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Physio > Pain and temperature > Flashcards

Pain and temperature Flashcards

1
Q

thermal receptors are on __ commonly found in the skin

A

free nerve endings

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2
Q

are there more warm or cool receptors?

A

cool

3-10 more

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3
Q

what is the core body temp?

A

37 degress

lowest at 6am

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4
Q

thermal receptors are found in the

A

hypothalamus, spinal cord, and deep tissues

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5
Q

nociceptors are activated by extreme

A

cold or heat

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6
Q

thermal sensation uses __ channels

A

transient receptor potential (TRP)

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7
Q

warm use what type of fibers

A

**C **and some A-delta

By the sea(C) it is warm

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8
Q

cool uses what type of fibers

A

A-delta and C

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9
Q

you will percieve ________ before _______

A

mechanical; thermal

due to fiber type

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10
Q

what temp. gives equal activation of cool and warm receptors?

A

34-34 C

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11
Q

Menthol/cool temps receptor

A

TRPM8

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12
Q

capsacion/ hot temps receptor

A

TRPV1

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13
Q

TRP stand for

A

transient receptor potential

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14
Q

sometimes cold fibers are also activated at high temps known as

A

paradoxial cold

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15
Q

Thermo receptor adaption

A
  • phasic
  • never fully does
  • very sensitive
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16
Q

if temp. reaches one pain threshold, sensation becomes __ throughout the stimulus

A

more persistent

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17
Q

Warm and Cool receptors are best able to detect a change at the

A

mid- range of temp.

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18
Q

Cold pain symptoms

A
  • prickling
  • burning
  • numbing
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19
Q

hot pain symptoms

A
  • sharp
  • stinging
  • throbbing
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20
Q

when nociceptors activated, the system is even better at

A

discerning small changes in temp.

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21
Q

as temp. increases __ receptors activated

A

more (varying thresholds)

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22
Q

what causes thermal receptors to have greater perception?

A
  • larger area effected
  • larger stimulus

increase number of receptors activated

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23
Q

some thermal receptors are also sensitive to __

A

chemicals

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24
Q

Vanilloid Receptor Subtype known as __ receptor

A

TRPV1

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25
Q

Vanilloid Receptor Subtype decreases the threshold of channel activation so heat is perceived at __

A

33 C

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26
Q

Vanilloid Receptor Subtype activated by

A
  • capsaicin
  • temp> 43
  • protons
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27
Q

Cold-Menthol Receptor Type I (CMR1/TRPM8) decreases the threshold of channels so that __

A

warmer compounds perceived as cold

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28
Q

thermoreceptors have __ receptive fields

A

small

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29
Q

subjects can better detect increments in warmth or cold?

A

warmth

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30
Q

The face is __ as sensitive to thermal change (warming) as the inner mucosa

A

2-4x

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31
Q

the _____ is most senstive to changed in temp

A

tongue

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32
Q

Thermoreceptors in tongue are the __ to changes in temperature

A

most sensitive

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33
Q

nociception usually results in perception of __

A

pain or unpleasant stimuli

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34
Q

all nociception produces __, though not all pain results from nociception

A

pain

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35
Q

pain can be evoked by __ stimuli if strong enough

A

mechanical, thermal, chemical

polymodal

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36
Q

what is the most common reason patients seek healthcare and most common symptom of disease?

A

PAIN

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37
Q

acute pain <__ months duration

A

6

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38
Q

2 types of acute pain

A

somatic and visceral

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39
Q

superficial somatic pain comes from the

A

skin, subcutanous tissues or mucus membranes

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40
Q

superficial somatic pain uses what fibers

A

A-delta

A (superfical) before c (deep)

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41
Q

deep somatic pain uses what fibers

A

C- fibers

a before c (deep)

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42
Q

deep somatic pain comes from the

A

muscles, tendons, joints or bones

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43
Q

superficial somatic pain described as

A

localized, sharp, pricking and burning

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44
Q

visceral acute pain due to a disease process or abnormal function involving an __

A

internal organ

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45
Q

true visceral pain use what fibers

A

C fibers

visCeral

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46
Q

true visceral pain described as

A

dull, diffuse, poorly localized

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47
Q

deep somatic pain described as

A

dull, aching, diffuse and can be referred

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48
Q

parietal visceral pain described as

A

sharp, stabbing and better localized

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49
Q

parietal visceral pain use what fibers

A

A-delta

pArietAl

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50
Q

Two nociceptive afferent neurons—from different regions of the body— converge on the

A

same second order neuron

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51
Q

refered pain is mostly

A

visceral, but some parietal

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52
Q

where does refered pain converge that causes the brian to get confused?

