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AP1 Neuro & Spinal pathway 24 > Lecture 2 Test 3 > Flashcards

Lecture 2 Test 3 Flashcards

1
Q

2 types of pain anterolateral system (ascending) tracts

A

Lateral spinothalamic tract
Anterior spinothalamic tract

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2
Q

Extrapyramidal tracts (descending motor) ex.

A

Vestibulospinal tract; eye fixation, balance
Olivospinal tract; movement coordination
Reticulospinal tract; muscle tone
Rubrospinal tract; monitoring, adjusting voluntary movements

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3
Q

Main motor output pathway

A

Pyramidal tracts

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4
Q

What is the body’s Inhibitory pain system; helps the body deal with pain

A

Descending pain suppression system

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5
Q

Where do incoming sensory information go into?

A

Dorsal roots, dorsal horn

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6
Q

Name for ascending pain pathway

A

Anterolateral spinothalamic pathway

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7
Q

Does pain sensory get crossed over at the spinal cord right away?

A

Yes, before it ascends to the brain

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8
Q

What info travels through the DCML pathway?

A

Pressure sensor information (what we’re holding, what surface we’re in contact with)

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9
Q

Explain the descending primary pathway sequence

A

Cortex > internal capsule > Ventrobasal complex > X-over Medulla decussation > lateral corticospinal tracts > anterior horn > Anterior roots > spine nerve > motor response

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10
Q

How many % of our somatic motor sensations/functions go through the primary pathway?

A

80% and x-over is at the medulla

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11
Q

How many % of our somatic motor sensations/functions go through the anterior corticospinal tract??

A

17% and x-over is at the level of the cord

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12
Q

How many % of sensory that doesn’t cross over any?

A

3% of motor function

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13
Q

Fast pain is transmitted through what type of fibers?

A

Myelinated A(d) neuron fibers (nociceptors / free nerve ending)

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14
Q

Fast pain gets transmitted through the …..

A

Lateral neospinothalamic tract

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15
Q

What neurotransmitter is used for fast pain?

A

Glutamate (binds quick, released quick)

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16
Q

What part of the brain gets the fast pain?

A

Parietal lobe

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17
Q

What is DCML?

A

(Dorsal column medial lemniscus ) pathway

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18
Q

what part of the parietal lobe (post central gyrus) takes care of the lower extremity

A

Top

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19
Q

what part of the parietal lobe (post central gyrus) takes care of the face

A

bottom

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20
Q

what part of the parietal lobe (post central gyrus) takes care of the upper extremity

A

Mid bottom

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21
Q

what part of the parietal lobe (post central gyrus) takes care of the trunk

A

Mid top

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22
Q

Is fast pain easy to localize?

A

Yes

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23
Q

Is slow pain easy to localize?

A

No

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24
Q

Where does the cross over occur for the pain pathway?

A

AWC (anterior white commissure) same level where the information comes in

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25
Q

Other name for fast pain pathway

A

Neospinothalamic tract (Neo= new)

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26
Q

Name for Slow pain pathway

A

Paleospinothalamic pathway (paleo = old)

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27
Q

Which lamina takes care of fast pain?

A

Lamina I

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28
Q

Which lamina takes care of slow pain?

A

Lamine II & III and V

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29
Q

What type of fibers transmit slow pain?

A

non myelinated C fibers

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30
Q

Neurotransmitter for slow pain?

A

Substance P, Glutamate, CGRP (calcitonin gene related peptide)

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31
Q

Where in the brain does slow pain travel to?

A

Top of the brainstem no more higher than the thalamus.

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32
Q

What other sensors do slow pain get associated with?

A

Temperature sensors, vibration sensors

33
Q

Where does slow pain crossover?

A

AWC at the level of the cord

34
Q

What tract/pathway does slow pain use?

A

Anterior paleospinothalamic tract

35
Q

What does the somatosensory area do for fast pain signal?

A

Helps localize where the pain originated.

36
Q

What else do slow pain affect?

A

Emotional centers

37
Q

Where do most slow pain signals terminate?

A

RETICULAR FORMATION (brain stem)

38
Q

1st order descending neuron for Descending Inhibitory Complex (DIC)

A

Pariaqueductal gray or Periventricular nucleus (anterior 3rd ventricle)

39
Q

1st order descending neuron releases what in the middle of the pons?

A

Enkephalins (excitatory)

40
Q

Where is the 2nd order descending neuron for DIC located?

A

middle of the pons (Raphe Magnus Nucleus) Serotonergic neuron (5-HT)

41
Q

Where is serotonin released by the 5-HT?

A

in the spinal cord, dorsal horn. Enkephalin (inhibitory) neuron (3rd order DIC)

42
Q

Enkephalin receptor aka

A

opiate receptor

43
Q

What is enkephalin?

