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Physiology > NS VII Pain and Temperature Sensations > Flashcards

NS VII Pain and Temperature Sensations Flashcards

1
Q

when is body temperature the lowest

A

at 6 am

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2
Q

where are thermal receptors found

A

on free nerve endings in the skin, hypothalamus, spinal cord, and deep tissues

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3
Q

are cool or warm receptors more numerous

A

there are 3-10 times as many cool receptors

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4
Q

what are nociceptors activated by

A

extreme cold or heat

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5
Q

what fibers transmit warm and cool signals

A

C fibers and A Delta

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6
Q

what type of receptors are used in thermal sensation

A

TRP channels

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7
Q

what does temperature do to the rate of intracellular chemical reactions

A

increases it

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8
Q

what receptor does menthol activate and what temps

A

TRPM8 at cooler temperatures

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9
Q

what receptor does capsaicin activate and what temps

A

TRPV1 at warmer temps

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10
Q

how would you describe cold pain

A

tickling, pricking, aching, burning, numbing

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11
Q

how would you describe hot pain

A

sharp, pricking, stinging, burning, throbbing

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12
Q

what happens to cold/pain fibers if skin reaches freezing

A

they are no longer stimulated

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13
Q

what is the average skin temp

A

34-35 degrees C

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14
Q

at average skin temp are cool receptors or warm receptors activated more

A

equal

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15
Q

what happens at 45 degrees celcius of skin

A

heat/pain fibers are activated and sometimes cold fibers are activated too called paradoxical cold

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16
Q

do thermoreceptors adapt

A

almost but never completely

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17
Q

are thermoreceptors sensitive

A

very sensitive to changes in temperature

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18
Q

what happens to sensation when temperature reaches one of the pain thresholds

A

the sensation becomes more persistent throughout the stimulus

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19
Q

are nociceptors tonic or phasic

A

tonic

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20
Q

when are warm and cool receptors best able to detect a change

A

at the mid range of their temperature sensitivity

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21
Q

what happens to receptors as temperature increases

A

more receptors are activated and perception is increased
- increased rate of thermal receptors firing

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22
Q

the greater the area of skin affected by a thermal stimulus the greater______

A

the number of receptors, receptive fields, and first order neurons, and greater perceived sensation

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23
Q

is there are greater or lesser ability for detection of a temperature stimulus if a large region is activated

A

greaters

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24
Q

what receptor types are sensitive to chemicals

A

-vanilloid receptor subtype
- cold menthol receptor type 1 (CMR1/TRPM8)

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25
Q

what type of receptor is the vanilloid receptor and what is it activated by

A

-TRPV1
- activated by capsaicin, temperature greater than 43, and protons

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26
Q

what is the effect of the vanilloid receptor

A

decreases the threshold of channel activation so that heat is perceived at 33 C

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27
Q

what activates the Cold menthol receptor and what is the effect

A

-activated by menthol and related compounds
- effect: decreases the threshold of the channels so that warmer compounds are perceived as cold

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28
Q

what are the characteristics of thermoreceptors in the orofacial region

A
  • small receptive fields
  • more cool than warm receptors
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29
Q

do nociceptive thermal receptors have large or small receptive fields

A

large

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30
Q

are we able to detect warming or cooling more

A

warming

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31
Q

is the face or inner mucosa more sensitive to thermal change

A

the face

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32
Q

what location of thermoreceptors are most sensitive to changes in temperature

A

tongue

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33
Q

what can nociceptors be stimulated by

A

mechanical, thermal or chemical

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34
Q

what qualifies acute pain vs chronic pain

A

less than 6 months - acute pain

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35
Q

what are the two types of acute pain

A

-somatic and visceral

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36
Q

what is somatic pain from

A

skin, subcutaneous tissues or mucus membranes or muscles(superificial) , joints, tendons, or bones (deep)

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37
Q

describe superficial somatic pain and what fibers carry it

A

localized, sharp, pricking and burning
- A delta fibers

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38
Q

describe deep somatic pain and what fibers carry it

A

dull, aching, diffuse and can be referred
-C fibers

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39
Q

what is visceral pain from

A

a disease process or abnormal function involving an internal organ (visceral) or its covering (parietal)

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40
Q

describe true visceral pain and what fibers carry it

A

dull, diffuse, poorly localized and associated with nausea and autonomic symptons
- C fibers

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41
Q

describe parietal visceral pain and what fibers carry it

A

sharp, stabbing, and better localized than true pain
-A delta fibers

42
Q

what types of visceral pain can be referred

A

both types

43
Q

what is the pathway of referred pain

A

two nociceptive afferent neurons from different regions of the body converge on the same second order neuron. the brain doesnt know the true source of input and may make a mistake in interpretation

44
Q

what are the three types of chronic pain

A
  • nociceptive pain
    -neuropathic pain
    -mixed pain
45
Q

what is nociceptive pain due to

A

activation of nociceptors

46
Q

what is neuropathic pain due to

A

neuronal injury

47
Q

describe the pain associated with neuropathic pain and what fibers carry it

A

-paroxysmal, sharp and stabbing
-a delta fibers

48
Q

what is neuropathic pain associated with

A

hyperalgesia

49
Q

what are the major difference in acute pain vs chronic pain

A

-acute pain has autonomic responses
-chronic pain has psychological component

50
Q

what can moderate to severe pain do

A

increase morbidity and mortality

51
Q

what chemicals excite nociceptors

A

substance P, ATP, calcitonin gene related peptide (CGRP), glutamate, aspartate

52
Q

what chemicals sensitize nociceptors

A

substance P, prostaglandins, histamine, bradykinin

53
Q

what chemicals inhibit nociceptors

A

enkephalins, beta endorphin, cannabinoids

54
Q

what is allodynia

A

painful stimulus that should not cause pain

55
Q

what does stimulation of nociceptors lead to

A

antidromal activation of nociceptive nerve terminals and release of substance P and CGRP

