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M3.1 Flashcards

1
Q
  • are NOT DISEASES but are symptoms of a certain pathologic states
  • are body’s response toward a physiologic event and may not always be pathologic
  • may lead to discomfort and creates an impact on patient’s health, mental, emotional, psychological, etc.
A

PAIN and INFLAMMATION

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2
Q
  • an UNPLEASANT SENSORY and emotional experience associated with actual or potential tissue damage, or described in terms of such damage
A

PAIN

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3
Q
  • an escessive NOXIOUS STIMULUS giving rise to intense and unpleasant sensation
  • pain of recent onset and porbable LIMITED DURATION
  • it is usually has an identifiable temporal and causal relationship to injury or disease
A

ACUTE pain

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4
Q
  • are associated with ABERRATIONS of the normal physiological pathway, giing rise to hyperalgesia, allodynia, or spontaneous spasm of pain with no precipitating stimulus
  • pain that commonly persists BEYOND THE TIME OF HEALING of an injury and frequently there may not be any clearly identifiable cause
  • impacts on emotional health
A

CHRONIC PAIN

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5
Q
  • SEVERE chronic pain produced by NEUROLOGICAL disease affecting the SENSORY pathway
  • the pathway itself ang may problema
A

NEUROPATHIC PAIN

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6
Q

QUALITY OF PAIN

signals tissue injury via an INTACT NERVOUS SYSTEM

A

NOCICEPTIVE PAIN

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7
Q

QUALITY OF PAIN

NOCICEPTIVE PAIN:
* easy to identify
* muscles, bones
* localized, aching, throbbing

A

SOMATIC PAIN

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8
Q

QUALITY OF PAIN

NOCICEPTIVE PAIN:
* hard to identify
* internal organs
* vague, diffuse, crampy

A

VISCERAL PAIN

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9
Q

QUALITY OF PAIN

  • signals injury to the NERVOUS PATHWAY ITSELF
  • common complication in DIABETES
  • burning, shooting, pins & needles, lancinating
A

NEUROPATHIC PAIN

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10
Q

QUALITY OF PAIN

  • PROPORTIONATE tot he stimulation of the nociceptor
  • pathologic when chronic
  • when acute
    * physiologic pain
    * serves a protective function
    * normal pain
  • pain in arthritis, chest pain in angina
A

NOCICEPTIVE PAIN

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11
Q

QUALITY OF PAIN

  • DIPROPORTIONATE to the stimulation of nociceptor
  • sustained by ABERRANT processes in PNS or CNS
  • serves NO protective function
  • pathologic pain
  • neuralgia, myalgia, cancer pain, neuropathies
A

NEUROPATHIC PAIN

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12
Q

GENERAL PAIN PATHWAY

brain does NOT have ____

A

nociceptors

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13
Q

GENERAL PAIN PATHWAY

STIMULATION OF PAIN RECEPTORS (NOCICEPTORS):
pain begins with the ____

A

activation of nociceptors

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14
Q

specialized receptors that detect HARMFUL STIMULI such as extreme temperatures, mechanical pressure, or chemical irritants

A

NOCICEPTORS

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14
Q

GENERAL PAIN PATHWAY

  • the pain signal is transmitted via ____ from the NOCICEPTOR to the DORSAL HORN of the spinal cord
  • this is the ENTRY POINT for sensory information in the CNS
A

1ST ORDER NEURON

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15
Q

GENERAL PAIN PATHWAY

1ST order neuron

A

Peripheral nerve (nociceptor) to Dorsal horn

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16
Q

GENERAL PAIN PATHWAY

  • the signal then crosses to the OPPOSITE SIDE of the spinal cord and ascends via the SPINOTHALAMIC TRACT to the thalamus
A

2nd order

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17
Q

GENERAL PAIN PATHWAY

2nd order neuron

A

Dorsal horn to Thalamus via Spinothalamic tract

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18
Q

a major RELAY CENTER in the brain

A

thalamus

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19
Q

GENERAL PAIN PATHWAY

in 2nd order neuron, the signal ascends to the thalamus via ____

A

spinothalamic tract

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20
Q

GENERAL PAIN PATHWAY

  • the signal is then sent to the CEREBRAL CORTEX, specifically the SOMATOSENSORY CORTEX, where the brain interprets the pain’s LOCATION, INTENSITY, and QUALITY
A

