Pain

Question 1

labeled line theory

Answer 1

Descartes (and others) believed pain was carried by specialized receptors (ie. We feel pain because pain receptors tell us that something is painful)

Question 2

what fibers detect pain

Answer 2

free nerve endings

freen nerves are high threshold

everything else is low threshold so it is a mix of both theories

Question 3

different types of nociceptors in free nerve endings

Answer 3

• Nociceptoris umbrella term for “noxious” receptor
• Thermal, mechanical, chemo
• Silent/sleeping nociceptors
• Polymodalnociceptors

Question 4

polymodal nociceptros

Answer 4

one free nerve ending that can respond to abunch of things``

Question 5

A alpha and Abeta

Answer 5

myelinated
large diamet
proprioception and light touch
lowest intensity
fastes

Question 6

Adelta

Answer 6

lightly myelinated
medium diameter
nociception (mechanical themal chemical)
high intensity
free nerve endings
sharp pain

Question 7

c fiber

Answer 7

slowest 
dull pain
highest intensity
unmyelinated
small diameter
temp itch
nociception (mechanical thermal chemical)

Question 8

glutamate nociception

Answer 8

released in lamina I-VI
ampa
nmda - learning in spinal cord
once active you get a bunch of ca in and it becomes responsive for a long time

Question 9

substance P

Answer 9

neuropeptide
released with glutamate
nociception

Question 10

calcitonin gener related peptide

Answer 10

released with glutamate nociception

Question 11

what kind of pain is neospinothalamic

Answer 11

discriminatory pain

Question 12

what kind of pain is paleospinothalamic and spinoreticular?

Answer 12

reflective pain

Question 13

neospinothalamic tract is carried by what fibers

Answer 13

delta

Question 14

delta and c fibers localized?

Answer 14

delata is localized

c is poorly localized and long lasting

Question 15

phantom limbs

Answer 15

PAIN is psychological

Question 16

pain on battlefield

Answer 16

gets blocked or modulated

Question 17

depression and pain and sleep

Answer 17

more sensitive to pain with less sleep bc of the psychological aspect and with depression

Question 18

chronic pain

Answer 18

like phatom pain had damage a long time ago but still there

Question 19

nocebos

Answer 19

opposite of placebo

Question 20

pain sensitization

Answer 20

somtimes when we feel it we get more sensitive other times we get less sensitive

it depends on the neuron and temporal order that the painful stimulus is presented

Question 21

gate control theory of pains

Answer 21

inside spinal cord you have large and small neurons that converge in substantia gelatinosa, that are against each other whether we will receive pain or pressure or no, normal things are inhibited by substantia gelatinosa, and will inhibit other neurons from ascending also

Question 22

Specific properties of nociceptive and non-nociceptive signals togethercode for pain perception in the spinal cord
Some spinal cord layers contribute to pain-modulatory pathways by spino-bulbo-spinalmechanisms

Answer 22

spinal cord >brainstem> spinal cord

perabrachial nucleus is part of reticular formation

spinoreticular pathway

parabrachial nucleus talks to limbic so it adds to fer anxiety depression

limbic and cognitive systems both talk to pag (periaqueductal gray matter) which sends descding projection to rvm (rostral Ventral medulla) which is another part of the reticular system
rvm sends neurons down that will positively or negatively feedback so exacerbate or ameliorate the pain

on battlefield adrenalin is pumping and frontal lobe inhibits this system with limbic system and pag to say now is not the time, and norepi is released into psinal cord and you do not feel the pain

happnes when haveing a great time or really pumped really pumped

Question 23

2 pain modulatory pathways: Anterolateral system and Spino-bulbo-spinal pathways:

