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Physiology > Pain and Vestibular Control > Flashcards

Pain and Vestibular Control Flashcards

1
Q

Map pain from stimulus to perception

A

transduction ->transmission ->modulation -> perception

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2
Q

what is transduction?

A

translation of noxious stimulus into neural activity

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3
Q

what is transmission?

A

propagation of nerve impulses from receptors into CNS

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4
Q

what is modulation?

A

facilitation of inhibition of neurons and interneurons in spinal cord

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5
Q

what is perception?

A

result of the integration of projection pathways with modulation to produce the final conscious, subjective and emotional response

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6
Q

what are the stimulus energies of nociception?

A

mechanical deformation
application of chemicals
change in temperature

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7
Q

how does mechanical deformation cause nociception?

A

stretches or damages the receptor membrane and open ion channels

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8
Q

how does application of chemicals cause nociception?

A

opens ion channels in chemoreceptors

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9
Q

how does changes in temperatures cause nociception?

A

alters permeability of membrane of thermoreceptors

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10
Q

what is pain detected through?

A

free nerve endings

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11
Q

what are the nerve fibers that detect pain?

A

Ad fibers
C fibers

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12
Q

what type of pain does Ad fibers detect?

A

immediate, sharp

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13
Q

what type of pain does C fibers detect?

A

dull, burning pain

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14
Q

does pain occur in the brain?

A

NO

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15
Q

what type of channels do warm and cold receptors have?

A

transient receptor potential (TRP) channels

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16
Q

what receptor increases AP frequency with an increase in temperature?

A

warm receptor

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17
Q

where are warm receptors located?

A

C nerve fibers

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18
Q

what receptor increases AP frequency with a decrease in temp?

A

Ad fibers

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19
Q

when are heat nociceptors activated?

A

> 45 degrees celsius

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20
Q

what type of nociceptors are in Ad fibers?

A

mechanical - mechanical damage (cutting, crushing, pinching)
noxious thermal - extreme heat and cold

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21
Q

what type of nociceptors are in C fibers?

A

thermal - thermal gradients
polymodal - various noxious damaging stimuli (thermal, mechanical, chemical)

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22
Q

how is pain transmitted to the brain?

A

3-neuron afferent pathway

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23
Q

what are the 3 neurons needed to convey pain?

A

first-order sensory neuron -> second-order sensory neuron -> third-order sensory neuron

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24
Q

which neurons are in the PNS and the CNS for pain afferent pathway?

A

PNS - first-order
CNS - second-order, third-order

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25
Q

what do first order neuron synapses onto?

A

2nd order neuron in spinal cord

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26
Q

what do second order neuron synapse onto?

A

thalamus - perception of pain

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27
Q

what do 3rd order neuron synapse onto?

A

somatosensory cortex - location of pain

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28
Q

what spinothalamic tract transmits pain?

A

lateral spinothalamic

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29
Q

what is a non-adapting receptor?

A

nociceptors are activated as long as lesion is present

30
Q

what is hyperalgesia?

A

an increased insensitivity to pain

31
Q

what type of fiber and pain does initial injury stimulate?

A

acute pain sensation
Ad fibers

32
Q

what type of fibers and pain is present for pain over time?

A

dull pain sensation increases in intensity
C fibers

33
Q

what does the inflammatory response release?

A

bradykinins, prostaglandins, substance P

34
Q

what does bradykinins in ECF stimulate?

A

polymodoal nociceptors and contribute to tissue inflammation

35
Q

what does substance P stimulate?

A

mast cells to release histamine

36
Q

how does substance P enhance pain sensitivity?

A

bind neurokinin 1 receptors in neurons -> vasodilation and inflammation -> sensitizes afferent pain fibers to inc pain perception

37
Q

what causes central sensitization?

A

repeated stimulation of dorsal horn neurons

38
Q

what make C fibers more sensitive?

A

recruitment of additional glutamate receptors

39
Q

what constitutes a memory of the state of c-fiber nociceptors?

A

repeated stimulation of dorsal horn neurons
recruitment of additional glutamate receptors

40
Q

what mechanisms are the pain-relieving pathway?

