newborns
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the superior enlargement of the spinal cord, and where does it span?

A

It’s a cervical enlargement, that nerves to and from the upper limb arise from

Spans from C4 to T1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the inferior enlargement of the spinal cord, and where does it span?

A

It’s a lumbar enlargement, that nerves to and from the lower limb arise from

Spans from T11 to S2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is the conical structure at the end of the spinal cord called?

A

Conus medullaris (between L1, 2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is the filum terminale?

A

Extension of pia mater that extends from conus medullaris to the arachnoid and dura mater at the coccyx- anchors spinal cord to coccyx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is contained in a dorsal root ganglion?

A

Cell bodies of sensory neurons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is in the white matter of the spinal cord?

A

Bundles of myelinated axons of neurons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What are the anterior median fissure and posterior median sulcus of the spinal cord?

A

Anterior median fissure - wide groove on ventral side

Posterior median sulcus - narrow furrow on dorsal side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What is contained in the grey matter of the spinal cord?

A

Dendrites and cell bodies of neurons, unmyelinated axons and neuroglia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What are denticulate ligaments?

A

Triangular shaped membranous extensions of the pia mater than suspend the spinal cord in the middle of the rural sheath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What is found in the centre of the grey commissure?

A

Central canal - contains CSF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is there grey commissure?

A

Crossbar between the two lateral sides of the grey matter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What are nuclei?

A

Clusters of neuronal cell bodies arranged in functional groups in the grey matter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What parts of the spinal cord are the intermediate grey horns found in, and what do they contain?

A

Thoracic and upper lumbar Contain autonomic motor nuclei - regulate activity of cardiac muscle, smooth muscle and glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is the difference between a nerve and a track?

A

Nerves are bundles of axons in PNS Tracts are bundles of axons in the CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What are the two spinothalamic pathways?

A

Neospinothalamic tract - fast pain Palaeospinothalamic tract - slow pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Outline the common course of primary afferent of the spinothalamic pathway

A

Peripheral receptor, body in the dorsal root ganglion, synapses in the lamina I+II of the dorsal horn, glutamergic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Outline the common course of secondary afferent of the spinothalamic pathway

A

Body in the lamina I+ II of dorsal horn Cross over to the lateral funiculus Travel through medulla In midbrain give fibres to periaqueductal grey matter and to reticular formation, to hypothalamus In thalamus synapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

When are nociceptors activated?

A

When the pain reaches a noxious threshold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Describe pain sensitization in relation to nerve fibres?

A

Continued stimulation decreases the threshold at which nociceptors respond

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What type of pain do the C-fibres send to the brain?

A

The poorly localised, diffuse ‘second’ pain (slow and burning)- polymodal; respond to mechanical, thermal and chemical stimuli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Name the three neurotransmitters used by nociceptive fibres.

A

Glutamate Substance P Calcitonin gene-related peptide (CGRP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Outline the common course of tertiary afferent of the spinothalamic pathway

A

Body in thalamus

Signals to the cerebral cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Describe the course of the descending inhibitory tracts

A

Originate in periaqueoductal grey matter and locus ceoruleus

Synapse in medulla and move down through the inhibitory dorsal columns to the synapse of primary and secondary afferents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

How does a thermal stimuli activate A-delta and C-fibres?

A

Hot activates the TRPV1 receptor

Cold activates the TRPM8 receptor

Results in either cooling or warming of the body behaviours - mediated through projections to the hypothalamus

70
Q

How does a mechanical stimuli activate A-delta and C-fibres

A

High threshold

Only activated when stimuli is noxious and may cause tissue damage

71
Q

How does a chemical stimuli activate C-fibres?

A

Can be external irritation or substances released during tissue damage

72
Q

What chemicals are released when tissues are injured?

A
  • Bradykinin
  • 5-HT
  • Prostaglandins
  • Potassium ions
73
Q

How are C-fibres activated in general?

A

In response to the chemicals procured by tissues during tissue damage

  • CGRP and substance P are released
  • mast cells are simulated
  • histamine release
  • vasodilation, plasma extravasion, oedema and bradykinin release
74
Q

What happens to the activated threshold after the initial chemical release and vasodilation?

A

It is lowered to make the area more sensitive to pain

  • hyperalgesia
  • allondyia
75
Q

Are the interneurons modulating pain inhibitory/excitatory and what neurotransmitters do they use?

A

Inhibitory GABA and Glycine

76
Q

Describe how shifting towards A-beta fires in the gate control theory works.

