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Neuroanatomy 2 > PAIN- Ballyk lecture > Flashcards

PAIN- Ballyk lecture Flashcards

1
Q

what is algesia?

A

Sensitivity to pain

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2
Q

what is analgesia?

A

Absence of sensitivity to pain

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3
Q

What is hyper/hypoalgesia?

A

Increased or decreased sensitivity to pain

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4
Q

what is allodynia?

A

Pain sensation elicited by a normal non painful stimulus

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5
Q

What is dysesthesia?

A

Abnormal unpleasant sensation

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6
Q

What is nociceptive pain?

A

Normal pain functioning system

  1. Tissue damage
  2. Inflammatory pain
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7
Q

What is neuropathic pain?

A

Pain-reporting system is malfunctioning - perceive pain but no damage

  1. post-herpetic neuralgia
  2. central pain
  3. phantom limb pain
  4. diabetic neuropathy
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8
Q

What are the three types of nociceptors?

A
  1. Thermal (Adelta)
  2. Mechanical (A delta)
  3. Polymodal (C fibers)
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9
Q

Describe characteristics of thermal Nociceptors

A
  1. Respond to >45 and <5 degree temps
  2. Adelta fibers
  3. Fast pain (well-localized, not distressing)
  4. part of cutaneous nerve
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10
Q

Describe characteristics of Mechanical nociceptors

A
  1. Respond to intense pressure, nociceptive mechanical stimulus, pinch, pin prick
  2. HIGH threshold mechanoreceptors
  3. Adelta
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11
Q

Describe characteristics of polymodal nociceptors

A
  1. respond to mechanical, thermal or chemical stimuli
  2. DIFFUSE pain not well-localized, aching burning, SLOW Pain, distressing
  3. C fibers
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12
Q

What 2 things happen when a noxious stimulus is applied?

A
  1. Withdrawal reflex

2. Perception of pain - (post central gyrus)

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13
Q

2 mechanisms that inflammation results from

A
  1. Neurogenic inflammation (axon reflex)

2. Tissue damage

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14
Q

During the inflammatory event are pain signals sent to CNS?

A

YES, and nociceptors are sensitized

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15
Q

What are 3 things characterize inflammation?

A
  1. Redness
  2. swelling
  3. warmth
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16
Q

Neurogenic inflammation (axon reflex) characterized by

A
  1. C fiber transmit signals
  2. CGRP and Substance P are released from peripheral nerve
  3. change in blood vessels
  4. Mast cells release histamine
  5. platelets release 5-HT - serotonin
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17
Q

What are the effects on blood vessels after neurogenic inflammation?

A
  1. Vasodilate
  2. Increase permeability - plasma extravasation
  3. Release bradykinin -
18
Q

What 3 things are released during an axon reflex that ACTIVATE nociceptors?

A

ALL ACTIVATE NOCICEPTORS

  1. Histamine
  2. Serotonin (platelets)
  3. Bradykinin (plasma)
19
Q

What 3 things are released during an axon reflex FROM DAMAGED CELLS? SENSITIZE NOCICEPTORS

A
  1. K+ - sensitizes nociceptors
  2. Prostaglandins -
  3. Leukotrienes
20
Q

What is released from the axon?

A

Substance P - also sensitizes

21
Q

What does sensitization do?

A

Decreases activation threshold

22
Q

Where does primary hyperalgesia occur?

A

In the skin region that is damaged

23
Q

where does secondary hyperalgesia occur?

A

Adjacent region of the skin that was not damaged

24
Q

What is mechanical hyperalgesia?

A

hyperalgesia to a mechanical stimulus that would not normally be painful

25
Q

What is thermal hyperalgesia?

A

Hyperalgesia to a temperature that would not normally produce pain

26
Q

What is the pain we feel due to?

A

sensitization of C fibbers by prostaglandins

27
Q

3 effects of PGE2

A
  1. has no effect on its own
  2. enhances responses to Bradykinin
  3. produced from arachidonic acid by COX
28
Q

Pain due to tissue damage is decreased by NSAIDs how?

A
  1. Analgesic effects
  2. Antipyretic effects
  3. anti-inflammatory effects
29
Q

How do NSAIDs work?

A

Block COX, so block PGE2 synthesis

30
Q

4 examples of NSAIDs

A
  1. ibuprofen
  2. indomethacin
  3. Naproxen
  4. Aspirin
31
Q

What are the two ways in which inputs are integrated in the dorsal horn in nociception?

A
  1. Referred pain (convergent afferents from viscera)

2. Gate-control theory (inhibition from touch afferents)

32
Q

How does referred pain work?

A

First order sensory neurone from 1) body wall 2) viscera (afferents) converge onto second order spinal neurons!

33
Q

How does inhibition from touch afferents work?

A

1) First order neurone (C-fiber or Adelta pain fiber) ACTIVATES/OPENS the gate to STT
2) Abeta fiber activates inhibitory interneurons - collaterals, inhibit SECOND order neuron cLOSE the gate

34
Q

What is the basis of the transcutaneous electrical stimulation for pain relief?

A

Inhibition from touch afferents

35
Q

What is the function of the periaqueductal Grey Matter?

A

1) descending input to the dorsal horns

2) Release of enkephalins, endogenous opioids from dorsal horn interneurons

36
Q

Enkephalins act on specific opioid receptors to inhibit pain 2 ways…

A

1) Inhibit NT release from the FIRST ORDER afferent nerve terminal
2) hyper polarize the post-synaptic SECOND order neurons

37
Q

How do exogenous opioids act?

A
  1. Inhibit pain transmutation by binding.activating opioid receptors in first order and second order dendrite/cell body
38
Q

What is responsible for the emotional response to nociception?

A
  1. SECOND order neurons in SL synapse onto
  2. THIRD order neurons in thalamus (RETIC?) project to
  3. Cingulate gyrus
    NOT POST CENTRAL GYRUS
39
Q

Does neuropathic pain activate nociceptors?

A

NO

40
Q

When does neuropathic pain occur?

A

Damage to nerves/neural tissue in PNS, CNS (by injury or diseasE)

41
Q

What 3 things may be involved with neuropathic pain?

A
  1. Allodynias
  2. Dysesthesias
  3. Hyper algesias
42
Q

Give examples of neuropathic pain

A
  1. Peripheral damage
    a) Diabetic neuropathy
    b) Trigeminal neuralgia
    c) Post-herpetic neuralgia
  2. CNS damage
    a) Post-stroke pain
    b) brachial plexus avulsion pain
    c) spinal injury pain

Neuroanatomy 2 (25 decks)

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