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Nervous System > Pain and its Management > Flashcards

Pain and its Management Flashcards

1
Q

Analgesia

A

Inability to feel pain

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2
Q

What nerve ending is nociceptors?

A

Free nerve endings

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3
Q

Which fibres are responsible for fast response to pain?
Describe what they look like?
For what pain?

A

A delta fibes

Large, myelinated
up to 10m/sec

Sharp, stabbing pain

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4
Q

Which fibres are responsible for slow response to pain?
Describe what they look like?
For what type of pain?

A

C fibres

Small, unmyelinated
1.2m/sec

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5
Q

Which tract conducts pain?

A

Lateral spinothalamic tract

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6
Q

Is the pre-central gyrus sensory or motor?

A

Motor

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7
Q

Is the post-central gyrus sensory or motor?

A

Sensory

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8
Q

Where can local anaesthetic be administered?

A

At site of injury
Peripheral nerve
Spinal epidural

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9
Q

Where do NSAIDs take action?

A

At cortex

Site of injury

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10
Q

Role of PGE2

A

Pain sensitisation
Renal arteriole dilation
Ductus arteriosus patency
Cervix relaxation

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11
Q

How are prostaglandins produced?

A

Phospholipid goes to arachadonic acid (help of phospholipase)
Arachadonic acid goes to prostaglandin (help of cycle-oxygenase)
Prostaglandin H2 goes to prostaglandins (help of PG synthase)

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12
Q

Role of PGF2alpha

A

Bronchoconstriction

Uterine contraction

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13
Q

Role of PGI2

A

Vasodilation

Inhibition of platelet aggreagation

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14
Q

What does cox-1 do?

A

In background all time
Gastric protection
Platelet aggregation
Renal protection

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15
Q

What does cox-2 do?

A

Inflammation

Hyperalgesia- increased sensitivity to feeling pain

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16
Q

What do NSAIDS inhibit?

A

Cyclo-oxygenase

No prostaglandlinH2 so no prostaglandins produced

17
Q

Where do opioids act on?

A

Act on brain- how brain perceived pain (strongest)
Also site of injury- weakest
Spinal epidural can be beneficial - middle effectiveness

18
Q

Name opioids that are naturally occurring?

A

Morphine + Codeine

19
Q

What are prodrugs?

A

Metabolised in body into active drugs

20
Q

What are endogenous opiods?

A

Body’s own analgesics

Can be produced during exercise

21
Q

Signalling processing of pain

A

Delta fibre/C fibre enter posterior horn
Form synapse with neurone which takes info across contralateral side up to thalamus
Endorphins create negative control (from interneurone)
Endorphins will inhibit pathway at the synapse
When rub yourself give rise to mechanoreceptor stimulation and activation of neurone that releases endorphins and so inhibit red pathway

22
Q

What does acupuncture do?

A

Active mechanoreceptors release endorphins

23
Q

What is patient controlled analgesia?

A

Allow patient to regulate analgesic dosing schedule

Anaesthetist set lock mechanism so there is a max so no overdose

24
Q

What are analgesics?

A

Class of medications to relieve pain

Nervous System (7 decks)

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