pain

Question 1

stages of pain sensation

Answer 1

1. periphery: detection and transmission to spinal cord (1st ON)
2. spinal cord: processing, transmission to brain (thalamus) (2nd ON )
3. brain: perception, learning, response
4. modulation: descending tracts

Question 2

what is nociceptin

Answer 2

detection of tissue damage by specialised transducers connected to A-delta and C fibres

Question 3

nociceptors

Answer 3

free nerve endings of A-delta and C fibres

respond to thermal, chemical, mechanical, noxious stimuli

Question 4

primary afferents/1st order neurons

Answer 4

cell body in dorsal root ganglion

first order neurones

synapse at spinal cord

Question 5

spinal dorsal horn

Answer 5

first order synapse

Question 6

spinothalamic tracts

Answer 6

major ascending tract for nociception

arises in rexed lamina 2 and 5

Question 7

second relay station

Answer 7

thalamus

Question 8

where does thalamus connect to

Answer 8

cortex
limbic system
brainstem

Question 9

allondynia

Answer 9

decreased threshold for nociceptor response

Question 10

hyperalgesia

Answer 10

exaggerated response to normal and supranormal stimuli

Question 11

spontaneous pain

Answer 11

spontaneous activity in nerve fibres

Question 12

central sensitisation

Answer 12

response of second order neurons in the CNS to normal input both noxious and non-noxious

Question 13

3 main components of central sensitisation

Answer 13

wind-up
classical
long-term potentiation

Question 14

wind up

Answer 14

involves only activated synapses
homosynaptic activity dependant progressive in response of neurons
manifests over the course of stimuli and terminates with stimli

Question 15

classical

Answer 15

opening up of new synapses (silent nociceptors)
heterosynaptic acitivity dependent plasticity
immediate onset w approp stimuli
outlast initial stimuliu duration
can be maintained even at low levels of ongoing stimuli

Question 16

long term potentiation

Answer 16

involves mainly activated synapses

occurs primarily for very intense stimuli

Question 17

acute pain

Answer 17

<1mo 
usually obvious tissue damage
pain resolves upon healing
protective function 
prescence of noxious stimuli 
usually nociceptive

Question 18

chronic pain

Answer 18

at least 3mo
pain beyond expected period of healing
usually has no protective function
nociceptive, neuropathic or mixed

Question 19

what is nociceptive pain

Answer 19

sensory experience that occurs when specific peripheral sensory neurones (nociceptors) respond to noxious stimuli

Question 20

nociceptive pain features

Answer 20

localised site of injury
time limited, resoles with healing
can be chronic
responds to conventional analgesics

Question 21

what is neuropathic psin

Answer 21

psin initiated/caused by a primary lesion or dysfunction in the somato-sensory nervous system

Question 22

neuropathic pain features

Answer 22

may not be localised - pain occurs in neurological territory of affected structure (nerve, root, spinalcord)
almost always chronic
responds poorly to conventional analgesics

Question 23

nociplastic pain

Answer 23

pain that arises from altered nociception despite no clear evidence of damaged/threatened tissue causing activation of nociceptors