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Phys 2 > Pain & Thermoregulation > Flashcards

Pain & Thermoregulation Flashcards

1
Q

Mechanoreception

A

Touch

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2
Q

Thermoreception

A

Temp

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3
Q

Nociception

A

Pain

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4
Q

Somatic senses go through what nerve fibers?

A

Afferent

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5
Q

What are the 3 types of afferent nerve fibers?

A
  1. A-beta
  2. A-delta
  3. C fibers
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6
Q

What do a-beta fibers look like?

A

Thick (less resistance) and myelinated (fast conduct)

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7
Q

What do a-delta fibers look like?

A

Thin (increase resistance), myelinated (fast conduct)

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8
Q

What do C fibers look like?

A

Thin (increase resistance), unmyelinated (less conduct)

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9
Q

Which fibers are fast?

A

A-beta

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10
Q

Which fibers are moderate?

A

A-delta

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11
Q

Which fibers are slow?

A

C fibers

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12
Q

APs from a-beta fibers?

A

Mechanoreceptors (non-noxious stimuli; non pain)

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13
Q

APs from a-delta fibers?

A

Mechanoreceptors and nociceptor (mechanical, thermal, fast pain)

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14
Q

APs from C fibers?

A

Mechanoreceptors and nociceptor (touch, flow pain, temp/chemical)

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15
Q

N transmitter from a-beta fibers?

A

Glutamate

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16
Q

N transmitters from a-delta fibers?

A

Glutamate

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17
Q

N transmitters from C fibers?

A

Substance P (pain) and glutamate

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18
Q

What mechanoreceptor/nociceptor types are rapidly adapting and lower threshold?

A
  1. Hair follicles
  2. Meissner corpuscle
  3. Pacinian corpuscle
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19
Q

Perceptual functions of hair follicles?

A

Skin movement

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20
Q

What is meissner corpuscle skin stimulus?

A

Dynamic deformation (Braille text)

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21
Q

Meissner corpuscle perceptual functions?

A

Skin motion; detecting slipping objects

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22
Q

Skin stimulus of pacinian corpuscle?

A

Vibration; tapping

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23
Q

How deep is pacinian corpuscle in the skin?

A

The deepest

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24
Q

Perceptual functions of pacinian corpuscle?

A

Vibratory cues transmitted by body contact when grasping an object

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25
Q

Which mechanoreceptor/nociceptor types are slow adapting and low threshold?

A

Merkel cell-neurite complex, ruffini corpuscle, c-fiber LTM

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26
Q

Skin stimulus of merkel-cell complex?

A

Indentation depth (key board); form and texture

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27
Q

Perceptual functions of merkel-cell neurite complex?

A

Fine tactile discrimination; form and texture perception

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28
Q

Skin stimulus of ruffini corpuscle?

A

Stretch; hand shape and skin motion

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29
Q

Perceptual functions of ruffini corpuscle?

A

Skin stretch; direction of object motion, hand shape and finger position

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30
Q

Skin stimulus of C fibre LTM?

A

Tough (gentle)

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31
Q

Perceptual functions of C fibre LTM?

A

Pleasant contact; social interaction

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32
Q

What afferent response is mechano-nociceptor/polymodal nociceptor?

A

Slow adaption and high threshold

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33
Q

Skin stimulus for mechano-nociceptor/polymodal nociceptor?

A

Injurious forces; pain, temp

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34
Q

Which mechanoreceptor/nociceptor types need to have the greatest stimulus?

A

Mechano-nociceptor/polymodal nociceptor

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35
Q

Which mechanoreceptor/nociceptor type has the greatest receptive field?

A

Pacinian corpuscle

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36
Q

Receptive field of merkel cell-neurite complex?

A

4 smaller circles

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37
Q

Ascending neural pathway of somatosensory system for touch and pressure?

A

Dorsal column system (DCS)

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38
Q

2nd order fibers cross over where in touch and pressure?

A

From medulla to thalamus

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39
Q

What kind of fibers are in touch and pressure?

A

Large myelinated fibers (A-beta)

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40
Q

What kind of spatial fidelity in touch and pressure?

A

High degree

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41
Q

What are the 5 touch and pressure mechanoreceptors?

A
  1. Hair follicles
  2. Meissner corpuscle
  3. Pacinian corpuscle
  4. Merkel-cell neurite complex
  5. Ruffini corpuscle
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42
Q

Ascending neural pathways of somatosensory system for pain, temp, light touch?

A

Anterolateral system (spinalthalmic tract(STT))

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43
Q

2nd order fibers cross where in pain, temp, and light touch?

