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Module 3 Revision > Pain & Pain Management > Flashcards

Pain & Pain Management Flashcards

1
Q

Activation of neural pathways by stimuli that damage or threaten to damage tissues, is known as?

A

Nociception

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2
Q

What is noxious stimuli?

A

Potentially damaging stimulus

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3
Q

What activates nociceptive pathways?

A

Nociceptive stimuli

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4
Q

Pain that is felt in one part of the body but is actually caused by pain or injury in another part of your body is known as?

A

Referred pain

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5
Q

What is congenital sensitivity?

A

A rare condition that inhibits ability to perceive physical pain

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6
Q

What term is used to describe inflammation of gum tissue around wisdom teeth?

A

Acute pericoronitis

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7
Q

When is the term used to describe when a blood clot at site of extraction fails to develop, dislodge or dissolve before the wound has healed resulting in intense pain?

A

Dry socket

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8
Q

What does CMD stand for?

A

Craniomandibular dysfunction

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9
Q

Lasting pain in areas of skin, usually after shingles, is known as?

A

Post herpetic neuralgia

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10
Q

What is the result of trigeminal neuralgia?

A

Sudden, severe facial pain

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11
Q

What is another term for neuroma?

A

“Pinched nerve”

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12
Q

What is a neuroma?

A

Benign growth of nerve tissue

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13
Q

What part of the brain stem does the trigeminal roots enter/exit?

A

Pons

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14
Q

What is the site of the first synapse in the dental pain pathway?

A

Caudalis

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15
Q

What is unique about the trigeminal mesencephalic nucleus?

A

It is the only example of primary afferent cell bodies in the CNS ( however it does not synapse!)

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16
Q

-70mv is the voltage that signifies what?

A

The resting membrane potential

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17
Q

What is a voltage gated channel?

A

Opens or closes with a change in voltage

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18
Q

What is an example of a voltage-gated channel?

A

Sodium channel

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19
Q

What is the effect on membrane potential of opening sodium channels?

A

There is an increase in membrane potential

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20
Q

Define depolarisation

A

An increase/ rise in membrane potential

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21
Q

What is the refractory period?

A

A period where an action potential cannot be triggered. Usually follows initiation of action potential.

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22
Q

What happens to sodium channels during the refractory period?

A

They have to reset to resting state and are closed

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23
Q

Why is the refractory period important?

A

So that action potentials flow in one direction

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24
Q

What is the effect of opening potassium channels on membrane potential?

A

The membrane potential decreases

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25
Q

Define hyperpolarisation

A

Where membrane potential decreases

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26
Q

How does myelination increase conduction velocity? Give two reasons.

A
  1. By acting as an electrical insulator, reducing loss of depolarising current across the plasma membrane.
  2. Allows voltage across membranes to change much faster- action potentials ‘jump’
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27
Q

What is the slowest class of axon and why?

A

C- fibre
It is the thinnest/smallest and is not myelinated

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28
Q

What is the fastest class of axon and why?

A

A- alpha
Thickest and myelinated

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29
Q

Where are graded potentials found? And what are they in response to?

A

In the post-synaptic nerve, in response to neurotransmitter binding to a chemically gated channel that opens.

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30
Q

Are graded potentials variable or fixed in height, duration and size?

A

Variable

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31
Q

Is an action potential variable of fixed in duration?

A

Fixed

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32
Q

What triggers an action potential?

A

Voltage

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33
Q

Name the group of membrane receptors that are affected by high temperatures

A

TRPV channels

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34
Q

Why does hot mint tea also feel cool?

A

Activates cold receptors

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35
Q

What is the difference between nociception and pain?

A

Nociception is a physiological process where the body detects damaging or potentially damaging stimuli. Pain is a sensation.

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36
Q

Which parts of the body lack nociceptors?

A

Brain and lung

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37
Q

How is substance P released from nerve endings?

A

Axon reflex

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38
Q

Pain due to stimulus that does not normally provoke pain is known as what?

