Pain Flashcards
What are the pain fibers and are they myelinated or not?
A delta fibers - myelinated
C fibers - non myelinated
What pain receptors cause fast and slow pain?
Fast pain A delta fibers
Slow pain C fibers
What horn does the pain fibers enter and synapse?
Enter and synapse in the dorsal horn
Synapse at point of entry
What is the name of the ascending tract of the pain receptors and what horn is it found in?
Ventrolateral horn
Spinothalamic tract
What layers of grey matter does the pain fibers synapse in?
Rexed 2 and 5
What is the sensory relay station?
Thalamus
Where is responsible for pain perception ?
Somatosensory cortex
What is the periaqueductal grey?
The primary control Centre for the descending pain modulation
Where does the ascending tract for nociceptors synapse?
Second synapse
Ventromedial nucleii of thalamus
What is hyperalgesia?
Having an increased response to painful stimuli
What is allodynia?
Having a painful response to non painful stimuli such as light touch
What is spontaneous pain?
Spontaneous activity in nerve fibers, feeling pain without any stimulus
What condition is associated with spontaneous pain?
Fibromyalgia
What condition is associated with chronic acute pain?
Oesteoarthritis
What’s the difference between acute and chronic pain?
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
What is central sensitization?
The response of the second order neurons in the CNS to normal input both noxious and non-noxious
What are the 3 main components of central sensitization?
Wind up
Classical
Long term potentiation
What component of central sensitization involves
- opening up of new synapses?
- activated synapses?
1 = classical 2 = windup (and long term potential potentiation)
In which component of central sensitization involves homosynaptic activity and heterosynaptic activity?
Homosynaptic = wind up Heterosynaptic = classical
What is neuropathic pain?
Pain initiated or caused by a primary lesion or dysfunction in the somatosensory nervous system
What type of treatment is given for pain which acts on the periphery?
NSAIDS
Rest
Ice
Local anesthetics I.e. Na channel blockers
What type of treatment is given for pain which acts on the transmission of pain stimuli?
Nerve blocks
Drugs I.e. opioids, anticonvulsants
Surgery I.e. DREZ, cordotomy
What type of treatments are given for pain which work our the perception of pain?
CBT Mirror box therapy Graded motor therapy Education Relaxation Distraction
What type of treatment is given for pain which acts not he descending modulation of pain fibers?
Placebos
Drugs I.e. opioids, antidepressants
Surgery I.e. spinal cord stimulation
What is gate control theory?
Activation of A beta fibers (non-noxious) which stimulates the release of interneurones which inhibit nociceptive firing (A delta and C fibers)
What are the stages of transmission which can be modulated for pain therapy/treatment?
Transduction (acting at the periphery)
Transmission
Perception
Descending
What types of neurons receive nociceptive input?
Nociceptive specific neurons
Low threshold mechanoreceptors
