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VET 404: Neurology > Pain & Nociception > Flashcards

Pain & Nociception Flashcards

1
Q

nociception

A

activity in the nociceptors and nociceptive pathways (central and peripheral)
- initiated by a noxious stimulus
- involves pain processing pathways
- causes physical changes (BP, HR, cortisol)

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2
Q

pain

A

perception of the noxious stimulus; the unpleasant feeling and behavioral response to a noxious stimulus

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3
Q

5 key factors of pain

A
  1. has a physical cause
  2. it is a feeling (sensory and emotional experience)
  3. requires consciousness
  4. it is subjective
  5. it is unpleasant
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4
Q

reason for pain

A

overall protective and critical for survival

alerts the body of the threat and triggers protective behaviors to limit damage and promote healing

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5
Q

allodynia

A

pain experienced in response to a non-noxious stimulus

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6
Q

hyperalgesia

A

exaggerated response to a noxious stimulus

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7
Q

acute pain

A

pain that follows tissue damage (has a specific cause)
- short lived - resolves as tissues heal
- has protective function

nociceptive and physiologic/adaptive

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8
Q

chronic pain

A

pain that persists when the initial cause is gone
- long lasting
- no protective function
- difficult to treat

pathologic/maladaptive pain

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9
Q

somatic pain

A

pain from the skin, muscles, bone, soft tissues, teeth, etc

can be precisely localized/perceived at the affected area due to a LARGE # of fibers that go to SPECIFIC parts of the spinal cord that innervate the area

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10
Q

visceral pain

A

pain from internal organs, glands, smooth muscle

diffuse and poorly localized due to a SMALL # of fibers that spread extensively in the spinal cord that innervate the area

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11
Q

referred pain

A

visceral pain that can be felt at somatic sites due to viscero-somatic convergence

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12
Q

viscero-somatic convergence

A

the overlap of somatic and visceral nerve fibers in the spinal cord that causes altered processing of visceral and somatic pain inputs

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12
Q

viscero-somatic convergence

A

the overlap of somatic and visceral nerve fibers in the spinal cord that causes altered processing of visceral and somatic pain inputs

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12
Q

viscero-somatic convergence

A

the overlap of somatic and visceral nerve fibers in the spinal cord that causes altered processing of visceral and somatic pain inputs

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12
Q

viscero-somatic convergence

A

the overlap of somatic and visceral nerve fibers in the spinal cord that causes altered processing of visceral and somatic pain inputs

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13
Q

neuropathic pain

A

pain caused by a lesion/disease of peripheral nerve fibers

can be acute or chronic

ex. amputation, spinal cord injury, diabetic neuropathy, cancer

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14
Q

neuropathic pain

A

pain caused by a lesion/disease of peripheral nerve fibers

can be acute or chronic; often involves nervous system hyperexcitability

ex. amputation, spinal cord injury, diabetic neuropathy, cancer

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15
Q

nervous system hyperexcitability

A

bombardment of excitatory signals to CNS + a decrease in inhibitory signals that causes hyperexcitability

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16
Q

pain processing pathway

A

transduction –> transmission –> modulation –> perception

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17
Q

transduction

A

conversion of a noxious stimulus into an electrical signal (AP)

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18
Q

where does transduction occur

A

peripheral nociceptors

noxious stimulus triggers depolarization –> activates nociceptors –> generates AP

