PAIN PART 1

Question 1

Classification of pain

Answer 1

Acute - less than 3 months
Chronic pain - more 3 months

Question 2

Temporal features of pain

Answer 2

Onset, duration, course, pattern

Question 3

Inflammatory pain

Answer 3

Throbbing pulsating

Question 4

Neuropathic pain

Answer 4

Stabbing, shooting, burning,tingling

Question 5

Visceral pain

Answer 5

Squeezing

Question 6

Pain circuitry

Answer 6

Starts at the periphery and moves signaling to the spinal cord where CNS is activated and this signal goes to the brain where the signal of pain is processed and sent back down to the spinal cord for modulation

Question 7

Periphery receptors and channels involved in signaling pain - temperature sensitive

Answer 7

Transit receptor potential cation channel
TRPV (vanniloid) = heat
TRPM (Melastatin) = cold

Question 8

Acid sensitive peripheral receptors

Answer 8

ACID Sensing ion channels (ASIC) - activated by H and conduct Na

Question 9

Chemical irritant sensitive peripheral receptors

Answer 9

Histamine and bradykinin

Question 10

A beta fibers

Answer 10

These fibers have a Mylan sheet and are Stimuli of touch and pressure not pain, innervate skin and signaling is very fast

Question 11

A gamma fibers

Answer 11

These are my fibers that are response of pain and cold they stimulate the first can reflect arc (sharp and prickly)

Question 12

C fibers

Answer 12

Stimuli is the second pain, more prolonged, dull and aching feeling
Pain temp touch pressure itch
These are unmyelinated, fiber, and signaling is slow

Question 13

Substance P and it’s roll in heightening pain response

Answer 13

Substance P is involved in vasodilation the granulation of mass cells release of histamine and inflammation, and prostaglandins. All of this increases expression of pain receptors, which causes sensitization.

Question 14

Neuropathic pain sensitization

Answer 14

CGPR, substance p, and glutamate lead to chemical changes in the spinal cord postsynaptic which increases AMPA and NMDA leading to increase sensitization of glutamate receptors

Question 15

Pain circuitry brain

Answer 15

High expression of opioid receptors in the brain, stem along the descending pathway

Question 16

My opioid receptor expression in the brain, brainstem, spinal cord and periphery

Answer 16

Brain: alter mood produce sedation and reduce emotional reaction
Brainstem: increase activity of descending fibers which reduces activity of ascending pathways
Spinal cord: inhibit, physical release and hyper polarized postsynaptic membrane
Periphery: reduce activation of primary afferent and modulate immune activity 

Question 17

Different regions of the brain involved with pain 

Answer 17

Somosensory cortex
Amygdala, which is responsible for the feelings and emotions involved with pain
Nucleus accumbens which plays an important role with addiction
Prefrontal cortex and right lateral orbitofrontal cortex, which both play a role in decision-making and fight or flight response