Pain (Mixed)

Question 1

Describe the importance of CV fitness for (chronic) pain

Answer 1

It helps to stimulate the opiod system to control pain

• mod intensity, 10-20 minutes, walking etc.

Question 2

Term: Passage of the resulting sensory input from peripheral terminals to spinal cord

Answer 2

Transmission

Question 3

Describe the difference between primary and secondary pain

Answer 3

Primary - pain at the site of injury

Secondary - pain away from the site of injury, same as referred pain

Question 4

Describe the function and importance of Wide Dynamic Range Neurons

Answer 4

Function: Integrate painful/non-painful information received from both sides of the body and from multiple tissues/sites

Importance: Are the reason for referred pain!! There is a convergence of input from various tissues and misinterpretation from the cortex resulting in referred pain

Question 5

Describe the difference between Alpha delta/G 3 pain and C/G 4 pain

Answer 5

Alpha beta/G 3 = fast, sharp pain from thermal or mechanical noxious stimulus; low-threshold

C/G 4 = slow, dull pain from thermal, mechanical or chemical noxious stimulus; high-threshold

Question 6

Describe the difference between Alpha Delta/C fibers and Group 3/4 fibers

Answer 6

Alpha Delta and C fibers innverate the skin while Group 3/4 fibers innervate deep tissues (mm, joint, synovium, ligament, etc.)

Question 7

Term: Detection of noxious or damaging stimuli

Answer 7

Transduction

Question 8

Describe the physiology behind persistent pain

Answer 8

• Upregulation of specific ion channels
• Phenotypic switching of large myelinated axons
• Sprouting within DH
• Loss of inhibitory neurons
• Misinterpretation by the brain

Question 9

5 Descending Pathway NT

Answer 9

1. Opiods (-)
2. Serotonin (-)
3. GABA (-)
4. NE (+/-)
5. Glutamate (+)

Question 10

Describe the difference between peripheral and central sensitization

Answer 10

Peripheral = dysfunction in PNS, PRIMARY hyperalgesia/allodynia

Central = dysfunction in CNS, SECONDARY hyperalgesia/allodynia

Question 11

Describe how DH neurons are sensitized (central sensitization)

Answer 11

The DH neurons up regulate and sprout axons/dendrites to Rexed L I, II, V

Additonally there is production of genes, death of interneruons, and decreased descending pathway inhibition

All of this leads to increased responsiveness of DH neurons to noxious and innocuous stimuli

Question 12

Describe neurogenic inflammation and its cause

Answer 12

Neurogenic inflammation occurs as a result of persistent inflammation. In this condition the neurons themselves are adding to the inflammation process by releasing glutamate

Question 13

Type of Pain: Spontaneous nerve pain that is sharp/shooting/tingling, increased heat/cold sensitivity, increased pain perception

Answer 13

Neuropathic

Question 14

Term: Feeling of pain from a non-noxious stimulus

Answer 14

Allodynia

Question 15

Dimension of Pain: Emotions, anxiety, depression

Answer 15

Motivational-affective

Question 16

2 Main functions of the Primary Afferent Neuron

Answer 16

1. Transduction
2. Transmission

Question 17

Cortical areas that correspond to the following dimensions of pain

1. Sensory-discrimative
2. Motivational-affective
3. Cognitive-evaluative
   (4. Descending Control)

Answer 17

1. Thalamus and S1/2
2. Cerebrum (insula, cingulate, prefrontal cortex), Amygdala, Hypothalamus, Thalamus (ILN)
3. Prefrontal cortex
4. Brainstem and midbrain

Question 18

Describe the Gate Control Theory

Answer 18

Describes the physiological mechanisms whil accounting for phsychological factors

Overriding pain signals with non pain signals

The balance between the periperhal nocicpetors and the other periperhal fibers stimulation as well as descending pain pathways leave the gate “open” or “closes” and modify your perception of pain

Question 19

Dimension of Pain: Location, magnitude, duration, quality

Answer 19

Sensory-discrimination

Question 20

Describe the effects of central sensitization in the brain

Answer 20

1. Changes in the somatotopic arrangement (increased proportion given to area of sensitization)
2. Decreased brian chemicals essential to brain health (more glutamate and sub P, less inhibitory)
3. Loss of gray matter volume

Question 21

Describe what information type and to which Rexed Lamina the neurons send the informatin

1. Alpha Delta/G 3
2. C/G 4
3. Alpha Beta

Answer 21

1. Sharp pain with it’s intensity and location to Rexed L I, IV, and V
2. Dull pain to Rexed L II
3. Pressure information to Rexed L III and IV

Question 22

Term: Increased responsiveness or decreased threshold of neurons

Answer 22

Sensitization

Question 23

Describe the difference between slow and fast pain

Answer 23

Fast: immediate sharp sensation and id of location; processed by lateral pain system (spinothalamic)

Slow: dull/burning/throbbing followed by sharp pain that is not easily localized; processed by medial pain system

Question 24

Term: Increased sensitivity to noxious stimulus

Answer 24

Hyperalgesia

Question 25

3 Dimensions of Pain

Answer 25

1. Sensory-discrimination (SENSORY)
2. Motivational-affective (EMOTIONAL)
3. Cognitive-evaluative (COGNITIVE)

Question 26

3 Classifications of DH neurons and their location and effect

Answer 26

1. Projection n. – part of spinothalamic tract in Rexed LI – excitatory
2. Interneurons – span Rexed LII-IV – inbhititory
3. Wide dynamic range n. – body in Rexed LV, span to Rexed LI – excitatory or inhibitory

Question 27

Dimension of Pain: post experience, possibility of outcomes, influenced by one’s culture and beliefs

Answer 27

Congitive-evaluative