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Neuroscience > Pain > Flashcards

Pain Flashcards

1
Q

What is the function of the anterolateral system?

A
  • Pain and temperature
  • Gross touch
  • Light touch
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2
Q

What is the definition of pain?

A

Unpleasant sensory or emotional experience associated with actual or potential tissue damage, or described in terms of such damage.

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3
Q

What are the 2 duration classifications of the pain?

A
  • Acute

- Chronic

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4
Q

What causes nociceptive pain?

A
  • Stimulation of peripheral nerve fibers or their receptors that only respond to stimuli approaching or exceeding harmful intensity
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5
Q

What are the 3 modes of noxious stimulation to nociceptors?

A
  • Thermal
  • Mechanical
  • Chemical
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6
Q

What 3 terms are used to describe the perception of pain?

A
  • Visceral
  • Deep somatic
  • Superficial somatic
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7
Q

What type of pain is dull, aching, and poorly localized?

A
  • Deep somatic
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8
Q

What type of pain is sharp, well-defined, and clearly located?

A
  • Superficial somatic
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9
Q

What type of pain is diffuse, difficult to locate, and often referred?

A
  • Visceral pain
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10
Q

Why are somatic and visceral pain sometimes confused?

A
  • They share afferent pathways
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11
Q

What is neuropathic pain caused by?

A
  • Damage or disease that affects any part of the nervous system involved in bodily feelings
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12
Q

How is neuropathic pain typically described?

A
  • Burning
  • Tingling
  • Electrical
  • Stabbing
  • Pins and Needles
  • Funny bone
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13
Q

What is phantom pain?

A
  • Pain felt in a part of the body that the brain no longer receives signals from
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14
Q

Phantom pain is a subtype of which type of pain?

A
  • Neuropathic
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15
Q

What is psychogenic pain caused by?

A
  • Mental, emotional, or behavioral factors
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16
Q

Why are psychogenic pain sufferers sometimes stigmatized?

A
  • Medical professionals and general public think the pain isn’t real
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17
Q

Is psychogenic pain real?

A

Yes

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18
Q

What is referred pain?

A
  • Pain occurs in an area away from the damaged/ pain site
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19
Q

What are the 2 types of referred pain?

A
  • Myofascial

- Sclerotomic & Dermatomic

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20
Q

What is myofascial pain?

A
  • Trigger points

- Nerve impulses bombard CNS and expresses as referred pain

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21
Q

What is sclerotomic/ dermatomic pain?

A

Pain in the pattern of a spinal nerve root

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22
Q

Where may the heart refer pain to?

A
  • Upper chest
  • Left shoulder
  • Jaw
  • Arm
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23
Q

Where may the diaphragm refer pain to?

A
  • Lateral tip of either shoulder
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24
Q

Where may the gallbladder refer pain to?

A
  • Right shoulder

- Inferior angle of right scapula

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25
Q

What referred pain may result from a ruptured spleen? What is this called?

A
  • Pain on tip of shoulder

- Kerr’s sign

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26
Q

What may sclerotomic pain of L5 and S1 present as?

A

Lateral leg and foot pain

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27
Q

What is paresthesia?

A
  • Abnormal spontaneous sensations such as burning, tinging or pins and needles
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28
Q

What is dyesthesia?

A
  • Unpleasant sensation produced by a stimulus that is usually painless
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29
Q

What is anestheisa?

A

Loss of sensation

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30
Q

What is hypoesthesia?

A

Partial loss of touch and pressure sensations

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31
Q

What is hyperesthesia?

A

Increased sensitivity to touch and pressure sensations

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32
Q

What is analgesia?

A

Loss of pain and temperature sensations

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33
Q

What is hypoalgesia?

A

Partial loss of pain and temperature sensations

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34
Q

What is hyperalegsia?

A
  • Increased sensitivity to pain sensations
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35
Q

What is myalgia?

A

Tenderness or pain in the muscles

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36
Q

What is malaise?

A

General discomfort/ uneasiness

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37
Q

What is causalsia?

A

Intense, severe burning pain

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38
Q

What is allodynia?

A

Non-painful stimuli evokes pain

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39
Q

What nerve fibers carry fast pain?

A

Myelinated a-delta

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40
Q

What nerve fibers carry slow pain?

A

Unmyelinated C fibers

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41
Q

What neuron transmits pain info to the spinal cord?

A

Nociceptive neurons

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42
Q

Which type of pain is more localized?

A

Fast

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43
Q

Is fast or slow pain aching, throbbing, burning?

A

Slow

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44
Q

What time frame is considered acute pain?

A

< 6 months

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45
Q

Which type of pain typically has more actual tissue damage?

A
  • Acute
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46
Q

Which type of pain can have no actual damaging or threatening stimulus?

A
  • Chronic
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47
Q

What time frame is considered chronic pain?

A

> 6 months

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48
Q

What type of nerve fibers is typically responsible for acute pain?

A

Group III

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49
Q

What are the 2 aspects of the pattern of pain?

A
  • Frequency (firing rate of neuron)

- Intensity (frequency of stimuli acting on neuron)

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50
Q

What types of pain does the specific/ anatomic theory of pain not hold true for?

