Physiology of Pain Flashcards
Pain is an unpleasant and emotional experience, but why do we need pain?
- helps us learn to avoid harm/danger
- prevents further injury/death
- tells us to rest following injury
Pain can be subdivided into 2 categories. What are they?
1 - adaptive
2 - pathological
Pain can be subdivided into 2 categories, adaptive and pathological. What is adaptive pain?
- this is good protective pain
- we learn and adapt from this type of pain
Pain can be subdivided into 2 categories, adaptive and pathological. What is pathological pain?
- this is bad pain
- does not serve as a learning/adaptive pain
Pain can be subdivided into 2 categories, adaptive and pathological. Adaptive pain can then be subdivided into nociceptive and inflammatory pain. What is nociceptive pain?
1 - stimulus to sensory afferent neurons eliciting the sensation of pain
2 - stimulus to sensory efferent neurons eliciting the sensation of pain
3 - stimulus to ventral horn of spine eliciting the sensation of pain
1 - stimulus to sensory afferent neurons eliciting the sensation of pain
- can be toxic or physical
- nociceptive tell the body about potential danger
Nociceptive pain is pain that is caused by damage to tissue. This pain can be divided into somatic and visceral pain. What is somatic pain?
1 - pain due to activation of nociceptive receptors in peripheral tissues
2 - pain due to activation of nociceptive receptors in central tissues
3 - pain due to activation of nociceptive receptors around internal organs
1 - pain due to activation of nociceptive receptors in peripheral tissues
- include the skin, muscles, skeleton, joints, and connective tissues
Nociceptive pain is pain that is caused by damage to tissue. This pain can be divided into somatic and visceral pain. What is visceral pain?
1 - pain due to activation of nociceptive receptors in peripheral tissues
2 - pain due to activation of nociceptive receptors in central tissues
3 - pain due to activation of nociceptive receptors around internal organs
3 - pain due to activation of nociceptive receptors around internal organs
- often vague, happens every so often, and feels like a deep ache or pressure
Nociceptive pain is pain that is caused by damage to tissue. This pain can be divided into somatic and visceral pain. Somatic pain can be further subdivided into what 2 categories?
1 - deep (tendons, bones, muscles and are poorly localised)
2 - superficial (skin and are well localised)
Pain can be subdivided into 2 categories, adaptive and pathological. Pathological pain can then be subdivided into neuropathic and dysfunctional pain. What is neuropathic pain?
1 - pain affecting nervous system
2 - pain affecting the peripheral tissues
3 - pain affecting central organs
4 - pain affecting the brain
1 - pain affecting nervous system
- pain is generally chronic and serves no purpose
- normally due to chronic, progressive nerve disease
- can occur due injury or infection
Pain can be subdivided into 2 categories, adaptive and pathological. Pathological pain can then be subdivided into neuropathic and dysfunctional pain. Neuropathic can be further sub-divided into central and peripheral pain. What is central and peripheral pain?
- central = CNS pain cause by damage to CNS (stroke or Parkinsons disease)
- peripheral = PNS (burning, shooting, tingling pain)
Pain can be subdivided into 2 categories, adaptive and pathological. Pathological pain can then be subdivided into neuropathic and dysfunctional pain. What is dysfunctional pain?
- pain with no specific cause
- fibromyalgia and IBS are examples
Nociceptors are a type of neuron that are able to detect noxious stimuli. What type of neurons are these?
1 - 1st order sensory afferent neurons
2 - 2nd order sensory afferent neurons
3 - 1st order sensory efferent neurons
4 - 2nd order sensory efferent neurons
1 - 1st order sensory afferent neurons
Nociceptors are a type of neuron that are able to detect noxious stimuli. They are 1st (primary) order sensory afferent neurons. Where are the nerve endings of nociceptors found?
- deep or superficial tissues as this is somatic pain
- in tissues (skin, muscles, joints, meninges, viscera)
Nociceptors are a type of neuron that are able to detect noxious stimuli. They are 1st (primary) order sensory afferent neurons. The nerve endings can be found in tissues, but where is the cell body generally located?
1 - dorsal root ganglia
2 - ventral root
3 - dorsal root
4 - spinal nerve
1 - dorsal root ganglia
- synapses at the dorsal horn with 2nd order neuron
Nociceptors are a type of neuron that are able to detect noxious stimuli. They are primary sensory afferent neurons. Which tract is pain transmitted to the CNS along?
1 - spinothalamic tract (anterior specifically)
2 - spinothalamic tract (lateral specifically)
3 - corticospinal tract
4 - dorsal columns
2 - spinothalamic tract (lateral specifically)
- conveys pain and temperature changes
Nociceptors are a type of neuron that are able to detect noxious stimuli. They are 1st (primary) order sensory afferent neurons. Pain is transmitted to the CNS along the lateral spinothalamic tract and is able to convey pain and temperature information. Does pain in the left/right side of the body travel to the left/right side of the brain?
- no as it decussates at the level of the vertebrae where it synapses with 2nd order neuron
- left sided pain = travels to right side of the brain
- right sided pain = travels to left side of brain
- 2nd order neuron decussates at spinal cord
Nociceptors have free nerve endings, which are the most abundant type of nerve endings in the skin. What are free nerve endings?
1 - non-encapsulated dendrites
2 - non-encapsulated ruffini endings
3 - encapsulated dendrites
4 - encapsulated ruffini endings
1 - non-encapsulated dendrites
Nociceptors have free nerve endings, which are the most abundant type of nerve endings in the skin. They are essentially non-encapsulated dendrites with no specialised connective tissue. What type of sensory fibre type are these nerve free endings?
1 - a-δ (delta) or C
2 - a-δ (delta) or Aα
3 - a-δ (delta) or Aβ
4 - Aβ (delta) or C
1 - a-δ (delta) or C
The nociceptive nerve free end can be a-δ (delta) or C type fibres. What is the relevance of these fibre types?
- determines their size and degree of myelination
- speed of transmission and signal transmitted
- a-δ (delta) = thinly myelinated fast transmission - sharp/fast pain
- c type = unmyelinated slow transmission - slow/dull pain
Do larger or smaller diameter neurons have myelination?
- larger diameter neurons require myelin to effectively transmit action potentials
Afferent nerve fibre types can be subdivided into:
- C
- a-δ (delta)
- Aα
- Aβ
Which of these nerve fibres are fully myelinated and which has the fastest transmission?
- Aα and Aβ are fully myelinated with large diameters
- both of these fibres have the fastest transmission at 30-75m/s
Afferent nerve fibre types can be subdivided into:
- C
- a-δ (delta)
- Aα
- Aβ
Which of these nerve fibres are lightly myelinated with a medium diameter and transmission speed of 5-30m/second?
- a-δ (delta)
Afferent nerve fibre types can be subdivided into:
- C
- a-δ (delta)
- Aα
- Aβ
Which of these nerve fibres is not myelinated with a small diameter and transmission speed of -0.5-2m/second?
- C fibres
In the image below from a laboratory experiment we can see the response from afferent nerve fibre types A-alpha, B-alpha, A-delta and C fibres. Knowing what we know about the size of these fibres and the degree of myelination, label the Afferent nerve fibre types can be subdivided into A-alpha, B-alpha, A-delta and C fibres on the figure?
1 = A-alpha and B-alpha 2 = A-delta 3 = C
In the image below from a laboratory experiment we can see the response from afferent nerve fibre types A-alpha, B-alpha, A-delta and C fibres. Generally what type of sensation would we expect if nociceptive sensory afferent fibres A-delta and C fibres are stimulated?
- A-delta = fast, well localised sharp pain (pin prick)
- C = slow poorly localised dull pain (burning sensation)
As we know that visceral pain is dull, aching and poorly localised, we can determine which nociceptive sensory afferent fibres mediate visceral pain. Which nerve fibre is this?
1 - C
2 - a-δ (delta)
3 - Aα
4 - Aβ
- C fibres
- slow transmission and non-specific site of pain
What are the 4 stimuli that can activate nociceptive sensory afferent nerve fibres, which are polymodal (respond to multiple stimuli)?
1 - pressure
2 - temperature (hot/cold)
3 - chemical
4 - tissue damage
How do nociceptors that are sensitive to pain, specifically pressure transmit pain to the CNS?
- mechanically activated channels deform under pressure
- the deformity allows cations to enter the cell
- depolarisation occurs and transmits signals
Temperature transduction is mediated by which channels?
1 - mechanoreceptors
2 - proprioceptors
3 - transient receptor potential (TRP) cation channels
3 - transient receptor potential (TRP) cation channels
- non-selection cation (+ charge) channel
Temperature transduction is mediated by transient receptor potential (TRP) cation channels, non-selection cation (+ charge) channel. How do these channels become stimulated and transmit this information to the CNS?
- channels have permeability that is dependent on temperature
- permeability allows cations to flow in, generating an action potential