56
Q

what is the triple response is neurogenic inflammation

A

-red flush around site o finjury
- local tissue edema
- sensitization to noxious stimuli

57
Q

what is the NT of a delta fibers

A

glutamate

58
Q

what stimulates a delta fibers

A

thermal and mechanical stimuli

59
Q

what is the NT of c fibers

A

substance P

60
Q

what stimulates C fibers

A

thermal, mechanical and chemical stimuli

61
Q

what fibers are in the neospinothalamic tract and what info does it provide

A

-A delta fibers
-provides location, intensity, and duration information

62
Q

what fibers are in the paleospinothalamic tract and where do these fibers synapse

A
  • c fibers
  • brainstem structures
63
Q

what does the spinoreticular pathway do and what fibers

A

-mediates arousal and autonomic responses
- c fibers

64
Q

what does the spinomesencephalic pathway do and what fibers

A

activates anti-nociceptive, descending pathways

65
Q

what does the spinohypothalamic pathway do and what fibers

A

activates the hypothalamus

66
Q

where are the first, second and third order neurons cell bodies located in the spinothalamic pathway

A

-first: dorsal root ganglion
-second: dorsal nuclei, axons dessucate via the anterior commisure and terminate in the thalamus
-third:thalamus, axons project to sensory cortex

67
Q

what types of neurons can second order neurons in the spinothalamic pathway be

A

nociceptive or wide dynamic range

68
Q

what cranial nerves are in the dorsal horn

A

1 through 6

69
Q

what stimuli do nociceptive neurons receive vs WDR neurons

A

nociceptive neurons only receive noxious stimuli, WDR neurons receive input from non-noxious afferent fibers from a Beta, a delta, and c fibers

70
Q

what cell type is most abundant in the dorsal horn

A

WDR neurons

71
Q

what do WDR neurons do during repeated stimulation

A

increase their firing rate

72
Q

which neurons have larger receptive fields: WDR or nocicpetive

A

WDR

73
Q

where are nociceptive neurons found and what do they respond to

A

found in lamina I and respond to high threshold noxious stimulation

74
Q

what are the three mechanisms for central modulation of pain to facilitate pain

A

-WDR neurons
- receptor field expansion
-some second order neurons increase their frequency of activation

75
Q

what are the mechanisms to inhibit pain

A

-gate control theory of pain
-pain inhibits pain
- conditioned pain modulation

76
Q

explain the gate control theory of pain

A

-activation of a beta fibers from the same region inhibits the spinothalamic pathway and reduces pain perception
-a beta fibers activate an inhibitory interneuron that causes post-synaptic inhibition of the second order neuron for the pain pathway. weaker signal is sent to thalamus

77
Q

what explains massage therapy and rubbing an area in pain to make it feel better

A

gate control theory of pain

78
Q

how does the pain inhibits pain theory work

A

-stimulate pain in other regions of the body to inhibit pain through GABA at second order WDR neurons in spinal cord

79
Q

what is the mechanism being the conditioned pain modulation theory

A

a second noxious stimulus leads to activated of the PAG, NRM, and RVm in the brainstem which results in diffuse analgesic effect over the rest of the body

80
Q

what do interneurons in the dorsal horn of the spinal cord release and what does it do

A

enkephalin which inhibits the first order and second order neurons

81
Q

what is analgesia

A

selective suppression of pain without effects on consciousness or other sensations

82
Q

what is pain in the orofacial region conveyed into the CNS by

A

the trigeminospinothalamic tract and the trigeminoreticular tract

83
Q

when would thermal stimuli cause sudden and stinging pain in teeth

A

with missing enamel and exposed dentin

84
Q

what do weak air puffs to exposed dentin result in

A

intense pain

85
Q

each afferent nerve innervates ___

A

multiple teeth

86
Q

large receptive fields = _______

A

poor localization

87
Q

what makes dentin sensitive

A

dentinal tubules

88
Q

where are odontoblasts located

A

in the dentinal tubule and their cell body is on the surface of the dental pulp

89
Q

is dentinal tubule radius more important or number

A

radius

90
Q

describe tooth pulp

A

highly vascular, innervated but low compliance

91
Q

describe dentin

A

mineralized avascular

92
Q

what is dentin suprasensitive to

A

extreme temperatures and hyperosmotic solutions

93
Q

what fibers carry dentinal and pulp nociceptors

A

a delta and C fibers (90%)

94
Q

describe dentinal pain vs pulp pain and what fibers carry each

A

dentinal pain is sharp pain (a delta), pulp pain is dull (C fibers )

95
Q

what are the theories for dental nociception

A

-neural theory
- hydrodynamic theory
-odontoblast transducer theory

96
Q

what is the hydrodynamic theory

A

stimulus displaces fluid in dentinal tubules which activates mechanoreceptors in nerve endings of dentin r pulp

97
Q

what is the neural theory

A

free nerve endings in dentinal tubules are activated

98
Q

what is the odontoblast transducer theory

A

odontoblasts are excited and transduce the signal to nearby nerve cells

99
Q

what are the receptors in the periodontal ligament

A

nociceptors and ruffini endings

100
Q

what do ruffini endings in the periodontal ligament regulate

A

occlusion, mastication and biting

101
Q

what portion of the periodontal ligament is most heavily innervated

A

apical portion

Physiology (41 decks)

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