A

Inhibitory neurotransmitter in the cord; Morphine analog (shut down pain transmission signals)

44
Q

slow pain pathway process

A

Slow Pain sensor > Nociceptor (C fiber) > spinal nerve > dorsal root ganglion > dorsal roots > dorsal rootlets > synapse lamina II, III, V > x-over AWC > ascend anterior paleospinothalamic tract > terminate at brainstem

45
Q

Fast pain pathway process

A

Fast Pain > Nociceptor (A(d) fibers)> spinal nerve > dorsal root > dorsal rootlets > dorsal horn > synapse > lamina I > x-over AWC > ascend lateral neospinothalamic tract > brain stem > ventrobasal complex > internal capsule > parietal lobe

46
Q

Descending pain suppression system (DIC) process

A

Periventricular nuclei > (1st order descending neuron) excitatory Enkephalin neuron 1 released in the Pons > Raphe Magnus Nucleus (RMN) > (2nd order descending neuron) Serotonergic neuron > release serotonin > (3rd order descending neuron) release Enkephalin Inhibitory neuron 2 > Pain is either shut down in (presynaptic neuron) or shuts down the post synaptic neuron of the ascending pathway.

47
Q

Examples of Pain origins

A

lactic acid build up, excess k+, Histamine, serotonin in the periphery, Ach, PGs augment pain, bradykinin

48
Q

How does SSRI (Paxil, Prozac, Tricyclic) help with pain?

A

Helps manage chronic pain by stopping the Reuptake of serotonin and augment the 3rd order inhibitory effect.

49
Q

Some side effects from older drugs like tricyclic (TCA) can be useful.

A

Drowsiness for sleep, people with chronic pain has a hard time sleeping.

50
Q

What happens when neurons for pain and pressure are next to each other at the dorsal horn?

A

One shuts off the other (lateral inhibition)

51
Q

acupuncture works through…..

A

lateral inhibition

52
Q

Is glutamate inhibitory or excitatory?

A

Excitatory

53
Q

What can block NDMA-R (pain receptor)

A

ETOH, Lead, Ketamine (dissociative), NO, tramadol

54
Q

AMPA-R (glutamate pain receptor) process

A

(1st order pain sensor neuron) > glutamate in vesicle next to membrane > AP causes Ca++ influx > release glutamate into synapse > bind to AMPA-R of 2nd neuron > Na+ influx > Action potential > send info up the brain.

55
Q

NDMA-R (glutamate pain receptor) process

A

(1st order pain sensor neuron) > glutamate in vesicle next to membrane > AP causes Ca++ influx > release glutamate into synapse > bind to glutamate NMDA-R (2nd receptor; slower; occurs AFTER AMPA-R) > Ca++ influx > Mg+ efflux after depolarization caused by AMPA-R

56
Q

Chronic pain has more of what type of pain receptors?

A

AMPA- R and NMDA-R

57
Q

What are the Ionotropic glutamate pain receptors

A

AMPA-R
NMDA-R
Kanate-R (mediates GABA activity in the brain)

58
Q

Categories of glutamate pain receptors

A

Ionotropic and metabotropic (GCPR)

59
Q

Neurotransmitter for Fast pain

A

Glutamate

60
Q

Neurotransmitter for Slow pain

A

Glutamate as well but mainly Substance P and CGRP

61
Q

Is fast pain myelinated or non-myelinated?

A

Myelinated

62
Q

Is slow pain myelinated or non-myelinated?

A

Non-myelinated but may or may not

63
Q

What is lateral inhibition?

A

When pain sensors are inhibited in the cord or the periphery

64
Q

Are ionotropic and metabotropic glutamate receptors inhibitory or excitatory?

A

Excitatory

65
Q

Where are metabotropic glutamate receptors located?

A

In the brain

66
Q

What is the body’s endogenous opiate system?

A

Enkephalins; Endorphins

67
Q

Enkephalin receptors (opiate receptors) are what type of receptors?

A

GCPR

68
Q

Enkephalin receptors and A2 receptors are linked to?

A

Potassium channels

69
Q

What happens to the cell when enkephalin receptors are activated?

A

Potassium channels open and release K+ into the ECF to inhibit the cell (make negative)

70
Q

What happens when A2 agonist is activated at the pre or post synaptic neurons?

A

Potassium channels open and release K+ to inhibit the cell (make negative)

71
Q

Examples of A2 receptor agonist
(slows down CNS)

A

Xylazine (also for A1)
Clonidine (more specific A2)
Precedex (most specific A2)

72
Q

Which A2 agonist is used by drug users and what is the other name for it?

A

Xylazine aka Horse tranq

73
Q

How does volatile anesthetics work in the synapse?

A

Open potassium channels (conductance) to suppress the CNS

74
Q

For our class which way does potassium go?

A

Out of the cell!!!

75
Q

Cox 2 (increase pain sensitivity) and produces PGs due to?

A

Induced by pain

76
Q

Prostaglandins (PGs) produces more of what in the presynaptic and post synaptic neurons?

A

More action potentials

77
Q

What else amps up pain signals in the synapse other than PGs?

A

iNOS

78
Q

Which electrolyte helps with chronic pain?

A

Magnesium but risk for toxicity and cause diarrhea

79
Q

Does increase calcium levels in ECF impact pain?

A

No

AP1 Neuro & Spinal pathway 24 (7 decks)

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