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Y2 > MSK - PAIN PHYSIOLOGY > Flashcards

MSK - PAIN PHYSIOLOGY Flashcards

1
Q

what is pain?

A

an unpleasant sensory and emotional experience assoc with actual tissue damage or described in terms of damage

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2
Q

processes involved in pain

A

transduction
transmission
modulation
perception

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3
Q

transduction

A

translation of noxious stimulus into electrical activity at the peripheral nociceptor

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4
Q

transmission

A

propagation of pain signal as nerve impulses through the nervous system

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5
Q

modulation

A

modification/hindering of pain transmission in the NS eg by inhibitory neurotransmitters like endogenous steroids

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6
Q

perception

A

conscious experience of pain

causes physiological and behavioural responses

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7
Q

what begins pain?

A

activation of nociceptors

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8
Q

what are nociceptors?

A

specific primary afferent neurones normally activated by intense noxious stimuli eg thermal, mechanical or chemical

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9
Q

how do nociceptors relay information to second order neurones?

A

chemical synaptic transmission

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10
Q

what are the neurotransmitters?

A

glutamate and peptides eg substance P and neurokinin A

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11
Q

how do second order neurones ascend the spinal cord?

A

the anterolateral system terminating in the thalamus

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12
Q

which tracts are involved?

A

spinothalamic tract

spinoreticular tract

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13
Q

what happens in the spinothalamic tract?

A

pain perception - location and intensity

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14
Q

what happens in the spinoreticular tract?

A

autonomic responses to pain, arousal, emotional responses, fear of pain

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15
Q

where does the sensory information go after the thalamus?

A

it is relayed by third order neurones to the primary sensory cortex

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16
Q

what are the types of nociceptors?

A

Adelta fibres

C fibres

17
Q

both types of nociceptors are myelinated. true/false

A

false

only adelta fibres are (thinly myelinated)

18
Q

what do adelta fibres mediate?

A

first or fast pain eg lancinating, stabbing, pricking sensations

19
Q

what do c fibres mediate?

A

second or slow pain eg burning, throbbing, aching sensations

20
Q

what are the classifications of mechanisms of pain?

A

nociceptive
inflammatory
pathological

21
Q

what is nociceptive pain and when is it provoked?

A

normal response to injury of tissues by damaging stimuli

only provoked by intense stimulation

22
Q

what is special about nociceptive and inflammatory pain?

A

adaptive
n- healing -> pain goes away)
I - promotes repair until healing occurs

23
Q

what causes inflammatory pain?

A

activation of the immune system by tissue injury or infection

24
Q

what activates the pain in inflammatory?

A

mediators released at the site of inflammation by leucocytes, vascular endothelium and tissue resident mast cells

25
Q

what is hyperalgesia (caused by inflammatory pain)?

A

heightened pain sensitivity to noxious stimuli

26
Q

what is allodynia (caused by inflammatory pain)?

A

pain sensitivity to innocuous stimuli

27
Q

when is pain pathological?

A

when simple analgesics are no longer effective

28
Q

what is pathological pain treated with?

A

antidepressants and anti epileptics

29
Q

what are the two types of pathological pain?

A

dysfunctional and neuropathic

30
Q

what is dysfunctional pain?

A

when there is no identifiable damage or inflammation

31
Q

what is neuropathic pain?

A

caused by damage to neural tissue

32
Q

how is neuropathic pain usually perceived?

A

burning, shooting, numbness, pins and needles

less localised

33
Q

what are the 3 time courses of pain?

A

acute
chronic
breakthrough (all of a sudden on top of chronic pain eg cancer)

34
Q

how to describe the severity of pain?

A

mild
moderate
severe

35
Q

what are the 2 sources of origin of pain?

A

somatic

visceral

36
Q

what is referred pain?

A

deep or visceral pain developed in one part of the body felt in another structure away from its place of development

37
Q

what causes referred pain?

A

convergence of nociceptive visceral and skin afferents upon the same spinothalamic neurones at the same spinal level

Y2 (8 decks)

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