Neurology

Question 1

4 main processes of preception of pain

Answer 1

1. Transduction
   - A stimulus generates impulses in the primary afferent nociceptors.
2. Modulation
   - message is conveyed to thalamus, either directly through the spinothalamic tract itor indirectly via reticular formation and reticulothalamic pathway.
3. Perception
   - message is relayed to cerebral cortex. Pain- moduIation system receives inputs from frontal cortex and hypothalamus, with outflow through the midbrain and medulla to dorsal horn of spinal cord
4. Transmission
   - impulses travel to spinal cord connecting with central pain- transmission cells.

Question 2

Pain

Answer 2

Primal instinct in human and primates
Characterized as a distressing sentation and emotional response
Associated with actual or potential tissue damage
Alert body’s defense mechanism to react and prevent further harm from stimulus.

Question 3

Classification of pain

Answer 3

Acute pain
Stimulation of peripheral nociceptors triggers the release of COX enzymes and prostaglandin.
A few seconds to 6 months
Eg: headache, post-operation, sprains, injuries

Chronic pain
Stimulation occurs at the level of spinal neurons via various mechanisms
More than 6 months
Eg: chronic primary pain, cancer, post-trauma, visceral pain, neuropathic pain, musculoskeletal pain

Question 4

NSAIDs

Answer 4

Act by inhibiting the cyclooxygenase enzyme, involved in synthesis od prostaglandin and thrombaxane.

Potent analgesic, anti-inflammatory, antipyretic effect.

Question 5

Cyclooxygenase

Answer 5

Catalyze (inhibit) arachidonic acid to generate prostaglandin G2