Pain (Mixed) Flashcards
Describe the importance of CV fitness for (chronic) pain
It helps to stimulate the opiod system to control pain
- mod intensity, 10-20 minutes, walking etc.
Term: Passage of the resulting sensory input from peripheral terminals to spinal cord
Transmission
Describe the difference between primary and secondary pain
Primary - pain at the site of injury
Secondary - pain away from the site of injury, same as referred pain
Describe the function and importance of Wide Dynamic Range Neurons
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
Describe the difference between Alpha delta/G 3 pain and C/G 4 pain
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
Describe the difference between Alpha Delta/C fibers and Group 3/4 fibers
Alpha Delta and C fibers innverate the skin while Group 3/4 fibers innervate deep tissues (mm, joint, synovium, ligament, etc.)
Term: Detection of noxious or damaging stimuli
Transduction
Describe the physiology behind persistent pain
- Upregulation of specific ion channels
- Phenotypic switching of large myelinated axons
- Sprouting within DH
- Loss of inhibitory neurons
- Misinterpretation by the brain
5 Descending Pathway NT
- Opiods (-)
- Serotonin (-)
- GABA (-)
- NE (+/-)
- Glutamate (+)
Describe the difference between peripheral and central sensitization
Peripheral = dysfunction in PNS, PRIMARY hyperalgesia/allodynia
Central = dysfunction in CNS, SECONDARY hyperalgesia/allodynia
Describe how DH neurons are sensitized (central sensitization)
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
Describe neurogenic inflammation and its cause
Neurogenic inflammation occurs as a result of persistent inflammation. In this condition the neurons themselves are adding to the inflammation process by releasing glutamate
Type of Pain: Spontaneous nerve pain that is sharp/shooting/tingling, increased heat/cold sensitivity, increased pain perception
Neuropathic
Term: Feeling of pain from a non-noxious stimulus
Allodynia
Dimension of Pain: Emotions, anxiety, depression
Motivational-affective
2 Main functions of the Primary Afferent Neuron
- Transduction
- Transmission
Cortical areas that correspond to the following dimensions of pain
- Sensory-discrimative
- Motivational-affective
- Cognitive-evaluative
(4. Descending Control)
- Thalamus and S1/2
- Cerebrum (insula, cingulate, prefrontal cortex), Amygdala, Hypothalamus, Thalamus (ILN)
- Prefrontal cortex
- Brainstem and midbrain
Describe the Gate Control Theory
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
Dimension of Pain: Location, magnitude, duration, quality
Sensory-discrimination
Describe the effects of central sensitization in the brain
- Changes in the somatotopic arrangement (increased proportion given to area of sensitization)
- Decreased brian chemicals essential to brain health (more glutamate and sub P, less inhibitory)
- Loss of gray matter volume
Describe what information type and to which Rexed Lamina the neurons send the informatin
- Alpha Delta/G 3
- C/G 4
- Alpha Beta
- Sharp pain with it’s intensity and location to Rexed L I, IV, and V
- Dull pain to Rexed L II
- Pressure information to Rexed L III and IV
Term: Increased responsiveness or decreased threshold of neurons
Sensitization
Describe the difference between slow and fast pain
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
Term: Increased sensitivity to noxious stimulus
Hyperalgesia
3 Dimensions of Pain
- Sensory-discrimination (SENSORY)
- Motivational-affective (EMOTIONAL)
- Cognitive-evaluative (COGNITIVE)
3 Classifications of DH neurons and their location and effect
- Projection n. – part of spinothalamic tract in Rexed LI – excitatory
- Interneurons – span Rexed LII-IV – inbhititory
- Wide dynamic range n. – body in Rexed LV, span to Rexed LI – excitatory or inhibitory
Dimension of Pain: post experience, possibility of outcomes, influenced by one’s culture and beliefs
Congitive-evaluative
