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NeuroPhys > Pain > Flashcards

Pain Flashcards

1
Q

What are the two components of pain?

A

Sensory and emotional components - Multifactorial.

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2
Q

which part of the brain is the Sensory-Discriminate portion of pain activated by

A

The primary and secondary somatosensory cortex.

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3
Q

The motivation-affective part of pain is powered by which brain regions?

A

Sympathetic/emotional responses fouund within the frontal cortex, limbic system, and brainstem areas.

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4
Q

What does the sensory discriminative component supply information about?

A

Location
intensity
Modality - Hot vs cold and stab vs burn.

All via somatosensory cortex.

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5
Q

What does the emotional component of pain tell you?

A

Negative impact on affect/mood

Chronic pain accompanied by depression.

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6
Q

What fiber type carries the very fast traveling acute/physiologic pain?

A

Critical for warning carried by Adelta fibers.

Is highly adaptive, goes away as you heal.

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7
Q

What fiber types carry chonic pain?

A

C-Fibers.

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8
Q

What pain type is known to be maladaptive?

A

Chronic pain, the pain does not go away even after healing.
Not considered a physiological function.

Neuropathic pain is as well.

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9
Q

nociceptive pain serves as a warning where as inflammatory pain serves as….

A

Protective, promoting healing.

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10
Q

What is dysfunctional pain?

A

No understanding lesion found, disproportionate to tissue injury such as iritable bowel or fibromyalgia.

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11
Q

Which type of pain serves no protective function?

A

Neuropathic pain.

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12
Q

Somatic pain can be broken into superficial or deep.

Which fibers carry each?

A

Superficial is easily localized carried by A delta (Sharp) and C-fibers (delayed burning)

The deep somatic pain is more diffuse. The fiber type isnt listen

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13
Q

Which pain is visceral pain carried on and which patterning does it display?

A

Carried on C-fibers travels within a dermatomal patterning “Convergence”

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14
Q

Which type of thermal modality do CMR-1 fibers relay?

A

Cold-menthol

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15
Q

Which type of thermal modality do VRL-1 fibers relay?

A

Noxious heat

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16
Q

What type of thermal modality do VR-1 AKA TRPVR1

A

Noxious heat and capsaicin.

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17
Q

What types of nerves are nociceptors?

A

High threshold*****
Slowly adapting will stay active for awhile once activated.
FREE NERVE ENDINGS.

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18
Q

What does Substance P and CGRPfrom nocieptors do?

A

Released by activated nociceptors and acts to mediate pain!

Substance P will dilate blood vessels => edema. Activates mast cells for histamine.

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19
Q

What is Primary Hyperalgesia (Peripheral sensitization)

A

Amplification of pain signalling at the periphery.
Increased sensitivity and receptive field size of adjacent areas.

The silent nociceptors are activated as well. Mostly by substance P.

20
Q

What is hyperalgesia defined as?

What is allodynia?

A

An increased response to a stimulus that is normally painful.

Pain resulting from non-noxious stimulus.

21
Q

What is the axon reflex?

A

Coupling of sympathetics with nociceptors causing triple response of lewis (Redness, edema, wheal and flare)

22
Q

A-delta fibers respond to which type of pain?

A

Respond to intense mechanical and thermal stimuli. Are very fast as they are myelinated and serve as the first type of pain.

23
Q

C-Fibers respond to which type of pain?

A

Poorly localized, diffuse “second pain”.

Is polymodal in that it acts to mechanical, thermal, chemical stimuli.

24
Q

Which nociceptor is dominant in the joints, muscles, and viscera?

A

Unmyelinated C-fibers.

25
Q

Which fibers are found within Lamina I in processing?

A

A-delta fibers come in bringing fast and acute pain.

26
Q

Which fiber types are found in lamina II and III?

A

Slow, chronic pain C-fibers.

Go directly onto 2nd afferent or modulate Wide range receptors.

27
Q

Which fiber types are found within the lamina V?

A

Wide dynamic range neurons activated by noxious and non-noxious signals.

Called wide range as they are activated by (low threshold) A-Beta fibers as well.

28
Q

What is central sensitization (Secondary Hyperglesia)?

A

Amplification of pain signalling in the central nervous system via PNS and CNS events.

Leads to exagerated release of neurotransmitters and receptors and recruitment of adjacent neurons = “Wind up”

29
Q

Chronic pain is ultimately an overexagerated release of what?

A

Central sensitization, in other words its an exaggerated wind up response.

30
Q

What is neuronal plasticity related to?

A

Nerves changing expressions in chronic pain, not good!

31
Q

What is an example of allodynia?

A

Sunburn, the shirt rubbing against the skin is not a noxious stimulus but it still hurts.

32
Q

What is carried in the anterolateral system?

A

Temerpature, pain, and crude touch.
The spinothelamic tract runs here.

a-delta and C-fibers.

33
Q

Which fibers and which lamina project into the neospinothalamic tract?

A

A-Delta from lamina 1, 4, and 5 Lateral pathway

Terminates in the VPL of the thalamus. Yields location, intensity, and modality via the somatosensory cortex.

34
Q

Which fibers mediate the paleosinothelamic tract and which lamina?

A

Slow C-type via lamina 2,3,5
Terminates in the dorsomedial nucleus of the thalamus.

medial system activates the limbic system forming motivational version of pain

35
Q

What role does the spinoreticular tract play?

A

Descending pain control. Allows for the motor response to pain.

36
Q

What role does the spinomesencephalic tract play?

A

Periaqueductal gray and superior colliculus allowing descending pain control.

Superior colliculus moves eyes to site of injury.

37
Q

The anterior cingulate cortex will respond to what modalities of pain?

A

Perception of pain, imaging of pain, and observing pain of others.

38
Q

the insula will respond to which modalities of pain?

A

Relay station to the limbic system in which there is learning and pain memory to the hypothalamus.

39
Q

What is the gate theory of pain?

A

Gating mechanism within the spinal cord that closes in response to normal stimulation of A-beta fibers.

It OPENS with slow pain fibers A-delta and C.

Thus shaking your hand or sucking on it turns the A-Beta fibers back on closing the gate.

40
Q

What does the periaqueductal gray midbrain do for pain modulation?

A

Activates enkephalin-releasing neurons that project to the raphe nuclei in the brainstem.

41
Q

What do the rostral vental medulla-branstem do for pain modulation?

A

Nucleus raphe magnus 5HT projections to dorsal horn of spinal cord.

42
Q

What do the Locus coerulus in the pons do for pain modulation?

A

NE projections to the dorsal horn of the spinal cord.

43
Q

Which drugs activate the descending pain control pathway?

A

Opiate and catecholamines.

44
Q

In converngence the somatic and visceral pain fibers merge on which type of afferent nerves?

A

On the secondary afferents in the dorsal horn.

45
Q

What is projected pain?

A

Pain to one segment causes pain in a range of areas ex: hit funny bone.

NeuroPhys (10 decks)

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