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Neuroscience 1 > Pain > Flashcards

Pain Flashcards

Describe the anatomy of the sensory nervous system Understand the gate control theory of pain Identify the key molecules involved in pain pathways Understand how voltage-gated sodium channels are involved in pain pathways

1
Q

Describe cutaneous somatic pain

A

Pain from the body surface, felt as a sharp and burning sensation

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2
Q

Describe deep tissue somatic pain

A

Pain from the musculoskeletal system, usually felt as a dull or aching but localised sensation

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3
Q

Describe visceral pain

A

Pain originating from the organ tissues of the thorax, abdomen, or pelvis, felt as a deep dull, and vague sensation

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4
Q

Describe neuropathic pain

A

Pain caused by lesions of the nervous system that results in structural damage to nerve units instead of receptor stimultion, felt as a burning or stabbing sensation

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5
Q

Name four causes of neuropathic pain

A

Diabetes mellitus, chemotherapy drugs, antiretroviral drugs, HIV

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6
Q

Describe phantom pain

A

Sensations of burning or tingling felt in an absent body part

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7
Q

State four differences between acute and chronic pain

A

1) Acute pain is usually sudden-onset; chronic pain can be sudden or gradual in onset
2) Acute pain is self-limiting and resolves within 6 months, whereas chronic pain lasts over 6 months, with periods of remission and exacerbation
3) Acute pain usually has a precipitating event, whereas chronic pain is rarely associated with an injury
4) Acute pain usually resolves with treatment, whereas chronic pain is hard to treat

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8
Q

Where does pain occur?

A

The brain

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9
Q

Which neurons transmit most pain signals?

A

Dorsal root ganglia neurons

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10
Q

How is facial pain different to other pain?

A

It is transmitted by the trigeminal ganglion instead of dorsal root ganglia neurons

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11
Q

Which nerve fibres mediate acute pain, and which mediate chronic pain?

A

Acute: A-delta fibres
Chronic: C fibres

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12
Q

Define Descartes’ specific theory of pain

A

The intensity of pain is directly related to the amount of associated tissue injury

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13
Q

Define tactile allodynia

A

Extreme sensitivity to light touch

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14
Q

What causes touch sensitivity?

A

Dysfunctional inhibitory interneurons

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15
Q

Describe the role microglia play in interneuron nerve damage

A

Nerve damage causes signals to be sent to microglia, which activates them and causes them to proliferate around laminae I. If the signals persist, this leads to chloride-mediated hyperpolarisation, because the microglia release BDNF which leads to KCC2 (potassium-chloride co-transporter 2) downregulation and an inability to regulate the chloride ion concentration gradient. This means interneurons lose their inhibitory power, and can even become excitatory

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16
Q

Who proposed the gate control theory of pain, and when?

A

Melzack and Wall, 1960s

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17
Q

Define the gate control theory of pain

A

Pain messages can only get through easily when the gates are open. When the gates closed, pain messages are prevented from reaching the brain and may not even be experienced

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18
Q

Why can information on pressure and touch override information on pain?

A

Tactile information is carried by faster A-beta fibres, whereas pain is carried by slower A-delta and C-fibres. This means touch information reaches the brain first and can override later messages

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19
Q

How many laminae are the cells of the spinal cord arranged in, and where are they?

A

10 - six in the dorsal horn, three in the ventral horn, and one clustered around the central canal

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20
Q

In which spinal cord laminae do C fibre nociceptive afferents terminate?

A

Laminae I and II (dorsal horn)

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21
Q

In which spinal cord laminae do A-delta fibre afferents terminate?

A

Laminae I, II, and V (dorsal horn)

22
Q

In which spinal cord laminae do A-beta fibre afferents terminate?

A

Laminae V and VI (dorsal horn)

23
Q

Name the major brain areas involved in pain perception

A

Primary and secondary sensory cortices, anterior insula, and cingulate gyrus

24
Q

What is bradykinin?

A

A polypeptide made from kininogen by proteolysis in the blood, in response to tissue damage or coagulation

25
Q

What type of receptors are the bradykinin receptors B1 and B2?

A

G-protein coupled receptors

26
Q

Which receptor do prostaglandins bind to, and where is it located?

A

EP2 at free nerve endings

27
Q

Name three cells which release prostaglandins in response to tissue damage

A

Granulocytes, macrophages, and nociceptive neurons

28
Q

Name the rate-limiting enzyme of prostaglandin synthesis

A

Cyclo-oxygenase (COX)

29
Q

State the function of nerve growth factor (NGF) in pain

A

It regulates the peripheral sensitivity of nociceptive neurons and increases functional sodium channel expression

30
Q

State the consequence of increases levels of NGF to pain

A

Mechanical and thermal hyperalgesia

31
Q

Name the receptors NGF binds to, and where they are located

A

TrkA receptors - single-TM tyrosine kinase receptors selectively expressed in unmyelinated nociceptive sensory neurons

32
Q

Why is NGF a good target for analgesic drugs?

A

While it is necessary for development, it is non-essential in adults

33
Q

Name three tachykinins

A

Substance P, neurokinin A, neurokinin B

34
Q

What is the main inhibitory neurotransmitter?

A

GABA

35
Q

State three neurotransmitters involved in descending pain regulation

A

Noradrenaline, serotonin, enkephalins, and endorphins

36
Q

Why is the NMDA receptor inactive without glutamate?

A

It is physically blocked by a magnesium ion sitting in its ion channel

37
Q

Name three substances produced by the NMDA receptor

A

C-fos, prostanoids, and nitric oxide

38
Q

In which spinal cord laminae is GABA highly expressed by interneurons?

A

Laminae I, II, and III (dorsal horn)

39
Q

How do GABA-ergic neurons mediate gate control in the dorsal horn?

A

They synapse on neurons containing glutamate and substance P (excitatory neurotransmitters)

40
Q

What is the difference between the GABA-A receptor and the GABA-B receptor?

A

GABA-A: Ligand-gated calcium channel

GABA-B: 7-TM G-protein coupled receptor

41
Q

Name three stimuli which activate TRPV1

A

Capsaicin, noxious heat over 43 degrees Celsius, low pH

42
Q

Why can capsaicin activate TRPV1?

A

It has a similar structure to the endogenous ligand anandamide

43
Q

Where is TRPV1 exclusively expressed?

A

Nociceptive sensory neurons

44
Q

Name two stimuli which activate TRPM8

A

Cool temperatures (8-28 degrees Celsius) and menthol

45
Q

State the pre-cursor of anandamide, and its molecular class

A

Arachidonic acid, an omega-6 fatty acid (pro-inflammatory)

46
Q

Why are ATP-gated channels found on nociceptive neurons?

A

ATP is only found extracellularly after cell damage

47
Q

Which ATP-gated channel results in the release of BDNF?

A

P2X4

48
Q

Which are the key ion channels for action potential production?

A

Sodium channels

49
Q

What role does the alpha2delta subunit play in the formation of voltage-gated sodium channels?

A

It acts as a chaperone for the trafficking of the alpha1 subunit from the Golgi to the membrane

50
Q

How many voltage-gated sodium channels are there in the human body?

A

10 (9 main)

Neuroscience 1 (15 decks)

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