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Year 2- CNS > Physiology and Pathophysiology of Pain > Flashcards

Physiology and Pathophysiology of Pain Flashcards

1
Q

What is pain?

A

Unpleasant sensory and emotional experience associated with, or resembling, actual/potential tissue damage.

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2
Q

Are pain and nociception the same?

A

No

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3
Q

What is nociception?

A

The physiological process by which noxious stimulation is communicated through the peripheral and central nervous system

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4
Q

Where does the perception of pain occur?

A

Somatosensory cortex

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5
Q

What detects pain in the periphery?

A

Nociceptors

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6
Q

Which neurons transmit the pain from the periphery to the spinal cord?

A

First order neurons

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7
Q

Which type of neurons transmits from the spinal cord to the thalamus?

A

Second order neurons

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8
Q

What happens when the pain information reaches the thalamus?

A

Perception, learning, response

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9
Q

Nociceptors are free nerve endings of which types of fibres?

A

A delta and C fibres

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10
Q

At which temperature does it become known as noxious stimuli range?

A

Above 42 degrees.

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10
Q

Which type of things do nociceptors respond to?

A

Thermal, chemical and mechanical noxious stimuli

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11
Q

The first order neurons carry fibres to which part of the spinal cord?

A

Cell body in dorsal root ganglion

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12
Q

Which fibres transmit fast, sharp pain?

A

A delta fibres

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13
Q

Which types of fibre transmits dull pain?

A

C fibres

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14
Q

Where in the dorsal root ganglion do the first order neurons synapse?

A

Rexed lamina 1 and 2

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15
Q

Give three characteristics of the neurons which receive the input from primary afferents.

A
  1. Nociceptive specific
  2. Low threshold mechanoreceptive
  3. Wide dynamic range
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16
Q

Which tract in the main ascending tract for nociception?

A

Spinothalamic tract

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17
Q

Which rexed lamina does the spinothalamic tract arise from?

A

Rexed lamina 1, 2 & 5

18
Q

What is allodynia?

A

Pain due to a stimulus which does not usually provoke pain

19
Q

What changes are seen in the nociceptor in response to allodynia?

A

Decreased threshold for response

20
Q

What is hyperalgesia?

A

Abnormally heightened sensitivity to pain

21
Q

What changes are seen in the nociceptor in response to hyperalgesia?

A

Exaggerated response to normal and supranormal stimuli

22
Q

What changes are seen in the nociceptor in response to spontaneous pain?

A

Spontaneous activity in nerve fibres

23
Q

What is central sensitization?

A

Response of second order neurons in the CNS to both noxious and non-noxious stimuli

24
Q

There are three components of central sensitization; wind-up, classical and long-term potentiation.
What is meant by wind-up?

A

Homosynaptic activity is dependant on the progressive increase in neuron response

25
Q

Which type of synapses does wind-up involve?

A

Only activated synapses

26
Q

Name the neurotransmitters involved in the process of wind-up.

A

Substance P
CGRP

27
Q

What happens in classical central sensitization?

A

Involves opening up of new synapses and is responsible for a lot of pathophysiology

28
Q

Which synapses are involved in long-term potentiation?

A

Mainly activated synapses

29
Q

Which two things can pain be based on?

A

Duration e.g. chronic or acute
Mechanism

30
Q

What are three mechanisms of pain?

A

Nociceptive
Neuropathic
Nociplastic

31
Q

Is acute pain physiological or pathological?

A

Physiological

32
Q

Is chronic pain physiological or pathological?

A

Pathological

33
Q

Which type of pain serves as a protective function?

A

Acute pain

34
Q

Which type of pain is nociceptive?

A

Acute

35
Q

Which type of pain can be nociceptive, neuropathic or neoplastic?

A

Chronic

36
Q

What is nociceptive pain?

A

A sensory experience that occurs when nociceptors respond to noxious stimuli

37
Q

Describe nociceptive pain.

A

-Pain usually localised to site of injury
-Usually time limited
-Tends to respond to conventional analgesics

38
Q

What is neuropathic pain?

A

Pain caused by a lesion or disease of the somato-sensory NS

39
Q

Describe neuropathic pain.

A

-Painful region may not necessarily be the same of the affected site
-Predominantly chronic
-Poor response to analgesics

40
Q

What is nociplastic pain?

A

Pain that arises from altered nociception despite no clear evidence of tissue damage, lesion or disease affecting the somatosensory system.

41
Q

Describe nociplastic pain.

A

-Stimulus independent
-No inflammation/injury
-No structural neuronal damage
-Pathological
-No protective or adaptive function
-Due to central plasticity

42
Q
A

Year 2- CNS (49 decks)

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