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NB > NB10 > Flashcards

NB10 Flashcards

1
Q

What is the name for pain receptors

A

Nociceptors

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2
Q

What are the chemical stimuli released from damaged cells

A

Bradykinins
Prostaglandins
H+
ATP

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3
Q

What are the chemical stimuli released from platelets

A

Serotonin

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4
Q

What are the chemical stimuli released from immune cells

A

Cytokines

Chemokines

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5
Q

Cold receptor

A

TRP A1
TRP M8
trp - Transient Receptor Potential

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6
Q

Heat receptor

A

TRP V1

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7
Q

Protons receptor

A

ASIC

acid-sensing ion channel

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8
Q

Bradykinin receptor

A

B1/B2

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9
Q

Mechanical receptor

A

DRASIC/mDEG
dorsal root acid-sensing ion channel
mammalian degenerin

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10
Q

What type of fibres are there

A
  1. Aδ fibres

2. C fibres

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11
Q

What are Aδ fibres

A
  • Produces sharp, localised, immediate pain
  • Relay info via thalamus to cortex and trigger immediate withdrawal and allow localisation of pain
  • Small, myelinated fibres
  • Speed of conduction: 12-30m/s
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12
Q

What are C fibres

A
  • Produces dull, diffuse pain
  • Relay info to the limbic system and hypothalamus (triggering memory of stimulus and emotional response)
  • Small, unmyelinated fibres
  • Speed of conduction: 0.5-2m/s
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13
Q

Pain pathways

A
  1. Primary pain afferent to spinal cord
  2. Spinothalamic tract to thalamus
  3. Thalamus to sensory cortex

*pain from face (cranial nerve) bypasses the spinal cord

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14
Q

Nociceptive fibres in spinal cord dorsal horn

A
  1. On entering spinal cord, Aδ and C fibres ascend in tract of Lissauer
  2. They synapse with 2nd order neurones in superfiila layers of dorsal horn:
    - Aδ = layers I and V (limited in II)
    - C = layers II (substantia gelatinosa)
  3. Decussation of ascending 2nd order neurones carrying pain or temperature info occurs immediately
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15
Q

Neurotransmitters involved in pain

afferent terminal of primary sensory neurone to dorsal horn neurone in spinal cord

A

Glutamate - NMDA, AMPA

Substance P - NK1

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16
Q

Inhibitors of pain receptor

A

GABA
Opiods
eCBs (endocannabinoids)
-inhibitory neurons in substanstia gelatonisa (layer II)

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17
Q

Where is endogenous opiods released

A

At sites associated with modulation of pain and act on opioid receptors

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18
Q

How are opioid receptors classified

A
  1. μ (heat)
    - β-Endorphin and Leu-Enkephalins
  2. δ (mechanical)
    - Leu and Met-Enkephalins
  3. κ (visceral)
    - Dynorphin
19
Q

Example of eCBs (endocannabinoids)

A

Anandamide

2-arachidonylglycerol

20
Q

What are eCBs (endocannabinoids) derived from

A

arachidonic acid derivatives

21
Q

How does eCBs (endocannabinoids) mediate their effects

A

Anagelsic effect mediated via activation of cannabinoid receptors:
CB1 - brain, spinal cord, dorsal root ganglion neurons
CB2 - immune cells
-reduce NT release
-reduce Ca2+ in presynaptic terminal

22
Q

What are the responses to painful stimuli

A
  1. Concious perception of pain
  2. Spinal withdrawal reflex
  3. ANS changes
  4. Emotional response
23
Q

What happens when reticular formation is activated by pain fibres

A

Increase alertness

raphe nuclei - increase serotonin production

24
Q

What happens when pain receptors activates thalamus

A

Perception of pain

25
Q

What happens when pain receptors which activate thalamus and reticular formation activates the hypothalamus and limbic system

A

Behavioral and emotional responses to pain

26
Q

What happens when activated thalamus (by pain fibres) activate somatosensory cortex

A

Localisation of pain

27
Q

What is visceral pain

A

Poorly localised

  • felt in areas removed from site of stimulus
  • referred to somatic structures
  • due to convergence of visceral and somatic afferents on dorsal horn neurones and the brain interprets the signals as coming from somatic structure
28
Q

Where does pain from heart referred to

A

Left arm

29
Q

Where does pain from liver and gallbladder referred to

A

Right neck and shoulder
Right below the right breast

*note: both anterior and posterior

30
Q

Where does pain from lung and diaphragm referred to

A

Left neck and shoulder

31
Q

Where does pain from ureter referred to

A

Anterior groin area

32
Q

Where does pain from colon referred to

A

Anterior suprapubic region

33
Q

Where does pain from urinary bladder referred to

A

Anterior pubic region

Midline of butt

34
Q

Where does pain from stomach referred to

A

Epigastric region

Midline of the back

35
Q

What is gate theory

A

modulation of pain perception in dorsal horn of spinal cord

Somatic non-painful signals can inhibit transmission of pain signals in the spinal cord (analgesia)

  • large diameters Aα and Aβ fibres carrying touch, pressure, vibration, temperature
  • stimulate inhibitory interneurons in the substantia gelatinosa
  • inhibit transmission of pain at the synapse between 1st and 2nd order neurons
  • GABA and endogenous opioids are released
36
Q

Descending/Analgesic pathway

A
  1. Neurons from PAG (periaqueductal gray matter) activate reticular formation and stimulate the release of endogenous opioids
  2. Binds to opiate receptor
  3. Inhibits release of substance P from afferent pain fibres
  4. Transmission of pain impulsese to brain blocked
  5. No perception of pain at thalamus

PAG - has enkephalin-producing cells which binds to opioid receptors

37
Q

Neurotransmitter involved in descending control

A

Serotonin

Noradrenaline

38
Q

Origin of descending modulating pathways

A
  1. Peri-ventricular and peri-aqueductal grey matter in midbrain
  2. Rostroventral medulla including raphe nuclei
39
Q

Paresthesia

A

Pins and needles

40
Q

Dysesthesia

A

Burning sensation

41
Q

Hyperalgesia

A

Lower pain threshold or exaggerated pain response to noxious stimulus

42
Q

Allodynia

A

Pain in response to a non-noxious stimulus

43
Q

Deafferentation pain

A

Peripheral nerve lesions such as phantom limb pain

44
Q

Psychogenic pain

A

Occuring with or without an organic cause or disproportionate to the organic cause

NB (4 decks)

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