A

Allodynia

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39
Q

What is the mode of NSAIDs?

A

They block sensitisation of nerves

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40
Q

Name the three theories of dentinal sensitivity

A
  1. Odontoblast theory
  2. Dentine innervation theory
  3. Hydrodynamic theory
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41
Q

Which dentine hypersensitivity theory is most commonly accepted?

A

Hydrodynamic theory

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42
Q

Why is the pain experienced by application of a cold stimulus to the tooth worse than from a hot stimulus?

A

Cold stimulus would cause fluid in dentinal tubules to flow outward. Heat would cause fluid to flow inwards. Outward flow of fluid stretches sensitive ion channels which results in more pain.

43
Q

What phenomenon results from divergence of primary afferents and their convergence on to 2nd order neurons?

A

Referred pain

44
Q

What is the nature of the ‘gate’ in gate control theory?

A

Mechanism where pain signals can be let through or restricted. Involves inhibitory neurotransmitter which can prevent chemical message being passed on any further.

45
Q

Rubbing your hand after hitting it activates mechanoreceptors, shutting ‘gate’ and Lessing the pain. What is this an example of?

A

Segmental control

46
Q

What happens to sodium ions when an action potential is initiated?

A

They move inside the cell membrane

47
Q

What type of signalling are graded and action potentials?

A

Electrical

48
Q

Why are action potentials required?

A

In nerves, signals decay over 2-3mm, action potentials;as are required as propagating signals

49
Q

What term is used to describe large protein ions?

A

Anions

50
Q

What voltage is resting membrane potential at?

A

-70 mv

51
Q

At resting potential where is Na+ more concentrated?

A

Outside the cell

52
Q

At resting potential where is K+ more concentrated?

A

Inside the cell

53
Q

What ion drives resting membrane potential and why?

A

K+, as it has greater membrane permeability

54
Q

What uses ATP to transport Na+ out of cells and K+ into cell, helping to maintain concentration gradients?

A

Sodium-potassium pump

55
Q

What ion is the cell membrane most permeable to?

A

K+

56
Q

What are the 5 stages of nerve conduction?

A
  • resting membrane potential
  • depolarisation
    -rapid depolarisation overshoot
  • repolarisation
  • hyper-polarisation
57
Q

What voltage is threshold for action potential?

A

-50mv

58
Q

What is the voltage when a membrane rapidly depolarises?

A

+30 mv

59
Q

What happens to voltage gated Na+ channels when depolarisation of a membrane occurs?

A

They open and Na+ flows inside the cell

60
Q

What happens to ion channels when rapid depolarisation overshoot occurs?

A

Na+ channels inactivate, K+ channels open after delay

61
Q

What is the voltage when a membrane repolarises?

A

-70 mv

62
Q

What happens to ion channels on repolarisation of membrane?

A

K+ open and flow out of cell
Na+ channels are inactivated

63
Q

What is the voltage upon hyperpolarisation of a membrane?

A

-90 mv

64
Q

What happens to ion channels when hyperpolarisation of a membrane occurs?

A

K+ channels close
Na+ channels reset

65
Q

What is the stage after hyperpolarisation of a membrane?

A

Back to resting potential

66
Q

What is the feedback loop called that’s associated with depolarisation, with Na+ channels opening to allow Na+ to move into cells?

A

Hodgkin’s cycle

67
Q

Why do action potentials only flow in one direction?

A

So not to confuse signal transmission

68
Q

What is an absolute refractory period?

A

Where Na+ channels are not in resting state so an action potential cannot occur

69
Q

What is the relative refractory period?

A

Where K+ channels open and the membrane is hyperpolarised. So an action potential can occur, but requires large stimulus to do so.

70
Q

What two factors does nerve conduction velocity depend upon?

A
  • width of axon
  • myelination
71
Q

Which classification of nerve is the fastest?

A. C fibre, B. A- beta fibre, C. A- alpha fibre, D. A- delta fibres

A

C. A- alpha fibres

72
Q

Which classification of nerve is the slowest?