A

C and A-delta fibres activate projection neuron firing - causing pain These can be inhibited by inhibitory interneurons A-beta firing activates the inhibitory interneuron

77
Q

How do endogenous opiods and opiates work?

A

Stimulates PAG matter in the midbrain, which sends descending, inhibitory pathways that supresses transmission of pain signals

78
Q

Names the three classes of endogenous opioids.

A

Endorphins Enkephaline Dynorphin

79
Q

Name three types of opioid receptor.

A

mu kappa delta

80
Q

How is back pain managed between the ages of 5 and 20?

A

It’s likely to be mechanical - managed with analgesia, brief rest and physiotherapy

81
Q

What is the best way to manage back pain (in any age)?

A

Physiotherapy Being as active as possible Early management

82
Q

Describe the role of the pysiotherapist in management of back pain

A

Builds up muscles to cope with problems Prevents and manages musculoskeletal disorders/other health problems Works in hospital or community Passive modalities to assist pain relief - electric stimulation Provides pain relief

83
Q

What is nociception?

A

The neural mechanism by which an individual detects the presence of a potentially tissue harming stimulus

84
Q

What are the stages of nociception?

A

Transduction Transmission Modulation Perception

85
Q

Through which type of sensory vesicle is pain felt and where they are located?

A

Free nerve endings - skin, bone, muscle, internal organs, blood vessels - not in brain

86
Q

Name the 2 levels of pain modulation

A

Spinal: gate control theory Supra-spinal: Conditioned pain modulation

87
Q

Describe the role of the hospital specialist in management of back pain

A

Further evaluates, manages and treats the underlying problem causing the back pain Cause may be mechanical, metabolic, malignant or infectious

88
Q

What is a ‘yellow flags’, when regarding back pain?

A

Psycho-social barriers to recovery

89
Q

List some yellow-flags of back pain.

A

Belief that pain is harmful and debilitating Fear - avoidance behaviours Sickness behaviours - extended rest Social withdrawal Emotional problems - constant low mood Problems at work Financial problems Overprotective family Inappropriate expectations of treatment

90
Q

What are the two different types of pain?

A

Neuropathic - nerve damage Nociceptive - tissue damage

91
Q

Describe somatic nociceptive pain.

A

Well localised - dermatomal Sharp, aching and gnawing pain Constant

92
Q

Describe visceral nociceptive pain.

A

Vague distribution, diffuse Dull, cramping and digging pain Can be periodic Causes nausea, vomiting, sweatiness, CV symptoms

93
Q

What are the symptoms of neuropathic pain?

A

Shooting Electric shock like Burning Tingling Numbness

94
Q

What kind of pain is lower back pain? (neuropathic, nociceptive)

A

Local nociceptor activation = nociceptive Compression and inflammation of nerve root = neuropathic

95
Q

What’s the difference between somatic referred back pain and radicular pain in the leg?

A

Somatic referred pain - nociceptive pain affecting large areas of the posterior thigh Radicular pain - neuropathic pain radiating down lower limb to the heel in a narrow band

96
Q

How can pain be measured?

A

NRS - numerical rating scale VAS - visual analgoue scale

97
Q

Name some of co-morbidities associated with neuropathic pain.

A

Poor appetite Anxiety Depression Difficulty concentrating Drowsiness Lack of energy Difficulty sleeping

98
Q

Describe the WHO analgesic ladder

A

1 - Paracetamol, NSAIDs 2- Codeine, dihydrocodeine 2-3 Tramadol 3 - Morphine, methadone, oxycodone

99
Q

What are the possible side effects of NSAIDs?

A

GI ulceration Bleeding Renal problems Asthma Decreased bone healing

100
Q

What criteria must be looked at before prescribing opioids?

A

Appropriate - pain model- pain patient- pain prescription

101
Q

From most to least effective, list conditions opioids can be used in.

A

Arthritis Nueropathic pain Lower back pain Visceral pain Fibromyalgia

102
Q

Name some adjuvants which can be used for neuropathic analgesics.

A

Anti-depressants Anti-convulsants Anti-arrhythimcs

103
Q

Describe the lumbar facet syndrome.

A

Lower back pain to groin, hip or thigh Worse on back extension/rotation Tender over paraspinal region

104
Q

How is lumbar facet syndrome diagnosed?

A

X-ray shows nothing local anaesthetic to medial branch of dorsal primary rami

105
Q

What is resting membrane potential?

A

Difference in charge between inside and outside of the neuron/cell at rest

106
Q

What is the typical resting membrane potential?