A

Neurogenic

Neuropathic

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51
Q

What are the 4 underlying aspects of the neuromatrix?

A
  • Body self
  • Sensory
  • Affective
  • Cognitive
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52
Q

What is the sensory aspect of the neuromatrix?

A

The actual stimulus

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53
Q

What is the affective aspect of the neuromatrix?

A
  • Emotional or personality influence
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54
Q

What is the cognitive aspect of the neuronmatrix?

A

Frontal lobes remember pain

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55
Q

What role does the insular cortex play in pain perception?

A
  • Distinguishes pain from other homeostratic emotions (itch, nausea_
56
Q

What role does the anterior cingulate cortex play in pain perception?

A
  • Motivation
57
Q

What role does the sensory cortex play in pain perception?

A

Localizes pain

58
Q

Do type IV or III fibers react more quickly to pain stimulus?

A
  • IV
59
Q

What is volume transmission?

A

Dumping of neurotransmitters

60
Q

What do the primary afferents of pain synapse on?

A
  • Tract cells
  • Inhibitory interneurons that regulate ascending flow of nociceptive input
  • Facilitory interneurons that regulate ascending flow of nociceptive input
  • Interneurons that mediate local refelxes
61
Q

What method of communicaiton is used by primary afferents of pain?

A
  • Volume transmission
62
Q

Which type of pain is more discriminitive? (fast or slow)

A

Fast

63
Q

What laminae do fast pain fibers synapse on?

A
  • Lamina 1 and 5 (marginal nuceleus)
64
Q

What 2 areas do fast pain fibers synapse on in the higher centers?

A
  • Lateral thalamus (VPL)

- Post central gyrus of parietal cerebral cortex

65
Q

On which laminae do most slow pain neurons synapse?

A

Laminae 2 and 5

66
Q

What chemical mediators may cause a slow pain response?

A
  • Histamine
  • Prostaglandin
  • Substance P
  • Other inflammatory mediators
67
Q

Which type of pain projects laterally? (fast or slow)

A

Fast pain

68
Q

Which type of pain projects medially? (fast or slow)

A

Slow pain

69
Q

Which type of pain has more interneurons? (fast or slow)

A
  • Slow pain
70
Q

Which type of pain deals with the affective components of pain? (fast or slow)

A

Slow pain

71
Q

Which type of pain gives information regard perception of sharpness, intensity, location of pain? (fast or slow)

A

Fast pain

72
Q

Where do the fast and slow pain fibers split during their ascent to higher centers?

A
  • At the brain stem
73
Q

What is the axon reflex (Why does the skin become red and flare up around the area of the injury)?

A
  • Pain receptors transmit impulses in orthdromic and antidromic directions to neighboring skin, where free nerve endings release substance P binding to arteries, and causing dilation, and also binds to mast cells releasing histamine resulting in fluid accumulation
74
Q

What is the triple response (in relation to inflammation)?

A
  • Red line
  • Flare
  • Weal

in response to skin stretching

75
Q

Which autonomic nervous system causes the redness of inflammation?

A

Sympathetic

76
Q

What is peripheral sensitization of primary afferents?

A
  • Nerves become inflamed and fire without reason or stimulus
77
Q

What are the aspects of peripheral sensitization of primary afferents?

A
  • Receptor sensitivity
  • Membrane threshold lowered
  • Ectopic firing (random firing)
78
Q

Why is it so difficult to treat central sensitiization?

A
  • There are so many causes
79
Q

How may neuronal receptive fields be changed in central sensitization?

A
  • Expanded so that more stimuli acts on one field
80
Q

How can neuronal activity be altered in central sensitization?

A
  • Increased response to noxious stimuli
81
Q

How can the glia affect central sensitization?

A
  • Release chemical mediators
82
Q

How can interneurons affect central sensitization?

A
  • Inhibit neurotrasmission
83
Q

What is long-term potentiating?

A
  • Stimulation of a cell over time increases it excitability/ and its duration of action
84
Q

How can central sensitization affect membranes?

A

Lower thresholds

85
Q

What is wind-up?

A
  • Dorsal cells activated a lot, they’ll fire more often
86
Q

What is the origin of the lateral spinothalamic tract?

A
  • Laminae I and V - VII in dorsal horn (nucleus proprius)
87
Q

Do the fibers of the lateral spinothalamic tract cross?

A

Yes, at the level of the dorsal horn

88
Q

What is the extent of the lateral spinothalamic tract?

A
  • Throughout the cord
89
Q

What does the lateral spinothalamic tract synapse on?

A
  • Lateral thalamus
90
Q

What is the function of the lateral spinothalamic tract?

A
  • Concious pain and temperature
91
Q

What is the origin of the anterior spinothalamic tract?

A
  • Laminae III and V/ dorsal horn
92
Q

Do the fibers of the anterior spinothalamic tract cross?

A
  • Yes, at the level of the dorsal horn
93
Q

What is the extent of the anterior spinothalamic tract?

A
  • Throughout
94
Q

What is the termination of the anterior spinothalamic tract?

