Pain & Nociception 1 Flashcards
what are some plural pains
dentine sensitivity
caries
trauma
cracked cusp
what is dentine sensitivity
expo dentine irritates the pulp as they are inseparable, bacteria prod toxins which = inflam
what is cracked cusp
restoration sill alive (amalgam) cusp fracture fell pain from hot/cold and biting down due to inflam at apex
what is the pain associated with the periodontium
typically abscess (apical pulp died off)
what is dry socket pain
socket doesn’t heal properly, clot comes out open socket and bone gets infected (osteitis)
what are CMD’s
cranio mandiular disorders (TMJ problems)
what are the CMD’s that can be present
TMJ
Masticatory muscles
what can be the pain assc with the salivary glands
blocked duct = drier mouth but more imp when eat alive prod and is blocked = infected and swollen duct
what is the pain assc with sinusitis
symptoms can manifest as both pain
sore when pt moves head
what are some neuropathic pains
dysesthesia trigeminal neuralgia deafferntation neuroma post hepatic neuralgia burning mouth syndrome
what is dysesthsia
pain from damage of peripheral nerves
what is trigeminal neuralgia
idea of cutting someones spinal trigeminal tract
what is deafferation
nerves cut sometimes die off
what is a neuroma
formed from deafferation ball nerves spontaneously active
what is post hepatic neuralgia
assc with skin deramotme and zoster virus
what is burning mouth syndrome
not well known just burning sensation assc with mouth
what are a few headache types assc wit pain
migraines
temporal (giant cell) arteritis
what is temporal (giant cell) arthritis
arteries become inflam in head and neck
what is pain the only possible outcome of
a noxious stimulus
what are the non sensory effects of a nociceptive stimulus
protective reflexes
CVD reflexes
alertness
what are non sensory effects of thermorecetptive stim
thermoreg reflex
sweating
shivering
what are non sensory effects of mechanoreceptive tim
reflexes
stretch
protective
salivary
what are non sensory effects of proprioceptive stim
stretch reflexes
what are non sensory effects of gustation stim
salivary reflexes
what si the definition of pain
an unpleasant sensory and emotional experience assc with actual or potential tissue damage
what does the experience of pain depend on
usually strength stim or degree tissue damage
adrenaline
emotions
past experience of pain
ability to comprehend causes/consequences
what are other sensations of pain
mechanical - segmental controls - dull pain down
other pains - diffuse noxious inhibit controls
(one pain cancels out other)
what is nocicieption
th activation of neural pathways by stimuli that damage or threaten to damage tissue - process
what is noxious stimulus
potentially damaging stimulus - e.g. hot water
what is nociceptive stimulus
a stimulus that activates nociceptive pathways ( in research electrical stim)
what does pains usually signify
something is wrong
- caries
- abscess
- TMJ
- Fracture
what does it mean if there is pain in healthy areas
refereed pain
- jaws- sinuses
- cardiac pain in left arm
- phrenic pain in neck
is pain useful
learning process
- avoid further damage
- future avoidance
what are the types of pain
acute (fast, sharp, slow, brurning)
chronic(long lasting pain)
what are the dimensions of pain
sensory - discriminative
- quality, intensity, location
affective - emotional aspects
what does sensory nervous system do
informs the CNS of the internal nd external enviro
what us the role of the nociceptive system
is to signal the threat or occurrence of injury
where are nociceptors especially present in the body
cornea and tooth pulp- where pain is the predominant sensation
where are nociceptors lacking in the body
brain
liver
lung parenchyma
how can u study pain and nocicceptrion in animals
nociception - electrophysical records
vocalisation - behavioural
reflex studies
how can you study pain and nocicception in humans
microneurography
psychophysical studies
blister studies
reflex studies
what are nociceptors
receptors that respond to noxious/nociceptive stimuli
what are nociceptors classified by
parent axon
stimulus
what is nociceptor anatomy
free nerve ending
C - fine unmyelinated
A beta - fine myelinated
what are some nociceptor parent axons
C - fine unmylinated, slow burning pain
A beta - fine myelinated, fast sharp pain
what are the predominant nerve fibres in tooth pulp
A beta
where is double pain associated
in limbs as in head and neck too short a distance to get double pain
what are the A fibre nociceptors
mechanical - respond to strong mechanical stimuli
polymodal - respond to all noxious stimuli
what are the C fibre nociciepors
non specific
polymodal
what si direct nocciceptiive transduction
stimulus acts directly on nerve ending (mechanical, chem, thermal)
mem perm changes - graded potential
whats indirect nociceptor transduction
tissue injury/ inflam
chems released -> nerve ending
what is mechanical nociceptor transduction
stimulus - pinch, pressure
mech sensitive ion channels
what are thermal nociceptor transduction
vanilloid receptors
TRPV1/2 - 1 activated by capsaicin burning pain
what are allogenic substances
pain producing substances
what chemicals are activate nocicipetove nerve endings
ATP
H+
K+
what chemicals activate or sensitise nocicipetive nerve endings
bradykinin
histamine
serotonin
what does sensitising nerve endings do
it makes the more responsive, doesn’t take as much stimulus to push nerve to threshold
what chemicals are sesnitze nocicpeitive nerve endings
prostaglandins
what s substance P
present in fine peripheral fibres
role in central transmission
what releases substance P
from free nerve endings
- vasodilation
- mast cell deg
- axon reflex
what is axon reflex
by activating nerve ending cause sub P released
backfire up another branch
what is orthodromic
if enough graded potential causes fire to CNS
what is antidromic
backfire up to another branch back o periphery
localised path, AP causes activation release sub P
what can substance P do
sensitise system
cause mast cell to release serotonin and/or histamine
what do +/- axon reflexes so
effects produce peripheral sensitisation - lowers threshold
what is allodynia
pain produced by a stimulus that would not normally produce pain - sunburn
what is an analgesic
pain killer
what are COX inhibitors
block prostaglandin formation
NSAID
- ibuprofen, aspirin
non selective COX inhib
what do COX enzymes do
make prostanglandisn
what are the two types of prostaglandins
physiological
- gastric protection
- haemostasis
- vasodilation
inflammatory
- pain and inflam
