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Pain Flashcards

1
Q

What is nociception?

A

The sensory response to a noxious stimulus

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2
Q

What is pain?

A

The perception of nociceptive sensory information

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3
Q

What is congenital indifference to pain?

A

Congenital condition where a person is not responsive to pain

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4
Q

What are the two dimensions of pain?

A
  1. sensory-discrimination

2. motivation-affective

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5
Q

What is the sensory-discrimination part of pain?

A

perception of exteroceptive (external) or enteroceptive (internal)
noxious information and ‘localization’ of the site.

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6
Q

What is the motivation-affective aspect of pain?

A

emotional and sympathetic responses and associated (learning) behaviors

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7
Q

What are the three types of pain?

A
  1. Physical
  2. Inflammatory
  3. Neuropathic
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8
Q

What is the main part of the brain that is associated with the sensory-discriminatory part of pain?

A

Primary and secondary somatosensory cortices

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9
Q

What are the main part of the brain that is associated with the motivation-affective part of pain?

A

Frontal cortex
Limbic system
Brainstem areas

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10
Q

What are the three functions of the sensory-discriminative component of pain?

A
  1. location
  2. Intensity
  3. Modality
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11
Q

What are the two components of the emotional component of pain?

A

Negative impact on affect/mood

Chronic pain accompanied by depression

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12
Q

How fast is acute pain felt?

A

0.1 sec after initiation of stimulus (very fast)

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13
Q

What is the fiber type that conducts pain?

A

A-delta fibers

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14
Q

How adaptive is physiologic pain?

A

Very–as tissue heals, pain lessens

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15
Q

What is the initial type of pain sensations that are felt?

A

Sharp, prickling, electric sensation

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16
Q

What is pathologic pain?

A

Chronic pain

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17
Q

When does pathologic pain begin?

A

> 1 sec after the stimulus, then increases slowly

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18
Q

How can pathologic pain become maladaptive?

A

Persistence even without tissue damage

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19
Q

What type of fibers carry pathologic pain? Is this fast or slow conducting?

A

C fibers

Slow conducting

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20
Q

What are the sensations felt with pathologic pain?

A

Dull, throbbing, aching, nauseous senstion

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21
Q

What is the function for nociception? Inflammatory?

A 
Nociception = warning
Inflammatory = promotes healing
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22
Q

What is dysfunctional pain?

A

Pain without understanding or the origin

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23
Q

What is neuropathic pain?

A

Pain d/t damage to nerves

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24
Q

What is the function of neuropathic pain?

A

It has no protective function

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25
What are the two types of somatic pain? What is the quality of the pain for each? Well or not well localized?
``` Superficial pain (sharp, well localized) Deep (dull, poorly localized) ```
26
What are the fibers that carry superficial pain (initial and delayed)?
A delta intially, followed by C fibers for delayed
27
Where is deep pain felt?
CT, bones, joints, muscles,
28
What type of fibers carry visceral pain?
C fibers
29
What type of pain follows a dermatomal distribution?
Visceral
30
What are the four processes of pain processing?
1. Transduction 2. Transmission 3. Modulation 4. Perception
31
What is transduction?
sensation taken in from receptors, transmitted
32
What are the nociceptors for pain?
Free nerve endings
33
Do pain neurons have a high or low threshold? Do they adapt slowly or fast?
High threshold | Slowly adapt
34
What are the three stimuli that nociceptors respond to?
Mechanical (nociceptive) Thermal Chemical
35
Free nerve endings that innervate the body go where (where are the cell bodies)? Face?
``` Body = spinal ganglia Face = trigeminal ganglia ```
36
What is the first process that occurs with damage?
Nociception via direct activation of: - open cation channels - Membrane depolarization - Generate action potential
37
What is the major mediator of pain? Other two? ("inflammatory soup") What do these do?
Bradykinin 5HT Prostaglandin These interact with primary afferent neurons near the site of pain to release other substances
38
What is the MOA of substance P, which is released in response to a painful stimulus? (What is the effect on blood vessels, and on the immune system)?
Vasodilation and inflammation | Mast cell release of histamine
39
What is the indirect sensitization of the peripheral nociceptive processing?
Lowered threshold of nociceptors
40
What is peripheral sensitization?
Spreading of the action potential over other areas where membrane is at a resting state
41
What does peripheral sensitization lead to? (4)
1. Increased sensitivity 2. Increased receptive field size 3. Inflammatory mediators release 4. Activation of silent nociceptors
42
What are the silent nociceptors? What is their function?
nociceptors that only respond to the molecules secreted by other activated nociceptors Expand the receptive field for the pain stimulus
43
What is primary hyperalgesia?
Increase response to a stimulus that is normally painful
44
What is allodynia?
Pain resulting from non-noxious stimulus
45
What is the triple response of Lewis?
Erythema Edema Wheal
46
What type of pain is nociceptive pain (physiologic or chronic)?
Physiologic
47
Which has tissue damage, nociceptive pain or inflammatory pain?
Inflammatory pain
48
Fibromyalgia or IBS is what type of pain? What causes it?
Dysfunctional pain | --no understandable lesion found
49
Does neuropathic pain have a protective function?
No
50
True or false: neuropathic pain is disproportionate to the intensity of nociceptor activation
True
51
What are the receptors utilized for thermal stimuli?
TRP
52
What is the axon reflex?
Activation of the sympathetic system in response to pain
53
Activator of pain, or sensitizer: K
Acivator
54
Activator of pain, or sensitizer: prostaglandins
Sensitizer
55
Activator of pain, or sensitizer: hydrogen
Activator
56
Activator of pain, or sensitizer: substance P
Activator
57
Activator of pain, or sensitizer: leukotrienes
Sensitizer
58
Activator of pain, or sensitizer: ATP
Sensitizer
59
Activator of pain, or sensitizer: bradykinin
Activator
60
What are the type of fibers that sense mechanical sensations (2)? Which has a high threshold, and which a low?
``` A-alpha = low threshold A-delta = high threshold ```
61
What is the type of fiber that senses heat, chemical, and other multimodal stimuli? Do theses have a high or low threshold? Fast or slow fibers?
C fibers High threshold Slow conduction

Physiology (75 decks)

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