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BB2 > pain mechanism and management > Flashcards

pain mechanism and management Flashcards

1
Q

nociception

A

perception of injurious stimuli

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2
Q

factors influencing pain perception

A

cognition
mood
context
genetics
chemical+structural
injury

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3
Q

types of pain

A

nociceptive
neuropathic
acute
chronic

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4
Q

neuropathic pain

A

chronic maladaptive pain after TBI

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5
Q

how long does chronic pain last

A

3 months+

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6
Q

which type of pain is often resistant to analgesics

A

neuropathic

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7
Q

how is pain intensity conveyed by nocioceptors

A

frequency coding - freq of discharge

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8
Q

what factors increase speed of transmission along an axon

A

increased axon diameter
myelination

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9
Q

which axons convey pain

A

A delta
C

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10
Q

what do A delta fibres convey

A

pain
temperature

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11
Q

what do C fibres convey

A

pain
temperature
itch
chemoreception

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12
Q

which fibres convey first pain and second pain

A

first - A delta
second - C

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13
Q

what do TRP and TRPM8 channels on thermal nociceptors transduce

A

TRP - heat
TRPM8 - cold

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14
Q

what do thermal nociceptors respond to

A

heat and cold

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15
Q

what do mechanical nociceptors respond to

A

excess pressure
mechanical deformation

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16
Q

what do chemical nociceptors respond to

A

inflammatory mediators

17
Q

inflammatory mediators

A

histamine
prostaglandins
proteases
bradykinins
serotonin
ATP
H+
potassium

18
Q

what type of receptor are most nociceptors

A

polymodal - respond to temp+pressure+mechanical deformation+inflammatory mediators

19
Q

how does capsaicin prevent response from nociceptors

A

overstimulates receptor

20
Q

what does substance P do

A

attracts histamine releasing cells
dilates blood vessels
alters cell signalling pathways to modulate pain perception

21
Q

erythromelalgia

A

neuropathy characterised by recurrent burning pain, warmth, and redness of extremities

22
Q

what causes primary erythromelalgia

A

Autosomal dominant genetic mutation causing hypersensitive nav1.7 channel

23
Q

what part of the brain does the spinothalamic tract transmit to

A

thalamus

24
Q

where does the spinothalamic pathway decussate

A

second neurone in spinal cord immediately after synapse with primary afferent

25
Q

where does the DCML pathway decussate

A

second neurone at medial lemniscus of medulla

26
Q

which part of the cortex controls the sensory-discriminative aspect of pain

A

somatosensory cortex

27
Q

which part of the cortex controls the affective-motivational aspect of pain

A

anterior cingulate cortex and insular cortex

28
Q

discriminative pain pathways

A

spinothalamic tract
trigemino-thalamic tract

29
Q

phantom pain

A

feeling pain where a missing body part should be

30
Q

what causes phantom pain

A

mal-adaptive plasticity

31
Q

what causes referred pain

A

primary afferent from skin and primary afferent from viscera converge on same secondary neurone

32
Q

why does rubbing an injury reduce pain

A

Melzack and Walls gate theory of pain - free nerve endings in the deeper layers of the skin respond to touch by inhibiting spinal transmission of pain signals from the body to the brain

33
Q

areas of the brain involved in descending pain modulation

A

Anterior cingulate cortex
hypothalamus
nucleis cuniformis
periaqueductal grey
Dorsolateral pontine tegmentum
rostral ventromedial medulla

34
Q

where are cannabinoid receptors present

A

pain pathways at peripheral and central levels
CNS
GI
Bones
Immune system
Muscles

35
Q

where are endocannabinoids synthesised

A

membranes of neurones and other nervous cells

36
Q

cannabinoid receptors

A

CB1 CB2

37
Q

do cannabinoids increase or decrease NT release

A

decrease

38
Q

release of which NTs are inhibited by activation of cannabinoid receptors

A

L-glutamate
GABA
noradrenaline
dopamine
serotonin
ACh

39
Q

CNS structures activated by nociceptive stimuli

A

spinal cord
thalamus
somatosensory cortex
anterior cingulate cortex
insula
amygdala
prefrontal cortex
hippocampus

BB2 (26 decks)

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