PAIN Flashcards

1
Q

what is pain?

A

it is an unpleasant, sensory/emotional experience.

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2
Q

what is nociception

A

activation of neural pathways by stimuli that damage or threaten tissues

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3
Q

what is a noxious stimuli

A

potentially damaging stimulus

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4
Q

what is a nociceptive stimulus

A

stimulus that activates the neural pathway

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5
Q

a nerve is a poor insulator and conductor! what does it need?

A

it needs PROPAGATED by an ACTION POTENTIAL!

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6
Q

what is the resting membrane potential?

A

-70mV (all cells) , excitable cells like nerve and muscle cells cause a rapid change in membrane potential

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7
Q

what is the resting membrane potential driven by?

A

it is driven by ions with the greatest membrane permeability

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8
Q

how is the RMP dervied?

A

permeability of ions, conc gradient of ions, active transporters

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9
Q

where is Na located in the cell membrane

A

OUT of the cell

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10
Q

where is K located in the cell membrane

A

IN the cell

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11
Q

what is the ratio of Na to K to transport in and out of the cell

A

3 to 2 , we also need ATP (energy)

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12
Q

what is the K equilibrium potential

A

-90mV (drives RMP of -70mV which is closer to -90)

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13
Q

what is the Na equilibrium potential

A

+60mV

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14
Q

describe what happens during an action potential

A

the MP depolarises to -50 (threshold), sodium channels open, sodium flows in down the CG meaning that the membrane is more permeable to sodium at this point.
this results in RAPID depolarisation to +30mV - closer to na +60 as drives MP as now more peremable.

due to the rapid depolarisation it then means that the sodium channels inactivate, then the K channels open and k flows in causing rapid depolarisation (slight delay). the membrane is now driven by k+ toward -90mv. the k channels close and na channels rest back to the rmp of -70mv

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15
Q

what is the hodgkins cycle

A

positive feedback loop, AP propagates along a nerve like the domino effect. this results in depolarisation and NA is open.

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16
Q

what does LA do to sodium channels

A

it blocks it, meaning there is no AP along the nerve and therefore no PAIN signal.

17
Q

describe the features of an action potential

A

it is an all or nothing event , it moves in one direction

18
Q

describe the absolute refractory period

A

Na channels do not get reset therefore the AP cant occur

19
Q

describe the relative refractive period

A

k channels open, AP can occur with a large stimulus

20
Q

what happens when we increase the width of an axon

A

conduction will be faster

21
Q

what is myelination

A

basically insulator of the nerve, making it faster as it jumps from node to node.

22
Q

class of nerves, identify them.

A

C (NOTE THAT C FIBRES ARE NOT MYELINATED!!!) , A DELTA, A BETA, A ALPHA (order from slowest to fastest and thinnest to thickest) increase in width means faster nerve

23
Q

what makes up the PNS

A

cranial nerves and spinal nerves

24
Q

what makes up the CNS

A

brain stem and spinal chord

25
Q

what makes up the sensory root

A

the trigeminal nerve! - opthalmic, maxillary, mandibular (this exhibits efferent muscles of mastication), motor root (exhibits afferent) - 3 DIVISIONS, 2 ROOTS, 1 GANGLION

26
Q

what makes up the brainstem

A

pons at the top then the medulla then the spinal chord going off the pons

27
Q

what is the SENSORY order of pathway in the brainstem

A

main sensory nucleus, nucleus oralis, nucleus interpolaris, nucleus caudalis

28
Q

what are nociceptors

A

nociceptors are AFFERENT and are found at nerve endings, they are absent in the brain liver and lung

29
Q

what 2 types of pain do we get?

A

FAST - A delta fibres, wider diameter than C fibres
SLOW - fine, unmyelinated, smallest diameter

30
Q

what is a graded potential

A

a local change, triggering event needs to occur for it to happen eg a stimulus (it is also post synaptic)

31
Q

what is transduction

A

it is a SENSORY STIMULUS (electrical) - it MUST have an adequate stimulus to reach (-50mv) in order to cause an action potential/a response

32
Q

describe what happens with nociceptor transduction

A

we have DIRECT and INDIRECT

DIRECT - can be chemical, mechanical, or thermal ie TRVP1 (capsican)

INDIRECT - tissue injury response, inflammation, it is generally the effect of substances released from nerve endings - this makes sense as it is a nociceptor transduction!!!

33
Q

what do NSAIDS do?

A

they block sensation of nerves!

34
Q

what is substance P

A

A NEUROTRANSMITTER AND A MODULATOR OF PAIN PERCEPTION. It is released as a result of the axon reflex - it increases sensitisation of neighbouring nociceptors and also increases vascular permeability

35
Q

explain the different types of pain in the teeth

A

enamel and dentine - short and sharp pain

pulp - dull and long

36
Q

describe what makes up pulp nerves

A

they are AFFERENT (meaning its coming from the outside world to IN) - c and delta fibres are to do with pain then we have b fibres which are to do with mechanoreception.

37
Q

what zone is the plexus of nerves found within pulp?

A

the plexus of nerves are found in the cell free zone - under odontoblast layer.

38
Q

what 3 theories are there for dentinal sensitivity?

A

dentine innervation theory, odontoblast receptor theory, hydrodynamic theory (most likely one)