Pain

Question 1

Which neurotransmitters are involved in the pain pathway? 

Answer 1

• glutamate
• GABA
• serotonin
• endorphins
• dynorphines
• norepinephrine

Question 2

What happen during the pain pathways

Answer 2

1. Sight of injury
2. Spinal cord
3. Brain stem
4. Cerebrum - stomasensory cortex

Question 3

What is nociception

Answer 3

Encoding an noxious stimuli

this doesn’t always pain patient preserves pain

Question 4

Which terminals sense the noxious stimuli?

Answer 4

Peripheral sensory terminals

Question 5

Where is the cell body of the nocieptor located?

Answer 5

• Dorsal hom of spinal cord
• terminal ganglia
• Vargus node ganglian

Question 6

Types of Nociecptors - thermal, mechanical & chemical

Answer 6

Thermal - respond to extreme temps
Mechanical- respond to extreme mechanical pressure
Chemical - respond to tissue damage/inflammation

Question 7

What can activate nociceptors? E.g physical trauma

Answer 7

• chemical
• excessive temperature
• stretching
• ischaemia (insufficient blood flow)

Question 8

The steps of activating nociceptive neurons?

Answer 8

Detecting nexious stimuli
• chemical, mechanical, thermal

Stimuli is converted into an AP, AP started at site on injury

AP travels to dorsal hom of spinal cord
• here second order neurotransmitters relay information to brain

Brain process this information

Then there is a perception of pain
• cognitive, sensory, emotive

Question 9

Nociception: Types of fibres -

Answer 9

•A-apha / A-beta
•A-delta
•C-fibres

Question 10

•A-apha / A-beta ?

Answer 10

• myelinated
• nociception - thermal & mechanical
• mechanical sensitivity
• Speed: very fast

Question 11

A-delta ?

Answer 11

• myelinated
• nociception - thermal, mechanical & chemical
• mechanical & thermal sensitivity
• Speed: fast

Question 12

C-fibres ?

Answer 12

• non
• nociception - thermal, mechanical & chemical
• mechanical, thermal & chemical sensitivity
• Speed: slower

Question 13

Hot plate examples - first pain and second pain?

Answer 13

First pain:
• quick and fast
• signals are carried by myelinated fibres

Second pain:
• slow and delayed
• signals are carried by unmyelinated C fibres

Question 14

When AP travels to dorsal hom of spinal cord, 2 things can happen ?

Answer 14

• trigger a reflex (hot plate)
• convey info to brain regarding location and intensity

Question 15

What areas of the brain is affected

Answer 15

• Stomasensory cortex
• limbic system
• prefrontal cortex

Question 16

Stomasensory cortex - function & linkage to pain perception

Answer 16

Function: sensory aspect
Pain perception: location & intensity of stimulus

Question 17

Limbic System- function & linkage to pain perception

Answer 17

Function: affective/emotion
Pain perception: emotional aspect of pain

Question 18

Prefrontal - function & linkage to pain perception

Answer 18

Function: cognitive aspect
Pain perception: behaviour, emotion, memory & decision making

Question 19

Nociceptors

Answer 19

• Are usually activated by stimuli that can be harmful
• can also be activated by stimuli that can be beneficial e.g. inflammatory response to promote healing
• pain and suffering I’m not the same

Question 20

Neurotransmitters involved in the descending modulation?

Answer 20

• GABA - BNZ
• serotonin - amitriptyline
• opioid - morphine
• noradrenaline - mythylphenidate

Question 21

Pain modulation

Answer 21

• Occurs in the spinal level from non-noxious inputs
• occurs in the supraspinal level through the descending modulatory system

Question 22

Types of pain

Answer 22

Somatic
• pain receptors in muscle, bone, soft tissue

Visceral
Visceral organs
• heart, lungs, pancreas, intestines

Neuropathic
• damage to sensory nerves 

Question 23

Pain definition?

Answer 23

A unpleasant emotional and sensory experience with tissue damage

Question 24

Which agent neuropathic pain respond to? 

Answer 24

Anticonvulsants & antidepressant

Question 25

Which agent does borne damage respond to? 

Answer 25

NSAIDs & bisophenates 

Question 26

Which agency do muscle spasms respond to? 

Answer 26

Antispasmodic & muscle relaxants

Question 27

Which agents to cerebral irritation respond to

Answer 27

BZDs