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PA20023 > Pain, nociception and analgesia > Flashcards

Pain, nociception and analgesia Flashcards

1
Q

What is the definition of pain?

A

The subjective conscious appreciation of a stimulus that is causing, or threatening to cause, tissue damage. Pain exists in your cerebral cortex.

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2
Q

What is nociception?

A

The physical process of detection and transmission of damaging or potentially damaging stimuli.

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3
Q

What are nociceptors?

A

Structures that detect noxious stimuli - peripheral tissues?

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4
Q

What is algesia?

A

The induction of a condition leading to nociception and pain.

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5
Q

What is analgesia?

A

The reduction or prevention of either nociception or pain without loss of consciousness.

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6
Q

What is the function of pain?

A

It is a body protection mechanism - prevents harm to the body.

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7
Q

What are mechanosensory receptors involved in?

A

Motion detection, grip control, form and texture perception, shape, motion detection, stretch, deep pressure and vibration.

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8
Q

What kind of corpuscles are close to the skin surface?

A

Meissner.

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9
Q

What type of corpuscles are lower down the skin surface?

A

Pacinian.

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10
Q

How is information sent to the spinal cord from receptors?

A

Primary afferent neurons such as the mechanosensory afferent fibre or pain and temperature afferent fibre.

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11
Q

What are the two types of nociceptor?

A

The polymodal nociceptor and mechanical nociceptors.

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12
Q

What do polymodal nociceptors respond to?

A

They respond to high intensity mechanical pressure, thermal temperatures above 45 degrees or below 10 degrees.

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13
Q

What do mechanical nociceptors respond to?

A

High intensity mechanical pressure and strong thermal temperatures above 60 degrees.

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14
Q

What are some somatosensory afferent fibres?

A

Proprioception, touch, pain/temperature, pain/temperature and itch.

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15
Q

What is the sensory function of muscle spindle?

A

Proprioception.

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16
Q

What is the sensory function of merkel, meissner, pacinian and ruffini cells?

A

Touch.

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17
Q

What is the sensory function of free nerve endings?

A

Pain and temperature.

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18
Q

What is the sensory function of unmyelinated free nerve endings?

A

Pain, temperature and itch.

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19
Q

How does the axon diameter of afferent fibres vary between receptors?

A

Muscle>merkel/meissner etc>free nerve ending>unmylineated free nerve endings

20
Q

Are proprioceptors or temperature receptors faster?

A

Proprioreceptors.

21
Q

What are the two types of pain?

A

Fast pain and slow pain.

22
Q

What are the differences between the two types of pain?

A

Fast pain is sharp/pricking and usually well tolerated whereas slow pain is usually burning, aching, throbbing and is poorly tolerated.

23
Q

What is the differences in fibres between fast and slow pain?

A

Fast - A delta fibre, slow - C_fibre.

24
Q

How do local anaesthetics work on slow and fast pain?

A

Different anaesthetics affect fast and slow pain.

25
Q

What local anaesthetic can stop fast pain?

A

Procaine.

26
Q

What local anaesthetic can stop slow pain?

A

AL-381.

27
Q

What is the difference between thermoreceptors and thermal nociceptors?

A

Thermoreceptors tell you when things are hot, but nociceptors tell you when things are dangerously hot.

28
Q

How does receptivity of thermoreceptors and thermal nociceptors differ?

A

Nociceptors - signal increased with temperature, thermoreceptors same above certain threshold.

29
Q

What happens when there is a stimulus that is potentially harmful?

A

Primary transduction - channels open.

30
Q

What happens when there is primary transduction of nociceptors?

A

Secondary transduction - change in membrane voltage.

31
Q

What happens after secondary transduction in the pathway?

A

Depolarisation and action potential generation.

32
Q

What happens after depolarisation in the pathway?

A

Transmitter release and second order ascending neurone response.

33
Q

What does it mean that there are graded potentials in nociceptors?

A

Action potentials vary in size depending on the size of the stimulus.

34
Q

Why else is nociception not just exaggerated somatosensory transmission?

A

Nociceptors project to different spinal sites.

35
Q

What is the main ascending pain pathway?

A

Spinothalamic-anterolateral system.

36
Q

What is the pain pathway involving the face?

A

Trigemino-thalamic pathway.

37
Q

What pain pathway runs dorsally?

A

The viscero-thalamic pathway.

38
Q

What is another reason why somatosensory transmission and nociception is different?

A

They have different ascending pathways.

39
Q

What is hyperalgesia?

A

Increased response to a noxious stimulus.

40
Q

What is allodynia?

A

painful responses to a non-noxious stimulus.

41
Q

What causes sensitisation of nociceptors?

A

H+, ATP,K+ released from damaged cells sensitise the nociceptors along with 5HT, histamine, bradykinin and prostaglandins released from mast cells and macrophages.

42
Q

What happens after nociceptors are sensitised?

A

SP and CGRP cause increased blood flow and there is increased access of inflammatory cells.

43
Q

What is SP and CGRP?

A

Substance P and Calcitonin gene-related peptide.

44
Q

What does SP trigger?

A

Histamine release.

45
Q

What is neuropathic pain?

A

Pain unrelated to peripheral nociception - it serves no purpose.

46
Q

What are some causes of neuropathic pain?

A

Thalamic stroke, peripheral nerve damage, spinal damage and peripheral nerve terminal damage/infection.

PA20023 (17 decks)

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