Nocioception

Question 1

Nociception

Answer 1

detection of noxious stimuli through the activatino of nociceptors

Question 2

Stimulus for nociception

Answer 2

mechanical, thermal or chemical

Question 3

The path of nociception for superficial and deep pain are the same. T/F

Answer 3

F. Superficial and Deep pain have completely different pathways

Question 4

What are the two main two nerve fiber types:

Answer 4

A delta fibers and C fibers

Question 5

Delta fibers sense

Answer 5

sharp and pricking pain

fast conducting, myelinated

Question 6

C fibers sense

Answer 6

dull, ahcing, burning, throbbing pain

slow conducting, unmyelinated

Question 7

What makes the refelx arc more exaggerated?

Answer 7

UMN damage

Question 8

Is pain a reflex?

Answer 8

No, it is a voluntary behavior

Question 9

acute pain

Answer 9

arises from trauma or inflammation

Question 10

chronic pain

Answer 10

persists beyond the expected time fram for the given disease/injury (present longer than 3-6

Question 11

Hypalgesia

Answer 11

decreased perception of pain

Question 12

Analgesia

Answer 12

complete absence of pain perception

Question 13

anesthesia

Answer 13

absense of all senesory perception

Question 14

hypalgesia, algesia and anesthesia all refer to changes in

Answer 14

cortical perception

Question 15

ARAS stands for

Answer 15

ascending reticular activating system

wakefullness system

Question 16

What is clinically relevent about ARAS?

Answer 16

link between sensory stimulation and conscious awareness of stimuli (alertness)

Question 17

Noxious stimuli increases:

Answer 17

alertness and autonomic functions (heart and respiratory rate)

Question 18

spinocervicothalamic tract transmits

Answer 18

superficial pain and tactile sensation

Question 19

How to test spinocervicothalamic tract?

Answer 19

lightly and briefly pinch the skin

Question 20

Both proprioception and nociception decussate where?

Answer 20

to the contralateral cortex

Question 21

The spinoreticular tract transmits

Answer 21

deep pain and visceral sensation

Question 22

Spinoreticular tract is characteristically

Answer 22

indiscriminate- animal experiences pain/arousal, but cannot identify the source (diffuse nature)

Question 23

How to test spinoreticular tract?

Answer 23

apply hemostats to the base of the toenail, dont include skin
(stimulates nociceptors in the periosteum)

Question 24

What is the goal of deep pain sensation?

Answer 24

To notify as much CNS as possible

Question 25

What kind of image does the deep pain pathway create?

Answer 25

2D impression of a massive recruitment of signaling, 3D to vast areas of the CNS

Question 26

Which tract is more susceptible to compressive injury: spinocervico thalamic or spinoreticular?

Answer 26

Spinocervicothalamic tract

Question 27

GVA generally respond to

Answer 27

stretch, ischemia, dilation or spasm (colic, GDV)

Question 28

What is the affective component of pain?

Answer 28

pain notifies the CNS of knowing the body is in trouble

Question 29

What does connecting pain pathways to the limbic system ensure?

Answer 29

that the individual will have a negative emotional reaction to pain

Question 30

How can a stimulus modify the perception of pain?

Answer 30

periphery, spinal cord, brainstem and higher centers

Question 31

Where are inflammatory mediates released at?

Answer 31

injured tissues

Question 32

What are examples of inflammatory mediators

Answer 32

prostaglandins, leukotriens

Question 33

Inflammatory mediators modulate pain by

Answer 33

1. lowering the threshold of nociceptors | 2. directly stimulate nociceptors

Question 34

hyperalgesia

Answer 34

minimal noxious stimuli produces greater than normal nociceptive activity

Question 35

allodynia

Answer 35

non-noxious stimuli activates nociceptors

Question 36

Wide- dynamic range (WDR) neurons respond to

Answer 36

noxious and non-noxious simuli

Question 37

What are WDR neurons associated with?

Answer 37

referred pain of visceral organs and cell associated "wind up"

Question 38

What are examples of referred pain?

Answer 38

* kidney --> back pain | * heart attack--> left arm pain

Question 39

What is cell "wind-up"?

Answer 39

rapid, continuous firing of primary nociceptive afferents | ie. chronic or intense pain

Question 40

In cell wind up, how does activation of the 1st neuron effect the second neuron?

Answer 40

1st neuron activation can result in sustained, amplified depolarization of the 2nd neuron

Question 41

How do NMDA receptors function?

Answer 41

allow Ca and NA into the cell

Question 42

What are the effects of wind-up?

Answer 42

long term changes in the postsynaptic cell that decreases its threshold for excitement

Question 43

Does anesthesia prevent wind up?

Answer 43

NO

Question 44

How do you prevent wind-up?

Answer 44

nerve blocks and aggressive pain management

Question 45

What are Pre-med options to treat wind-up?

Answer 45

local nerve blocks, anti-inflammatories, opioids, NMDA reecptor inhibitors

Question 46

The gate control theory states that

Answer 46

pain perception is achieved, but decreased by: 1. simultaneous tactile info traveling up the WDR neurons with the nociceptive info. 2. inhibitory neurons directly affecting the C fiber

Question 47

What are examples of therapy that utilize the gat control theory

Answer 47

massage compression water therapy acupuncture

Question 48

What are examples of neuotransmitters at the level of the spinal cord that have anti-nociceptive properties?

Answer 48

endorphins serotonin norepinephrine

Question 49

multimodal pain control

Answer 49

1. modulate or prevent transduction at the nociceptor 2. interfere with conduction to the CNS 3. gate control therapy 4. inhibit spinal cord sensitization 5. augment descending modulatory mechanisms 6. sedation/tranquilization/anxiolytic

Question 50

What stimuli provokes an itch?

Answer 50

1. pressure 2. thermal stimuli 3. electricity 4. chemicals (histamine)

Question 51

Neuropathic pain

Answer 51

results from injury to the nervous system, causing inappropriate pain signal

Question 52

What is an example of TRAUMA that can cause neuropathic pain?

Answer 52

amputation, crushing injury | declaw --> neuroma

Question 53

What is an example of vASCULAR INJURY that can cause neuropathic pain?

Answer 53

thromboembolic disease

Question 54

What is an example of ENDOCRINOPATHY that can cause neuropathic pain?

Answer 54

diabetes mellitus

Question 55

What is an example of INFECTION that can cause neuropathic pain?

Answer 55

post- herpetic neuralgia

Question 56

Dyesthesia

Answer 56

unpleasant sensation associated with neuropathic pain (tingling or electric)