3rd order neuron

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21
Q

GENERAL PAIN PATHWAY

3rd order neuron

A

Thalamus to Cerebral cortex

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22
Q

GENERAL PAIN PATHWAY

where the brain interprets the pain’s location, intensity, and quality

A

SOMATOSENSORY CORTEX

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23
Q
  • thinly
  • FAST
  • SHARP, localized, IMMEDIATE pain
  • provides QUICK AWARENESS; triggers reflex actions
  • NEOSPINOTHALAMIC tract (direct, fast pathway)
  • a sudden CUT or BURN
A

MYELINATED FIBERS
(Aδ fibers)

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24
Q

MYELINATED FIBERS

conduction speed

A

FAST

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25
Q

MYELINATED FIBERS

PAIN type

A

sharp
localized
immediate

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26
Q

MYELINATED FIBERS

FUNCTION

A

provides quick awareness
triggers reflex actions

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27
Q

MYELINATED FIBERS

PATHWAY

A

Neospinothalamic tract
(direct, fast pathway)

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28
Q

MYELINATED FIBERS

example SENSATION

A

sudden cut or burn

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29
Q
  • SLOW
  • DULL, ACHING, BURNING or THROBBING pain
  • signals PROLONGED pain; encourages rest for recovery
  • PALEOSPINOTHALAMIC tract (slower, emotional response pathway)
  • persistent SORENESS or aching pain
A

UNMYELINATED FIBERS
(C fibers)

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30
Q

UNMYELINATED FIBERS

CONDUCTION speed

A

SLOW

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31
Q

UNMYELINATED FIBERS

PAIN type

A

dull
aching
burning
throbbing

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32
Q

UNMYELINATED FIBERS

FUNCTION

A

signals prolonged pain
encourages rest for recovery

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33
Q

UNMYELINATED FIBERS

PATHWAY

A

PALEOSPINOTHALAMIC tract
(slower, emotional response pathway)

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34
Q

UNMYELINATED FIBERS

example SENSATION

A

persistent sorness or aching pain

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35
Q

direct, fast pathway

A

NEOSPINOTHALAMIC TRACT

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36
Q

slower, emotional response pathway

A

PALEOSPINOTHALAMIC tract

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37
Q

is the transmission of painful stimulus from the SENSORY ORGAN to the BRAIN

A

ASCENDING PATHWAY

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38
Q

NEUTRALIZE or DIMINISH the transmission of painful stimulus

perceive the pain LESS

A

DESCENDING INHIBITORY PATHWAYS
(DIP)

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39
Q

PATHWAY

  • carries pain signals from the BODY to the BRAIN
  • transmits pain stimuli for processing and awareness
  • 1st order → 2nd order → 3rd order
  • Glutamate, Substance P
  • ALERTS the brain to potential or actual tissue damage
  • SHARP pain form a cut traveling up the spinothalamic tract
  • increases pain perception
A

ASCENDING PATHWAY

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40
Q

PATHWAY

ASCEDNING PATHWAY:
direction of signal

A

body to brain

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41
Q

PATHWAY

ASCENEDING PATHWAY:
purpose

A

transmits pain stimula for processing and awareness

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42
Q

PATHWAY

ASCEDNING PATHWAY:
key neurons involved

A

123 order neurons

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43
Q

PATHWAY

ASCEDNING PATHWAY:
neurotransmitters

A

Glutamate, Substance P
(excitatory)

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44
Q

PATHWAY

ASCENDING PATHWAY:
function

A

alerts the brain

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45
Q

PATHWAY

ASCEDNING PATHWAY:
effect on pain

A

increases pain perception

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46
Q

PATHWAY

  • carries signals from the BRAIN to the BODY
  • Modulates or inhibit pain signals to control pain perception
  • originates in the brainstem and descends to the dorsal horn
  • Endorphins, Enkephalins, Serotnin, Noradrenaline (inhibitory)
  • Release of endorphins to reduce pain after injury
  • decreases pain perception
A

