Pain Flashcards
What are the three components of pain
- Sensory
- Affective-motivational
- Cognitive-evaluative
What is descarte’s historical perspective on pain
Fluid-filled nerves transmit processing to the brain
What mechanisms travel by the medial meniscal pathway
mylentated Abeta mechanoreceptors, Aalpha and Adelta
What type of signals travel via the medial meniscal pathway
Touch, vibration, 2-point discrimination, body in space
What mechanisms travel by the spinothalamic pathway
Lightly mylineated Adelta, unmylinated C-fibres
What type of signals travel via the spinothalamic pathway
Noxious sensations
What is the nociceptive flexion reflex
Pathway from peripheral stimulus -> nociceptive signal -> dorsal horn -> withdrawal motor signal
What is NFR a measure of
Spinal hyperexcitability
Can NFR be modulated by top-down processing
Yes
What is central sensation
Heightened pain sensation caused by imbalance in excitatory and inhibitory signals
What is allodynia
Experience of pain to an innocuous stimulation
What types of patients is allodynia common in
Amputees or people with neuropathic injuries
What is hyperalgesia
Increased pain from stimulation that normally provokes pain
What is primary hyperalgesia
Increased pain at location of injury
What is secondary hyperalgesia
Increaed magnitude and modality of pain
Does repeated stimulation leasd to an increase in pain intensity
Yes
How does repeated stimulation lead to an increase in pain intensity
Disinhibiting nociceptive input to the dorsal horn
What does capsaicum do
Cause pain but no tissue damage
Does capsaicum generate primary and secondary hyperalgesia
Yes
If you take a peripheral nerve block does that prevent secondary hyperalgesia
Yes
What pathway does sensory-discriminative pain take
Lateral ascending pathway
What pathway does motivational-affective pathway take
Medial ascending pathway
What is the route of the sensory-discriminative pathway
via thalamus to somatosensory cortex
What is the route of the motivational-affective pathway
via medial thalamus to amygdala and insula
What type of strucutral change is seen in chronic pain
Atrophy of the thalamus
What type of functional change is seen in chronic pain
Reorganisation of the somatosensory cortex and motor cortex
Does local anesthetic lead to acute deafferation
Yes
Does amputation lead to chronic deafferation
Yes
How does the motor cortex change in chronic pain
Loss of feedback loop for motor processing
Does the degree of pain related to the degree of remapping of motor organisation
Yes
What is the feeling that a limb is not your owne
Somatoparaphremia
What is the lack of awareness of your limbs
Asomatognosia
What is complex regional pain syndrome
Pain generated by teh spinal and central processing disturbances
Is complex regional pain syndrome related to lateral or contralateral reorganisation
Contralateral - reorganisation of the good limb
What is a fear of reinjury
Kineseophoba
Is the disinhbition of descending pathways bad
Yes
What does the inhibition of descending pathways result in
Less pain
Do rodents experience stress induced analgesia
Yes
Is there an attentional bias towards pain
Yes
Is the attentional bias towards pain greater in people with chronic pain
No
Are women with fibromyalgia more prone to distractibility in Wisonsin card tasks
Yes
Do women with fibromyalgia have a bias to disadvantageous decks in the Iowa gambling task
Yes
Does fear lead to an increase or decrease in pain reactivity
Decrease
Does anxiety lead to an increase or decrease in pain reactivity
Increase
If you see someone stoic take pain are you more or less likely to experience pain
less
Do sensory or emotional images modulate the NFR more
sensory
If you are more empathetic do you have a greater NFR
Yes - but pain is less intense
When viewing media of others in pain what regions are activated
Somatosensory cortices and inferior parietal regions
Is your motor evoked potential reduced when viewing media of others in pain
Yes
Do people with high hypervigilance to pain have fewer vicarious pain repsonse
Yes
Do people who experience vicarious pain have dampened theta activity (cognitive emotional processing) when viewing pain
yes
Do people who experience vicarious pain have gerater motor cortext activity
yes