A

-60 mV to -70 mV

107
Q

What is equilibrium potential?

A

Membrane potential where N ions entering cell = N ions leaving cell E.g. concentration gradient moves K+ out of cell but electrical potential gradient moves K+ into cell

108
Q

What is action potential?

A

Very brief, but dramatic change in membrane potential All or nothing

109
Q

What are the stages of action potential?

A

Depolarisation Repolarisation Hyperpolarisation

110
Q

What happens during depolarisation?

A

Fast opening of voltage-gated Na channels

111
Q

What happens during repolarisation/ hyperpolarisation?

A

Slow opening of voltage-gated K channels

112
Q

Name 2 ways in which an action potential can be propagated

A
  1. along axon 2. out of axon via membrane
113
Q

What cells myelinate neurons in CNS?

A

Oligodendrocytes

114
Q

What cells myelinate neurons in PNS?

A

Schwann cells

115
Q

How does action potential propagation differ in myelinated and umyelinated neuron?

A

Myelinated: AP jumps from node to node, faster Unmyelinated: slower, cannot jump

116
Q

Name 2 disorders associated with defective myelination

A

Multiple sclerosis (CNS, autoimmune) and Guillan-Barre syndrome (PNS, inflammatory)

117
Q

Outline the steps in synaptic transmission

A
  1. AP enters presynaptic terminal 2. Ca2+ entry through voltage-gated Ca2+ channels 3. Docking of synaptic vesicles containing neurotranmitters 4. Neurotransmitter released by exocytosis 5. Neurotransmitter binds to and activates receptors on postsynaptic membrane 6. Ions enter cells Na+ = depolarisation Cl- = hyperpolarisation
118
Q

Name 5 types of neurotransmitters

A

Cholinergic Biogenic amines Amino acids Neuropeptides Miscellaneous

119
Q

Name example of cholinergic neurotransmitter

A

Acetylcholine

120
Q

Name example of biogenic amines neurotransmitters

A

Catecholamines: noradrenaline, adrenaline, dopamine 5-hydroxitryptamine

121
Q

Name example of amino acids neurotransmitter

A

Excitatory: glutamate Inhibitory: GABA

122
Q

Name example of neuropeptides neurotransmitter

A

Endogenous opioids

123
Q

Name example of miscellaneous neurotransmitter

A

Gases: NO Purines: adenosine, ATP

124
Q

Name 2 diseases that disrupt cholinergic transmission

A

Botulism (toxin prevents Ach release), Myasthenia gravis (inflammatory)

125
Q

What is temporal summation?

A

Frequency of firing of APs at one point

126
Q

What is spatial summation?

A

Firing at multiple sites combines e.g. 2 different dendrites

127
Q

What does inhibitory postsynaptic potential?

A

Moves the post-synaptic membrane further away from threshold

128
Q

What does excitatory post-synaptic potential do?

A

Brings the post-synaptic membrane closer to threshold

129
Q

Name the 2 ways in which information can spread in the nervous system

A

Divergence (one neuron signals to many, spreading the signal) and convergence (integration of many signals to one cell)

130
Q

What are the methods used to localise cerebral function?

A

Electro-encephalography (EEG) PET fMRI Transcranial magnetic stimulation (TMS)

131
Q

What is the function and role of EEG in investigating brain?

A

Records the electrical activity of the brain Investigate cognitive processes in response to a stimulus

132
Q

What is the function and role of PET in investigating brain?

A

Measures blood flow - radioactive injected Locate brain activity while performing a task

133
Q

What is the function and role of fMRI in investigating brain?

A

Measures blood flow Locate brain activity while performing a task

134
Q

What is the function and role of TMS in investigating brain?

A

Electromagnet to stimulate brain activity Interrupt brain activity while performing a task

135
Q

List the disadvantages of pain

A

CNS - anxiety, depression, sleep deprivation CVS - increased BP, HR and risk of ischaemic heart disease RESP - inhibits cough, hyperventilation GIT - nausea, vomiting Genitourinary - urinary retention, uterine inhibition Muscle - restless, immobility Metabolic - Acute catabolic stress response - cortisone, glucagon..