A

Spinal cord

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44
Q

What do the fibers look like in pain, temp, light touch?

A

Smaller myelinated (a-delta) and unmyelinated (c fibers)

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45
Q

Pain, temp, light touch spatial fidelity?

A

Low (more loss to regions lower than thalamus)

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46
Q

What are the 2 mechanoreceptors for pain, temp, light touch?

A
  1. C-fibre LTM

2. Mechano-nociceptor/polymodal nociceptor

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47
Q

What is the dorsal column system (touch and pressure) pathway?

A
  1. Ascending branches of dorsal root fibers
  2. Dorsal column nuclei at lower medulla oblongata
  3. Ventrobasal complex of thalamus
  4. Somatosensory cortex
48
Q

Anterolateral system of pain, temp, light touch pathway?

A
  1. Dorsal root and spinal ganglion
  2. Cross over in spinal cord
  3. Ventrobasal and intralaminar nuclei of the thalamus
  4. Postcentral gyrus of cerebral cortex
49
Q

What area can manipulate pain signals?

A

Spinomesencephalic tract

50
Q

What is the postcentral gyrus in charge of?

A

Somatosensory

51
Q

What is precentral gyrus in charge of?

A

Motor

52
Q

What do all pain receptors look like?

A

Free nerve endings of unmyelinated C fibers and small diameter myelinated a-beta fibers

53
Q

What are the 5 things that nociceptors look like?

A
  1. Widely distributed free nerve endings
  2. High threshold
  3. Specific to stimulus
  4. NOT adapt to stimulation
  5. Correlated to rate of tissue damage
54
Q

Increased sensitivity of free nociceptive afferent nerve endings by chemical factors associated with what?

A

Inflammation

55
Q

What is pain enhancement from?

A
  1. Prostaglandins and substance P
56
Q

What are the pain induction?

A

Sleep nociceptors and awakening agents (bradykinin, serotonin, histamine, K+ ions, acids, nerve growth factor)

57
Q

Where are pain induction most important?

A

Deep tissue afferents (gut, joints) as they are insensitive normally

58
Q

What activates TRPV1 and induce depolarization of nociceptive axons via Na and Na entry

A

Bradykinin, substance P, and nerve growth factor

59
Q

What opens the TTX-Resistant VGNC’s?

A

Prostaglandins

60
Q

What blocks VGNC’s?

A

TTX (tetrodotoxin)

61
Q

Pain: fast fiber and slow fibers

A

Fast: a-delta (myelinated)
Slow: C fibers (unmyelinated)

62
Q

Pain: fast vs slow

  1. Neurotransmitters
  2. Speed
  3. Feeling
  4. Location
  5. Tract
A
  1. Fast: glutamate; slow: substance P
  2. Fast: .1s; slow: 1s
  3. Fast: shape, localized well; slow: dull, throbbing, aching, poor localization
  4. Fast: surface, not deep in tissue; slow: seen with tissue destruction
  5. Fast: neospinothalamic tract (localization); slow: paleospinothalmic tract (reticular activing system: attention, arousal)
63
Q

What is dual pain?

A

A-delta fibers (fast) transmit firs pain sensation, which is felt as prickling pain of rapid onset. Later transmission by slower C fibers, results in delayed aching or burning sensation

64
Q

Physiological painful: acute or chronic?

A

Acute

65
Q

Pathological pain: acute or chronic?

A

Chronic

66
Q

3 facts about physiological pain (acute)

A
  1. Reflexive avoidance
  2. Little or no tissue injury
  3. Pain stops shortly after stimulus is removed
67
Q

6 facts about pathological pain (chronic)

A
  1. Tissue or nerve injury
  2. Inflammation occurs
  3. Release NTs with ongoing stimulation of nociceptors
  4. CNS pathway sensitized/reorganized
  5. Lead to hyperalgesia
  6. Persists after stimulus is removed (refractory to NSAIDs and opioid therapy)
68
Q

Area of skin supplies by sensory neurons that arise from a spinal nerve ganglion

A

Dermatome

69
Q

What analgesics affect brain?

A

Opioids

Alpha 2 adrenoceptor agonists

70
Q

What analgesics affect dorsal horn?

A

Local anesthetics
Opioids
Alpha 2 adrenoceptor agonists

71
Q

What analgesics affect peripheral nerve?

A

Local anesthetics

72
Q

What analgesics affect peripheral nociceptors?

A

Local anesthetics

Antiflammatory drugs

73
Q

What is responsible for pain?

A

Prostaglandins produced by COX-2

74
Q

What does corticosteroids inhibit?

