Pain and Neural Transmission Flashcards

1
Q

where in the skin layer are light touch receptors found?

A

near the top.

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2
Q

where in the skin layer are harder touch receptors found?

A

further down than light touch.

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3
Q

what in the skin layer are pain receptors?

A

free nerve endings.

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4
Q

what are free nerve endings?

A

pain receptors/ nociceptors.

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5
Q

In dermis are peripheral nerve firbe branches and terminals myelinated or unmyelinated?

A

unmyelinated.

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6
Q

due to tissue damage and inflammation blood rushes to the area, what can it do in this area?

A
  • bring substances
  • sensitise peripheral nociceptors.
  • induce hyperalgesia (heightened pain response)
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7
Q

what are the 2 type of nociceptors that transduce painful stimuli?

A
  • unmyelinated ‘C’ fibres.

- thinly myelinated ‘A delta’ fibres.

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8
Q

what can nociceptors respond to?

A
  • Mechanical stimuli
  • thermal stimuli
  • chemical stimuli.
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9
Q

where is a thermoreception for heat found? where is it found? what fibre type is it? and what is its role?

A
  • found in deep epidermis
  • fibre type = C
    = role is warmth.
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10
Q

where is a thermoreception for cold found? where is it found? what fibre type is it? and what is its role?

A
  • found in deep epidermis
  • fibre type - ‘A delta’
  • role is cold.
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11
Q

for short pain what is the type of receptor? what is its submodality, where is it found? and what are its fibre type?

A
  • Nociception
  • submodality = small and myeliated.
  • found in epidermis
  • fibre type - ‘A delta’
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12
Q

for burning pain what is the type of receptor? what is its submodality, where is it found? and what are its fibre type?

A
  • Nociception
  • submodalitly = unmyelinated
  • found in epidermis
  • fibre type = C
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13
Q

if a nerve fibre is myelinated what does this mean for the speed and duration of the pain?

A

fast shorter pain

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14
Q

How do all sensory receptors work?

A
  • stimulus deform/ changes the nerve ending.
  • alters the membrane permeability of the receptor membrane
  • produces a receptor potential
  • triggers an action potential which travels along the axon to the CNS.
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15
Q

For thermoreceptors or nociceptors: which one will give out a nerve signal to a max point and then not climb many more?

A

thermoreceptors.

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16
Q

what fibres are involved in 1st pain?

A

fast A-delta fibres.

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17
Q

what are the indications of 1st pain?

A
  • sharp or prickling
  • easily localised
  • occurs rapidly
  • short duration
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18
Q

what type of receptors cause 1st pain?

A
  • mechanical or thermal nociceptors.
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19
Q

what fibres are involved in 2nd pain?

A
  • slow C fibres.
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20
Q

what are the indications of 2nd pain?

A
  • dull ache,
  • burning
  • poorly localised
  • slow onset
  • persistent.
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21
Q

what type of receptors cause 2nd pain?

A

polymodal nocaceptors.

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22
Q

what are primary afferents?

A

axons bringing info from the somatic receptors (free nerve endings)

23
Q

what are motor efferents?

A

axons taking info from the CNS to peripheral structures.

24
Q

what is the afferents pathway?

A

feed into the spinal cord via the spinal nerve and the dorsal root.

25
Q

what is the efferents pathway?

A

leave the spinal cord via a ventral root and the spinal nerve.

26
Q

where is the nocicepive fibres cell bodies found?

A

within the dorsal root ganglion.

27
Q

What are the steps of the afferent pathway inside of the spinal cord?

A
  • enter the dorsal horn
  • travel up/down a short distance within the zone of lissauer
  • synapse onto neurones within the superficial laminae of hte dorsal horn.
28
Q

what are the principle areas in the spinal cord that are innervated by nociceptor afferents?

A
  • Lamina l and Lamina ll
29
Q

what causes refereed pain?

A
  • ‘cross talk’ - this is cause due to afferents from the internal organs/skin enter the spinal cord through common routes and so target overlapping populations of spinal neurones.
30
Q

is the ascending pain pathway a contralateral pathway? why?

A

It is because sensory inputs cross at the level of the spinal cord and ascend on the opposite side.

31
Q

what is phantom pain?

A

pain/touch sensations with no sensory inputs.

32
Q

what is endogenous analgesia and pain modulation?

A

sensory inputs without pain sensations

33
Q

what is alledynia?

A

damage to nerve fibres, meaning touching gently will cause chronic pain.

34
Q

where are opiates found? and what are they?

A

in the brain - they are reseptors.

35
Q

what do opiates control?

A
  • pain
  • immune responses
  • other body functions.
36
Q

what does endocannabinoid do?

A

inhibits behavioural responses to acute noxious stimuli

- limits hyperalgesia and neuropathic pain.

37
Q

what is acute pain?

A

fast, not long lasting pain.

38
Q

what causes acute pain?

A
  • skin abrasions,
  • deep tissue injury
  • postoperative
  • dental
  • superficial burns.
39
Q

what receptors are stimulated and what fibres are involved in acute pain?

A
  • nociceptive stimulation

- C afferent fibres.

40
Q

what receptors are stimulated and what fibres are involved in non-painful sensation?

A
  • innocuous stimulation

- A delta afferent fibres.

41
Q

what is chronic pain?

A

pain that lasts over 3 months.

42
Q

what causes chronic pain?

A
  • inflammatory pain
  • neuropathic pain
  • neuralgias
  • musculo-skeletal pain
  • visceral- cancers.
43
Q

what fibres are involved in chronic pain?

A

C afferent fibres,

44
Q

what is hyperalgesia?

A

issue that has already been damaged or inflamed resulting in a reduced pain threshold in that area.

45
Q

what else can cause pain rather than just physical damage?

A
  • prior experiance
  • attention/ expectation
  • mood (anxiety/depression)
  • neurochemistry/ structural changes.
  • genetics.
46
Q

why do we experience pain?

A
  • provides constant feedback abut the body.
  • warning sign
  • triggers help
  • has psychological consequences.
47
Q

what is the Gate Control Theory?

A
  • that there is a neural ‘gate’ in the spinal cord that regulates the experience of pain.
  • there are physiological and psychological causes to pain.
  • pain is a perception on experience rather than a sensation.
  • individuals actively interprets and appraises the stimuli.
  • pain is the result of the relative activity in large and small diameter nerve fibres.
48
Q

what information in the Gate Control Theory is believe be be sent to the gate?

A
  • behavioural state
  • emotional state
  • previous experience or self-efficacy in dealing with the pain.
49
Q

According the the Gate Control Theory, Large fibres carrying sensory inform would do what to the gate?

A

close the gate - inhibiting information flow

50
Q

According the the Gate Control Theory, Small fibres carrying noxious inform would do what to the gate?

A

open the gate - facilitating info flow.

51
Q

How can you help with pain control? (without the need for drugs)

A
  • avoid negatives
  • ‘reframing’ sensation
  • NEVEr say you wont feel anything
  • relaxation and lowered pain threshold
  • distraction
  • massage area
  • apple pressure or strech mucosa prior to injection.
52
Q

what are examples of chronic oro-facial pain?

A
  • TMJ pain (facial arthromyalgra)
  • Atypical facial pain (PIFP)
  • Burning mouth syndrome
  • Atypical odontalgia (PDAP)
53
Q

How do you make a pain diagnosis?

A

S.O.C.R.A.T.E.S

  • Site
  • Onset
  • Character
  • Radiation
  • Association
  • Time course
  • Exacerbating/ Relieving factors
  • Severity.