Brainscape's Knowledge GenomeTM

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


See full index

Neurology > Lecture 27 Physiology and Pathophysiology of Pain > Flashcards

Lecture 27 Physiology and Pathophysiology of Pain Flashcards

1
Q

Define pain

A

unpleasant sensory and emotional experience which we primarily associate with tissue damage or describe in terms of such damage or both

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

Define Nociception

A

The detection of tissue damage by specialised transducers connected to A-delta and C fibres

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

What do A-delta and C fibres respond to

A

Thermal, chemical, mechanical and noxious stimuli

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

Describe the myelination of the primary afferents

A

A alpha and A beta- myelinated
A delta- lightly mtelinated
C fibres- not myelinated

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

Describe the diameter of the primary afferent fibres

A

A alpha and A beta- large
A delta- medium
C fibre- small

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

What doe A alpha and A beta respond to

A

Proprioception and light touch

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

What does A delta respond to

A

Nociception (mechanical, thermal, chemical)

Fast pain or sharp pain

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

What does C fibres respond to

A

Innocuous temperature, itch
Nociception (mechanical, thermal, chemical)
Dull second pain after someone pinches you

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

What does the grey matter in the spinal cord represent

A

Neurons

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

What doe the white matter in the spinal cord represent

A

Nerve tract arising from the neurone r descending neurone in the brain

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

What is the grey matter divided into

A

Ventral, lateral and dorsal horn

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

What layer of the grey matter are nociceptive neurons located

A

1 & 2 receiving inout from A delta and C fibres

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

Name Ascending Tracts (sensory)

A

Dorsal columns

Spinothalmic Tract

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

Name Descending Tracts (Motor)

A

Lateral Corticospinal Tract

Ventral Corticospinal Tract

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

Where does the spinothalmic tract lead to

A

Major tract sending impulses to thalamus

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

Where are the cell bodies of the spinothalmic tract located

A

Rexed lamina 1,2&5

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

Where does the spinothalmic tract feed to

A

Somatosensory cortex to facilitate spatial, temporal and intensity discrimination of painful stimulus

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

Name the second relay station in the brain

A

Thalamus

19
Q

What does the thalamus connect with

A

Cortex
Limbic system
Brainstem

20
Q

What is located in the medial part of the pain matrix

A 
Amygdala
Hippocampus
Cigulate cortex
Insula
Prefrontal cortex
21
Q

What is located at the lateral aspect of the pain matrix

A

Somatosensory cortex and Basal ganglia

22
Q

What is usually the function of the descending pathways

A

Decrease pain signal

Noradrenergic system

23
Q

Where does pain modulation happen

A

Each level of pain transission

24
Q

Outcomes of sensitisation

A

Hyperalgesia
Primary hyperalgesia
Primary hyperalgesia
Allodynia

25
Q

Name the types of pain modulation

A
  • Peripheral sensation
  • Central sensitisation
  • Gate control theory
  • Descending control
26
Q

What changes occur in the Nociceptor in Allodynia

A

Decreased threshold for response

27
Q

What changes occur in the Nociceptor in Hyperalgesia

A

Exaggerated response to normal and supernormal stimuli

28
Q

What changes occur in the Nociceptor in Spontaneous pain

A

Spontaneous activity in nerve fibres

29
Q

Describe the resting state in gate Control Theory

A

Firing of C fibre indirectly inhibits the inhibitory neurone and increases the chances the projection neurone will fire

30
Q

Describe the firing stage in the Gate Control Theory

A

Firing of the Aβ fibres activates the inhibitory interneuron, reducing the chances that the projection neuron will fire, even in the presence of a firing nociceptive fibre

31
Q

What is central sensitisation

A 
•	It is the response of second order neurons in the CNS to normal input both noxious & non-noxious
•	3 main components 
o	wind-up
o	classical 
o	long-term potentiation
32
Q

Describe the wind-up process

A

Progressively increases the response of the neurones

Manifests over course of stimuli and terminates with stimuli

33
Q

Describe the Classical process

A
  • Involves opening up of new synapses (silent nociceptors) in dorsal horn
  • Outlast the initial stimuli duration
  • Can be maintained even at low levels of ongoing stimuli
34
Q

What is the clinical result of classical central sensitisation

A

Hyperalgesia

35
Q

Describe long term potentiation

A
  • Involves mainly the activated synapses

* Occurs primarily for very intense stimuli

36
Q

Name types of pain

A

Acute

Chronic

37
Q

Describe the features of acute pain

A 
Physiological
Noxious stimuli
Protective function
Nociceptive
Pain resolves upon healing
Less than 1 month
38
Q

Describe the features of chronic pain

A 
Pathological
Presence of noxious stimuli not essential
No protective function 
Nociceptive, neuropathies or mixed
Pain for 3-6 moths or more
39
Q

What is Nociceptive Pain

A

A sensory experience that occurs when specific peripheral sensory neurones (nociceptors) respond to noxious stimuli (actually or potentially tissue damaging event)

40
Q

What is Neuropathic Pain

A

Pain initiated or caused by a primary lesion or dysfunction in the somato-sensory nervous system

41
Q

How is pain involving transduction treated

A

NSAIDs
Ice
Rest
LA blocks

42
Q

How is pain involving transmission treated

A
  • Nerve blocks
  • Opioids
  • Anticonvulsants
  • Surgery- DREZ, Cordotomy
43
Q

How is pain involving perception treated

A
  • Education
  • Cognitive behavioral therapy
  • Distraction
  • Relaxation
  • Graded motor imagery
  • Mirror box therapy
44
Q

How is pain involving descending modulation treated

A
  • Placebos
  • Opioids
  • Antidepressants
  • Surgery: spinal cord stimulation

Neurology (44 decks)

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