Pain

Question 1

What are the pain classification systems

Answer 1

Temporal
Mechanism
Diagnosis
Body Site
Etiology

Question 2

Explain the temporal pain classification sysem

Answer 2

Acute pain- lasts less than 3 months

Chronic pain- lasts more than 3 months

Question 3

Explain the Mechanism pain classification system

Answer 3

Nociceptive pain
-arises from damage or disease of non neural tissue
-pain is a symptom

Neuropathic pain
-arises from damage or disease of somatosensory nervous system
-pain is a symptom

Nociplastic pain
-arises from dysfunction of somatosensory nervous system
-pain is the disease

Question 4

Explain the diagnosis pain classification system

Answer 4

Chronic Primary MSK pain
-pain has no apparent damage/disease
*diagnosis= ex. non specific low back pain

Chronic secondary MSK pain
-pain arises from damage/disease
*diagnosis= ex. spondylosis

*assigning an actual reason to the pain (naming it)

Question 5

Explain the body site pain classification sysem

Answer 5

Associating pain with a specific area on the body
-visceral, pelvic, neck, low back

Question 6

Explain the etiology pain classification system

Answer 6

*what is the underlying cause

-post traumatic pain
-post surgical pain
-idiopathic
-disease
-genetic disease

Question 7

Nociceptive neuron vs nociceptor

Answer 7

NN
-neuron of the somatosensory NS that can encode noxious stimuli

NR
-high threshold sensory receptor that can transduce (detect) and encode noxious stimuli

Question 8

Nociceptor neuron fibre types

Answer 8

Abeta
-myelinated
-fast conductivity

C fibres
-unmyelinated
-slower conductivity

Question 9

Explain what happens during transduction

Answer 9

-noxious stimuli activates nociceptor
-ion channels open and ions enter the neuron, depolarizing it
-depolarization reaches threshold (high in NN) and the AP is generated

*first order neurons (primary afferent) are responsible for this (peripheral to SC)

Question 10

Explain what happens during transmission

Answer 10

-nociceptive signals enter dorsal horn of SC
-signal is transmitted to brain

*2nd (SC to thalamus) and 3rd (thalamus to brain regions) order neurons

Question 11

Explain what happens during perception

Answer 11

-nociceptive signals enter brain along with other info (feelings etc)
-brain determines whether to produce pain

*3rd order neurons

Question 12

Explain what happens during modulation

Answer 12

-brain sends signals to SC to modulate incoming nociceptive signals (excitatory or inhibitory)
-there are opioid receptors in brainstem and midbrain so they can be activated and release NT (serotonin etc)

Question 13

Explain referred pain

Answer 13

-when receptor fields from multiple NN located in viscera and elsewhere converge onto a common 2nd order neuron