A

2nd order

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53
Q

with referred pain brain doesn’t know the true source of input and may __

A

make a mistake in interpretation

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54
Q

true visceral pain associated with

A

nausea and autonomic symptoms

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55
Q

both types of visceral pain can be __

A

referred

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56
Q

chronic pathologic pain is

A

pain that is continuously occurring (abnormal)

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57
Q

chronic pain is _____ pain

A

pathologic

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58
Q

acute pain is ______ pain

A

physiological

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59
Q

3 types of chronic pain

A
  • nociceptive
  • neuropathic
  • mixed pain
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60
Q

nociceptive pain due to activation of __

A

nociceptors

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61
Q

neuropathic pain is associated with __

A

hyperalgesia (increased sensitivity)

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62
Q

neuropathic pain is due to

A

neuronal injury

stroke, spinal cord

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63
Q

neuropathic pain is

A

paroxysmal

comes and goes

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64
Q

summation of nociception is __

A

spatial

65
Q

neuropathic pain due to __ injury

A

neuronal

66
Q

acute pain has a lot of ________

A

autonomic responses

67
Q

neuropathic pain is __ (sharp and stabbing)

A

paraoxysmal

68
Q

nociceptor activity increases if painful stimuli continues due to

A

nociceptor sensitization

69
Q

where are nociceptor found?

A

free nerve endings

70
Q

Nociceptors are

A

tonic

minimal adaption

71
Q

allodynia is a painful sensation to a __ stimulus

A

innocuous

feel pain when you shouldn’t

72
Q

Chemicals known to excite nociceptors

A
  • glutamate
    * Histamine
  • ATP
    * Substance P
  • serotonin
    * Bradykinin
  • aspartate
  • calcitonin gene relatedpeptide (CGRP)
  • K+ (potassium)

Get her A.S.S. B.A.C.K. girls r excited when make progress in gym

bold also sensitize

73
Q

Chemicals known to sensitize nociceptors

A
  • Histamine
  • *Prostaglandins
    • Bradykinin
    • Substance P

“His Penis big (or) small?” men are SENSITVE about the size

non bold also excite

74
Q

chemicals that sensitize the recerptor cause

A

decrease in threshold for receptor activation

75
Q

Chemicals known to inhibit nociceptors

A
  • Enkephalins,
  • β Endorphin
  • Cannabinoids
76
Q

with neurogenic inflammation what do nerve terminals release?

A

substance P and calcitonin gene

77
Q

triple response in neurogenic response

A
  1. red flush around site of injury
  2. local tissue edema
  3. sensitization to noxious stimuli
78
Q

with neurogenic inflammation release of these peptides cause

A

mast cell degranulation, vasodilation, edema and further sensitization

79
Q

A-delta fibers __ pain

A

sharp, localized (fast)

80
Q

C fibers __ pain

A

dull, diffuse (slow)

81
Q

A-delta fiber neurotransmitter

A

glutAmAte

82
Q

C fiber neurotransmitter

A

substance P

PC

83
Q

A-delta fibers __ stimuli

A

thermal, mechanical

84
Q

C fiber __ stimuli

A

thermal, mechanical, chemical

85
Q

what tract is a major pathway with pain?

A

lateral spinothalamic

crossses in spinal track

86
Q

Neospinothalmic mostly __ fibers

A

A delta

87
Q

Neospinothalmic provides __ info

A

location, intensity, duration

neo lid

88
Q

Paleospinothalamic mostly __ fibers

A

C

pale cale

89
Q

Paleospinothalamic synapse with

A

brain stem

PAG, RAS, limbic

90
Q

Spinomesencephalic pathway activates

A

anti-nociceptive,
descending pathways

91
Q

Spinohypothalamic pathway activates

A

the hypothalamus

92
Q

spinoreticular pathway mediates

A

arousal & autonomic
responses

93
Q

Paleospinothalamic fibers synapse with __ structures and also with __ localized sense of pain

A

brainstem, poorly

94
Q

second order neurons can be solely __ or __ neurons

A

nociceptive, wide- dynamic range (WDR)

95
Q

Nociceptive-specific neurons receive only __ stimuli

A

noxious

96
Q

WDR neurons also receive non- noxious afferent input from __ fibers

A

A-delta and C

97
Q

WDR neurons are the most prevalent in the __

A

dorsal horn (location within varies)

98
Q

what lamina goes with WRD

A

5

99
Q

what lamina goes with nociceptive

A

1

100
Q

Nociceptive Specific Neuron found in __ and have discrete, __ receptive fields

A

lamina I, somatic

101
Q

Nociceptive Specific Neurons are normally __ and only respond to __ stimulation

A

silent, high threshold

102
Q

during repeated stimulation, WDR neurons __ firing rate

A

increase

103
Q

WDR neurons have __ than nociceptive-specific neurons

A

larger receptive fields

104
Q

WDR neurons respond to all __ modalities

A

somatosensory

105
Q

WDR neurons normally only sensitive to __ stimuli unless the stimulus is __ noxious

A

somatosensory, highly

106
Q

Some second order neurons increase their frequency of activation
following __

A

prolonged discharge

107
Q

WDR are only _______ unless _____

A

non-noxious; highly noxious

108
Q

WDR continue to get activatied at a greater level which is known as

A

“wind up”

109
Q

chronic pain conditions can be due to __ neurons

A

WDR

110
Q

Activation of A-beta fibers from the same region
__ the Spinothalamic pathway and __ pain perception

A

inhibits, reduces

111
Q

The A-β fibers activate an __ interneuron that causes post-synaptic inhibition of the __-order neuron for the Pain Pathway

A

inhibitory, second

112
Q

what are ways to inhibit pain?

