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M3 Pain and management > Pain experience 1 > Flashcards

Pain experience 1 Flashcards

1
Q

What are the 2 different dimensions of pain?

A

Sensory – discriminative – Quality, intensity and location

Affective – Emotional aspects

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2
Q

informs the CNS of the internal and external environment

What is the role of the nociceptive system?

A

role of the nociceptive system is to signal the threat or occurrence of injury

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3
Q

What are the 2 types of nerve fibres?

A

Aδ-fibre - fast pain, sharp

  • Fine
  • Myelinated axon

C-fibre - slow pain, burning

  • Fine
  • Unmyelinated axon
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4
Q

What are the 2 types of nociceptors?

A

Aδ mechanical nociceptors

• respond to strong mechanical stimuli

Aδ polymodal nociceptors

• respond to all types of noxious stimuli

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5
Q

What is the only type of C-fibre nociceptors?

A

polymodal C-fibre nociceptors

– Respond to all types of noxious/nociceptive stimuli

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6
Q

What are the 2 Tooth pulp afferent nerves?

A
  • Aδ myelinated afferents (touch)
  • C-fibre unmyelinated afferents
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7
Q

If you stimulate a nerve trunk what can you get?

A

Double pain because it wil contain A delta fibres AND C fibres

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8
Q

What is Nociceptor transduction?

A

Where mechanical, chemical or thermal stimulus is converted into a electrical change and if that is sufficient to reach threshold then we fire off action potentials up the nerve to the CNS

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9
Q

What are the 2 factors involved in Nociceptor transduction?

A

Direct:

Stimulus acts directly on the nerves

– Mechanical, Chemical and thermal

Indirect:

Tissue injury / inflammation

Effect of substances released from a nerve ending

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10
Q

In Nociceptor transductions what is the Direct: Mechanical Transduction?

A

Stimuli: pinch, pressure

Mechanically sensitive ion channels

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11
Q

What chemicals does Local tissue damage produce?

A

Algogenic substances - can activate or sensitise nerve endings

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12
Q

What chemicals can acitvate a Nociceptor nerve ending?

A
  • ATP
  • H+
  • K+
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13
Q

What chemicals can acitvate or Sensitise a Nociceptor nerve ending?

A
  • Histamine
  • Serotonin
  • Bradykinin
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14
Q

What chemicals can only Sensitise a Nociceptor nerve ending?

A

Prostaglandins

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15
Q

Example of a chemical released from nerve ending?

A

Substance P

Present in fine peripheral fibres

Substance P release causes:

– Vasodilation

– Increase in vascular permeability

– Mast cell degranulation

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16
Q

What can Sensitisation of nociceptors cause? (2)

A

Hyperalgesia = exaggerated response to a nociceptive stimulus

Allodynia = pain produced by a stimulus that would NOT normally produce pain – e.g. Sunburn, tender tooth

17
Q

One of the ways to manage pain is for drugs like asprin to act on chemistry at a nerve ending. What are these drugs called?

A

Cox inhibitors

  • Non-steroidal anti-inflammatory drugs
  • e.g. Aspirin, Ibuprofen
18
Q

Where is the Site of receptors of the following sensations?

  • Touch
  • Pain
  • Cold
A

Touch = Periodontal ligament

Pain = Dentine/pulp, periodontal ligament

Cold = Gingiva, dentine/pulp

19
Q

be familiar with this chart

A
20
Q

What is the plexus of nerves called when they enter the pulp of a tooth?

A

Plexus of Raschkow

21
Q

Why in relation to nerves is it sometimes difficult to localise dentinal/pulpal pain?

A

Nerves branch to supply more than 1 tooth pulp

22
Q

What are the 3 Theories of dentinal sensitivity?

A
  • Dentine is innervated
  • Odontoblast receptor theory
  • Hydrodynamic Theory
23
Q

What is Dentine innervation Therory?

A

Dentine is innervated but nerves to not extend beyoned the innner third

24
Q

What is Odontoblast receptor theory?

A
  • Stimulus transduction via the odontoblast process
  • Communication between odontoblast and primary afferents
  • Problem:*
    • No evidence of electrical, communication chemical synapses between odontoblast and nerve*
  • Odontoblast process likely only extends 1/3 into dentine
25
Q

What is the Hydrodynamic theory?

A

Apply Stimuli that causes pain to dentine:

– Increase fluid flow in dentine in vitro

– Generate action potentials in intradental nerves in vivo

– Action potential rate linked to fluid flow

Cold sensitivity may not be mediated by a hydrodynamic mechanism

M3 Pain and management (12 decks)

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