Pain

Question 1

Projections of CN V in the pons

Answer 1

Parabrachial Nucleus

Question 2

Projections of CN V in the Midbrain

Answer 2

periaquaductal grey matter

Question 3

Projections of CN V in the Thalamus

Answer 3

VM Nucleus,

MedioDorsal Nucleus

Question 4

Projections of CN V in the forebrain

Answer 4

globus pallidus- MOTIVATIONAL
amygdala, – EMOTIONAL
Ventral medial Hypothalmus - DANGER RESPONSE

Question 5

Projections of CN V in the Cortex

Answer 5

S1 – MOTIVATIONAL
Insula - MOTIVATIONAL
Cingulate – EMOTIONAL, MOTIVATIONAL

Question 6

Locus Ceruleus

Answer 6

Nor Epi generation

Question 7

What order of cord feedback to pain occurs? ( 4 levels))

Answer 7

1. Parabrachial N, Medullary reticular, Locus Ceruleus, Raphe
2. Periaquaductal gray
3. Amygdala and Hypothalmus
4. Somatosensory cortex

Question 8

How do pain reflexes work?

Answer 8

Raphe nuclei (serotonin) and Locus ceruleus (noradrenalin)
 Feedback opioids immediately to spinal cord

Question 9

What are the four types of pain disorders?

Answer 9

nociceptive (cutaneous and visceral)
• inflammatory
• dysfunctional
• neuropathic

Question 10

Which pain fiber types are mylinated? Which are not?

Answer 10

A-Delta = mylenated and fast
C = unmylenated and slow

Question 11

referred pain

Answer 11

Viceral pain that criss crosses with nocioceptive pain

Question 12

Inflammatory pain works how?

Answer 12

Mast cells, macrophages, and neutrophils release factors that amplify pain peripherally

Question 13

allodynia definition

Answer 13

normally nonpainful stimuli become painful

Question 14

Hyperalgesia

Answer 14

exaggerated pain

Question 15

Dysfunctional Pain

Answer 15

Fibromyalgia (central amplification)

Rare genetic disorders/channelopathys lead to peripheral amplification

Question 16

Neuropathic Pain

Answer 16

Maladaptive plasticity

Question 17

allodynia mechanism

Answer 17

wide dynamic range neurons in the dorsal horns connect C and Abeta fibers

Question 18

Central sensitization

Answer 18

changes in gene expression that amplify pain signals

Question 19

Phantom limb pain

Answer 19

maladaptive reorganization

Question 20

Neuropathic pain tx (5)

Answer 20

Antidepressants – stop NorEpi and seratonin
Anticonvulsants (Na channel) – block extra APs
Anticonvulasnts (Ca Channel) – block extra APs
Opiods - enhance endogenous analgesics
Cannabinoids - reduces pain in amygdala
Topical - Chile peppers overwhelm nerves