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Block 5 ellen > Pain and nociception L9 > Flashcards

Pain and nociception L9 Flashcards

1
Q

Pain=

A

unpleasant sensory and emotional experience associated with actual or potential damage (subjective response)

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2
Q

Nociception=

A

The neural processes of detecting, encoding and processing noxious stimuli
(physiological response)

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3
Q

pain based on origin can be; (2)

A

Somatic

Visceral

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4
Q

Visceral pain=

A

organs of thorax and abdominal cavity

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5
Q

Somatic pain=

A

superficial or/

deep

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6
Q

Superficial pain=

A

sharp brief pain (pinching)

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7
Q

Based on duration pain can be either

A

chronic or/

acute

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8
Q

Chronic pain= (3)

A

persists
ill defined onset
poorly treatable

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9
Q

Acute pain= (3)

A

resolves when injury heels
adequately treatable
recent well defined onset

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10
Q

nociception involves

A

PNS and CNS

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11
Q

nociceptors=

A

sensors found in most body tissues that respond to noxious stimuli

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12
Q

Nociception is separate to

A

somatosensory

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13
Q

Where has no nociceptors

A

the brain

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14
Q

What two things are nociceptors characterised by

A

axon properties

receptor channels

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15
Q

What is special about the end of nociceptors

A

unspecialised (free) nerve endings

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16
Q

Types of nociceptors

A 
thermal 
mechanical 
Chemical 
Polymodal 
Sleeping/ silent
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17
Q

What are polymodal nociceptors

A

include thermal, mechanical, chemical stimuli

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18
Q

What are sleeping/ silent nociceptors

A

inflammation, only once injury has occurred

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19
Q

What fibres are large diameter, rapidly conducting

A

A alpha and A beta

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20
Q

What receptors are associated with A alpha and B beta

A

Low threshold mechanoreceptors

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21
Q

Small diameter, slow conducting afferents=

A

A delta and C fibres

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22
Q

What are A delta associated with

A

nociceptors and thermo-receptors

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23
Q

What are C fibres associated with

A

polymodal nociceptors

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24
Q

What is first pain (4)

A

Sharp or prickling
fast A delta fibres
Mechanical or thermal nociceptors
rapid and short

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25
Q

what is second pain (4)

A

dull, aching, burning
Slow C fibres
slow onset and long duration
Polymodal nociceptors

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26
Q

what neurotransmitters are associated with nociception

A

glutamate and substance P

27
Q

What do gene mutations in Na+ channels (specific to nociceptors) lead to

A

congenital analgesia

28
Q

What is cogenital analgesia

A

insensitivity to pain (internally and externally)

29
Q

Which is the nociceptive pathway

A

spinothalamic pathway

30
Q

where do sensory inputs from the spinothalamic pathway decussate

A

2 levels up on the spinal cord (ascend on opposite side)

31
Q

In the spinothalamic pathway where does the information travel from the medulla

A

to the thalamus—-> then to the somatosensory cortex

32
Q

What causes our emotional response to pain

A

side pathways to the hypothalamus and limbic system

33
Q

What causes our alertness from pain

A

reticular formation

34
Q

Where does the DCML pathway decussate

A

in the medulla

35
Q

What does the DCML pathway carry signals off

A

Touch,
vibration
proprioception

36
Q

Where does pain from the face and head enter the pons

A

cranial nerves 5,7,9 and 10

37
Q

What is the tract for face pain called

A

spinal trigeminal tract

38
Q

What fibres is tooth pulp innervated by

A

c and A delta fibres

39
Q

What causes referred pain

A

convergance of nociceptor inputs from viscera and skin

40
Q

Where is heart pain referred

A

chest and left arm

41
Q

Where is early appendicitis referred to

A

abdominal wall

42
Q

What is a phantom limb

A

sensation that a missing limb is still attached to the body and moving appropriately

43
Q

what is phantom limb pain

A

chronic pain in phantom limb

44
Q

Treatment for phantom limb pain

A

mirror therapy

stump stimulation

45
Q

what is gate theory

A

co-activation of A alpha/ beta (not nociceptors) suppresses activation of C fibres (nociception)

46
Q

Where is perception of pain modulated

A

higher brain centres

47
Q

What can suppress pain

A

strong emotions, stress, stoic determination

48
Q

Dissociation=

A

central modulation of pain

49
Q

Hyperalgesia=

A

increased pain sensitivity (reduced threshold)

Caused by C afferents —> stimulus that normally evokes pain

50
Q

allodynia=

A

touched evoked pain

caused by Beta afferents (stimulus that does NOT normally evoke pain. )

51
Q

What can induce hyperalgesia

A

the sensitisation of peripheral nociceptors; by tissue damage/ inflammation releasing substance P, histamine ect

52
Q

primary hyperalgesia

A

occurs at the site of tissue damage

53
Q

secondary hyperalgesia

A

occurs around the site of tissue damage

54
Q

What is fibromyalgia

A

medical disorder characterised by chronic widespread pain and allodynia

55
Q

symptoms of fibromyalgia

A

fatigue
difficulty sleeping
muscle stiffness
IBS

56
Q

Treatment for fibromyalgia

A

analgesics
antidepressants
exercise
counselling

57
Q

back pain

A

is the number one cause of disability in Britain

58
Q

Pharmacological pain treatment overview

A

opioids
NSAID
Local anaesthetics
Psychotropic drugs

59
Q

What do Opioids produce

A

analgesia (pain relief)

60
Q

where do opioids bind

A

to opioid receptors in the brain

61
Q

Three types of opioid receptors

A

Mu
Delta
Kappa

62
Q

6 clinical analgesics

A 
Morphine
Diamorphine (heroin) 
Codeine 
Fentanyl
Pethidine
Tramadol
63
Q

When not have to morphine

A

acute respiratory depression

Block 5 ellen (17 decks)

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