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19
Q

what is action potential frequency proportional to

A

intensity and duration of the noxious stimulus

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20
Q

nociceptors

A

peripheral endings of nociceptive A-delta and C fibers in their target tissues

have a HIGH activation threshold - requires very intense/prolonged stimuli

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21
Q

what type of signals do nociceptors detect

A

mechanical, temperature, and chemical

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22
unimodal nociceptors
only get activated by 1 type of stimulus usually A-delta fibers
23
polymodal nociceptors
activated by a wide variety of noxious stimuli usually C fibers
24
silent nociceptors
MIAs - mechanical insensitive afferents nociceptors with an extremely high activation threshold that are usually inactive and require previous sensitization to be activated
25
transmission
action potential propagation from periphery to the CNS
26
where does transmission occur
along A-delta and C fibers
27
process of transmission
AP generated at nociceptors travels along nerve fibers causing voltage gated Na channels to open --> AP propagates down fiber
28
A-delta fibers
FAST, medium sized, lightly myelinated nerve fibers involved in IMMEDIATE SHARP pain
29
C fibers
SLOW, small, unmyelinated nerve fibers involved in slow burning/dull pain
30
what type of fiber is more abundant in somatic tissues
A-delta fibers causes somatic pain to be more immediate/sharp
31
what type of fiber is more abundant in visceral tissues
C fibers causes visceral pain to be more slow/dull
32
A-beta fibers
FASTEST, large, myelinated nerve fibers involved in NON-PAINFUL touch NOT involved in nociception
33
dorsal horn of the spinal cord
site of A-delta/C fibers synapsing with secondary afferents
34
main neurotransmitter released by A-delta/C fibers
glutamate
35
main neurotransmitter released by A-delta/C fibers
glutamate
36
main receptor on secondary afferent neurons in the spinal cord
AMDA receptors
37
AMDA receptors
glutamate receptor on the secondary afferent neuron causes depolarization and further propagation of AP to the CNS
38
secondary pain afferents
located in the dorsal horn of the spinal cord types: 1. interneurons 2. propriospinal neurons 3. projection neurons
39
interneurons
major target for primary afferent neurons (A-delta/C) can be excitatory or inhibitory to pain transmission to CNS used as a target for pain meds
40
propriospinal neurons
transfer inputs between spinal cord segments
41
projection neurons
transfer inputs from spinal cord to supraspinal centers in the brain via ascending tracts
42
wide dynamic range neurons (WDRn)
special projection neurons (or interneurons) that receive information from all primary afferents (A-delta, C, A-beta) to detect noxious and non-noxious stimuli receptors cover a large area with high overlap --> many WDRns activate in response to single stimulus
43
modulation
up or down regulation of action potential transmission; affects how much of the action potential reaches the brain to determine amount of pain experienced
44
where does modulation occur
dorsal horn of the spinal cord
45
function of ascending tracts
transmit the action potential from dorsal horn of the spinal cord to supraspinal centers
46
gate control mechanism
activation of nerves that do not transmit pain signals (A-beta) to alleviate the final pain feeling non-painful mechanical stimuli --> activates A-beta (FAST) fibers --> activates inhibitory interneurons at the dorsal horn --> decreases painful signals sent to the brain
47
descending modulation
feedback mechanism from supraspinal centers to the dorsal horn of the spinal cord that change pain perception in the brain supraspinal centers send excitatory/inhibitory interneurons/projection neurons to dorsal horn --> facilitates amount of pain signal that gets sent back up to the brain
48
how does emotional state/manipulation of attention alter pain perception
descending modulation not focusing on pain/positive thoughts --> increased inhibitory signals sent from supraspinal centers --> less pain felt focusing on pain/negative thoughts --> decreased inhibitory signals sent from supraspinal centers --> more pain felt
49
what are two descending modulary systems
1. PAG-RVM (tonically active - inhibitory) 2. Pontine-NE Cell Groups (activated by PAG-RVM)
50
sensitization
increased responsiveness of the nervous system (PNS or CNS) to noxious stimuli makes nervous system hyperaware during pain to decrease further damage --> results in allodynia and hyperalgesia produces reversible changes in nervous system (if long lasting, can become chronic)
51
peripheral sensitization
sensitization that occurs at the site of injury caused by local inflammation that changes the environment of the nociceptors results: allodynia and primary hyperalgesia (at site of injury)
52
central sensitization
sensitization that occurs at the dorsal horn neurons in the spinal cord caused by sustained noxious stimulation leading to neuronal hyper-responsiveness results: allodynia and secondary hyperalgesia (spreads to surrounding areas)
53
WIND-UP phenomenon
an increase in neuron responsiveness after sustained noxious stimulation leading to an increased number of APs generated following each individual stimulus increased efficacy of synaptic transmission leads to central sensitization of WDRns (less glutamate required to transmit pain)
54
what receptors and nerve fibers are involved in the WIND-UP phenomenon
NMDA receptors C fibers repetitively firing
55
perception
awareness of the feeling of pain leading to negative emotions, behavioral responses, and learning
56
where does perception occur
cortical regions of the brain subcortical regions project to the cortex to modify
57
pain experience
multidimensional experience of pain based on the characteristics: 1. sensory-discriminative 2. emotional-motivational 3. cognitive-evaluative
58
sensory discriminative aspect of pain experience
somatosensory cortex involves pain intensity, location, quality and duration
59
emotional motivational aspect of pain experience
limbic system emotional reaction to pain
60
cognitive evaluative aspect of pain experience
prefrontal cortex pain meaning and its possible consequence

VET 404: Neurology (23 decks)

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