Exam 3 Lecture 2 Flashcards
If the Slow Pain does not make it to the Thalamus, where does it terminate?
*Location of this location
Reticular Formation in the Brainstem
How does Chronic Pain effect the Pain receptors?
With chronic pain, there are more pain receptors, so it is harder to bind to them and inhibit pain transmission; more NDMA and AMPA-R and less Enkephalin
What is Lateral Inhibition?
The DCML pathway running parallel with the nociceptor to INHIBIT pain signals in the dorsal horn of the cord
Main Glutamate I-Receptor:
*What ion can flood in
*Location
*Activation of this Receptor causes reaction of what other receptor?
AMPA - Influx of Na+ ions into cell after bound by Glutamate
*Located on cell wall in receiving neuron
*Depolarization of this receptor can cause NDMA to open
How does Ca++ enter a nociceptor?
V-G Ca++ sends Ca++ into the Nociceptor via AP
3 Ionotropic Glutamate Receptors?
AMPA, NDMA, Kanate
2 Drug Classes that Increase Serotonin in the Synapse?
*With SSRI example
SSRI [prozac], TCA
What is an Enkephalin Receptor?
*What is it an analog of?
Endogenous Opiate Receptors
*Morphine analog
Extrapyramidal Motor Tract: Olivospinal
Nothing to know per lecture
5 things that can Block NDMA Receptors?
Ethanol, Lead, Ketamine, NO, Tramadol
What is the pathway for fast pain?
*What lamina?
* Detailed or Poor Localization?
Same as DCML Pathway; Lateral Cord, Ventrobasal Complex, Parietal Lobe
*Lamina 1
*Detailed Localization
Where is the 1st Order Descending Neuron located?
Periaqueductal Grey [mecencephalon] or Periventricular Nucleus [Anterior to 3rd ventricle]
Extrapyramidal Motor Tract: Vestibulospinal
Maintain balance and focus eyes on things when moving around
Where does the DTML pathway usually stop?
The gray matter of the dorsal horn
What is the pathway for slow pain?
*What lamina?
*Detailed or poor localization?
Anterior Cord - to brainstem and terminates usually
*Lamina 2, 3, 5
*Poor localization
Where is the crossover for Fast/Slow Pain?
AWC
Where are the emotional areas for pain, per lecture?
Around where the brainstem meets the diencephalon
How does Chronic Pain look in terms of receptors?
Increased receptors, so harder to control pain via Ekephalin analogs
Extrapyramidal Motor Tract: Rubrospinal
Used by cerebellum; modulation of voluntary movement
Is Glutamate Excitatory or Inhibitory? What is Glutamate?
Excitatory; Main NTM for fast pain pathway
How does a SSRI create more free-floating Serotonin?
Blocks the reuptake of Serotonin, leading to more free floating in the 2nd degree neuron; also helps with 3rd degree neuron
How are our NDMA receptors as a baby?
*When we are older?
We do not have very many NDMA receptors as a baby
*As we grow older, we develop more NDMA receptors
What type of Neurons are used for Fast Pain?
A-Delta Myelinated Nociceptors
What does the 3rd order descending release?
*Is this excitatory or inhibitory?
*What does this do to the nociceptor and the 2nd order receiving neuron
Releases Enkephalins in the spinal cord
*INHIBITORY in the spinal cord
*Binds to the Nociceptor and 2nd order receiving neuron to inhibit pain
2nd Main Glutamate I-Receptor:
*What ion can flood in
*Location
*Activation of this receptor can do what to Mg++?
NDMA - Ca++ can flood in, as it is bigger
*Located on cell well synapse
*Kick Mg++ out and allow Ca++ in
What does the 2nd Descending Order Neuron release?
*Where is this released?
*What does this stimulate?
Releases 5-HT [Serotonin] at the dorsal horn in the spinal cord
*This excites the 3rd Order Descending Neuron
What is CGRP?
Slow NTM in the Slow pain pathway; Calcitonin Gene Related Peptide
What does Ca++ do inside the nociceptor?
It binds to the Glutamate vesicles and causes exocytosis at cell wall [similar to ACh]
What NTM does the 1st Order Descending Neuron Release when excited?
*Where are they released
*What does this stimulate
Enkephalins in the middle of the Pons @ the Raphe Magnus Nucleus
*Stimulates/Excites the 2nd order descending neuron
How does Acupuncture work?
Lateral Inhibition
How does Dr. Schmidt classify Tramadol?
SSRI, NDMA Blocker, Ekephalin Blocker
Which pain messes more with the Emotional System?
Slow Pain [chronic pain]
Another Name for Serotonin?
5-HT
Which Extrapyramidal Motor Tract is used by the cerebellum?
Rubrospinal
How many Neurons make up the DIC?
3
Per lecture, what can we use to stimulate the DIC?
Electrodes to stimulate the DIC, which leads to dull pain
Main NTM’s for Slow Pain?
Substance P, CGRP, Glutamate [slow]
Another name for Lateral Spinothalamic Pain Sensory Tract?
Neospinothalamic Tract
What type of neurons are used for slow pain?
Non-Myelinated C Fibers
Another name for Anterior Spinothalamic Pain Sensory Tract?
Paleospinothalamic Tract
4 Parts of the Extrapyramidal Motor Tract
VestibuloSpinal
Olivospinal
Reticulospinal
Rubrospinal
Examples of Slow Pain?
Vibrations, Thermoreceptors
7 Things that Cause A Nociceptor to Depolarize
*ACh
*Damage
*Acid [H+] or K+
*Histamine
*Prostaglandins
*Bradykinin
*5-HT
What is the Descending Inhibitory Complex [DIC]
The descending pain suppression pathway
Extrapyramidal Motor Tract: Reticulospinal
Maintenance of muscle tone at rest
How do TCA’s help with Chronic Pain?
SE include drowsy, so can help a chronic pain pt sleep
