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Neurology - professional - batt > Pain and Thermosensation > Flashcards

Pain and Thermosensation Flashcards

1
Q

What are the 3 types of pain?

A

nociceptive pain; inflammatory and pathological

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2
Q

What are nociceptors?

A

specific peripheral primary sensory afferent neurones normally activated preferentially by intense noxious stimuli

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3
Q

Where are the cell bodies of nociceptors located?

A

dorsal root ganglia and trigeminal ganglia

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4
Q

What type of fibre are nociceptors?

A

Ad and C

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5
Q

What is the difference between the type of pain that Ad and C fibres carry?

A

Ad mediate first or fast pain whereas C fibres mediate slow pain

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6
Q

What type of sensations is first pain?

A

stabbing; pricking

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7
Q

What type of sensation is slow pain?

A

bruning; throbbing; cramping; aching

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8
Q

What type of stimuli do nociceptive Ad fibres respond to?

A

noxious mechanical and thermal stimuli

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9
Q

What ytpe of stimuli do nociceptive C fibres respond to?

A

all noxious stimuli- polymodal

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10
Q

What is frequency coding?

A

rate of AP discharge correlates with the intensity of the applied stimulus

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11
Q

What are the types of nociceptive Ad fibres?

A

type 1 (HTM) and type 2

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12
Q

What is the difference between the thresholds of heat required to activate type 1 and type 2 Ad fibres?

A

type 1- >53 whereas type 2 43-47

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13
Q

What type of fast pain do type 1 fibres mediate?

A

mechanical

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14
Q

What type of fast pain do type 2 fibres mediate?

A

heat

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15
Q

What happens to type 1 Ad fibres in response to prolonged stimuli?

A

show sensitisation

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16
Q

What are the types of C fibre?

A

C-MH; C-M; C-H and CMiHi

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17
Q

What are the features of C-MH fibres?

A

shows sensitisation to repeated stimuli and contributes to location of stimulus

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18
Q

What are the features of C-H fibres?

A

mediates heat hyperalgesia; acquires sensitivity to mechanical stimuli in inflammation

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19
Q

What are C-MiHi fibres?

A

normally insensitive to both mechanical and heat stimuli but acquires sensitivity through inflam mediators

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20
Q

How does the peripheral terminal of nociceptors influence local tissue environment?

A

releases molecules eg substance P and CGRP

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21
Q

What does substance P do?

A

vasodilation and extravasation of plasam proteins

22
Q

What is CGRP?

A

calcitonin gene related peptide- vasodilation

23
Q

Where do nociceptors terminate in the spinal cord?

A

laminae of Rexed

24
Q

What do C and Ad fibres synapse with in the spinal cord?

A

nociceptive specific cells

25
Q

What type of fibre do wide dynamic range neurones receive input from?

A

Ab; Ad and C

26
Q

Where are the soma of the sensory neurones of the trigeminal system located?

A

trigeminal sesnory ganglion

27
Q

What modality synapses in the chief sensory nucleus?

A

general tactile stimuli

28
Q

What modality synapses in the spinal nucleus?

A

pain and temperature

29
Q

How do peptides participate in neurotransmission?

A

cause a slow and prolonged epsp facilitating activation of NMDA receptors by relieving voltage-dependent blokc by magnesium

30
Q

When do peptides mainly take part in neurotransmission?

A

during high frequency stimulation

31
Q

Whta are the 2 types of sensisation of the nociceptive pathway following tissue damage?

A

peripheral and central

32
Q

What mediates peripheral sensitisation?

A

nociceptors at the site of injury/tissue inflam

33
Q

How does peripheral sensitisation cause primary hyperalgesia?

A

via reduced threshold and amplified response

34
Q

What type of stimuli is peripheral sensitisation mainly involved in?

A

heat, to lesser extent mechanical

35
Q

What mediates central sensitisation?

A

an increase in CNS neurone activity and properties

36
Q

How does central sensitisation cause secondary hyperalgesia and allodynia?

A

recruitment of novel inputs to nociceptive pathways (eg Ab fibres) and abnormal processing of sensory input

37
Q

What type of stimuli is central sensisation mainly involved in ?

A

mechanical sensitivity

38
Q

How do visceral afferents from nociceptors reach the dorsal horn?

A

follow sympathetic pathways

39
Q

What are the two nociceptive tracts i nthe spinal cord?

A

spinothalamic and spinoreticular

40
Q

What type of pain does the spinothalamic tract carry?

A

fast fibre Ad pain and wide dynamic range

41
Q

What does pain perception require in the spinothalamic tract?

A

simultaneious firing in both the Ad fibres and wide dynamic range neurones

42
Q

What type of pain does the spinoreticular tract carry?

A

slow C-fibre pain

43
Q

Where does the SRT connect?

A

reticular nuclei in the brainstem eg periaqueductal grey

44
Q

What response to pain is the spinoreticular tract involved in?

A

autonomic respones to apin- arousal, emotional and fear

45
Q

Where does the Spinoreticular tract relay information to after the thalamus?

A

limbic areas of the forebrain (cingulate and insular cortices and amygdala)

46
Q

Where does the spinothalamic tract take pain signals after the thalamus?

A

primary sensorimotor cortices

47
Q

How can pain evoked by acitivty in nociceptors be reduced?

A

simulatneous activity in LTMs (Ab fibres)

48
Q

What is the gate control theory?

A

projection neurones to the spinothalamic tract receive inhibitory input from Ab and excitatroy input from C/Ad fibres- if both are Ab and Ad/C fibres are excited dont get pain

49
Q

What area of the dorsal horn does the gate control theory take place?

A

substantia gelaninosa

50
Q

What type of info does the ventral horn deal with ?

A

motor

51
Q

How does TENS work?

A

Ab fibres can be activated by high freq, low intensity electrical stimulation through the skin, reducing the pain felt

52
Q

What are thermoreceptors?

A

neurones specialised to respond to small changes in temperature

Neurology - professional - batt (40 decks)

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