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Nerves 1 > Pain and Nociception > Flashcards

Pain and Nociception Flashcards

1
Q

How can pain be classified

A

Nociceptive pain and clinical pain

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2
Q

How can clinical pain be classified

A

Acute and chronic

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3
Q

What is nociceptive pain

A

Normal pain - mediated through As and C fibres
Only elicited when intense/noxious stimuli threaten to damage normal tissue
Protective function

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4
Q

Describe acute clinical pain

A

Results from soft tissue injury or inflammation

Serves as a protective function

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5
Q

Describe chronic clinical pain

A

A sustained sensory abnormality
Result of an ongoing peripheral pathology
Pain is maladaptive, offering no survival advantage

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6
Q

What are different attributes of pain as a symptom

A 
Location
Quality - sharp stabbing, dull aching
Intensity
Frequency/duration
Provoking/relieving events
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7
Q

What is referred pain

A

Pain felt in one part of the body but the pathology is elsewhere
Pains tend to be referred to sites of common embryological origin
Due to a convergence of inputs in the CNS

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8
Q

What are nociceptor endings

A

Free nerve endings with a high threshold of activation that respond to intense noxious stimuli associated with pain

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9
Q

What nerve fibres are nociceptors

A

As fibres - noxious mechanical/heat

C fibres - polymodal - respond to quite a few stimuli which eventually lead to a dull, aching sensation

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10
Q

Give examples of different neural pathways in the CNS

A

Mechanoreception (touch)

Nociception (pain)

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11
Q

Which CNS relay nerves are involved in nociception

A

Spinal dorsal horn

Spinal trigeminal nucleus

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12
Q

Which CNS pathways are involved in nocicpetion

A

Spinothalamic tract

Anterior trigeminothalamic tract

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13
Q

Which areas of the forebrain are involved in nociception

A

Primary sensory cortex

Subcortical areas

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14
Q

What are factors that affect perception of pain

A 
Genetic
Molecular
Cellular
Anatomical
Physiological
Psychological
Social
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15
Q

Describe the molecular basis of pain

A

SCN9A gene encodes a-subunit of voltage gated Na+ channel Nav1.7
Nav1.7 is strongly expressed in nociceptive afferents (receptor endings)
SCN9A mutation - loss of Nav1.7 function - inability to experience pain

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16
Q

Give examples of psychological factors in pain

A 
Sex
Age
Cognitive levels
Previous pairs
Family
Culture
17
Q

Give examples of situational factors in pain

A

Expectation
Control
Relevance

18
Q

Give examples of emotional factors in pain

A

Fear
Anger
Frustration

19
Q

Describe the gate control theory of pain

A

Rubbing sore areas lessens the perception of pain
Noxious stimuli activate C or As fibres which project into dorsal horn activating second order neurons which activate tertiary, eventually lessening the pain
Rubbing recruits Ab fibres, branch comes off called inhibitory interneurone which block activity of pain fibres so the pain disappears

20
Q

What is the triple response

A

Mild trauma to the skin region, red line appears - the red line is the point of trauma - this is called the red reaction
The area around the skin appears very pale and swells up - this is wheal
After this, further away the skin appears red and discoloured - this is called flare

21
Q

What occurs after mild trauma to the skin

A

Release of potassium, prostaglandins and bradykinin which are released from plasma if there is any damage to capillaries
There is also release of 5-HT from platelets
The nerve endings of skin can express substance P and CGRP

22
Q

What does substance P and CPRG do to mast cells

A

Cause their degranulation

23
Q

What does CPRG do

A

Causes dilation of blood vessels which is what gives rise to the flare region as there is more blood flowing through them making the skin appear red

24
Q

What does substance P do

A

In the wheal region, the release of substance P causes plasma extravasation meaning they are leaky and it causes oedema

25
Q

How can pain be stopped

A

Blocking conduction of action potentials

26
Q

What’s the easiest way to stop an action potential

A

At the receptor ending

Can be done through anaesthetic

27
Q

What do analgesics do

A

Block transmission of information from the 3rd order neurons to the sensory cortex

Nerves 1 (4 decks)

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