Pain & Nociception No.2

Question 1

what re two types of 2nd order neurones

Answer 1

nociceptive specific and non specific

Question 2

what is specific 2nd order nueorns

Answer 2

only input form nociceptors

presence and location at noxious stimulus

Question 3

what are wide dynamic range non specific 2nd order neurones

Answer 3

inputs from nociceptors, mechanoreceptors, thermorcepes

respond to wide range stim intensities

Question 4

where next fro 2nd order neurones

Answer 4

contralateral thalamus va triemino thalamic that 
ventrobasal nuclei 
posterior/medial nuclei 
(emotional/motor resp)
primary sonatosense cortex 
insula
cingulate gyrus

Question 5

what are the interactions that ca happen between ptahywas at first synapse

Answer 5

divergence 
convergence 
hyperalgesia 
raidiating 
referred pain

Question 6

what are the modulations that can happen at first synapse

Answer 6

gate control
0 segmental
- descending control

diffuse noxious inhibit controls

Question 7

what is divergence

Answer 7

final branching of primary afferent multiple times to loads 2nd neurons

Question 8

what is convergence

Answer 8

numerous pre syn axons to one 2nd order neurone
allows summation
spatial inaccuracies

Question 9

what is the path for discrete pain

Answer 9

stim area X and conscious pain to area X

Question 10

what is hyperalgesia

Answer 10

increased pain form a stimulus that normally provokes pain

Question 11

what is path of hyperalgesia

Answer 11

area X tim cause conscious pain to area X

also sensitise area Y so if this is stim means pain more at area Y

Question 12

what is radiating pain

Answer 12

pain appears tone spread beyond the area affected

Question 13

what is the path of radiating pain

Answer 13

area X tim causes area X and Y to be consciously pain

Question 14

what is referred pain

Answer 14

pain appears originate form an area that is diff to the injured area

Question 15

what is the path for referred pain

Answer 15

area X tim conscious pain in area Y due to inhibit influences in path of area X

Question 16

where is referred pin usually from

Answer 16

a deep to superficial structure

to a tissue that produces sensory activity

Question 17

what is segmental referred pain

Answer 17

heart to left arm
max sinus to teeth
appendix to abdominal skin

Question 18

what are interneurons activated by

Answer 18

segmental inputs

descending controls

Question 19

what sit he gate control theory

Answer 19

gate of inhibitory interneurons modulate pain signals

Question 20

what can be affected by gate theory

Answer 20

A eta and C nocicipetors
A beta mechanoreceps
higher centres

Question 21

what are the excitatory neurotnasmittters

Answer 21

substance P
CGRP
Glutamate

Question 22

what are the inhibitory neurotransmitters

Answer 22

endogenous opioids
Glycine
GABA

Question 23

what is the analgesic pregabalin

Answer 23

decreases release of sub P, CGRP, glutamate

Question 24

what is ketamine

Answer 24

analgesic

receptor antagonisist for glutamate

Question 25

what is morphine

Answer 25

analgesic mimics endogenous opiods

Question 26

what is Gabapentin

Answer 26

analgesic o have simianr effects to GABA

Question 27

what si counter irritation Phenomena

Answer 27

one pain masks another

pain modulation

Question 28

what is an example of counter irritation phenomena

Answer 28

acupuncture

Question 29

what is prolonged pain

Answer 29

long acting neurotransmitters
neuromodulators
Bi stable neurones (active until off)
+ve feedback circuits

Question 30

what are ways of pain control

Answer 30

simple analgesics 
LA
surgical interruption 
narcotic analgesics counter irritation 
GA