Pain

Question 1

What are the pain fibers and are they myelinated or not?

Answer 1

A delta fibers - myelinated

C fibers - non myelinated

Question 2

What pain receptors cause fast and slow pain?

Answer 2

Fast pain A delta fibers

Slow pain C fibers

Question 3

What horn does the pain fibers enter and synapse?

Answer 3

Enter and synapse in the dorsal horn

Synapse at point of entry

Question 4

What is the name of the ascending tract of the pain receptors and what horn is it found in?

Answer 4

Ventrolateral horn

Spinothalamic tract

Question 5

What layers of grey matter does the pain fibers synapse in?

Answer 5

Rexed 2 and 5

Question 6

What is the sensory relay station?

Answer 6

Thalamus

Question 7

Where is responsible for pain perception ?

Answer 7

Somatosensory cortex

Question 8

What is the periaqueductal grey?

Answer 8

The primary control Centre for the descending pain modulation

Question 9

Where does the ascending tract for nociceptors synapse?

Second synapse

Answer 9

Ventromedial nucleii of thalamus

Question 10

What is hyperalgesia?

Answer 10

Having an increased response to painful stimuli

Question 11

What is allodynia?

Answer 11

Having a painful response to non painful stimuli such as light touch

Question 12

What is spontaneous pain?

Answer 12

Spontaneous activity in nerve fibers, feeling pain without any stimulus

Question 13

What condition is associated with spontaneous pain?

Answer 13

Fibromyalgia

Question 14

What condition is associated with chronic acute pain?

Answer 14

Oesteoarthritis

Question 15

What’s the difference between acute and chronic pain?

Answer 15

Acute < 1 month and occurs in response to tissue damage (pain stops when tissue is healed)

Chronic >3-6 months and occurs in the absence of tissue damage

Question 16

What is central sensitization?

Answer 16

The response of the second order neurons in the CNS to normal input both noxious and non-noxious

Question 17

What are the 3 main components of central sensitization?

Answer 17

Wind up
Classical
Long term potentiation

Question 18

What component of central sensitization involves

1. opening up of new synapses?
2. activated synapses?

Answer 18

1 = classical
2 = windup (and long term potential potentiation)

Question 19

In which component of central sensitization involves homosynaptic activity and heterosynaptic activity?

Answer 19

Homosynaptic = wind up 
Heterosynaptic = classical

Question 20

What is neuropathic pain?

Answer 20

Pain initiated or caused by a primary lesion or dysfunction in the somatosensory nervous system

Question 21

What type of treatment is given for pain which acts on the periphery?

Answer 21

NSAIDS
Rest
Ice
Local anesthetics I.e. Na channel blockers

Question 22

What type of treatment is given for pain which acts on the transmission of pain stimuli?

Answer 22

Nerve blocks
Drugs I.e. opioids, anticonvulsants
Surgery I.e. DREZ, cordotomy

Question 23

What type of treatments are given for pain which work our the perception of pain?

Answer 23

CBT
Mirror box therapy 
Graded motor therapy 
Education
Relaxation
Distraction

Question 24

What type of treatment is given for pain which acts not he descending modulation of pain fibers?

Answer 24

Placebos
Drugs I.e. opioids, antidepressants
Surgery I.e. spinal cord stimulation

Question 25

What is gate control theory?

Answer 25

Activation of A beta fibers (non-noxious) which stimulates the release of interneurones which inhibit nociceptive firing (A delta and C fibers)

Question 26

What are the stages of transmission which can be modulated for pain therapy/treatment?

Answer 26

Transduction (acting at the periphery)
Transmission
Perception
Descending

Question 27

What types of neurons receive nociceptive input?

Answer 27

Nociceptive specific neurons

Low threshold mechanoreceptors