Lecture 5

Question 1

number needed to treat (NNT)

Answer 1

1 divided by (proportion benefitting from experimental intervention) minus (proportion benefitting from a control intervention)

Question 2

what NNT means

Answer 2

if the number needed to treat is 4, I need to treat 4 patients to make one better that wouldnt have gotten better by themselves. the number of patients that will get better because you treted them with that drug is 1 in 4

Question 3

GRADE

Answer 3

Grading of Recommendations, Assesment Development and Evaluation

Question 4

GRADE does what

Answer 4

most eminent doctors in certain feild meet, comb through the evidence that each drug presents, and come up with recommendation of which should be first line, second or third

Question 5

how do the doctors make the decision fro GRADE

Answer 5

based on quality, effect size, tolerability and saftey, preferences, cost and resource allocation, and strength of the recommendation

Question 6

descartes was the first person to

Answer 6

develop the concept of pain pathways

Question 7

stress induced algesia

Answer 7

when the brian doesnt want to know about something and will prevent itself from hearing it- what descending modulation is for

Question 8

PAIN PATHWAY

Answer 8

periphery > DRG > dorsal horn > brain

Question 9

the pain matrix (ascending pathways)

Answer 9

thalamus, somatosensory cortex, limbic cortex and prefrontal cortex

Question 10

the descending pathways go from

Answer 10

the hypothalamus > the midbrain > the brainstem > the spinal cord

Question 11

two types of skin

Answer 11

hairy skin and glabrous

Question 12

free nerve endings

Answer 12

where the nerve just starts to stop - important for pain

Question 13

Free nerve endings are

Answer 13

one end of nociceptors

Question 14

nociceptors

Answer 14

are neurons that are responsive to noxious stimuli and are unipolar

Question 15

dendrites are

Answer 15

free nerve endings in the skin, joints, muscles, and viscera

Question 16

axons are

Answer 16

end of the central processes in the spinal cord

Question 17

cell body is

Answer 17

in the DRG

Question 18

Nociceptors are the __ cells in your body

Answer 18

longest

Question 19

nociceptors are a type of

Answer 19

sensory nerve fibre called an afferent fibre

Question 20

afferent meaning

Answer 20

going up towards the brain

Question 21

muscle control fibres or efferent fibres go from

Answer 21

brain to the muscles

Question 22

four diff types of afferent fibres

Answer 22

A-alpha (proprioception or muscle control)
A-beta (touch and vibration)
A-delta (thermal and pain)
C (pain and sweating)

Question 23

A-alpha fibres

Answer 23

are the biggest, have the largest myelin sheath and conduct the fastest

Question 24

C afferent fibres are

Answer 24

the thinnest, no myelin sheath and conduct the slowest

Question 25

Pain can come in two waves

Answer 25

immediate pain and pain that takes a second to kick in which is low, dull, and longer lasting

Question 26

The A-deltas are responsible for

Answer 26

instantaneous pain as they conduct much faster than Cs and produce sharper pain

Question 27

Cs produce

Answer 27

duller pain

Question 28

four different sections of the spinal cord

Answer 28

cervical, thoracic, lumbar, and sacral

Question 29

cervical has

Answer 29

8 spinal nerves

Question 30

thoracic has

Answer 30

12 spinal nerves

Question 31

lumbar has

Answer 31

5 spinal nerves

Question 32

sacral has

Answer 32

5 spinal nerves

Question 33

dermatones

Answer 33

parts of the body or skin htat a spinal nerve serves

Question 34

dorsal is

Answer 34

the back

Question 35

ventral is

Answer 35

the stomach

Question 36

rostral is

Answer 36

the head

Question 37

caudal is

Answer 37

the tail

Question 38

the ipsilateral side is on the same side as the

Answer 38

noxious stimulus

Question 39

contralateral side is

Answer 39

the opposite of the noxious stimulus

Question 40

the bulbous bone is on the

Answer 40

ventral side

Question 41

the tri-horned bone is on the

Answer 41

dorsal side

Question 42

there are two roots of the spinal nerve

Answer 42

ventral root and dorsal root

Question 43

dorsal root

Answer 43

has a bulge, which is the dorsal ganglion or spinal ganglion

Question 44

a ganglion

Answer 44

collection of cell bodies

Question 45

in the ventral root

Answer 45

are only axons hence no bulge

Question 46

as you move laterally away from the spinal cord

Answer 46

the ventral and dorsal roots merge

Question 47

once the ventral and dorsal root merge its called

Answer 47

spinal nerve

Question 48

spinal nerve

Answer 48

contains motor axons going out and sensory axons coming in

Question 49

the spinal cord has

Answer 49

meninges

Question 50

meninges

Answer 50

the dura matter on the outside, the arachnoid matter in the middle and the pia matter on the inside

Question 51

anterior or ventricle horns are

Answer 51

bigger than posterior or dorsal horns

Question 52

white matter is

Answer 52

axons, nerve fibres either going in or out

Question 53

why is white matter white

Answer 53

because most axons are myelinated

Question 54

grey matter is

Answer 54

the neurons

Question 55

there are big neurons in the ventral horn called

Answer 55

motor neurons

Question 56

the cell bodies of motor neurons will

Answer 56

go out of the ventral root into the mixed spinal nerve and travel down to whatever muscle or plate they're controlling and produce movement

Question 57

the spinal cord is divided into

Answer 57

rexed's laminae or spinal cord laminae

Question 58

there are __ laminae in the dorsal horn and __ on the ventral horn

Answer 58

6, 4

Question 59

outside of laminae 1 is

Answer 59

the dorsolateral fasiculus (fasiculus means fibre tract)

Question 60

dorsolateral fascilus

Answer 60

no cell bodies here

Question 61

laminae 1 and 2 are also called

Answer 61

the substantia gelatinosa (gelatinous substance)

Question 62

the nociceptor or sensory afferent is also known as the

Answer 62

primary afferent because its the first thing to fire

Question 63

the route of the primary afferent

Answer 63

nociceptor sends information to dorsal ganglion > then enter through dorsolateral fasiculus > into spinal cord > they then go to the substantia gelatinosa and do one of two thingsw

Question 64

what are the two things the nociceptors can do once theyve reached the substantia gelatinosa

Answer 64

1. can synapse on second-order neurons, the spinal cord neurons activated by the primary afferent, which then cross the midline and get into white matter and start going up to the brain 2. can also synapse on second-order neurons that never leave the spinal cord. instead they project to the deeper lamina of the spinal cord (five and six) theres then a third order neuron that then corsses sides and goes up to the brain. sometimes, the spinal cord just passes info to the brian and sometimes theres processing inside the spinal cord before the infromation gets sent up