A

Phosphorlipidase A2

75
Q

What does NSAID inhibit?

A

COX 1 and 2

76
Q

What does reduced prostaglandins do?

A

Reduces Na entry into nociceptors

77
Q

What are the 2 anti inflammatory drugs?

A

NSAIDs and corticosteroids

78
Q

What does local anesthetics do?

A

Block APs in peripheral neurons

79
Q

What is the nonionized form of local anesthetic and what does it do?

A

R-NH2; penetrates the axonal membrane and is then converted to the ionized form (R-NH3+)

80
Q

What is the ionized form and what does it do?

A

R-NH3+; binds to the Na channel in the open state and this prolongs the Na channel inactivation state and Na entry is blocked during inactivation sate

81
Q

What is endogenous pain stress response?

A

Serotonin and beta-endorphin (opioid)

82
Q

Where is endogenous pain stress response found and what does this do?

A

Found in hypothalamus and pituitary

Simulates endogenous opiate production

83
Q

What are the opioids?

A

Enkephalins and dynorphins

84
Q

Where are the opioids found and what do they do?

A

Found in brain stem and spinal cord

Pre-post synaptic inhibition of type C and a-delta

85
Q

What is naloxone?

A

Opioid receptor antagonist

86
Q

What does opiates do on the presynaptic?

A
  • decrease peripheral AP

- decrease distal Ca++ influx and NT release

87
Q

What does opiates do on the Postsynaptic?

A

Hyper polarized due to K+ efflux

88
Q

What does alpha 2 agonism do on the presynaptic?

A

Decrease distal Ca++ influx and NT release

89
Q

What are the NMDA antagonisms?

A

Ketamine and magnesium

90
Q

What do the NMDA antagonisms do on the Postsynaptic?

A
  • allow lots of Ca++ and little Na into cell

- decrease glutamate receptor signaling NT release

91
Q

What can substance P do to NMDA antagonism?

A

Enhance NMDA opening

92
Q

What functions as the bodies thermostat?

A

Hypothalamus

93
Q

What is body temp controlled by?

A

Balance between heat production and heat loss

94
Q

What provides heat transfer?

A

Blood flow to the skin from the body core

95
Q

Thermoregulation afferent fibers?

A

A-delta and C fibers

96
Q

What detects the fever and hyperthermia damage?

A

Hypothalamus

97
Q

What are the efferent outputs for thermoregulation (4)

A

Temp (arteriole and sweat glands)

Metabolism (skeletal muscle and thyroid)

98
Q

What is the greatest mechanism of heat loss?

A

Radiation 60%

99
Q

What is the least mechanism of heat loss?

A

Conduction to objects 3%

100
Q

Sweating caused by stimulation of what?

A

Anterior hypothalamus preoptic area (AHPA)

101
Q

Nerve impulses from AHPA lead to stimulation of what?

A

Cholinergic nerve fibers that innervate sweat gland

102
Q

How does post ganglionic neuron for sweat gland innervates differs and what does it release?

A

Differs from other sympathetic postganglionic neurons in that it releases acetylcholine to act on muscarinic receptors (atropine fever)

103
Q

Do adrenergic fibers innervate sweat glands usually?

A

No

104
Q

Sweat glands can be stimulated by what?

A

Circulating Epi and NorE

105
Q

What does the sweat gland duct absorb?

A

Mainly Na and Cl

106
Q

What does the sweat gland primary secrete?

A

Mainly protein free filtrate

107
Q

Increased blood and internal temp causes what kind of firing and temp at the hypothalamus?

A

Increase

108
Q

What 2 things occur when the hypothalamus temp increase?

A

Vasodilation and sweat glands become more active increasing evaporative heat loss

109
Q

Decreased temp causes what kind of temp and firing in hypothalamus?

A

Decreasing

110
Q

What 2 things occur when hypothalamus temp and firing decrease?

A

Vasoconstriction and skeletal muscles shivering to increase metabolism that generates heat

111
Q

What kind of feedback does temperature reflex have?

A

Negative feedback

112
Q

Redistribution phase:

A

core temp decreases 1-1.5 degree during the 1st hour

113
Q

Linear phase:

A

During following 3 hr core temp linearly decreases due to heat loss exceeding metabolic heat production

114
Q

Core temp plateau:

A

After 3-5 hr of anesthesia core temp stops dropping

115
Q

What are the 4 major factors for heat loss?

A
  1. Type and dose of anesthesia
  2. Amount of surgical skin exposure
  3. Ambient temp
  4. Duration

Phys 2 (5 decks)

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