Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Biochemistry Final Exam > Pain, Analgesia, and Anesthesia > Flashcards

Pain, Analgesia, and Anesthesia Flashcards

1
Q

What is an unpleasant sensory or emotional experience associated with actual or potential tissue damage?

A

pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What happens when we experience pain of moderate to high intensity?

A

it is accompanied by anxiety and urge to escape or terminate the feeling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What unconscious activity is induced by a harmful stimulus applied to sense receptors?

A

nociception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

_____ are harmful, poisonous, or very unpleasant stimuli.

A

Noxious stimuli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

____ is an exaggerated response to a noxious stimulus.

A

Hyperalgesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

____ is the sensation of pain in response to a normally innocuous stimulus (e.g. painful sensation of a warm shower from damaged skin).

A

Allodynia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Is all pain accompanied with an emotional experience?

A

YES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

_____ is when intense, repeated, or prolonged stimuli are applied to inflamed tissues and the threshold for activating primary afferent nociceptors is lowered and the frequency of firing is higher for all stimulus intensities.

A

Sensitization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What happens when the primary afferent nociceptors’ threshold is lowered?

A

the frequency of firing for all stimulus intensities is HIGHER, which means the area is more sensitized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which inflammatory mediators contribute to the process of sensitization?

A

bradykinin (BK)
nerve-growth factor (NGF)
prostaglandins (PGs)
leukotrienes (LTs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What do hyperalgesia and allodynia signify?

A

increased sensitivity of nociceptive afferent fibers (nociception)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Over time, does sensitization enhance or diminish the pain response?

A

enhance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the inability or reduced ability to feel pain without the loss of consciousness or other sensations?

A

analgesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

____ are substances that reduce the ability to feel pain (e.g. opioids, aspirin, etc.).

A

Analgesics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the insensitivity to pain?

A

anesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the substances called that produce a general insensitivity to pain?

A

anesthetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

_____ anesthetics depress the CNS to a sufficient degree to permit the performance of surgery and unpleasant procedures.

A

General

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

____ anesthetics are substances that, when in contact with a nerve trunk, can cause both sensory and motor paralysis in the area innervated.

A

Local

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Isoflurane, halothane, nitrous oxide, and propofol are all _____.

A

general anesthetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Cocaine, lidocaine, and bupivacaine are all ____.

A

local anesthetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the 3 receptors by which biochemical and molecular bases of pain occur?

A

mechanoreceptors
thermoreceptors
chemoreceptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which pain receptors mediate responses to touch and pressure?

A

mechanoreceptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which pain receptors detect the sensations of warmth and cold?

A

thermoreceptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which pain receptors are stimulated by a change in the chemical composition of the local environment?

A

chemoreceptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

_____ are mechanical nociceptors that respond to strong pressure.

A

Mechanoreceptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

When are thermoreceptors activated?

A

activated by skin temperatures that are more than 45C or severe cold (<20C)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Taste and smell receptors are _____.

A

chemoreceptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Visceral receptors that are sensitive to plasma levels of oxygen, pH, and osmolality are ____.

A

chemoreceptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Chemicals such as bradykinin, histamine, acidity, acidity, and chemical irritants all trigger ____.

A

chemically sensitive nociceptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

A variety of receptors on the endings of _____ nerves/neurons respond to noxious thermal, mechanical, or chemical stimuli.

A

nociceptive sensory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Which ganglion do nociceptive sensory nerves send signals to the brain through?

A

trigeminal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Which channels are activated by intense heat, acids, and chemicals?

A

TRP channels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

____ receptors are activated by intense heat, acids, and chemicals such as capsaicin.

A

TRPV1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Capsaicin is found in hot peppers and is an example of a _____.

A

vanilloid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

____ receptors are activated by noxious mechanical, cold, and chemical stimuli.

A

TRPA1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What protein attaches transmembrane receptors to internal cytoskeleton proteins?

A

ankyrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Which receptors are activated by pH changes within a physiologic range and may be the dominant receptors mediating acid-induced pain?

A

acid-sensing ion channel (ASIC) receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

TRP receptors are classically associated with _____.

A

thermoreceptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Can the TRP channels be directly activated by different stimuli in the post-synaptic membrane?

A

YES - cold, heat, H+, etc.

40
Q

What are some of the intermediate signaling molecules that can activate the receptors on the nerve ending?

A
  • ATP
  • molecules that act on G-protein coupled receptors
  • NGF
41
Q

What acts on purinergic receptors to open channels on the nerve ending?

A

ATP

42
Q

What are some molecules in pain reception that can act on G-protein coupled receptors?

A
  • bradykinin
  • histamine
  • prostaglandins
  • serotonin
  • substance P
  • calcitonin gene-related protein
43
Q

____ acts on tyrosine receptor kinase A (TrkA) receptors.

A

NGF

44
Q

P2X, an ionotrpic receptor, and P2Y, a G-protein coupled receptor are acted upon by ____ to open their channels.

A

ATP

45
Q

Does NGF signal through G-protein coupled receptors?

A

NO - it signals through tyrosine kinase A receptors

46
Q

Tissue injury releases ____ and ____ that sensitize or activate nociceptors that release substance P and CGRP.

A

bradykinin; prostaglandins

47
Q

Do mast cells produce additional pain response?

A

YES - by their degranulation

48
Q

What happens when NGF acts on the TRK receptor?

A

it elicits a variety of cellular responses:

  • pro-apoptotic genes
  • anti-apoptotic genes
  • decrease cell growth
  • promote cell survival
  • outgrowth of neurites
  • cell growth + survival
  • rapid responses (ion channels)
49
Q

Does NGF acting on the TRK receptor cause rapid or slow responses?

A

BOTH

  • rapid
  • slower transcriptional regulation
50
Q

How does NGF acting on the TRK receptor elicit its effects?

A
  • rapid protein kinase actions

- slower transcriptional regulation

51
Q

In the inflammatory response at the neuron level, ___ can quickly activate the neuron to produce a painful sensory reception and produce sustained changes in the neuron that may lead to heightened sensitization.

A

NGF

52
Q

NGF is an intermediary molecule in pain signaling that works through _____ receptors and can produce rapid and sustained responses.

A

tyrosine kinase

53
Q

ATP can act on _____ receptors, leading to cellular depolarization.

A

ionotropic

54
Q

Bradykinin, histamine, prostaglandins, serotonin, substance P, and CGRP are all ____ of G-protein coupled receptors.

A

agonists

55
Q

Intermediate signaling molecules can all produce ____ of nociceptive neurons, leading to immediate or prolonged changes in neuronal responsiveness.

A

sensitization

56
Q

What part of the brain receives pain transmission signals and then interprets them?

A

cerebral cortex

57
Q

What are the two major types of fibers that carry pain?

A

A-delta

C axons

58
Q

A-beta fibers carry signals related to _____.

A

proprioception

59
Q

What fibers are present in nerves that innervate the skin and respond primarily to light touch or moving stimuli?

A

A-beta

60
Q

Which fibers are present in nerves that respond to intense or painful stimuli?

A

A-delta

C axons

61
Q

Which horn of the spinal cord do fibers from nociceptors and thermoreceptors synapse on?

A

dorsal horn

62
Q

Which ganglion do fibers from nociceptors and thermoreceptors synapse on if coming from the head?

A

trigeminal ganglion

63
Q

How do pain fibers ascend the spinal cord to signal to the brain?

A

via the ventrolateral spinothalmic pathway

64
Q

Pain in your right hand would be perceived in your ____ cerebral cortex.

A

left

65
Q

The nerves that are carrying pain pass through to the _____ side to transmit the pain signals to the opposite side of the brain.

A

contralateral

66
Q

The ventrolateral spinothalmic tract mediates ____ and ____.

A

pain; temperature

67
Q

The pain sensory fibers terminate in the dorsal horn, projections cross the midline, ascend in the ventrolateral quadrant of the spinal cord and reach which structures of the brain?