A

endogenous opioid mechanisms

41
Q

how do endogenous opioids relieve pain?

A

activate opiate receptors -> block release of substance P in spinal cord and preiaqueductal gray matter of midbrain

42
Q

how does enkephalin relieve pain?

A

inhibit release of substance P

43
Q

what are the analgesia endogenous opioid substances?

A

enkephalin, endorphins, dynorphins

44
Q

what blocks opioid substances?

A

naloxone
u-opioid receptor competitive antagonist

45
Q

what type of opiate receptors are concentrated in the dorsal horn of the spinal cord?

A

u-receptors

46
Q

what locations in this pathway would morphine act?

A

dorsal horn
raphe nucleus

47
Q

what are the methods of exogenous pain control?

A

serotonin & norepinephrine
NSAIDs
Endocannabinoids
Exogenous opioids

48
Q

how does serotonin and norepinephrine modulate pain?

A

stimulate enkephalin release interneurons or pain modulating nuclei in brainstem

49
Q

what does the vestibular system meaure?

A

static tilt of the head
linear acceleration
rotary acceleration

50
Q

what movements are facilitated by the vestibular system?

A

correction of posture and balance
maintain focus of the eyes and head moves

51
Q

what do the two ampulla connect to?

A

utricle and saccule

52
Q

what do the sensory nerves in the hair cells lead into?

A

vestibulocochloear nerve

53
Q

what does bending toward the large cilia in a hair cell lead to?

A

K+ channels open -> depolarization -> exocytosis of neurotransmitters glutamate and aspartate

54
Q

what does bending the hair cells in the ampullae in the opposite direction lead to?

A

hyperpolarization

55
Q

what direction of the hair cells in the ampullae excites and inhibits?

A

excites - toward largest
inhibit - away from largest

56
Q

what can the semicircular canals detect?

A

rotational acceleration and deceleration

57
Q

what does the utricle and saccule detect?

A

linear acceleration and deceleration

58
Q

what orientation is the utricle macula?

A

horizontal

59
Q

what orientation is the saccule macula?

A

vertical

60
Q

what happens in the utricle and saccule when a head tilts?

A

otoliths will pull down causing firing rates to change

61
Q

Fill in the blanks
1. utricle and saccule otolith organs project to the ________________ to facilitate ____________________
2. crista ampulla of semicircular canals feed ____________________ to provide compensatory eye movements in response to rotation
3. ____________________________________ receives and returns inputs to fine tune coordination of postural and oculomotor reflexes

A
  1. utricle and saccule otolith organs project to the vestibulospinal tracts to facilitate a-y coactivation
  2. crista ampulla of semicircular canals feed medial longitudinal fasciculus to provide compensatory eye movements in response to rotation
  3. Flocculonodular node of cerebellum recieves and returns inputs to fine tune coordination of postural and oculomotor reflexes
62
Q

what is the goal of the vestibuloocular reflex?

A

move extraocular eye muscles to maintain visual contact with target

63
Q

what is the goal of the vestibulospinal reflex?

A

stabilize body

64
Q

what reflex is this testing?

A

vestibulospinal reflex

65
Q

what is activated when the head is rotated and extensors are activated on the side where the head is rotated?

A

vestibular nerve and nucleus
lateral and medial vestibulospinal tracts

66
Q

which reflex maintains eyes on visual target while head/body is in motion?

A

vestibulo-ocular

67
Q

which reflex does the head and neck muscles adjust to maintain head position?

A

vestibulo-collic

68
Q

what is the goal of the vestibulocollic reflex in birds?

A

maintain position of head

69
Q

what are the two types of vestibular syndrome?

A

peripheral - labyrinth within petrosal bone affected
central disease. -brain stem affected

70
Q

which vestibular syndrome is head tilt associated with?

A

peripheral condition

71
Q

which vestibular syndrome is paresis/hemiparesis and gait and posture affects associated with?

A

central disease

72
Q

what can a middle ear infection lead to?

A

head tilt, pressure difference -> unbalanced action potential frequency between affected and normal ear

Physiology (8 decks)

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