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S3 Case 1 - Neurology > Pain Mechanisms - Acute > Flashcards

Pain Mechanisms - Acute Flashcards

1
Q

What is pain?

A

Unpleasant or emotional experience originating in real or potential damaged tissue

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2
Q

What are the 3 systems that interact to produce pain?

A

Sensory
Motivational
Cognitive

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3
Q

What is somatogenic pain?

A

Pain with a cause localised in the body tissue

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4
Q

What are the 2 types of somatogenic pain?

A

Nociceptive pain - stimulation -eg. sunburn
Neuropathic pain - associated with activation of nerves

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5
Q

What is psychogenic pain?

A

Pain for which there is no known physical cause but processing of info in the CNS is disturbed

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6
Q

What is an example of phychogenic pain?

A

Headache
Back pain

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7
Q

What is acute pain?

A

Protective mechanism that alerts the individual that something is causing them harm

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8
Q

What is the time scale for acute pain?

A

Up to 3 months

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9
Q

What can be the response to acute pain?
Body changes

A

Increased HR
Increased respiratory rate
Elevated BP
Pallor or flushing
Dilated pupils

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10
Q

What is chronic pain?

A

Lasts longer than 3 months and extends beyond an acute illness/injury
Cause is unknown

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11
Q

What is an example of acute pain?

A

Skin abrasions
Deep/soft tissue injury
Bone fractures
Superficial burn

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12
Q

What is an example of chronic pain?

A

Inflammatory
Neuropathic
Cancer
Migraine

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13
Q

When is pain tolerance decreased?

A

Repeated exposure
Fatigue, anger, boredom
Sleep deprivation

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14
Q

When is pain tolerance increased?

A

Alcohol consumption
Medication
Faith

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15
Q

What is the Gate Theory?

A

Pain is a balance between info travelling into the spinal cord through small nerve fibres and info travelling though large nerve fibres

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16
Q

What does large nerve fibres carry?

A

Non-nociceptive info

17
Q

What does small nerve fibres carry?

A

Nociceptive info

18
Q

Describe the production pain via the gate theory

A

Nociceptive impulses travel through C fibres + A-delta to spinal cord
Create synapses, which function as a gate
Stimulation of larger fibre (A-beta) = close the gate
Decreases stimulation of T cells
Decreases transmission of impulses
Decrease pain perception

19
Q

What are nociceptors?

A

Free nerve endings
Stimulated by mechanical, chemical + thermal noxae

20
Q

Where are nociceptors localised?

A

Muscle, skin + viscera

21
Q

What are the different fibre types?

A

A- beta
A- delta
C

22
Q

Describe C fibres

A

Smallest
Non-myelinated
Slow transmission
Transmission of dull + diffuse sensations

23
Q

Describe A-delta

A

Middle
Myelinated
Pain + touch
Middle transmission

24
Q

Describe A-beta

A

Biggest
Myelinated
Touch
Fastest = feel pain straight away

25
Q

What are the different classes of nociceptors?

A

TRP - thermal sensitivity
TREK - K+ channel with TRPs
MDEG - Na+ channel
ASICS + DRASICS - H+

26
Q

Describe simple physiology of pain

A

Nociceptors are free nerve endings
Signals are transmitted along afferent nerves (part of peripheral NS) to spinal cord
Fibres (C+A)
Travel to CNS in spinal cord
Then to the brain (thalamus + cortex) = pain perceived

27
Q

Summary of nociceptive transduction

A

Acute pain = depolarisation of DH neurons
Excitation via glutamate (AMPA) + SP (NK1R) receptors

28
Q

What are the 3 neuronal types in the superficial dorsal horn?

A

Projection neurons
Excitatory interneurons
Inhibitory interneurons

29
Q

What can each neuron in the SDH receive?

A

Inputs from A-delta + C fibres

29
Q

What happens from the spinal cord?

A

2nd afferent neurons transmit impulse from SG to other side of cord
Through ventral + lateral horn
Impulse carried to spinothalamic tract to the brain

30
Q

Describe the mechanism of the efferent analgesic system

A

Pain afferents stimulate neurons in periaqueductal gray (PAG)
= activation of efferent anti-nociceptive pathway
Impulse transmitted to dorsal horn
= block transmission of nociceptive signals

31
Q

What is the afferent portion composed of?

A

Nociceptors
Afferent nerve fibres
Spinal cord network
Terminate in dorsal horn

32
Q

What does the 2nd afferent neuron create?

A

Spinal part of afferent system

33
Q

What is the portion of CNS involved?

A

Limbic signal
Reticular formation
Thalamus
Hypothalamus
Cortex

34
Q
A

S3 Case 1 - Neurology (16 decks)

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