Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

year 2 neuro - Robbie > Physiology and Pathophysiology of Pain > Flashcards

Physiology and Pathophysiology of Pain Flashcards

1
Q

What is pain?

A

Pain is an unpleasant sensory and emotional experience which we primarily associate with tissue damage or describe in terms of such damage or both

Is not a stimulus

Final product of complex-information processing network

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the steps in the pain pathway?

A

Step 1. Periphery

  • Detection
  • Transmission to spinal cord (first order neurons)

Step 2. Spinal cord

  • Processing
  • Transmission to brain (Thalamus) (second order neurons)

Step 3. Brain

• Perception, learning, response

Step 4. Modulation

• Descending tracts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does the thalamus do?

A

Recieves all sensory information then sends it to all different parts of the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is nociception?

A

The detection of tissue damage by specialized transducers connected to A-delta and C fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are nociceptors and what do they respond to?

A

Free nerve endings of A delta and C-fibres

Respond to thermal, chemical, mechanical noxious stimuli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where is the cell body of primary afferents/1st order neurons located and where do they synapse?

A

Cell body in Dorsal root ganglion

First order neurons

Synapse at spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the features of the different types of fibres

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Are C fibres myleinated and therefroe do they conduct fast or slow?

A

non-myelinated

conduct slowly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What do axons entering the spinal dorsal horn continue as?

A

tracts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the spinothalamic tract?

A

Major ascending tract for nociception

Arises in Rexed Lamina 2 & 5

Forms the lateral spinothalamic tract

Ends in:

Ventroposterior thalamic nuclei

Medial thalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Thalamus is the second ___________

A

Thalamus is the second relay station

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Where does the thalamus have connections with?

A

cortex

limbic system

brain stem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Where is the main area in the thalamus that spinothalamic tracts go?

A

Ventroposterior thalamic nuclei

Medial thalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pain perception occurs in ________________

A

Pain perception occurs in somatosensory cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why does the thalamus send information about pain to the limbic system?

A

to help form memories, learning and emotion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Descending pathways come form the brain to ______

A

dorsal horn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What do the descending pathways do to the pain signal

A

usually decrease it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is allodynia?

A

Allodynia refers to central pain sensitization (increased response of neurons) following normally non-painful, often repetitive, stimulation. Allodynia can lead to the triggering of a pain response from stimuli which do not normally provoke pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is A?

Defnition of Allodynia

A

Decreased threshold for response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is B?

Definition of Hyperalgesia

A

Exaggerated response to normal and supranormal stimuli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is C?

Definition of Spontaneous Pain

A

Spontaneous activity in nerve fibres

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is Central sensitization?

A

Central sensitization is a condition of the nervous system that is associated with the development and maintenance of chronic pain

It is the response of second order neurons in the CNS to normal input both noxious & non-noxious

23
Q

What are the 3 main components of Central sensitization?

A

wind-up

classical

long-term potentiation

24
Q

What is wind up central sensitisation?

A

Involves only activated synapses

Homosynaptic activity dependent progressive increase in response of the neurons

Manifests over the course of stimuli & terminates with stimuli

Wind-up is literally winding up the response to the input. So the wind-up happens only in neurons taking part in the synapses with primary afferent input. It is activity dependent; progressively increases the response of the neurons

25
Q

What is classic central sensitisation?

A

Involves opening up of new synapses (silent nociceptors)

the new synapses, which were silent till then, will start to receive input and record the nociception

Heterosynaptic activity dependent plasticity

Immediate onset with appropriate stimuli

Outlast the initial stimuli duration

Can be maintained even at low levels of ongoing stimuli

26
Q

What is long-term potentiation central sensitisation?

A

Involves mainly the activated synapses

Occurs primarily for very intense stimuli

a persistent strengthening of synapses based on recent patterns of activity. These are patterns of synaptic activity that produce a long-lasting increase in signal transmission between two neurons

27
Q

What are the features of acute pain?

A

<1 month

Usually obvious tissue damage

Increased nervous system activity

Pain resolves upon healing

Serves a protective function

28
Q

What are the features of chronic pain?

A

>3-6 months

Pain for 3–6 months or more

Pain beyond expected period of healing

Usually has no protective function

Degrades health and function

29
Q

Differences between acute and chronic pain:

pathological or physiological?

