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locomotor system 1 > pain and nociception > Flashcards

pain and nociception Flashcards

1
Q

what is pain?

A

unpleasant sensory and emotional experience associated with actual or potential tissue damage

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2
Q

what are the 2 classifications of pain?

A
  • nociceptive

- clinical

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3
Q

clinical pain can be subdivided into 2 more types of pain what are these?

A
  • acute

- chronic

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4
Q

nociceptive pain is mediated through which type of nerves fibres?

A

A delta and C fibres

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5
Q

what causes nociceptive pain?

A

when intense/noxious stimuli threaten to damage normal tissue

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6
Q

what is the adaptive/biologically useful role of noxious pain?

A
  • protective function
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7
Q

what are the characteristic features of noxious pain?

A

high threshold and limited duration

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8
Q

what is the adaptive/biologically useful role of acute clinical pain?

A

protective function

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9
Q

what may acute clinical pain involve?

A

soft tissue damage or inflammation

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10
Q

which type of pain offers no protective function?

A

chronic clinical pain

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11
Q

a pain offering no survival advantage is said to be?

A

maladaptive

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12
Q

what may cause chronic clinical pain?

A
  • sustained sensory abnormality

- ongoing peripheral pathology (chronic inflammation)

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13
Q

chronic pain must last more than?

A

3 months

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14
Q

which type of pain is resistant to treatment?

A

chronic clinical pain

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15
Q

when making a differential diagnosis, what information would you want to obtain from the patient?

A
  • location
  • pain quality (sharp stabbing, dull ache)
  • pain intensity
  • frequency/duration
  • provoking/relieving agents
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16
Q

the spinal cord is organised segmentally, list the segments in order and state how many pairs of each there are

A
  • cervical (8)
  • thoracic (12)
  • lumbar (5)
  • sacral (5)
  • coccygeal (1)
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17
Q

what is referred pain?

A

when pain is felt in 1 part of the body but pathologically elsewhere

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18
Q

where does pain typically tend to be referred to ?

A

sites of common embryological origin

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19
Q

give some examples of referred pain?

A
  • heart felt down left arm/shoulder
  • oesophagus felt overlapping heart
  • stomach felt in lower thorax/upper abdomen
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20
Q

which pathway do nociceptor endings activate?

A

spinothalamic

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21
Q

a sharp stabbing pain refers to activation of which type of nerve fibre?

A

A delta

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22
Q

a dull pain refers to activation of which type of nerve fibre?

A

C fibres

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23
Q

on a pain graph showing time against voltage, what type of nerve fibres does the sharp peak and small curve represent?

A

peak - A delta

curve - C fibres

24
Q

sensory axons never the CNS via what?

A

dorsal roots

25
Q

where are cell bodies of sensory axons located?

A

dorsal root ganglia

26
Q

in the spinothalamic pathway, 1st order sensory neurons travel from where to where?

A

skin to spinal cord

27
Q

in the spinothalamic pathway, 2nd order sensory neurons travel from where to where?

A

spinal cord to thalamus in brainstem

28
Q

in the spinothalamic pathway, 3rd order sensory neurons travel from where to where?

A

thalamus to cortex

29
Q

in order to stop pain below the head, what region of the brain can be cut?

A

antero-lateral funiculus

30
Q

nociceptive afferents in the tooth are free nerve fibre endings that extend into where?

A

dentin

31
Q

in the ventral trigeminothalamic tract, 1st order sensory neurons travel from where to where?

A

face/head/oral cavity to the spinal nucleus in the pons

32
Q

in the ventral trigeminothalamic tract, 2nd order sensory neurons travel from where to where?

A

spinal nucleus in pons to thalamus

33
Q

in the ventral trigeminothalamic tract, 3rd order sensory neurons travel from where to where?

A

thalamus to somatosensory cortex

34
Q

list factors affecting pain perception

A
  • genetic
  • molecular
  • cellular
  • anatomical
  • physiological
  • psychological
  • social
35
Q

describe pain on a molecular level?

A
  • SCN9A is a gene that encodes a subunit of voltage gated sodium channels Nav1.7
  • Nav1.7 is strongly expressed in nociceptive afferents (receptor endings)
36
Q

a mutation in which gene results in inability to experience pain?

A

SCN9A

37
Q

what is the gate control theory?

A

non-painful input closes the nerve “gates” to painful input, which prevents pain sensation from traveling to the central nervous system.

38
Q

according to the gate control theory, how does rubbing a painful area reduced pain?

A
  • rubbing activates A beta fibres
  • a branch of A beta fibres activates an inhibitory interneuron
  • this interneuron, in turn inhibits the 2nd pain neuron therefore inhibiting the spinothalamic pathway
39
Q

what is the primary control centre for descending pain modulation?

A

periaqueductal grey matter

40
Q

how does periaqueductal grey matter reduce pain?

A

releases cells that suppress pain

41
Q

how does the raphe nuclei reduce pain?

A

receives descending afferents from periaqueductal grey matter the sends projections to dorsal horn to inhibit pain

42
Q

where receives descending afferents from the periaqueductal grey matter?

A

raphe nuclei

43
Q

afferents from the raphe nuclei project to where?

A

locus ceoruleus (nucleus in pons)

44
Q

how does the locus coeruleus reduce pain?

A

produce noradrenaline

45
Q

the triple response consists of the wheal, flare and red reaction, what is the red reaction?

A

initial red line in the centre

46
Q

the triple response consists of the wheal, flare and red reaction, what is the wheal reaction?

A

pale and swollen area round the red reaction

47
Q

the triple response consists of the wheal, flare and red reaction, what is the flare reaction?

A

red and swollen skin around the wheal

48
Q

which 2 substances are essential for the triple response?

A
  • substance P

- CGRP (gastrin-releasing peptide)

49
Q

the triple response works by which type of feedback reaction?

A

feed forward reaction

50
Q

what effect does CGPR have during the triple response?

A

dilate BVs

51
Q

what effect does substance P have during the triple response?

A
  • cause oedema

- release bradykinin (vasodilator)

52
Q

sever triple response is known as?

A

dermatographia

53
Q

a drug which relieves pain is known as what?

A

an analgesic

54
Q

what is an analgesic?

A

a drug which relieves pain

55
Q

analgesic drugs may act on 4 regions of the PNS, name where an analgesic may act?

A
  • receptor ending
  • sensory axon
  • secondary sensory neuron
  • terry sensory neuron

locomotor system 1 (6 decks)

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