Pain Flashcards
Pain is objective or subjective?
always subjective
what aspects to pain are where?
experience with sensory and emotional aspects
does tissue damage size = pain amount?
Nope. variable.
Nociception vs. pain?
Pain: reach conscious brain
nociception: before reach conscious brain
how is pain expressed?
in behaviour/communicated
nociceptors compared to somatosensory receptors?
nociceptors have higher threshold to transduction
nociceptive pain you get what reactions?
autonomic
withdrawal
acts as early warning
which nociceptors are myelinated? which faster?
A-delta (faster 3-30m/s)
C polymodals: unmyelinated (slower, <3m/s)
glabrous skin does not have what fibers?
A-delta fibres
first and second pains, how transmited?
A-delta: first
C: second
where are most pain receptors in dossal horn?
most are superficial
second order neurons project nociception via?
anterolateral tract
decussate at level of spinal cord
do all second order neurons project nociception up?
only 1 in 9, others make reflex circuits
how is nociceptive pain adaptive?
can signal potential tissue damage
What does the inflammatory pain do?
give info about the damage after the injury
describe inflammatory pain?
pain maintained continuously, tenderness promotes repair(protective)
What is TRPV1?
nociceptive ion transducer activated in hot chili peppers to capsaicin
what does polymodal mean?
neuron can depolarize due to multiple things: heat and mechanical
peripheral sensitization leads to what sensation?
primary allodynia and hyperalgesia due to sensitized terminal
what is secondary allodynia/hyperalgesia?
after CNS sensitization
also expanded region of sensitivity in nociceptive area
inflammatory pain purpose?
adaptive and reversible
protect during healing
inflammatory pain amplification? 2 ways
peripherally
centrally
2 kinds of maladaptive pain?
neuropathic: lesion: stroke, MS, trauma
dysfunctional: no lesion: migraine, fibro, pelvic
describe maladaptive pain:
spontaneous pain
pain hypersensitivity
what is peripheral neuropathic pain?
injury to primary sensory neuron anywhere along the transduction pathway
neuropathic pain purpose?
maladaptive, persistent
sensory amplification
low and high intensity stimuli
3 points for neuropathic pain:
- central amplification
- neuroimmune interactions, PNS/CNS
- peripheral amplification via lesion or disease
how does emotional come into pain with chronic conditions?
emotional more of a role as condition becomes worse as it shifts from physiological to emotional processes
how does spinal control of pain modulation happen?
inflamm will engage descending pain modulation inhibit or facilitate nociceptive transmission in spinal cord
3 cortical areas associated with top-down psychological modulation of pain:
anterior cingulate
prefrontal
insula
can you modulate placebo?
yes via opiod antagonist, you can reduce placebo effect
What is Nocebo?
expectations of positive of negative beliefs will modulate pain felt
6 psychobiological model of pain:
injury genetics chemical/structural context mood cognition
