Lecture 17: Acute Pain

Question 1

What are the two type of things influencing pain?

Answer 1

1. fixed factors (e.g., age, sex, genetics)

2. modifiable factors (e.g., context, prior life stressors, obesity, anxiety)

Question 2

What are the principles of the gate theory of pain?

Answer 2

There is a feedback loop in spinal cord determining which stimuli reach the brain. Chronic stress opens gate. Adrenalin closes gate.

Question 3

What are the differences between the two major pain nerves?

Answer 3

Adelta fibres: some myelin, faster - sharp pain

C fibres: no myelin, slower - dull pain

Question 4

What are the ascending pain pathways?

Answer 4

i. primary somatosesory cortex - identifies pain locaiton
ii. anterior cingulate - emotional aspects
iii. insular - modulates physical pain response

Question 5

What are the descending pain pathways?

Answer 5

i. amygdala and hypothalamus - modifies pain by activating periqueductal gray which uses endorphins

Question 6

What are four drug treatment options for pain?

Answer 6

1. opiates - block release of substance P in periaqueductal gray
2. panadol/tylenol - mechnism unknown
3. placebo - reduce emotional aspects aCC, increased endorphin release
4. acupuncture - release endogenous opioids

Question 7

how does hypnosis effect pain response?

Answer 7

Alters activity in ACC, amygdala, thalamus, insula, somatosensory cortex