136
Q

Describe the Gate Control Theory of Pain

A

In absence of input local tonically active inhibitory interneuron suppresses pain pathway With strong pain, C fibres stops inhibition -> signal send to brain If Abeta fibres are also activated they reactivate the interneuron and decrease the painful stimulus

137
Q

Name compartments of the supraspinal pain neuromatrix

A

Sensory discriminative: Thalamus, Post insula Affective-motivational: Ant insula cortex, Ant mid cingulate cortex Cognitive activation: Prefrontal cortex

138
Q

Define allodynia

A

Pain from a stimulus not normally painful

139
Q

Define Hyperalgesia

A

Abnormally high levels of pain from noxious stimuli Primary - Peripheral sensitisation Secondary - central sensitisation

140
Q

What are the mediators that activate nociceptors?

A

K+ 5-HT Bradykinin H+ Histamine ATP, Adenosine

141
Q

What are the mediators that sensitise nociceptors?

A

Prostaglandins Leukotrienes Substance P Noradrenaline Neurokinin A CGRP Nitric oxide Reactive oxygen species

142
Q

Describe the mechanism of peripheral sensitization

A

Change nociceptors from high to low threshold Process continues after the initial stimulus has ended Mediators: ATP, H+, NGF, Sub P, histamine, cytokines, PGI2, bradykinin

143
Q

What are the neurotransmitters that are part of conditioned pain modulation in the CNS?

A

NA 5HT Inhibitory

144
Q

What are the red flags of lower back pain?

A

Wt loss - malignancy Fever Signs of systemic inflammatory disease Anatomical change Possible history of trauma Cauda equina syndrome Neurological signs - radiculopathy (pinched nerve)

145
Q

Outline the triple response after a mild trauma

A

Red reaction - after scratching White wheal - around the scratch Flare - redder area of the skin

146
Q

Describe the mechanism at the scratch site in triple response reaction

A

Tissue damage: K+ and prostaglandins released Plasma releases bradykinin, platelets: 5HT -> activation of free nerve endings CGRP and sub P release - activate mast cells (histamine release), dilation of blood vessels (flare), sub P (oedema)

147
Q

Describe ischaemic pain

A

Results from a lack of adequate blood supply to active tissue Release of activating and sensitizing molecules resulting in breakdown of ATP

148
Q

What are vertebral foramina?

A

All of them together form the vertebral canal

149
Q

Define transverse processes of vertebrae

A

articulate with ribs in thoracic region, junction of pedicle and lamina

150
Q

Where are the superior and inferior articulate processes?

A

At the junction of pedicle and lamina

151
Q

What do superior and inferior vertebral notches form?

A

The intervertebral foramina

152
Q

Name the outer and inner layer of intervertebral disc

A

Anulus fibrosus - outer Nucleus propulsus - inner

153
Q

Give the distribution of major ions across the membrane of a typical neuron

A
154
Q

Label the areas of cortical specialisation

A
155
Q

Label

A
156
Q

What is the structure and label its parts

A
157
Q

Label

A
158
Q

Describe the parts of the lentiform nucleus

A
159
Q

Label

A
160
Q

Label

A
161
Q

Label diagram

A
162
Q

Label diagram

A
163
Q

Label diagram

A
164
Q

Which centre in the medulla controls the tone of blood vessels and thus total peripheral resistance in relation to pain?

A

The rostral ventrolateral medulla

165
Q

List the signals that the rostral ventrolateral medulla integrates

A
  • From periaqueductal grey matter
  • Cerebral cortex signals
  • Paraventricular nucleus in hypothalamus
  • Nucleus of the solitary tract
166
Q

What signals does the periaqueductal grey matter receive?

A

Pain signals

167
Q

What signals and where from, where to does the paraventricular nucleus in hypothalamus receive?

A

From the rostral ventrolateral medulla and nucleus of the solitary tract

Sends signals back to both these structures and to the intermediolateral column in spinal cord

168
Q

Where from does the nucleus of the solitary tract receive signals?

A

Baroreceptors and Paraventricular nucleus of the hypothalamus

169
Q

Where does the nucleus of the solitary tract signals to?

A

Paraventricular nucleus in the hypothalamus, rostral ventrolateral medulla and Nucleus ambiguus

170
Q

What is the role of nucleus ambiguus in the total peripheral resistence during pain response?

A

Receives signals from cerebral cortex, hypothalamus and nucleus of the solitary tract

Sends signals to heart

171
Q

What are the final signals to the spinal column in the total peripheral resistance pathway?

A

The paraventricular nucleus in the hypothalamus and the rostral ventrolateral medulla signal to the Intermediolateral column in spinal cord T1-L3; than to postganglionic sympathetic nerve activity

172
Q

What are the final effective signals of the total peripheral resistance pathway?

A

Vascular tone

Renal nerves

Other viscera

P2 Head, Neck and Neuro (11 decks)

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