A
  • gate control threory
  • pain inhibits pain
113
Q

gate control therory

A
  • localized (same area)
  • uses interneuron
  • decrease preception

ex. massaging area

114
Q

the A-B fibers activating an inhibitory interneuron leads to a weaker pain signal being sent to the __

A

thalamus and somatosensory cortex

115
Q

what is a treatment for chronic pain?

A

massage therapy

116
Q

Stimulate pain in other regions of the body to inhibit pain (via __)
at second order, __, neurons in spinal cord

A

GABA, WDR

117
Q

Pain Inhibits pain

A
  • diffuse (anywhere in the body)
  • second stim can inhibit 1st
118
Q

in pain inhibits pain the interneuron releases ______ and inhibits

A

enkephalin; 1st and 2nd order

119
Q

for gate control theory of pain the nociceptors and mechanoreceptors need to be __

A

in the SAME area

120
Q

(Diffuse Noxious
Inhibitory Control (DNIC) or Conditioned Pain Modulation (CPM)) does what?

A

second painful stimulus inhibits pain from the first stimulus

121
Q

A second noxious stimulus, leads to activation of the __ in the brainstem leasing to analgesic effect

A

PAG(midbrain), NRM and RVM(medulla)

nucleusr raphe magnus
rostral ventromedial medulla

122
Q

Interneurons in the dorsal horn of the spinal
cord are activated by __ and release __

A

5-HT/NE, endogenous opiates (Enkephalin)

123
Q

what in the dorsal horn inhibits first and second order neurons?

A

Enkephalin

124
Q

Analgesia is the selective suppression of pain without effects on __

A

consciousness or other sensations

125
Q

pain in the orofacial region is conveyed to the CNS via which tracts?

A

Trigeminospinothalamic and
Trigeminoreticular

Trigeminal Nerve

126
Q

how do opiods work?

A

activate same receptor as enkepahlin

endogenous anolygeisous

127
Q

how does topical lidocaine decrease pain?

A

causes Na+ channel to stay in inactive state

128
Q

Pain can be referred to the orofacial region (particularly teeth) in response to:

A
  • Maxillary Sinusitis
  • Angina
  • Migraine
  • Nasal Mucosa
  • Ear Pain
129
Q

why is it hard to localize tooth pain?

A

large receptive field

130
Q

dentin and enamel have limited space to __ resulting in __ pain

A

swell, exaggerated

131
Q

weak air puffs to exposed __ result in intense pain

A

dentin

132
Q

why does hot/ cold not cause pain in a healthy tooth?

A

enamel insulates

cold pain more common

133
Q

Stimulation of tooth pulp by any kind of stimulus results in a

A

painful sensation

134
Q

dentin use what kind of fibers

A

a-delta

fast pain

135
Q

trigeminal neurons have extensive branching causing

A

innervation of several teeth (hard to localize tooth pain)

136
Q

large receptive fields= __ localization

A

poor

137
Q

dentin has limited innervation so why is it sensitive?

A

dentinal tubules

138
Q

nerve fibers penetrate the dentinal tubules but only for a __ distance into the __ dentin

A

short, inner

139
Q

sensitiv3 teeth have __ dentinal tubules compared to non- sensitive teeth

A

8x more and 2x wider

140
Q

tooth pulp is very vascular but is low compliance tissue due to being surrounded by __

A

hard tissue

141
Q

Any change in volume within the tooth pulp translates to large
changes in __

A

pressure

142
Q

change in pulp tissue volume can be due to

A

inflammation and increased pulpal temp.

143
Q

change in pulp tissue volume can lead to

A

hypoxia and tissue necrosis

144
Q

dentin is a __ tissue

A

mineralized, avascular

145
Q

dentin is suprasensitive to __

A

extreme temp. (especially at neck)

146
Q

dentin is sensitive to __ solutions

A

hyperosmotic

147
Q

dentine is not sensitive to __

A

KCl, bradykinin, and histamine

148
Q

The nerve fibers in tooth pulp are ~90%
__-fibers

A

C

149
Q

dentinal pain described as __ pain

A

sharp (A delta fibers)

150
Q

pulp pain described as __ pain

A

dull (C fibers)

151
Q

neural theory for dental nociception- __ in dentinal tubules are activated

A

free nerve endings

152
Q

hydrodynamic theory for dental nociception- stimulus displaces __ in dentinal tubules which activates __ in nerve endings of dentin or pulp

A

fluid, mechanoreceptors

153
Q

odontoblast transducer theory for dental nociception- odontoblasts are excited and __ the signal to nearby nerve cells

A

transduce

154
Q

what is the most accepted theory for for dental nociception?

A

hydrodynamic

155
Q

The periodontal ligament has nociceptors AND

A

Ruffini Endings (a mechanoreceptor/proprioceptor)

156
Q

Periodontal nociceptive information from free nerve endings travels via

A

A delta/ C fibers

157
Q

subjects with dentures have issues with

A

biting force discrimination

158
Q

teeth have

A

thermorecptors

159
Q

what portion of the tooth is most innverrated?

A

apical

Physio (34 decks)

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