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Pathophysiology PH1002 > Pain > Flashcards

Pain Flashcards

1
Q

What is pain

A

it is an unpleasant sensory and emotional experience associate with actual or potential tissue damage, or described in terms of much damage

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2
Q

what does pain need

A

pain needs nociception- nociceptors- can occur without tissue damage

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3
Q

perception- sensory receptors (senses and somatic senses)

A

these relay information to our brains from- special senses- vision, hearing, balance, taste, smell
somatroy senses- tactile (touch, pressure, vibrations), thermal, proprioception, pain

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4
Q

transmission- sensory neurones- A delta fibres

A

nociceptors- small medium diameter/ myelinated, fast pain, response to thermal and mechanical stimulate, responses to acute pain- carry rapid and sharp pain, responsible for reflex response, information related to proprioception

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5
Q

transmission- sensory neurones- C fibres

A

nociceptors- small diameter/ non-myelinated, slow pain conduction, response to chemical, mechanical and thermal stimuli, slow burning type of pain

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6
Q

transmission- sensory neurones- a beta fibre

A

mechanoreceptors- large diameter/ myelinated, mechanical stimuli (heat or cold), allow rapid conduction, low activation threshold, usually response to light touch, transmit non painful information

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7
Q

pain pathway- stimulus

A

activates specific pain receptors called nociceptors (these are free nerve ending that respond to different stimuli, found in skin, joints etc.)

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8
Q

pain pathway- action potential

A

when these are stimulate an action potential is generated and A delta and C fibres transmit pain stimulus along the first order neuron to the spinal cord

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9
Q

pain pathway- nociceptors

A

the information from nociceptors then passes from the first to second order neuron via junction (use neurotransmitter

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10
Q

pain pathway- brain

A

pain signals travels to opposite side of spinal cord before ascending up to the brain, descending pathways- important in pain inhibition

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11
Q

how does pain move from PNS to CNS- 1

A

nociceptors are stimulated and send message along afferent nerve fibre (AKA first order neurone) to the spinal cord, A delta and C fibres transfer information to specific neurons in dorsal horn known as reclamae 1 and 2

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12
Q

how does pain move from PNS to CNS- 2

A

information crossed from first order neurone to second order neurone due to neurotransmitter glutenate and substance P that carry info over junction, the second order neurone then connects with the third order neurone

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13
Q

2 main pain pathways to brain

A

ascending and descending

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14
Q

2 main ascending pathways

A

spinothalamic tract and spinoreticular tract

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15
Q

2 main ascending pathways- spinothalamic

A

carries main pain signals, transmits info from dorsal horn via second order neurone, projectio to periaqueductal gray matter, terminates in thalamus where it connects with the third order neurone

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16
Q

2 main ascending pathways- spinoreticular

A

also ascending pathway in spinal cord, positioned closely to spinal flamed tract, ascends to reticular formation then the thalamus where it connects to the third order neurone, plays a role in memory and emotional pain

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17
Q

descending pathways

A

responsible for controlling and inhibiting information send along ascending pathway, neurones from periaqueductal gray go to nucleus raphe magnus they synapse here with the second and third order neurone ,, these descending pathways communicate at this junction- can stop transmission of messages

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18
Q

what are the important areas of descending pathway

A

important area- periaqueductal gray and nucleus raphe magnus

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19
Q

what is the role of descending pathway

A

they can inhibit pain transmission- by inhibiting the neurotransmitter, also stimulates neurone in substantia gelatinosa- when stimulated it releases an opioid- stops transmission of signals along second order neurone

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20
Q

registering pain- brain

A

receive the information, process information,execute an appropriate response

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21
Q

what determines the speed the information is transferred to the brain

A

it is dependant on the type of pain and the severity

22
Q

registering pain- thalamus

A

sorting office, transfers information to the limbic system

23
Q

registering pain- limbic system

A

emotional link, transfers info to somatosensory cortex, produces emotions that accompany pain, they can affect the intensity of pain

24
Q

registering pain- somatosensory cortex

A

sensation explained as pain, this reacts to pain locating the source of injury, severity of pain, and plans a response, relays info to automatic response system

25
Q

what does the automatic response system

A

these direct blood flow and nutrients to heal tissue and release pain suppressing chemicals that stops pain response

26
Q

why do reflexes develop

A

reflex developed to deal with situations that need immediate response, initiates a reflex arc pathway

27
Q

what is spinal reflex

A

integration occurs in the spinal cord (gray matter)

28
Q

Simple spinal reflex response- sensory

A

sensory receptor (responds to a stimulus by producing a generator or receptor potential

29
Q

Simple spinal reflex response- sensory neuro

A

sensory neuron axon conducts impulse from receptor to integrating centre
interneuron allow bypass to anterior horn of spinal cord where it can signal a motor signal to transfer to limb to be automatically moved

30
Q

Simple spinal reflex response- integrating centre

A

one or more regions within the CNS that relay impulses from sensory to motor neurones

31
Q

Simple spinal reflex response- motor neurones and effector

A

motor neurons- axon conducts impulses from integrating centre to effector, effector- muscle or gland that responds to motor nerve impulses

32
Q

pain gate theory- ascending

A

ascending inhibition- activate A beta fibres, inhibit pain transmission- by rubbing it

33
Q

pain gate theory- descending

A

descending inhibition- mind over matter, mid brain- axon descend to posterior horn of spinal cord and directly inhibit pain transmission

34
Q

what is pain gate affected by- stimulus

A

if no stimulus gate is closed

35
Q

what is pain gate affected by- A beta

A

if A beta are activated e.g. pressure, inhibitory interneuron is inhibiting P gate closed, substantia gelatinosa is excited and the gate is blocked/ closed to pain impulses which do not travel to the brain

36
Q

what is pain gate affected by- A delta and C fibres

A

if A delta and C fibres activated, carry pain impulse to the gate in spinal cord, inhibitory interneuron is inhibited, the gate is open, and the impulses can carry the pain messenger to brain

37
Q

what is pain gate affected by- unmodulated pain

A

activation of C fibres- info sent to junction connecting first order neurone and second order neuron and signals crossover with neurotransmitters

38
Q

what is pain gate affected by- modulated pain

A

C fibres sent signals to same junction but this time an inhibitory interneuron is being activated because the A beta fibres are also sending information to the junction, which is crossing over at this junction and travelling up the second order neuron, this is reducing the transmission of pain from the C fibres

39
Q

treatments to close pain gates- state of mind

A

the substantia gelatinosa at the pain gate can be affected by the person’s state of mind, e.g. anxiety causes impulses from the brain to open the gate and increase pain perception and being relaxed can activate the SG to close the gate

40
Q

treatments to close pain gates- encephalins and endorphins

A

pain impulses reaching the brain cause messages to be sent to increase the release of endorphins/ encephallins from posterior horn and SG in the spinal cord and act to close the pain gate. levels of chemicals are also raised by exercise and acute trauma

41
Q

treatments to close pain gates- central control

A

the brain can affect the gate as response to memories, past experiences and previous response strategies. all of these factors amy happen separately or at the same time

42
Q

treatments to close pain gates- other

A

exercise, massage, electro therapy

43
Q

pain types- acute and chronic

A

lasts a few months and chronic- persistent lasts for a prolonged period of time

44
Q

pain types- nociceptor pain

A

pain caused by stimulation in soft tissue

45
Q

pain types- neuropathic pain

A

causes by damage to nervous system- disorder of PNS and CNS- burning sensation

46
Q

pain types- psychogenic pain

A

affected by psychological factors

47
Q

what is chronic/ persistent pain

A

pain lasting beyond the time of healing of an injury and frequently there may not be any clearly identifiable cause, may be due to dysfunctional nociceptive system (e.g. hypersensitivity), some are due to ongoing tissue damage (e.g. arthritis, cancer)

48
Q

what is peripheral sensation

A

increased sensitivity to an afferent nerve supply- modifies CNS so more pain is felt with less stimuli

49
Q

what is a central sensitization

A

persistent nociceptive input from the knee drives the central neural changes within the spinal cord and brain resulting in pain amplification

50
Q

what does central sensitization lead to

A

it leads to widespread hyperalgesia- due to changes to CNS, allymia-malfunction of descending pathways- more sensitive to pain at lightest of touches, chronic pain stage

51
Q

example of central sensitization

A

pain starts in knee OA- from synovitis, subchondral bones, periosteum,
ascending C and A delta fibres activation to dorsal horn in spinal cord then to brain

Pathophysiology PH1002 (22 decks)

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