Pain Physiology

Question 1

Physiologic Pain

Answer 1

normal response to a noxious stimuli producing protective behavioural responses to potential or actual tissue damage

Question 2

Acute Pain

Answer 2

Sudden onset of pain, which may be severe but disappears when the stimulus is removed

Question 3

Chronic pain

Answer 3

Pain that lasts several weeks to months and persists beyond the expected healing time

Question 4

Somatic pain

Answer 4

originates from damage to bone, joint, muscle, or skin

well localized

Question 5

Visceral pain

Answer 5

originates from internal organs - stretching or twisting of viscera, mesenteries, and ligaments
poorly localized

Question 6

Neuropathic pain

Answer 6

originates from injury to the peripheral or central nervous system

Question 7

Inflammatory pain

Answer 7

Originates from tissue damage

Question 8

Referred pain

Answer 8

originates from one part of the body but perceived as occurring in another

Question 9

Transduction

Answer 9

peripheral pain receptors activated by a stimulus

Question 10

Transmission

Answer 10

signal communication via A-delta and C- nerve fibers to spinal cord

Question 11

Modulation

Answer 11

nociceptive input modified at the spinal cord

Question 12

Perception

Answer 12

Conscious recognition of pain at the cerebral cortex

Question 13

What do the Mechanoreceptors respond to?

Answer 13

Stretching
compression
crushing

Question 14

What do the Thermoreceptors respond to?

Answer 14

Heat

Cold

Question 15

What do the Chemoreceptors respond to?

Answer 15

Neurotransmitters
Prostaglandins
autocoids
cytokines
leukotrienes
nerve growth facotr

Question 16

What are the two types of peripheral nerves?

Answer 16

A-delta fibers

C-fibers

Question 17

A-delta fibers

Answer 17

Myelinated fast transmission

Acute, accurately localized, sharp, and rapid onset pain

Question 18

C-fibers

Answer 18

Nonmyelinated, slow transmission

Chronic, diffuse, dull, burning, aching pain

Question 19

What are the Facilitory/Excitatory substances?

Answer 19

Substance P

Glutamate

Question 20

What receptor does Substance P act on?

Answer 20

NK1 receptor

Question 21

What receptor does Glutamate act on?

Answer 21

AMPA
NMDA
Kainate

Question 22

What is the inhibitory substance?

Answer 22

GABA

Question 23

What tract transmits localized superficial pain?

Answer 23

Spinothalamic tract

Question 24

What tract transmits deep and visceral pain?

Answer 24

Spinoreticular tract

Question 25

How do you test the Spinoreticular tract?

Answer 25

hemostats across base of toenail

Question 26

What mediates head pain?

Answer 26

Trigeminal nerve (CN V)

Question 27

Allodynia

Answer 27

Pain evoked by a stimulus that does not normally cause pain

Question 28

Hyperalgesia

Answer 28

An increased or exaggerated response to a stimulus that is normally painful

Question 29

Peripheral sensitization

Answer 29

an increase in the activity, excitability, and responsiveness of peripheral nerve terminals leading to primary hyperalgesia

Question 30

Windup

Answer 30

Summation of painful stimulation in the spinal cord, mediated by C-fibers. Contributes to control sensitization

Question 31

Central sensitization

Answer 31

an increase in nerve excitability and responsiveness in the central nervous system, particularly the spinal cord, leading to primary and secondary hyperalgesia and allodynia

Question 32

What does central sensitization result in?

Answer 32

Hyperalgesia Allodynia Spontaneous pain Pain memory (phantom limb pain)

Question 33

Analgesia

Answer 33

Loss of sensitivity to pain

Question 34

Multimodal analgesia

Answer 34

The use of multiple drugs acting by different mechanisms to produce anlagesia

Question 35

Preemptive analgesia

Answer 35

the administration of analgesic therapy before painful stimulation, used to Prevent Wind up

Question 36

What is the clinical goal of analgesia?

Answer 36

reduce pain by interrupting nociception at one or multiple levels