Answer 23

Spinoreticularand spinomesencephalictracts

Question 24

Spinoreticularand spinomesencephalictracts type of info

Answer 24

poorly localized pain

Question 25

Spinoreticularand spinomesencephalictracts point of origin receptors involved

Answer 25

free nerve endings (TRP Channels) in skin visceral and muscle

Question 26

Spinoreticularand spinomesencephalictracts cell bodies

Answer 26

drg

Question 27

Spinoreticularand spinomesencephalictracts first synapse

Answer 27

lamina 1-2

Question 28

Spinoreticularand spinomesencephalictracts enters and travels

Answer 28

dorsal horn (Lissauer’s Fassciculusto ascend at least 1 segment in lamina I), after 1stsynapse, travels bilaterally, ascends through anterolateral spinothalamictract

Question 29

Spinoreticularand spinomesencephalictracts decussates

Answer 29

spinal cord after 1st synapse

Question 30

Spinoreticularand spinomesencephalictracts second synapse

Answer 30

Medullary/Pontine reticular formation, parabrachialnucleus (spinoreticular); PeriaquedcucatalGrey Matter (spinomesencephalic)

Question 31

Spinoreticularand spinomesencephalictracts final destination

Answer 31

dorsal horn of spinal horn

Question 32

spinomesencephalic tracts

Answer 32

are at midbrain level

Question 33

spinoreticular tracts

Answer 33

are below midbrain

Question 34

pb is pathway into

Answer 34

limbic system

Question 35

main pathway of inhibition uses rvm

Answer 35

periaquaductal gray sends axons down to rvm of medulla and synapse there then those axons go to spinal cord and inhibit gray 2 axon system 5ht is released from rvm, snri is prescribed to put mroe serotonin in system for pain and depression

Question 36

rvm and locus cerulous sends fibers

Answer 36

straight back to spinal cord

Question 37

periaqueductal greay sends fibers

Answer 37

to rvm then to spinal cord

Question 38

raphe nuclei

Answer 38

in middle rostal ventral medulla have serotonergic fibers that descend

Question 39

periaqueductal grey is good at

Answer 39

inhibiting pain signals

Question 40

endogenous opioids

Answer 40

are prescribed bc we have an endogenous opiod system that prevents transmission of pain signals acts at each system pag rvm and spinal cord

Question 41

pag signal

Answer 41

Major descending pathways form the PAGsignal through the Raphe nuclei of the RVMto either inhibit or excite the spinal cord nociceptive signals (This is neurotransmitter specific Endorphins Enkephalins (these top two ar found in terminals of axons in all three areas of pain inhibition adding endorphins make pms stronger) Norepinephrine Serotonin

Question 42

tens

Answer 42

Transcutaneous Electrical Nerve Stimulation Effectiveness supports the Gate-Control Theory of Pain

Question 43

pain matrix

Answer 43

Emotional responses, previous pain experioence, placebo can also affect pain modulation psychological aspect of pain exists all over and is affected by everything! tell kids to toughen up!

Question 44

chronic pain

Answer 44

arises from central sensitization (spinal cord and brain-based sensitization) in the absence of nociceptive stimuli hyperalgesia allodynia

Question 45

hyperalgesia

Answer 45

after we fill pain after it is chronic shouldnt hurt us but it is axon terminal grew so you get hyper response

Question 46

allodynia

Answer 46

activate nociceptor and mechanoreceptor rececptor everytime you activate mechanoreceptor you get painful response and things hurt that shouldnt

Question 47

windup

Answer 47

repeated stimulation from same source is interpreted as increasingly painful neurons are closer to threshold when keep stimulating not necessarily long term windup happens in the moment hyperalgesia is longterm

Question 48

axon reflex contributes to windup

Answer 48

psuedounipolar keep getting ap so you dont turn it up create substance p and you get inflammatory response mast cells release histamine which aggravates neuron on prolongs response

Question 49

pain differences

Answer 49

* Visceral pain info is ONLY carried by delta and delta-fibers * Visceral pain does not “feel like” the damage/disruption responsible for the pain * Female predominance * Psychological intervention improves “well-being,” not necessarily painful symptoms

Question 50

visceral pain paths

Answer 50

can travel in lateralspinotholamic or anterior and some will go through completely diff paths most is reffered not good at numbing just try to teach peole to deal with it types of fibers that

Question 51

visceral pain is referred due to

Answer 51

convergence