A

acute - physiological

chronic - pathological

30
Q

Differences between acute and chronic pain:

presence of noxious stimuli or not

A

acute - Presence of noxious stimuli

chronic - Presence of noxious stimuli is not essential

31
Q

Differences between acute and chronic pain:

what is the purpose?

A

acute - Serves protective function

chronic - Does not serve any purpose

32
Q

Differences between acute and chronic pain:

what controls it?

A

acute - Usually nociceptive

chronic - Nociceptive, neuropathic or mixed

33
Q

What is nociceptive pain?

A

A sensory experience that occurs when specific peripheral sensory neurones (nociceptors) respond to noxious stimuli

34
Q

Painful region is typically localised at the _______ -often described as throbbing, aching or stiffness

A

site of injury

35
Q

Nociceptive pain is usually ______ limited and resolves when ___________ heals (e.g. bone fractures, burns and bruises)

Can also be _______ (e.g. osteoarthritis)

A

Usually time limited and resolves when damaged tissue heals (e.g. bone fractures, burns and bruises)

Can also be chronic (e.g. osteoarthritis)

36
Q

What does nociceptive pain tend to respond to?

A

Tends to respond to conventional analgesics

37
Q

What is neuropathic pain?

A

Pain initiated or caused by a primary lesion or dysfunction in the somato-sensory nervous system

38
Q

Where is neuropathetic pain felt?

A

The painful region may not necessarily be the same as the site of injury - pain occurs in the neurological territory of the affected structure (nerve, root, spinal cord, brain)

39
Q

Does neuropathic pain tend to be a chronic or an acute condition?

A

Almost always a chronic condition (e.g. postherpetic neuralgia [PHN], poststroke pain)

40
Q

How does neuropathic pain respond to conventional analgesics?

A

Responds poorly to conventional analgesics

41
Q

What is nociplastic pain?

A

Pain that arises form altered nociception despite no clear evidence of actual or threated tissue damage causing the activation of peripheral nociceptors or evidence for disease or lesion of the somatosensory system causing the pain

42
Q

Does nociplastic pain depend on a stimulus?

A

no

stimulus independent

43
Q

In nociplastic pain is there any injury or structural neuronal damage?

A

No inflammation/injury

No structural neuronal damage

44
Q

What is nociplastic pain due to?

A

due to central plasticity - Neural plasticity refers to the ability of neurons to change in form and function in response to alterations in their environment

45
Q

Does nociplastic pain have any function?

A

serves no protective or adaptive function

46
Q

Is nociplastic pain pathological or physiologic pain?

A

pathological

47
Q

What can be used in the management of transduction of pain?

A

NSAIDs

Ice

Rest

LA blocks

Nerve blocks

Drugs e.g. opioids

Surgery

48
Q

What is the gate control theory?

A

The gate control theory of pain asserts that non-painful input closes the nerve “gates” to painful input, which prevents pain sensation from traveling to the central nervous system. Gate Control Theory of Pain describes how non-painful sensations can override and reduce painful sensations

49
Q

What is used in the management of perception of pain?

A

Education

Cognitive behavioural therapy

Distraction

Relaxation

Graded motor imagery

Mirror box therapy - helps allivate phantom limb pain

a box with a mirror down the center, patient places the good limb into one side and the residual limb into the other and patient then looks into the mirror on the side with the good limb and makes “mirror symmetric” movements. Because the subject is seeing the reflected image of the good hand moving, it appears as if the phantom limb is also moving

50
Q

What can be used in the management of descending modulation in pain?

(if the input of pain cant be contorlled then this is how pain would be contorlled)

A

Placebos

Drugs - Opioids, Antidepressants

Surgery - Spinal cord stimulation

51
Q

Pain is a _________ phenomena while nociception is the _________ process

A

Pain is a subjective phenomena while nociception is the physiologic process

52
Q

Pain is subjected to ___________at every stage of transmission (this can be used to our advantage)

A

Pain is subjected to modulation at every stage of transmission (this can be used to our advantage)

53
Q

Does chronic pain serve any protective function?

A

no

year 2 neuro - Robbie (48 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions