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Locomotor System BDS1 > Pain and Nociception > Flashcards

Pain and Nociception Flashcards

1
Q

what is pain?

A

an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage

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2
Q

what is nociceptive pain?

A

the day to day pain that we have all felt

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3
Q

what nerve fibres sense nociceptive pain?

A

A delta and C fibres

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4
Q

what are the two types of pain?

A

nociceptive and clinical chronic pain

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5
Q

when is nociceptive pain elicited?

A

when intense/noxious stimuli threaten to damage normal tissue

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6
Q

what is the adaptive/biological role of nociceptive pain?

A

it serves as a protective function

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7
Q

what is nociceptive pain characterised by?

A

a high threshold and limited duration

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8
Q

what are the two types of clinical pain?

A

acute and chronic

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9
Q

what does acute clinical pain come from?

A

tissue injury or inflammation

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10
Q

what is the protective function of acute pain?

A

makes you guard the area so no further pain

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11
Q

what is chronic clinical pain?

A

a sustained sensory abnormality >3 months, resistant to treatment

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12
Q

what is chronic clinical pain the result of?

A

ongoing peripheral pathology e.g. chronic inflammation, peripheral nerve injury

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13
Q

what type of pain is chronic pain?

A

maladaptive - offers no survival advantage

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14
Q

comment on the pain induction of chronic pain

A

it can either be spontaneous or evoked

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15
Q

what are the attributes to pain?

A

location, quality, intensity, frequency/duration, provoking/relieving events

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16
Q

what are the segments of the spinal cord?

A

cervical (8), thoracic (12), lumbar (5), sacral (5), coccygeal (1)

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17
Q

how many segments of the spinal cord are there in total?

A

31

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18
Q

what body region does the cervical nerves supply?

A

back of head, neck and arms

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19
Q

what body region does the thoracic nerves supply?

A

trunk and forearm

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20
Q

what body region does the lumbar nerves supply?

A

hips and front of legs and feet

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21
Q

what body region does the sacral nerves supply?

A

bum, back of legs

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22
Q

what is referred pain?

A

pain that is felt in one part of the body but the pathology is elsewhere

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23
Q

why is makes pain referred?

A

the convergence of inputs in the CNS

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24
Q

where does pain tend to be referred to?

A

sites of common embryological origin or from an internal organ to a superficial area e.g. skin

25
Q

what branches of the trigeminal nerve are for sensory only?

A

ophthalmic and maxillary

26
Q

what branch of the trigeminal nerve has mixed sensory and motor function?

A

mandibular division

27
Q

what is the structure of a sensory nerve cell?

A

receptor, axon, cell body

28
Q

name the cutaneous and subcutaneous receptors

A

meissners corpuscle, merkel disc, hair follicle receptor, pacinian corpuscle, ruffini ending

29
Q

what type of endings are nociceptor endings?

A

free endings

30
Q

comment on the threshold of activation of nociceptor endings

A

they have a high threshold of activation

31
Q

what type of stimuli do A delta fibres respond to?

A

noxious mechanical/heat

32
Q

what type of stimuli do C fibres respond to?

A

polymodal (respond to numerous stimuli but eventually lead to the dull aching pain)

33
Q

what is the advantage of nociceptor endings carrying several types of receptor proteins?

A

they are responsive to different noxious stimuli

34
Q

what happens when a nerve is stimulated?

A

all the axons conduct action potentials

35
Q

on a graph, what does the first recorded peak represent?

A

the activation of the fast conducting afferents (A alpha and beta)

36
Q

on a graph, what does the second peak represent?

A

activation of thinly myelinated A delta fibres

37
Q

on a graph, what does the third peak represent?

A

activation of the C fibres

38
Q

in the spinothalamic pathway where does the primary sensory neuron go?

A

to the spinal cord and then changes to the secondary neuron

39
Q

in the spinothalamic pathway where does the secondary neuron pass through?

A

spinothalamic tract - spinal lemniscus (medulla, pons, midbrain, thalamus)

40
Q

in the spinothalamic pathway where does the tertiary neuron pass through?

A

the internal capsule and then the sensory cortex

41
Q

in the tooth where do the nociceptive nerve endings extend to?

A

into the dentine

42
Q

in the anterior trigeminothalamic pathway where does the primary neuron go to instead of the spinal dorsal horn?

A

the spinal trigeminal nucleus

43
Q

what are the receeptors of the pain pathway?

A

nociceptors

44
Q

what afferent nerves are involved in the pain pathway?

A

A delta and C fibres

45
Q

what are the CNS relay cells of the pain pathway

A

spinal dorsal horn and spinal trigeminal nucleus

46
Q

what are the CNS pathways of the pain pathway

A

spinothalamic and anterior trigeminothalamic tract

47
Q

what areas of the forebrain are involved in the pain pathway?

A

primary sensory cortex and subcortical areas

48
Q

what factors affect pain perception?

A

genetic, molecular, cellular, anatomical, physiological, psychological, social

49
Q

what contributes to the molecular basis of pain?

A

SCN9A - gene that encodes the alpha subunit of voltage-gated sodium channels Na 1.7 is strongly expressed in nociceptive afferents, if the SCN9A gene is mutated there is loss of Na channel function and inability to experience pain

50
Q

what psychological factors contribute to pain?

A

sex, age, cognitive level, previous pains, family, culture

51
Q

what situational factors contribute to pain?

A

expectation, control, relevance

52
Q

what emotional factors contribute to pain?

A

fear, anger, frustration

53
Q

what is the gate control theory of pain?

A

by rubbing the place where you feel pain it makes you feel better, the A beta fibres activate the inhibitory INs which blocks the primary neuron entering the spinothalamic tract and pain is not felt

54
Q

what is wheal?

A

white bit around the site of pain

55
Q

what is flare?

A

red mottled appearance surrounding wheal

56
Q

what is CGRP

A

calcitonin gene related peptide

57
Q

what does CGRP do?

A

cause dilation of blood vessels so skin regions occur redder (flare)

58
Q

what is the triple response?

A

local mast cells degranulate and release histamine which acts on receptive endings to reinforce there is trauma in the region, plasma extravasation and oedema correspond to wheal region, CGRP causes dilation of blood vessels so skin regions occur redder (flare region)

Locomotor System BDS1 (8 decks)

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