A. C fibre, B. A- beta fibre, C. A- alpha fibre, D. A- delta fibres

A

A. C fibre

73
Q

Define afferent

A

Nerves that go from periphery’s to CNS

74
Q

Define efferent

A

Nerves that go from CNS to periphery’s

75
Q

What is the structure of voltage gated Na+ channels?

A

4 domains made up of 6 segments

76
Q

What is the most important domain in the voltage gated Na+ channel structure and why?

A

The yellow domain, it is made up of positive amino acids, responds and moves during depolarisation.

77
Q

LA works by blocking Na+ channels. What domain in Na+ channel structure does it target?

A

The yellow domain

78
Q

Where do cell bodies not exist, with the exception of the trigeminal mesencephalic nucleus?

A

CNS

79
Q

What is the first stage in the trigeminal sensory pathway?

A
  1. Primary afferent neurones in trigeminal ganglion in Peripheral nervous system
80
Q

What is the second stage of the trigeminal sensory pathway?

A
  1. Neurone synapses at the trigeminal sensory nuclei in the CNS
81
Q

What tract do second order neurones from the trigeminal sensory nuclei pass along in order to reach the thalamus?

A

Trigemino-thalmic tract

82
Q

What is stage 3 in the trigeminal sensory pathway?

A

Synapse of second order neurones at thalamus

83
Q

What is stage 4 in the trigeminal sensory pathway?

A

Neurones pass to higher centres in somatosensory cortex

84
Q

What are the peripheral trigeminal nerve divisions?

A
  • ophthalmic
  • maxillary
  • mandibular
85
Q

What is the ganglion in the peripheral trigeminal region?

A

Trigeminal ganglion

86
Q

Where do cell bodies for nerves of teeth exist?

A

In the trigeminal ganglion

87
Q

How many roots are there in the peripheral trigeminal nerve? And what are they?

A

Two:
- sensory
- motor

88
Q

Where does the trigeminal nerve exit and enter the CNS?

A

The pons

89
Q

What are the four zones of the trigeminal sensory nuclear complex?

A
  • trigeminal main sensory nucleus
  • nucleus oralis
  • nucleus interpolaris
  • nucleus Caudalis
90
Q

What type of nerves does the trigeminal mesencephalic nucleus contain?

A

Primary afferent nerves

91
Q

Which zone of the trigeminal sensory nuclear complex is out-with the skull?

A

Nucleus Caudalis

92
Q

Where is the site for synapses for pain and hot/cold sensations?

A

Trigeminal Nucleus Caudalis

93
Q

What will occur if the trigeminal nucleus Caudalis becomes damaged?

A

Ipsilateral loss of facial pain and hot/cold sensation

94
Q

Where is the centre where afferent nerves from teeth are processed?

A

Trigeminal nucleus oralis

95
Q

What would happen if damage to the main sensory nucleus occurs?

A

Ipsilateral loss of touch to the face

96
Q

What division of the peripheral trigeminal nerve is the motor root associated with?

A

Mandibular division

97
Q

Where can cell bodies for jaw muscle spindle afferents and some mechanoreceptive afferents from PDL be found?

A

Trigeminal mesencephalic nucleus

98
Q

Where are primary afferent cell bodies usually not found?

A

CNS

99
Q

Uniquely, what primary afferent cell body is found in the CNS?

A

Trigeminal mesencephalic nucleus

100
Q

Do nerves synapse at the trigeminal mesencephalic nucleus? Yes or no?

A

No

101
Q

What nerves of the peripheral trigeminal nerve is the trigeminal mesencephalic nucleus associated with?

A

Motor nerves at trigeminal motor nucleus

102
Q

Where does the trigeminal motor nucleus sit in relation to the main sensory nucleus in the pons?

A

Medially

103
Q

What does the trigeminal motor nucleus supply?

A

Muscles of mastication via motor root of CN V3

Module 3 Revision (20 decks)

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