A
  • Medial thalamus
95
Q

What is the function of anterior spinothalamic tract?

A
  • Gross touch and pressure

- Maybe pain

96
Q

What is the origin of the spinotectal tract?

A
  • Laminae I and V
97
Q

Dot he fibers of the spinotectal tract cross?

A

Yes

98
Q

What is the termination of the spinotectal tract?

A
  • Tectum of midbrain
99
Q

What is the function of the spinotectal tract?

A

Tectum: Reflexive responses to pain and temperature

Locomotor center/ PAG: Aversise behavior and algesia

100
Q

What is another name for the spinotectal tract?

A

Mesencephalic

101
Q

What is the origin of the spinoreticular tract?

A

Laminae VI and VII

102
Q

What is another name for the spinoreticular tract?

A
  • Hypothalamic

- Limbic

103
Q

Do the fibers of spinoreticular tract cross?

A

Yes

104
Q

What is the extent of the spinoreticular tract?

A

Throughout cord

105
Q

What is the termination of the spinoreticular tract?

A

Reticular formation

106
Q

What is the origin of the spinocervical tract?

A
  • Laminae III and IV
107
Q

Do the fibers of the spinocervical tract cross?

A

No

108
Q

What is the extent of the spinocervical tract?

A

Throughout cord

109
Q

What is the termination of the spinocervical tract?

A

Lateral cervical nucleus

110
Q

What is the function of the spinocervical tract?

A

Possibly a secondary tract for Pain and temperature to cerebral levels

111
Q

What is the function of the spinoreticular tract?

A
  • Reflexive response and state of conciousness
112
Q

What is the origin of the posterior synaptic dorsal column?

A
  • Laminae X
113
Q

Do the fibers of the posterior synaptic dorsal column cross?

A

No

114
Q

What is the extent of the posterior synaptic dorsal column?

A

Throughout the cord

115
Q

What is the termination of the posterior synaptic dorsal column?

A

The gracillis

116
Q

What is the function of the posterior synaptic dorsal column?

A

Visceral pain

117
Q

Where do the group III and IV afferents of the lateral spinothalamic tract enter the spinal cord? What is their pathway from entrance of the cord to their ascending pathway?

A
  • Enter by the lateral division
  • Go up or down 2 segments in Lissauers tract (dorsal-lateral fasciculus)
  • Enter dorsal horn
  • Synapse on projection cell
  • Projection cell crosses over cordl through anterior white commisure
  • Ascend as lateral spinothalamic tract
118
Q

How are fibers added to the lateral spinothalamic tract as it ascends the spinal cord?

A
  • From lateral to medial due to its contralateral - projection
  • Arranged from lateral to medial:
  • Sacral
  • Lumbar
  • Thoracic
  • Cervical
119
Q

Where do the two spinothalamic tracts split?

A

At the brain stem

120
Q

Which spinothalamic tract is the phylogenetically older?

A

Anterior spinothalamic

121
Q

Which spinothalamic tract has more synapses?

A

Anterior spinothalamic

122
Q

Which tract constitutes the neo spinothalamic tract? Which tract consitutes the paleo spinothalamic tract?

A

Neo: Lateral spinothalamic
Paleo: Anterior spinothalamic

123
Q

Where are phylogenetically newer structures located in the spinal cord?

A

On the lateral portion

124
Q

What pathway does visceral pain take up the spinal cord?

A

Post-synaptic dorsal column

125
Q

Why is meant by the “post-synaptic” in post-synaptic dorsal column?

A

A projection cell extends from the neuron in the dorsal horn to the pathway in the dorsal funniculus

126
Q

What is the Melzak and Wall theory?

A

The gate theory.

Mechanoreceptor/ group II fibers synapse on the projection cell, inhibiting it
- There requires a stronger stimulus to activate pain projection fibers

127
Q

What is the origin of descending modulatory sytems?

A

Periaqueductal gray

128
Q

What nuclei are stimulated by the periaqueductal gray in the descending modulatory system?

A
  • Lateral tegmental nucleus

- Nucleus raphe magnus

129
Q

What does the nucleus raphe magnus synapse on in the descending modulatory system?

A
  • Inhibits projection neuron that travel to the dorsal horn

- Excites endorphin interneuron that inhibits a projection cell to the dorsal horn and a-delta fiber

130
Q

What does the lateral tegmental nucleus synapse on in the descending modulatory system?

A
  • Excites an endorphin interneuron which inhibits projection neuron to dorsal horn and a-delta fiber
131
Q

What neurotransmitter does the nucleus raphe magnus pathway use? What is the name of the pathway?

A
  • Serotonin
132
Q

What neurotransmitter does the lateral tegmental nucleus pathway use?

A
  • Norepinephrine
133
Q

What is the overall effect of the descending modulatory system?

A

If stimulated, it inhibits pain/ causes analgesia

134
Q

What is the spinomesencephalic tract?

A
  • Projections of the lateral spinothalamic tract to the periaqueductal gray
135
Q

Review slides 24 - 27 possibly

A

24 - 27

Neuroscience (33 decks)

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