Pain lecture 2

Question 1

What are pain tranducers known as?

Answer 1

-Nociceptors

Question 2

What are the different types of nociceptors?

Answer 2

• Mechanical
• Thermal
• Polymodal
• Chemical

Question 3

What are mechanical subtypes of nociceptors?

Answer 3

• Force

- Trauma

Question 4

What are the receptor types for nociceptors?

Answer 4

• Transient receptor potential

- Prostaglandin/purino and pyrimidine receptors

Question 5

What are the chemical subtype of nociceptors?

Answer 5

-H+ ions

Question 6

What are the thermal subtypes of nociceptors?

Answer 6

• Cold

- Heat

Question 7

What receptor type is found in thermal nociceptors?

Answer 7

-TRP

Question 8

What are polymodal subtypes of nociceptors?

Answer 8

• Mechanical
• Thermal
• Chemical

Question 9

What does Capsaicin activate?

Answer 9

-Polymodal nociceptors TRPV1

Question 10

What is the transmitter for Capsaicin?

Answer 10

-Substance P

Question 11

What is the positive feedback that causes secondary activation of nociceptor nerves?

Answer 11

-Chemical messengers released from activated nociceptor nerve endings act locally to release messengers that further activate the nociceptors

Question 12

Action potentials propagate toward the cell body in the ______ and then enters the ______?

Answer 12

• Dorsal root ganglion

- Spinal cord

Question 13

What is sensitization?

Answer 13

-Increased sensitivity and response to stimuli in and near the injured area caused by chemical messengers that make the nociceptors more excitable

Question 14

What is Hyperalgesia?

Answer 14

-Increased perception of pain in response to painful stimuli

Question 15

What is Allodynia?

Answer 15

-Pain evoked by normally nonpainful stimuli

Question 16

What are the major candidates for sensitization?

Answer 16

• Substance P from nerve endings

- Prostaglandins from damaged cells

Question 17

Prostaglandin receptor stimulation results in activation of what?

Answer 17

-Specific Na+ channels

Question 18

What do you the activation of specific Na+ channels by PG receptor stimulations do?

Answer 18

-Makes the nociceptive nerve endings more excitable

Question 19

Do we have selective COX-1 inhibitors?

Answer 19

-No

Question 20

What is COX-1?

Answer 20

-Is constitutive (always present) in many tissues

Question 21

What does COX-1 do?

Answer 21

• GI cytoprotection
• Platelet aggregation
• Renal electrolyte homeostasis
• Renal blood flow maintenance

Question 22

What are COX -1 inhibited by?

Answer 22

-NSAIDS

Question 23

What are some adverse effects of classic NSAIDS?

Answer 23

• Bleeding
• stomach irritation
• GI side effects

Question 24

What does COX-2 do?

Answer 24

• Pain (inducible)
• Fever (inducible)
• Inflammation (inducible)
• Cardiovascular protection (constitutive)

Question 25

What is COX-2 inhibited by?

Answer 25

- NSAIDS | - Selective COX-2 inhibitors (Celebrex)

Question 26

What stimulated COX-2?

Answer 26

- Hormones - Growth Factors - Inflammatory mediators

Question 27

What do NSAIDS inhibit?

Answer 27

-Synthesis of prostaglandins that are involved in sensitizing the nociceptor nerve ending

Question 28

How are nociceptors in the viscera normally activated?

Answer 28

-Mechanical stimulation such and distention or contractions (visceral pain can be referred to outside areas)

Question 29

Do you take NSAIDS for visceral or somatic pain?

Answer 29

-Somatic

Question 30

Which pain pathways are small, myelinated, and fast conducting?

Answer 30

-A -delta

Question 31

What are A-delta fibers associated with?

Answer 31

-Mechanical and thermal nociceptors

Question 32

Are A-beta fibers pain associated?

Answer 32

-No they are proprioception fibers

Question 33

What pain fibers are small, unmyelinated, and slow conducting?

Answer 33

-C axons

Question 34

What are C- axons associated with?

Answer 34

-Polymodal nociceptors

Question 35

What are plexus of nerves in the tooth called?

Answer 35

- Sub-odontoblastic plexus | - Plexus of Raschkow

Question 36

Which fiber gives you sharp pain?

Answer 36

-A-delta

Question 37

Which fiber gives you dull diffuse pain?

Answer 37

-Dull diffuse

Question 38

Nociceptive fibers synapse with "projection" neurons in what area?

Answer 38

-Dorsal horn

Question 39

What are important pain neurotransmitters in modulation?

Answer 39

- Glutamate | - Substance P

Question 40

T/F Projection neurons send axons across midline

Answer 40

True

Question 41

Where do the ascending pathways ascend contralaterally?

Answer 41

- Spinothalamic tract - Thalamus - Somatosensory relay

Question 42

Where does the trigeminal nucleus input to?

Answer 42

-Thalamus

Question 43

Where is nociceptive input heavily modulated at?

Answer 43

-=Dorsal horn with both facilitatory and inhibitory influences

Question 44

What is Central sensitization?

Answer 44

-Dorsal horn projection neurons also become sensitized and hyper-responsive to nociceptive input.

Question 45

T/F Prostaglandins can sensitize at the nociceptive level and at the spinal cord level (central sensitization)

Answer 45

True

Question 46

T/F The dorsal horn is a major site of action for analgesic drugs

Answer 46

True

Question 47

What is a second mechanism for the anti-nociceptive action of NSAIDS for central analgesia?

Answer 47

-Inhibits the synthesis of prostaglandins in the dorsal horn that participate in central sensitization

Question 48

T/F The dorsal horn is a major site of action of opioids

Answer 48

True

Question 49

Sometimes strong touch stimulation can inhibit what?

Answer 49

-Nociception

Question 50

T/F A Beta and A delta fibers never converge together

Answer 50

False | -They do converge

Question 51

Visceral afferent nociceptors ________ on the same pain projection neurons as the afferents from the somatic structures in which the pain is perceived?

Answer 51

-Converge

Question 52

What is a type of referred pain that can be thought of a possible dental problem?

Answer 52

-Sinusitis feels like tooth pain sometimes