DESCENDING PATHWAY

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47
Q

PATHWAY

DESCENDING PATHWAY:
direction of signal

A

brain to body

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48
Q

PATHWAY

DESCENDING PATHWAY:
purpose

A

modulate or inhibit pain signals to control pain perception

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49
Q

PATHWAY

DESCENDING PATHWAY:
key neurons involved

A

originates in the brainstem and descends to the dorsal horn

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50
Q

PATHWAY

DESCENDING PATHWAY:
neurotransmitters

A

endorphins
enkephalins
serotonin
noradrenaline

50
Q

PATHWAY

DESCENDING PATHWAY:
function

A

dampens or suppresses excessive pain signals

51
Q

PATHWAY

DESCENDING PATHWAY:
effect on pain

A

decreseas pain perception

52
Q

MODULATORY MECHANISMS OF NOCICEPTIVE PATHWAY

BK, 5-HT, PGs, etc

A

pain promoter

53
Q

MODULATORY MECHANISMS OF NOCICEPTIVE PATHWAY

inhibits NEUROPEPTIDE RELEASE and excitation of transmission of neuron

A

OPIATES

pain reliever

55
Q

MODULATORY MECHANISMS OF NOCICEPTIVE PATHWAY

NITRIC OXIDE formation

A

pain promoter

56
Q

MODULATORY MECHANISMS OF NOCICEPTIVE PATHWAY

  • inhibits DESCENDING inhibitory pathways
  • pain promoter
57
Q

A physiologic DEFENSE MECHANISM (an immune response), and is NOT a disease but a symptom signaling tissue injury

A

INFLAMMATION

58
Q

INFLAMMATORY RESPONSE

CAPILLARY WIDENING:
key event

A

vasodilation

59
Q

INFLAMMATORY RESPONSE

CAPILLARY WIDENING:
effect

A

INCREASED blood flow

60
Q

INFLAMMATORY RESPONSE

CAPILLARY WIDENING:
symptom

61
Q

INFLAMMATORY RESPONSE

INCREASED PERMEABILITY:
key event

A

capillary walls become more porous

62
Q

INFLAMMATORY RESPONSE

INCREASED PERMEABILITY:
effect

A

fluid leaks into tissues

63
Q

INFLAMMATORY RESPONSE

INCREASED PERMEABILITY:
symptom

A

REDNESS
rubor

64
Q

INFLAMMATORY RESPONSE

LEUKOCYTE ATTRACTION:
key event

A

immune cells are recruited

65
Q

INFLAMMATORY RESPONSE

LEUKOCYTE ATTRACTION:
effect

A

immune response at the injury site

66
Q

INFLAMMATORY RESPONSE

LEUKOCYTE ATTRACTION:
symptom

A

SWELLING
tumor

67
Q

INFLAMMATORY RESPONSE

EXTRAVASATION:
key event

A

leukocytes exit blood vessels to attack pathogens

68
Q

INFLAMMATORY RESPONSE

EXTRAVASATION:
effect

A

direct immune response at injury

69
Q

INFLAMMATORY RESPONSE

EXTRAVASATION:
symptom

A

Tenderness

70
Q

INFLAMMATORY RESPONSE

SYSTEMIC RESPONSE:
key event

A

fever and immune cell porliferation

71
Q

INFLAMMATORY RESPONSE

SYSTEMIC RESPONSE:
effect

A

enhanced immune cell activation

72
Q

INFLAMMATORY RESPONSE

SYSTEMIC RESPONSE:
symptom

73
Q

INFLAMMATORY RESPONSE

loss of function

A

functio laesa

74
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

VASOACTIVE AMINES:
key mediators

A

histamine
serotonin

75
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

VASCOACTIVE AMINES:
source

A

mast cells
platelets

76
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

vasodilation, increased vascular permeability, and itching

A

vasoactive amines

77
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

EICOSANOIDS:
key mediators

A

prostaglandins
leukotrienes

78
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

EICOSANOIDS:
source

A

arachidonic acid
metabolism

79
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

PROSTAGLANDINS cause pain, fever, and vasodilation; LEUKOTRIENES promote bronchoconstriction and inflammation

