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NEURO 375 > Peripheral Pain > Flashcards

Peripheral Pain Flashcards

1
Q

What kind of neurons are nocicpetors?

A

pseudounipolar

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2
Q

remak bundle

A

one schwann cell that can ensheath multiple axons, but myelinates only one axon segment

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3
Q

What do the following connective tissue layers in a nerve surround:

  • endoneurium
  • perineurium
  • epineurium
A
  • endoneurium: surrounds axons
  • perineurium: surrounds axon fascicles
  • epineurium: surrounds entire nerve
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4
Q

What kind of nerves are spinal ganglia associated with?

A

spinal and cranial nerves

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5
Q

What kind of nerves are associated with autonomic ganglia?

A

sympathetic and parasympathetic nerves

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6
Q

What kind of neurons do spinal ganglia contain? autonomic ganglia?

A
  • spinal ganglia: large pseudounipolar sensory neurons
  • autonomic ganglia: multipolar neurons
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7
Q

Do synapses occur at spinal ganglia or autonomic ganglia?

A

autonomic ganglia

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8
Q

Arrange the following from most to least myelinated:

  • C
  • Abeta
  • Aalpha
  • Adelta
A

Aalpha > Abeta > Adelta > C

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9
Q

What are Aalpha fibers responsible for?

A

proprioceptors of skeletal muscle

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10
Q

What are Abeta fibers responsible for?

A

mechanoreceptors in skin

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11
Q

What are Adelta fibers responsible for?

A

sharp and immediate pain and temperature

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12
Q

What are C fibers responsible for?

A

dull and achey temperature, pain, and itch

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13
Q

Classify the Adelta and C nociceptors based on conduction velocity.

A
  • Adelta: first, sharp pain
  • C: second, prolonged and diffused pain; result from acute damage
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14
Q

What do merkel receptors respond best to?

A

steady pressur from small objects

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15
Q

What do Meissner corpuscles respond best to?

A

rubbing against skin

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16
Q

What do Ruffini cylinders respond best to?

A

steady pressure and stretching of the skin (e.g. joint movement)

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17
Q

What do Pacinian corpuscles respond best to?

A

changing stimulation

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18
Q

What causes nociceptive pain? Examples?

A
  • tissue damage
  • burns, fractures, lacerations
19
Q

What causes inflammatory pain? Examples?

A
  • inflammation initiated by autoimmune response
  • gout, rheumatoid arthritis
20
Q

What causes neuropathic pain? Examples?

A
  • nerve damage/somatosensory system
  • diabetic neuropathy, carpal tunnel syndrome, complex regional pain syndrome
21
Q

What causes nociplastic pain?

A
  • no clear evidence of tissue damage
  • fibromyalgia, chronic lower back pain, IBS
22
Q

Which organ does not have nociceptors?

A

brain

23
Q

Can you still feel second pain if first pain is blocked?

A

yes

24
Q

What kind of channels are associated with nociceptors? What kind of stimulus activates these channels?

A

transient receptor potential (TRP) channels; activated by heat

25
Q

Where do C fiber afferents synapse with 2nd order neurons?

A

dorsal horn of spinal cord; rexed’s laminae 1 and 2

26
Q

Where do Adelta fiber afferents synapse with 2nd order neurons?

A

dorsal horn of spinal cord; rexed’s laminae 1 and 5

27
Q

What type of information is transmitted in the anterolateral (spinothalamic) pathway? Dorsal Column Medial Lemnisus pathway?

A
  • anterolateral = pain and temperature
  • DCML = sensation, vibration, proprioception
28
Q

first order neuron path of the anterolateral path? DCML path?

A
  • anterolaterl: nociceptor –> dorsal horn
  • DCML: receptor –> dorsal column –> medulla
29
Q

second order neuron path of the spinothalamic path? DCML path?

A
  • spinothalamic: dorsal horn –> VPL nucleus of thalamus
  • DCML: medulla –> thalamus
30
Q

third order neuron path of the spinothalamic path? DCML path?

A
  • spinothalamic: thalamus –> somatic sensory cortex
  • DCML: thalamus –> somatic sensory cortex
31
Q

Site of decussation in the spinothalamic path? DCML path?

A
  • spinothalamic: cord
  • DCML: medulla
32
Q

In brown sequard syndrome, injury to the left hemi-cord causes?

A
  • loss of pain/temperature on RIGHT side below lesion (spinothalamic)
  • loss of touch, vibration, proprioception on LEFT side below lesion (DCML)
33
Q

What system manages spinal pain suppression (i.e. peripheral)?

A

gate control hypothesis

34
Q

What systems manage supraspinal pain suppression (i.e. from the brain/CNS)?

A
  • descending serotonergic and opioid inhibitory system
  • descending purinergic inhibitory system
  • descending adrenergic inhibitory system
35
Q

Describe the gate control hypothesis. What is the theory? Which order neuron does it act on?

A

theory: mechanoreceptors (pressure) blocks peripheral ascending pain; act on 2nd order neurons

1) Abeta fiber synapses on inhibitory interneuron
2) inhibitory interneuron synapses on C-fiber
3) decreased C fiber firing

36
Q

Describe descending control of central pain. Which order neuron does it act on?

A

act on 1st order neurons

1) PAG release enkephalin to Raphe nucleus
2) raphe nucelus release 5-HT to inhibit C fiber from releasing Sub-P
3) decreased C fiber firing in the dorsal horn

37
Q

What is chronic pain?

A

pain that persists past normal healing time (>3-6 months)

38
Q

hyperalgesia?

A

increased pain sensation to normally painful stimulus

39
Q

hyperesthesia?

A

increased sensitivity to stimulation (e.g. irritation)

40
Q

allodynia

A

perception of pain from non-noxious stimulus (e.g. tight clothes on sunburn)

41
Q

dysesthesia

A

unpleasant abnormal sensation (e.g. feel sick)

42
Q

Describe peripheral sensitization.

A

inflammatory substances sensitize/activate nociceptors

43
Q

Describe central sensitization.

A

transcription dependent and transcription independent

NEURO 375 (19 decks)

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