Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y1&2 Medicine Zoe Veary > NEURO 230 Pain > Flashcards

NEURO 230 Pain Flashcards

1
Q

What is pain?

A

Unpleasant sensory and emotional experience associated with potential or actual tissue damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is nociception?

A

Sensory process providing signals that provide pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is congenital insensitivity pain syndrome?

A

mutation in Na+ channels meaning no pain sensation therefore reducing life expectancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is chronic pain?

A

Pain that persists beyond normal healing time 3-6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is hyperalgaesia?

A

increased pain response to a noxious stimuli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is allodynia?

A

Pain response to a non-noxious stimuli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is parasthesia?

A

Pain response in absence of any stimulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are nociceptors and give some examples

A

Free nerve endings with specific receptors on membrane
e.g Thermal: TRPV1 detects temperature and spicy food (capsaicin)
Chemical - inflammation
Mechanical - excessive stretch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What different nociceptive fibres are there?

A

A-delta, C fibres, A beta fibres and Aalpha fibres

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe A-delta fibres?

A

Fast pain fibres - they are unimodal, myeliinated fibres so can only detect one type of pain that is not necessarily distinguishable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe C fibres

A

Slow pain fibres that are unmyelinated but polymodal and can provide further information about the pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe A-beta fibres

A

detect pressure and tactile sensation and have a slow response - enter spinal cord through same pathway as A-delta and can inhibit them by activating inhibitory interneurones

e.g. rubbing an injury lessens pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are A-alpha fibres

A

Myotatic reflex ! fast fibres detecting stretch in the GTO/muscle spindle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the 1st order neurone in pain pathway?

A

Nociceptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the 2nd order neurone in the pain pathway?

A

Spinothalamic tract/ Ascending pathways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the 3rd order neurone in the pain pathway?

A

The projections from the thalamus to the cortex

17
Q

What is the substantia gelatinosa?

A

Region of the dorsal horn where nociceptors synapse with interneurones

18
Q

Describe the pain pathway

A

Stimulus –> nociception –> dorsal horn in spinal cord –> decussation in lateral spinothalamic tract –> ST tract –> thalamus (VPL) –> thalamus –> cortex

19
Q

What is the VPL in the thalamus?

A

ventro-postero-lateral nucleus

20
Q

Where in the cortex do projections from the thalamus go to in the pain pathway?

A

Insula/ Cingulate cortex = unpleasant association with pain

1ry somatosensory cortex = location of painful stimuli

21
Q

What are the 3 descending pathways in pain and what is their function?

A

modulate the ascending pathways
peri-aqueductal grey (opioidergic)
Nucleus raphe magnus ( serotinergic)
Locus coeruleus ( noradrenergic)

22
Q

At the level of the spinal cord how is their descending modulation/downregulation?

A

Inhibitory interneurones contain enkephalins - they synapse in the spinal cord to both 1st and 2nd order neurones. Act on opioid receptors unhibiting NT release and hyperpolarising the post synaptic membrane

This is activated by descending pathways

23
Q

What are the main opioid receptors?

A

Mu - addictive

Delta and Kappa

24
Q

What are the types of opioids?

A

Endorphins (agonist to all groups of receptor)
Enkephalins - delta agonists
Dynorphins - kappa agonists

25
Q

How does inflammation cause pain?

A

Inflammation sensitises nociceptors by PG’s, substance P and bradykinin
self-perpetuating as nociceptors also release substance P

26
Q

How do opiates act?

A

upregulate descending pathways, direct inhibition and blunt emotional responses

27
Q

What is neuropathic pain?

A

due to neuronal damage = nociceptive stimulation

28
Q

What is trigeminal neuralgia?

A

Usually due to compression of the trigeminal nerve causing intense episodic pain on stimulation
treated with anticonvulsants

29
Q

What is phantom limb pain?

A

Perception of pain in a limb that is no longer there

30
Q

What is the physiology behind phantom limb pain?

A

massive loss of nociceptors but the remaining pain perception pathways are there - input may be sensitised.
There is reorganisation within the dorsal horn and somatosensory cortex so that pain fibres are activated by crude touch byt the somatosensory cortex confuses it with being in the region lost

31
Q

What is the 1st step on the WHO pain ladder?

A

non-opioid +/- adjuvant

32
Q

What is the 2nd step on the WHO pain ladder?

A

weak-opioid + non- opioid +/- adjuvants

33
Q

What is the 3rd step on the WHO pain ladder?

A

strong -opioid + non opioid +/i adjuvants

34
Q

What pain adjuvant therapies are there?

A

bisphosphonates, steroids, muscle relaxants and ADM’s

Y1&2 Medicine Zoe Veary (60 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions