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Dentistry Module 3 > Pain and Management > Flashcards

Pain and Management Flashcards

1
Q

xwhat is the definition of Nociception

A

Nociception: the activation of neural pathways by stimuli that damage or threaten to damage tissues

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2
Q

what is the definition of Noxious Stimulus:

A

Noxious Stimulus: potentially damaging stimulus.

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3
Q

what is a Nociceptive stimulus:

A

Nociceptive stimulus: a stimulus that activates nociceptive pathways

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4
Q

what is the sensation for nociception

A

pain

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5
Q

what is the sensation for thermoreception

A

hot and cold

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6
Q

what is the sensation for mechanoreception

A

touch

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7
Q

what is the sensation for proprioception

A

position sense

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8
Q

what is the sensation for gustation

A

taste

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9
Q

what is the sensation for olfaction

A

smell

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10
Q

when you have pain radiated in healthy areas of the body. what is this called

A

referred pain

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11
Q

give an example when some pains, may not be painful

A

tumours

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12
Q

being born with a condition which, allows you to feel no pain can be dangerous. what is the name of this condition

A

congenital insensitivity

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13
Q

what is dentoalveolar pain

A

pain of the tooth and its surroundings

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14
Q

what is dentine sensitivity

A

when there is an increase sensitivity stimulus to the dentine, this is a result of erosion of the enamel.

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15
Q

what is reversible pulpitis

A

: occurs when there is inflammation of the pulp, however this inflammation can be reversed.

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16
Q

what is irreversible pulpitis

A

occurs when inflammation to the pulp causes vessel and nerve damage beyond repair.

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17
Q

what is periapical periodontitis

A

is an acute or chronic inflammatory lesion around the apex of a tooth root which is usually caused by bacterial invasion of the pulp of the tooth.

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18
Q

what is acute pericoronitis

A

is inflammation of the tissue surrounding a third molar. The condition most often occurs in molars that are partially impacted, or not fully visible. Most people with pericoronitis have a flap of gum tissue partially covering the crown of the erupting tooth.

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19
Q

what is a dry socket

A

: occurs when you have had a permanent tooth extracted and a blood clot fails to develop at the site of extraction. Or it dislodges or dissolves before the wound has healed. Causing allot of pain.

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20
Q

what is maxillary sinusitis

A

is the inflammation of the maxillary sinuses. The symptoms are usually a headache.

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21
Q

how are blocked salivary glands formed

A

salivary stones as a result of crystallized saliva block saliva ducts and direct the flow saliva back to the gland, causing it swell, resulting in pain.

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22
Q

which receptor is a a sense organ or cell that responds to mechanical stimuli such as touch or sound

A

mechanoreceptor

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23
Q

which receptor is a a sensory receptor for painful stimuli

A

nociceptors

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24
Q

where does perception of the stimuli occur

A

cerebral cortex

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25
Q

where is the stimulus processed before it is reaches the cerebral cortex

A

thalamus

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26
Q

what is a synapse

A

a synapse is gap between nerve pathways

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27
Q

there are two electrical potentials for signalling the body. what are they?

A

graded potential

action potential

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28
Q

which electrical potential is used for long and short distance

A

short distance: graded potential

long distance:action potential

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29
Q

where do the graded potential occur in a nerve

A

at the nerve endings

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30
Q

what can change the charge of the cellular membrane of the neuron

A

neurotransmitter molecules released from other neurons

and environmental stimuli

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31
Q

The lipid bilayer membrane that surrounds a neuron is impermeable to charged molecules or ions. how do ions enter/exit

A

via special proteins called ion channels

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32
Q

Ion channels that change their structure in response to voltage are called?

A

voltage gated ion channels

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33
Q

The difference in total charge between the inside and outside of the cell is called the?

A

membrane potential

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34
Q

what is the function of the sodium potassium pump

A
  • Uses ATP
  • Transports sodium out of the cell
  • Transports potassium in to the cell
  • Ratio: 3Na+ out for every 2K+ in
  • Helps maintain concentration gradient
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35
Q

which ion is more permeable K+ or Na+

A

K+

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36
Q

Chemical gradient allows for K+ to flow out.

electrical gradient caused by what keeps the K+ inside to cause equilibrium

A

neagtively charged protein anion

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37
Q

what is nernst equation (equilibrium potential for K+ =)

A

-90mV

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38
Q

what is the equilibrium potential fo Na+

A

+60mV

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39
Q

will resting membrane potential be nearer to K+ or Na+ equilibrium potential

A

K+

the ion with greater membrane permeability will drive membrane potential

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40
Q

what does this image indicate

A

Image indicates that resting membrane potential has been achieved.

This is the equilibrium between the NA+ and K+ and is indicated at -70mV

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41
Q

what does this image indicate

A

Due to a stimulus from either a graded potential or a current from an APs.

It results in the rapid change. Due to an increase in positive gradient outside, the voltage gated Na+ channels rapidly open and increase its intake of Na+ ions.

The inside of the cell becomes more positive. This is indicated at -50mV

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42
Q

what does this image indicate

A

Due to the rapid influx of the Na+ ions, this causes a rapid depolarisation overshoot.

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43
Q

what does this picture indicate

A

As the depolarization peaks, this results in the depolarization of the cell.

K+ channels start to open after delay

As a result, the Na+ channels are now closed and inactivated.

The rapid outflux of K+ results in repolarization.

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44
Q

what does this picture indicate

A

Due to the rapid outflux of the K+ the threshold value reaches hyperpolarization.

Here we will begin to see the K+ channels close.

And the Na+ channels reset.

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45
Q

what does the image indicate

A

the cell has reached resting membrane potential.

Membrane will become permeable to K+.

The K+ will be closed

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46
Q

how does Local Anaesthesia work

A

Anaesthesia chemical compound works by moving in to the neuron and then sitting in the N+ channels.

This blocks the channels, thus blocking action potential propagation.

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47
Q

can an action potential occur, during absolute refractory period

A

no

Na+ channels not in their resting configuration (-50mV)

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48
Q

can an action potential occur, in relative refractory period

A

The K+ channels are open

Membrane is hyperpolarised (increased in negativity)

An action potential can occur, but it requires a larger stimulus.

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49
Q

what does an increase in axon width do.

A
  • Results in lower resistance and faster conduction
50
Q

does myelination increase or decrease speed of transmission

A

increase

  • Myelin sheath: acts as insulator
  • Node of Ranvier – exposed axon – ion channels
  • Local currents flow node to node
  • Depolarisation jumps from node to node.
51
Q

which nerve fibres are associated with nociception

A

C nerve fibres

alpha delta nerve fibres

52
Q

what is the function of afferent neurons

A

carry sensory signals from the body to the brain (input neurons)

53
Q

what is the function of Efferent neurons:

A

carry signals from the brain, such as those directed towards the muscles in the body.

54
Q

what is dorsal

A

Dorsal: on or relating to the upper side or back of an animal, plant, or organ

55
Q

what is ventral

A

Ventral: on or relating to the underside of an animal or plant; closer to the abdominal.

56
Q

what are first order neurons

A

first order neurons conduct impulses from receptors of the skin and from proprioceptors (receptors located in a join, muscle or tendon) to the spinal cord or brain stem, where they synapse with second-order neurons

57
Q

what are second order neurons

A

Second order neurons: the second-order neurons carry signals from the spinal cord to the thalamus (these neurons are generally located in the brain stem or spinal cord).

58
Q

what are third order neurons

A

Third order neurons: the third-order neurons carry signals from the thalamus to the primary sensory cortex.

59
Q

what is Somato (somatosensory):

A

relating to the human or animal body.

60
Q

how many roots does the trigeminal nerve have

A

two roots

sensory and motor

61
Q

The trigeminal sensory nuclear complex consists of the following:

A
  • Nucleus oralis
  • Nucleus interpolaris
  • Nucleus caudalis
  • Main sensor nucleus
62
Q

If there was damage to the nucleus caudalis or a V tractotomy, what would you experience:

A

Loss of ipsilateral facial pain, hot/cold

Still fee touch

63
Q

what is trigeminal neuralgia

A

is a chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain

64
Q

what occurs at nucleus oralis

A

Carry nociceptive inputs to N. Oralis, especially from teeth

Possibly the site of synapses for oral + dental pain

65
Q

what occurs at nuclear interpolaris

A

reflexes

66
Q

what occurs at nuclear caudalis

A

Synapses for facial pain and hot/cold

Possibly the site of synapse for oral + dental pain

67
Q

what is transduction

A

Transduction: transduction in the nervous system typically refers to stimulus-alerting events wherein a physical stimulus is converted into an action potential, which is transmitted along axons towards the central nervous system for integration.

68
Q
  • All or none event
  • Propagates along a nerve
  • Voltage gated channels

these are examples of what

A

action potentials

69
Q
  • Local change in membrane potential
  • Triggering event in – synaptic, post synaptic membrane
  • Triggering event in – receptor, action of stimulus
  • These triggers respond to mechanical, chemical or thermal gated channel

these are examples of what

A

graded potential

70
Q

action potential vs graded potential

trigger = depolarisation to threshold

A

action potential

71
Q

action potential vs graded potential

trigger = stimulus neurotransmitter

A

graded potential

72
Q

action potential vs graded potential

ion movement = Na+ then K+ through voltage gated channels

A

action potential

73
Q

action potential vs graded potential

net movement of Na+ K+ Cl- or Ca2+

A

graded potential

74
Q

action potential vs graded potential

coding of magnitude = all or none, frequency

A

action potential

75
Q

action potential vs graded potential

coding of magnitude = size of potential changes

A

graded potential

76
Q

action potential vs graded potential

duration = fixed

A

action potential

77
Q

action potential vs graded potential

duration = variable

A

graded potential

78
Q

action potential vs graded potential

propagation = self regenerating propagation

A

action potential

79
Q

action potential vs graded potential

propagation = decays with distance

A

graded potential

80
Q

action potential vs graded potential

refractory period = yes

A

action potential

81
Q

action potential vs graded potential

refractory period = no

A

graded potential

82
Q

action potential vs graded potential

direction of potential change = depolarisation then hyperpolarisation

A

action potential

83
Q

action potential vs graded potential

direction of potential change = depolarisation or hyperpolarisation

A

graded potential

84
Q

action potential vs graded potential

location = voltage gated channels

A

action potentials

85
Q

action potential vs graded potential

location = receptors and post-synapse

A

graded potential

86
Q

which receptors convert stimulus energy to elctrical energy

A

graded potential receptors

87
Q

what is transduction

A

transduction is the conversion of a sensory stimulus to another.

88
Q

what activates TRPV4

A

temperatures greater than 27 degress

89
Q

what activates TRPV3

A

temperatures greater than 31 degrees

90
Q

what activates TRPV1

A

>45°C

capsaisin

91
Q

what activates TRPV2

A

>50°C

92
Q

what does this picture indicate

A

Image indicates that a strong stimulus must occur in order for an action potential to occur.

93
Q

what do these drugs act on

  • Glutamate
  • GABA (gamma-aminobutyric acid)
  • Acetylcholine
  • Serotonin
  • Noradrenaline
A

Many drugs act at synapses and affect the neurotransmitters that relay between the synapses

94
Q

what is Temporal summation

A

occurs when a high frequency of action potentials in the presynaptic neuron elicits postsynaptic potentials that summate with each other. This allows the membrane potential to reach the threshold to generate an action potential.

95
Q

what is Spatial summation:

A

Spatial summation is the effect of triggering an action potential in a neuron from one or more presynaptic neurons. This occurs when more than one excitatory postsynaptic potential (EPSP) originates simultaneously and a different part of the neurone

96
Q
  • Pain is associated with two speeds. Fast and slow.

which nerve fibres are responsible for fast , sharp pain

A

alpha delta nerve fibres

97
Q
  • Pain is associated with two speeds. Fast and slow.

which nerve fibre is associated with slow, burning pain

A

C nerve fibres

98
Q

which nerve fibre has a conductive velocity of 5-30ms

A

alpha delta nerve fibres

99
Q

which nerve fibre has a conductive velocity of 0.2-2ms

A

c nerve fibres

100
Q

what do polymodal c fibre nociceptors respond to

A

respond to all pain stimuli

101
Q

what do alpha delta mechanical nociceptors respond to

A

respond to strong mechanical stimuli

102
Q

what do alpha delta polymodal nociceptors respond to

A

responds to all types of noxious stimuli

103
Q

what is carried to the trigeminal nuclei

A

Primary afferent sensations are carried from the periphery to the trigeminal nuclei. These are known as 1st order neurones.

104
Q

which order neurons transcend from the trigeminal nuclei to the thalamus

A

2nd order neurons

105
Q

3rd order neurones transcend from where

A

thalamus to the cerebral cortex

106
Q

what acts as a relay for the thalamus for nociceptive stimulus

A

ventrobasal nuclei

107
Q

where does perception occur

A

cerebral cortex

108
Q

where does processing occu

A

thalamus

109
Q

where does detection occur

A

at receptors

110
Q

what is divergence

A

Any individual neuron can make divergent connections to many different postsynaptic cells.

111
Q

what is convergence

A

One postsynaptic cell receives convergent input from a number of different presynaptic cells.

Convergence allows a neuron to receive input from many neurons in a network

112
Q

what does this image show

A

Discrete pain image shows the following:

If there is a noxious stimulus in a specific area. It follows the same pathway from the primary afferent to the 2nd order neurones

It also diverges on to another postsynaptic cell.

113
Q

what does this image show

A

Hyperalgesia image shows the following:

2nd order neurones can be sensitised by external factors (prostaglandin, serotonin)

As a result of this sensitised, they transmit a bigger signal to the consciousness along with the other 2nd order neurones.

This causes an increased in pain referred to as hyperalgesia.

114
Q

what does this image show

A

radiating image shows the following:

2nd order neurones can be sensitised by external factors (prostaglandin, serotonin)

As a result of this sensitised, they transmit a bigger signal to the consciousness along with the other 2nd order neurones.

This causes an increased in pain area. Which means pain can be perceived as originating from a larger area than the stimulus area.

115
Q

what does this image show

A

Referred image shows the following:

2nd order neurones can be sensitised by external factors (prostaglandin, serotonin)

As a result of this sensitised, they transmit a bigger signal to the consciousness along with the other 2nd order neurones.

The consciousness can perceive the location of the pain site somewhere else.

Usually deep to superficial structure:

  • Heart to left arm
  • Maxillary sinus to teeth
  • Appendix to abdominal skin
116
Q

How does chemical signalling work over different distances?

What speed does it work at?

A

Short distance (e.g. synapse)

Long distance (e.g. hormones)

Relatively slow

117
Q

How does electrical signalling work over different distances?

At what speed does it work at?

A

over short distances by graded potentials

over long distances by action potentials

very fast- up to 120m/s or around 270mph

118
Q

what are two properties of copper wire? how do they make it an excellent conductor?

A
  1. covered by a great insulator: plastic
  2. copper is an excellent conductor of electricity

This means that electricity is conducted rapidly by copper, and is not lost to the external environment because the plastic coating seals it in

119
Q

why are nerves not as good as copper wire?

What do we need to improve conductivity?

A

membrane is a poor insulator in an aqaeous environment

cytoplasm is a relatively poor conductor

Signal decays over a short distance (2-3mm), bad as nerves can be longer than a metre

This means we need a propagrating material: action potential

120
Q
A

Dentistry Module 3 (33 decks)

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