A

thalamus, and into the cerebral cortex

68
Q

Pain from the head and face will come in from cell bodies residing in the _____.

A

trigeminal ganglion

69
Q

The thalamic projections to the somatosensory cortex mediates the purely ____ aspects of pain.

A

sensory

70
Q

The thalamic projections that project to the cortical regions are linked to the _____ responses.

A

emotional; unpleasant emotional dimension

71
Q

The thalamic projections to the somatosensory cortex tell you the ____, ____, and ____ of pain.

A

location; intensity; quality

72
Q

What are the cortical regions of the brain linked to emotional pain responses?

A

frontal cortex
cingulate gyrus
insular cortex

73
Q

Noxious stimuli activate the peripheral ending of the primary afferent nociceptor by the process of ____.

A

transduction

74
Q

What is the basis for referred pain?

A

convergence of somatic and visceral pain fibers in the dorsal horn

75
Q

Why do we rub our knee when we bang it on a piece of furniture in the middle of the night?

A

because transmission in nociceptive pathways can be interrupted by actions that transmit sensation to the dorsal horn (AKA simultaneous activation)

76
Q

Activation of the post-synaptic opioid receptors _____ the dorsal horn interneuron by causing an increase in K+.

A

hyperpolarize

77
Q

The activation of the pre-synaptic opioid receptors leads to a decrease in ___ influx, resulting in decreased glutamate and substance P release.

A

Ca2+

78
Q

The actions of the opioid receptors on K+ and Ca2+ reduce the duration of the excitatory post-synaptic potential (EPSP) in the _____.

A

dorsal horn

79
Q

What happens when enkephalin and dynorphin activate opioid receptors?

A

the EPSP is reduced in the dorsal horn neuron

80
Q

Activation of opioid receptors in dorsal root ganglia cell bodies ____ the transmission from nociceptive afferents.

A

reduce

81
Q

Opioids _____ Ca2+ influx, decreasing the duration of the invoked action potential and reduce neurotransmitter release from the nociceptive neuron.

A

decrease

82
Q

Opioids ____ the membrane of the dorsal horn neuron by increasing intracellular ___.

A

hyperpolarize; K+

83
Q

What are the mechanisms of action of opioid analgesics?

A
  • decrease intracellular Ca2+

- increase intracellular K+

84
Q

Opioids decrease intracellular Ca2+. Decreasing intracellular calcium causes _____.

A

decreased neurotransmitter secretion

85
Q

Opioids increase intracellular K+. Increasing intracellular potassium does what to the cell?

A

hyperpolarizes the cell, disallowing depolarization and causing reduced action potential propogation

86
Q

Opioid receptors are linked to what kind of membrane proteins?

A

G-coupled

87
Q

What happens to Ca2+ and K+ concentrations intracellularly after morphine binds to an opioid receptor?

A
  • increased concentration of K+

- decreased concentration of Ca2+

88
Q

Ibuprofen, naproxen, ketorolac, and celecoxib are all ____.

A

NSAIDs

89
Q

Ibuprofen, naproxen, ketorolac, and celecoxib inhibit ____ and ____.

A

cyclooxygenase; production of prostaglandins

90
Q

NSAIDs _____ inflammatory-mediated pain signaling and ____ sensitization of nociceptors.

A

reduce; reduce

91
Q

What ion channels does lidocaine block?

A

Na+ channels

92
Q

How would you administer halothane, isoflurane, and nitrous oxide?

A

inhalation

93
Q

How would you administer propofol or midazolam?

A

intravenously

94
Q

What is the mechanism of action for most general anesthetics?

A

increase the sensitivity of the GABA receptor, thus inhibiting excitatory neurotransmission and depressing nervous system activity

95
Q

What is the mechanism of action for inhalational anesthetics?

A

they enhance the capacity of glycine to activate glycine receptors, which cause inhibitory effects in the brain

96
Q

What ion channels do halogenated inhalational anesthetics activate?

A

K+ channels; hyperpolarize neurons and make them unsusceptible to depolarization

Biochemistry Final Exam (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions