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Neurophys > Nociception Vs. Pain > Flashcards

Nociception Vs. Pain Flashcards

1
Q

What is Nociception?

A

Process by which information about a noxious stimulus is conveyed to the brain. It’s a summation of prior cognitive processes that occur before the brain is aware of a painful sensation

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2
Q

Nociceptor

A

Nerve receptor preferentially sensitive to nociceptive stimulation or to stimulation that becomes nociceptive if it persists

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3
Q

Nociceptive

A

Stimulation of sufficient intensity to activate nociceptors, and even produce a tissue lesion

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4
Q

-algia

A

Localized pain without presuming it’s cause

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5
Q

Antalgic/analgesic

A

Pertaining to the reduction of pain

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6
Q

Paresthesia

A

A spontaneous or provoked unusual sensation (NOT painful)

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7
Q

Hypoesthesia

A

A decrease in sensitivity to non-noxious stimulation

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8
Q

Hypoalgesia

A

A decrease in pain in response to a typically noxious stimulus

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9
Q

Anesthesia

A

Loss of sensation

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10
Q

Analgesia

A

Absence of pain following a typically noxious stimulus

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11
Q

Hyperesthesia

A

An increase in sensitivity to non-noxious stimulation

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12
Q

Hyperalgesia

A

Exaggerated response to typically noxious stimulation

Unusually low nociceptive threshold

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13
Q

Allodynia

A

Pain produced by typically non-noxious stimuli

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14
Q

Characteristics of pain

A

Universal
Subjective
Context-dependent
Clinically significant - it’s the #1 reason that patients seek chiropractic care

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15
Q

The paradox of pain

A

Adaptiveness: the experience of pain is important for survival and serve as warning signs but it’s considered negative

Lack of clear cortical representation: painful stimuli activate several regions of the cortex

Descending pain control mechanisms are present: cognitive and emotional factors can effectively suppress or amplify the experience of pain

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16
Q

What is “top-down” pain modulation?

A

The ability to suppress or amplify the experience of pain

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17
Q

What is pain?

A

An unpleasant sensory and emotional experience resulting from actual or potential tissue injury (or other stimulus that does not involve the tissue!) and engages the snensory, emotional and cognitive processes of the brain

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18
Q

What is transient nociceptive pain?

A

An unpleasant sensation in response to noxious stimuli that does not injure tissue

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19
Q

Is there tissue damage accompanying transient nociceptive pain?

A

No

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20
Q

Sensations of which pain fibres are recognized with transient nociceptive pain?

A

First pain (alpha delta fibers) and second pain (C fibers)

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21
Q

Which type of pain serves as an “early warning sign” that alerts the brain to the presence of a potentially tissue-damaging event?

A

Transient nociceptive pain

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22
Q

What will be triggered by transient nociceptive pain?

A

Behaviours aimed at avoiding potentially tissue-damaging stimuli

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23
Q

What is acute pain?

A

Unpleasant sensation in response to tissue injury and/or inflammation

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24
Q

What is recurrent acute pain?

A

Pain that returns in periodically in distinct episodes

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25
Q

Is there CNS plasticity change with acute pain?

A

Yes, central sensitization occurs

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26
Q

Is there PNS plasticity change with acute pain?

A

Yes, peripheral sensitization occurs

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27
Q

Is there PNS or CNS plasticity change in nociceptive transient pain?

A

Neither is present

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28
Q

Describe the physiologic change of the nociceptors in acute pain

A

Increased excitation or decreased inhibition of nociceptors

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29
Q

What do we know has occurred in the nervous system with chronic pain?

A

There is injury to the nervous system

30
Q

What can you see at a physiological level with chronic pain?

A

Cellular structural changes

31
Q

Is there change to the PNS plasticity with chronic pain?

A

Yes the pain afferents are modified

32
Q

Is there CNS plasticity change with chronic pain?

A

Yes, rewired networks and circuits

33
Q

Is chronic pain considered to be protective to our bodies?

A

No, it is not understood to have a protective role. It persists after the triggering event has RESOLVED

34
Q

What are the divisions of nociceptive pain?

A

Somatic
Visceral
Inflammatory

35
Q

After what kinds of noxious stimuli does Nociception pain occur?

A

Mechanical
Thermal
Chemical

36
Q

What is inflammatory nociceptive pain associated with?

A

The process of tissue repair following tissue damage

37
Q

What are the divisions of neuropathic pain?

A

Neurogenic pain

Functional pain

38
Q

What is neuropathic pain a result of?

A

A nervous system disorder

39
Q

What are the responses from somatic nociceptive pain?

A

Superficial or deep pain
Nociceptive reflex
Autonomic response

40
Q

What is the mechanism for visceral nociceptive pain?

A

Distension of viscera

41
Q

What are the possible responses toward visceral nociceptive pain?

A

Constant cramping
Diffuse pain
Autonomic response

42
Q

What are the possible responses toward inflammatory nociceptive pain?

A

Spontaneous pain (diffuse)
Hyperalgesia
Allodynia

43
Q

What are the mechanisms that cause inflammatory pain?

A

Tissue lesion and inflammation association

44
Q

What are the possible responses to neurogenic neuropathic pain?

A

Spontaneous pain (sharp, ELECTRICAL)
Hyperalgesia
Allodynia

45
Q

What are the mechanisms associated with neurogenic pain?

A

PNS injury

CNS injury

46
Q

What are the possible responses to functional neuropathic pain?

A

Spontaneous pain (diffuse, deep)
Hyperalgesia
Allodynia

47
Q

What are the mechanisms associated with functional neuropathic pain?

A

Hyper activation of nociceptive tract inhibition

Loss of nociceptive tract inhibition

48
Q

Why is quantifying pain so important to physicians?

A

Can diagnosis CAUSE of pain

MONITOR the pain

Monitor EFFECTIVENESS of treatment

49
Q

What is the current gold standard for assessment of pain?

A

Trick question! There is none. Boo.

50
Q

What are the 2 basic principles that govern the clinical measurement of pain?

A
  1. The patient is the only authority of their pain evaluation
  2. Pain should be evaluated in terms of its impact on the person as a WHOLE
51
Q

What are (5) quantifiable components of the pain experience?

A

Pain intensity (Wong-Baker faces, LOCQSMATT)

Physical capacity (prevent ADLs)

Spatial attributes (drawing where it is)

Pain quality (describe it in your own words)

Psychological component (Beck Depression Inventory)

52
Q

Can the perception of pain occur without Nociception?

A

YES!!!!! 😱😱😱😱😱

53
Q

What does the Biomedical model describe?

A

The mechanistic model which assumes that each disease process results from a unique underlying pathoanatomical/pathophysiological lesion

54
Q

Which model ties together a specific disease and its symptoms with the pathoanatomy and pathophysiology?

A

The biomedical model

55
Q

Under the biopsychosocial model of pain, would losing employment be a possible cause for increased pain perception?

A

Yes

56
Q

What are the goals of the biopsychosocial model of pain?

A

Explain the multidimensional nature of the pain experience

Emphasize the complexity and interdependence of each component which contributes to the experience of pain

Provide health professionals with a model of pain that helps them comprehend the different components and thus, find appropriate treatment

57
Q

What are the 4 distinct neurophysiological events of Nociception?

A

Transduction
Transmission
Modulation
Perception

58
Q

Define transduction

A

Converting noxious stimuli into electrochemical impulses

59
Q

Define transmission

A

Transmitting electrochemical impulses along afferents fibers to various nervous system regions

60
Q

Define modulation

A

Altering the perception of noxious stimuli by peripheral or central mechanisms

61
Q

Define perception

A

The conscious experience of pain created by the interpretation of nociceptive info by higher centres of the CNS

62
Q

Where are primary cell bodies for neurons carrying noxious info from the body located?

A

DRG

63
Q

Where are primary cell bodies of neurons carrying noxious stimuli to the face located?

A

The trigeminal ganglia

64
Q

What are the primary nociceptive neurotransmitters utilized with all nociceptive neurons?

A

Glutamate and Substance P

65
Q

Are myelinated nociceptors bimodal or polymodal?

A

They are bimodal

66
Q

Are unmyelinated nociceptors found in small axons in remak bundles or large axons?

A

Small axons in remak bundles

67
Q

Do we have large or small receptive fields for unmyelinated nociceptors?

A

Large!

68
Q

What kind of stimuli do unmyelinated nociceptors detect?

A

Mechanical, thermal and chemical (polymodal)

69
Q

How can inflammation enhance the perception of pain? (Hint: 2 ways)

A

Modifying (enhancing) the degree of Nociceptor activation/excitation

Decrease the threshold of excitation to cause peripheral sensitization of nociceptors (results in hyperalgesia and allodynia)

70
Q

What are 2 main causes of peripheral sensitization?

A

Exposure to inflammatory mediators

Repeated application of noxious stimuli

Neurophys (6 decks)

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