A

EICOSANOIDS

80
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

CYTOKINES:
key mediators

A

interleukins
TNF-a

81
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

CYTOKINES:
source

A

activated immune cells

82
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

promote fever, pain, and immune cell recruitment

83
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

KININS:
key mediators

A

bradykinin

84
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

KININS:
source

A

plasma proteins

85
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

strong pain inducer, increases vascular permeability

86
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

COMPLEMENT SYSTEM:
key mediators

87
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

COMPLEMENT SYSTEM:
source

88
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

promote chemotaxis, mast cell degranulation, and enhance inflammation

A

COMPLEMENT SYSTEM

89
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

REACTIVE OXYGEN SPECIES:
key mediators

A

Superoxide
Hydrogen peroxide

90
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

REACTIVE OXYGEN SPECIES:
source

A

activated neutrophils

91
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

tissue damage, amplifies inflammation

A

REACTIVE OXYGEN SPECIES

92
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

NEUROPEPTIDES:
key mediators

A

Substance P
Calcitonin Gene-related peptide (CGRP)

93
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

NEUROPEPTIDES:
source

A

sensory nerve endings

94
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

enhance pain signaling, vasodilation, and neurogenic inflammation

A

NEUROPEPTIDES

95
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

PLATELET-ACTIVATING FACTOR:
key mediators

96
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

PLATELET-ACTIVATING FACTOR:
soource

A

various immune cells

97
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

promotes platelet aggregation, vasodilation, bronchoconstriction

A

PLATELET-ACTIVATING FACTOR

98
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

____ and ____ are crucial in EARLY INFLAMMATION, causing swelling and pain

A

Histamine & Bradykinin

99
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

____ amplify pain signals and induce fever

A

Prostaglandins

100
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

____ like IL-1 and TNF-a play a central role in SYSTEMIC INFLAMMATION

101
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

____ DIRECTLY stimulates pain pathways

A

Substance P

102
Q

CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION

____ enhance immune cell RECRUITMENT and ATTACK PATHOGENS

A

COMPLEMENT PROTEINS

103
Q

ARACHIDONIC ACID METABOLISM

inhibits PHOSPHOLIPASE

A

Corticosteroids

104
Q

ARACHIDONIC ACID METABOLISM

PHOSPHOLIPASE will turn into

A

arachidonic acid

105
Q

ARACHIDONIC ACID METABOLISM

products of ARACHIDONIC ACID

A

Lipoxygenase
Cyclo-oxygenase

106
Q

ARACHIDONIC ACID METABOLISM

produces LTA4 (leukotriene)

A

LIPOXYGENASE

107
Q

ARACHIDONIC ACID METABOLISM

produces PROSTAGLANDINS (PGH2)

A

CYCLO-OXYGENASE

108
Q

ARACHIDONIC ACID METABOLISM

GOOD COX

109
Q

ARACHIDONIC ACID METABOLISM

CORTICOSTEROIDS

A

NSAID
Celecoxib
Rofecoxib

110
Q

ARACHIDONIC ACID METABOLISM

inhibits COX1&2

111
Q

ARACHIDONIC ACID METABOLISM

inhibits COX2 only

A

Celecoxib
Rofecoxib

112
Q

ARACHIDONIC ACID METABOLISM

LTB4

A

chemotaxis
hyperalgesia

113
Q

ARACHIDONIC ACID METABOLISM

LTC4, LTD4, LTE4

A

bronchoconstriction
edema

114
Q

ARACHIDONIC ACID METABOLISM

inhibits LTC4, LTD4, LTE4

A

Zafirlukast
Montelukast

effective for ASTHMA

116
Q

ARACHIDONIC ACID METABOLISM

inhibits LIPOXYGENASE

117
Q

ARACHIDONIC ACID METABOLISM

PGF2a

A

uterine contraction

118
Q

ARACHIDONIC ACID METABOLISM

PGE2

A

vasodilation
gastric cytoprotection

119
Q

ARACHIDONIC ACID METABOLISM

TXA2
(thromboxane)

A

platelet aggregation

120
Q

ARACHIDONIC ACID METABOLISM

PGI2
(prostacyclin)

A

inhibits platelet aggregation
vasodilation
gastric cytoprotection

121
Q

ARACHIDONIC ACID METABOLISM

inhibits THROMBOXANE (TXA2)

A

Dazoxiben

lead to BLEEDING

122
Q

ARACHIDONIC ACID METABOLISM

COX that can produce prostanoids with cytoprotection

PCOL (10 decks)

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