LECTURE 5- sensory receptors , pain science

Question 1

How many neurons pathways are there to the somatosensory cortex

Answer 1

3

Question 2

what is the 1st order neuron

Answer 2

info from the sensory receptors to SC or BS

Question 3

what is the 2nd order neuron

Answer 3

info betweeen SC or brain stem to thalamus

Question 4

what is the 3rd order neuron

Answer 4

info from the thalamus to cerebral cortex

Question 5

what is a receptor

Answer 5

converts stimulate energy into AP

Question 6

what determines the type of receptors that are activated and pattern of signal transmission

Answer 6

stimulus

Question 7

what is somatic senses

Answer 7

tactile, thermal pain , proprioception

Question 8

what is visceral senses

Answer 8

conditions within internal organs

Question 9

what are specialized senses

Answer 9

smell, taste, vision, hearing , balance and equilibrium

Question 10

where are exteroceptor and what do they detect

Answer 10

at or near the body surface and detect external stimuli

Question 11

where are interoceptors and what do they react to

Answer 11

deep and react to stimuli coming form internal body. organs (BH, blood pH)

Question 12

examples of chemoreceptors

Answer 12

smell and taste

Question 13

example of mechanoreceptors

Answer 13

touch
pressure
stretch
vitbratoin

Question 14

what does each type of receptor have that are sensitive to stimuli that either damage or have potential to damage tissue

Answer 14

nociceptors

Question 15

what are nociceptors

Answer 15

register pain

Question 16

where are proprioceptors found

Answer 16

muscles , tendons , ligaments

Question 17

what does tonic receptors detect and how do they adapt and how do they respond

Answer 17

detect object pressure and form
slow adapting
respond continuously as long as stimulus is present

Question 18

what does phasic receptors adapt to , how do they adapt and what do they detect

Answer 18

adapte to continuous stimulus and then stop responding even if stimulus is present
fast adapting
detect motion, vibration , rate of change

Question 19

what is the order of the peripheral sensory axons / afferents of decreasing diameter

Answer 19

la, lb, ll, lll, lV

Question 20

where is there greater density of receptors

Answer 20

in distal body regions

Question 21

what is considered to be superficial cutaneous receptors

Answer 21

meisners corpuscles (light touch , vibration)
merkel’s disk (pressure

Question 22

what is in the subcutaneous cutaneous receptors

Answer 22

pacinian courpuscle
ruffinis ending

Question 23

what are the 3 components of the sensory system

Answer 23

stimulus , receptors, conduction

Question 24

what are the 4 attributes to condution

Answer 24

modality , location , intensity, duration

Question 25

where are the 3 levels in the somatosensory system where signal processing for integration occur

Answer 25

receptor level circuit level perceptual leve

Question 26

what is the speed of information processing determined by

Answer 26

axon diameter amount of axon myelination # of synapses in pathway

Question 27

what is released when the AP goes above threshold

Answer 27

neurotransmitters

Question 28

what circuit level processing is when synapses can spread action potentials to several areas of CNS

Answer 28

divergence

Question 29

what is the convergence circuit level processing

Answer 29

synapses focus action potentials from several sensory neurons onto 1 narrowed area of CNS

Question 30

what is perceptual level processing

Answer 30

sensory nerve tracts carry impulses to respective region of brain

Question 31

What is a dermatome

Answer 31

skin area that is related to 1 spinal level

Question 32

what is distal latency

Answer 32

time form stim to distal recording site

Question 33

what is the pathology of peripheral nerve

Answer 33

neuropathy

Question 34

what does nerve compression impact first and last

Answer 34

first - large myelinated axions and smaller nociceptive thermal and autonomic axons last

Question 35

what can cause sensory ataxia

Answer 35

peripheral sensory nerves , dorsal roots, dorsal columns of SC or medial lemnisci

Question 36

patients with _____ axatia will have similar motor performance eyes open/closed

Answer 36

cerebellar

Question 37

what will be intact with cerebellar ataxia and impaired with sensory ataxia

Answer 37

proprioception/kinesthesia

Question 38

what is a painful skin rash with blisters following a dermatome pattern

Answer 38

shingles/ herpes zoster

Question 39

what is treatment for varicella zoster

Answer 39

antiviral drugs within 72 hours post onset

Question 40

what are free nerve endings that respond to noxious stimuli

Answer 40

nociceptors

Question 41

where are nociceptors located

Answer 41

skin, muscle joints

Question 42

what is the malfunction of neural pain regulating processes causes pain without the presence of tissue injury

Answer 42

non- nociceptive pain

Question 43

what central processing areas are active during perception of pain

Answer 43

cingulate and insular

Question 44

enkephalins , dynorphin , and b- endorphins are examples of what

Answer 44

endorphins

Question 45

what brain regions have opiate receptors that bind with both endorphins and opiates

Answer 45

rostral ventromedial medulla periaquedcutal gray in midbrain locus coeruleus in pons

Question 46

what are the inhibitory neurons in the SC of endogenous opioids

Answer 46

enkephalin and dynorphin

Question 47

what type of fibers are nocicpetive and non- nocicpetive

Answer 47

C and AB

Question 48

what theory is the activation of non- nociceptive sensory neurons close a “gate” for central trasnmission of nociceptive signals

Answer 48

gate control theory

Question 49

what does periphery pain inhibition do

Answer 49

decrease synthesis of prostaglandins

Question 50

what does the dorsal horn release for pain inhibition

Answer 50

enkeohalin or dynorphin

Question 51

what type of pain can MSK injury’s trigger

Answer 51

fast and slow pain

Question 52

what is pain that is perceived as coming from site distinctly different from actual OG site

Answer 52

referred pain

Question 53

referred pain is usually referred from _____ tissues to ___

Answer 53

visceral to skin

Question 54

what is primary pain

Answer 54

neural dysfunction that creates pain without evidence of tissue damnage

Question 55

• Fibromyalgia • Complex regional pain syndrome • Chronic nonspecific low back pain migraine HA’s are examples of

Answer 55

primary pain

Question 56

what is secondary pain

Answer 56

initially a symptom of another medical condition

Question 57

what is secondary pain caused by

Answer 57

1. continuous stimulation for ncicopetors from tissue injury 2. continued signaling after tissue has healed 3. damage to somatosensory system

Question 58

where does the central sensitization impact neurons?

Answer 58

through CNS dorsal horn, BS , thalamus , cerebral cortex

Question 59

what causes cellular changes including gene alterations and structural change in central sensitization

Answer 59

glutamate and neuropeptides

Question 60

what is abnormal sensation that is painless with no nociceptors stimulation

Answer 60

parasthesia

Question 61

what type of sensation do u get with parasthesia

Answer 61

tingling

Question 62

what is pain that arises as a direct result of a lesion or disease that affects the somatosensory system

Answer 62

neuropathic pain

Question 63

in neuropathic pain , central sensitization is characterized by

Answer 63

dysesthesias

Question 64

what is dysesthesias

Answer 64

unpleasant sensation that can occur on its own or with stimulation

Question 65

what does dysesthesias feel like

Answer 65

burning shooting or electrical sensation like hitting funny bone

Question 66

what i so ain’t hat is caused by something that normally wouldn’t cause pain

Answer 66

allodynia

Question 67

what are the 4 types of dysesthesias

Answer 67

allodynia hyperalgesia spontaneous pain temporal summation

Question 68

what is primary. hyperalgesia

Answer 68

stimuli that are normally mildly painful in injured tissue are causing excessive sensitivity

Question 69

what is secondary hyperalgesia

Answer 69

pain spreads to uninjured areas close to injury site

Question 70

what is pain unrealted to external stimulus

Answer 70

spontaneous pain

Question 71

what is increased pain due to repeated stimulus or continued prescience of single stimulus

Answer 71

temporal summation

Question 72

what disorder is it when people have tenderness and stiffness of muscle and neighboring tissues and achy pain

Answer 72

fibromyalgia

Question 73

people with FM have sig less gray matter density where

Answer 73

medial frontal cortex, mid cingulate cortex, and insular cortex

Question 74

is complex regional pina syndrome related to peripheral nerve or spinal never root distribution

Answer 74

none of

Question 75

complex regional pain syndrome is regional typically worse in

Answer 75

unilateral distal limb

Question 76

what is complex regional pain syndrome trigggerd by

Answer 76

abnormal response to trauma

Question 77

what is early stage of complex regional pain syndrome

Answer 77

res or pale skin a lot of sweating edema skin atrophy

Question 78

Raised levels of neurochemicals that produce peripheral neurogenic inflammation is the pathology for what

Answer 78

complex regional pain syndrome

Question 79

complex regional pain syndrome is central sensitization with structural and function changes of

Answer 79

• Thalamus • Somatosensory cortex - reduction of hand or foot cortical maps • Cingulate cortex • Hippocampus • Amygdala

Question 80

what are locations that are outside of the nociceptor or soma that trigger action potentials

Answer 80

ectopic foci

Question 81

what is also called cross talk

Answer 81

ephaptic transmission

Question 82

what is lack of insulation due to demyelination allows an action potential in 1 neuron to cause an action potential in another neuron

Answer 82

ephaptic transmissions

Question 83

small fiber neuropathy is seen in ppl with

Answer 83

post herpetic neuralgia diabetic neuropathy guillain barre syndrome

Question 84

what pain is Caused by lesion to CNS, localized to area of body deafferented by the lesion

Answer 84

central pain

Question 85

what is the great wall of fire

Answer 85

burning shooting aching freezing tingling pain

Question 86

what pain is due to absence of sensory inputs causing neurons in central nociceptive pathways to be overly active

Answer 86

phantom limb pain

Question 87

what are the “3 D’s” of chronic pain

Answer 87

distress disuse disability

Question 88

what is the difference from phantom limb sensations and residual limb pain

Answer 88

phantom limb sensation is pain to limb that is not there anymore where as residual limb pain is pain where the amputation occurs

Question 89

where does central pain come form post SC

Answer 89

coming from thalamus

Question 90

where does central pain come form post stroke

Answer 90

thalamus affecting the contralateral body

Question 91

where is the central pain for multiple sclerosis

Answer 91

the body part that is affected by the lesion location