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1. Neurology > Physiology of Pain and Thermosensation > Flashcards

Physiology of Pain and Thermosensation Flashcards

1
Q

What are the 3 types of pain?

A

nociceptive
inflammatory
pathological

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2
Q

Describe nociceptive pain?

A

immediate short lived protective response

adaptive

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3
Q

Describe inflammatory pain?

A

assists in healing, persists over days - weeks

adaptive

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4
Q

Describe pathological pain?

A

persists over lots of time
no physiological purpose
may be maladaptive

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5
Q

What fibres make up nociceptors?

A

A gamma and C fibres

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6
Q

What are the characteristics of A gamma fibres?

A

mechanical/thermal nociceptors
thinly myelinated
mediate fast/first pain

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7
Q

What are the characteristics of C fibres?

A

respond to all noxious stimuli
unmyelinated
mediate second/slow pain

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8
Q

What two peptides are released in inflammatory pain?

A

substance P

CGRP

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9
Q

What is the role of Substance P?

A

causes vasodilation and extraction of plasma proteins (promotes formation of bradykinin and prostaglandins) causes release of histamine
sensitises surrounding nociceptors

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10
Q

What is the role of CGRP?

A

induces vasodilation

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11
Q

What do substance P and CGRP cause?

A

slow and prolonged epsp that activate NMDA receptors by relieving voltage dependant block by Mg

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12
Q

What is the primary transmitter and what are its receptors?

A

glutamate

AMPA and NMDA receptors

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13
Q

Where are primary afferent cell bodies located?

A

dorsal root ganglia

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14
Q

Where do primary afferent cell bodies terminate?

A

laminae of Rexed

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15
Q

Which laminae do nociceptive C and A gamma dibres terminate?

A

laminae I and II

V also for A gamma

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16
Q

What fibre input do proprioceptive cells receive?

A

A beta fibres

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17
Q

What does visceral pain result from?

A

nociceptors covering tissues of hollow organs - follow sympathetic pathways before entering the dorsal horn

18
Q

What causes referred pain?

A

some afferents converge upon the same spinothalamic neurones - but all cells with visceral receptive fields also have separate cutaneous receptive fields

19
Q

What is referred pain?

A

pain percieved at a distance from the affected organ
area of referral is to the segmental dermatome
often associated with autonomic features

20
Q

What is viscerosomatic pain?

A

sharp and well localised pain

21
Q

What causes viscerosomatic pain?

A

occurs when inflammatory exudate from a diseased organ contacts a somatic (body wall structure)

22
Q

What are Abeta fibres?

A

mechanoreceptors

23
Q

What are Agamma and C fibres?

A

pain perceivers

24
Q

Where are Agamma, C and Abeta fibres processed?

A

substantia gelatinosa

25
Q

What does the gate control theory relate to?

A

synaptic transmission of nociceptive signals

26
Q

What happens to the gate control theory when Abeta activity > Agamma/C activity?

A

gate is CLOSED, synaptic transmission of nociceptive signals is SURPRESSED
SO PAIN IS NOT PERCIEVED

27
Q

What happens to the gate control theory when Agamma/C activity > Abeta activity?

A

gate is OPEN, synaptic transmission of nociceptive signals happens
PAIN IS PERCIEVED

28
Q

In the Spinothalamic tract, where do Agamma projection neurones originate?

A

lamina 1

29
Q

In the Spinothalamic tract, where do WDR projection neurones originate?

A

lamina V

30
Q

Where do projection neurones from lamina 1 terminate?

A

posterior nucleus of the thalamus

31
Q

Where do projection neurones from lamina V terminate?

A

posterior and ventroposterior nucleus of the thalamus

32
Q

What fibres does the spinoreticular tract transmit?

A

slow C fibre pain

33
Q

What fibres respond to cold? C or Agamma?

A

C fibres

34
Q

What fibres respond to warm? C or Agamma?

A

C fibres or Agamma fibres

35
Q

What are more common C or Agamma fibres?

A

C fibres

36
Q

What is the presentation of chronic regional pain syndrome?

A

allodynia - sore to stimulus that shouldnt be painful eg cotton wool
hyperalgesia - increased sensitivity to pain
swelling
hair and nail changes
osteopenia

37
Q

What is neuropathic pain?

A

pain generated from within the nervous system - does not respond to NSAIDs or paracetemol

38
Q

What is the presentation of neuropathic pain?

A

allodynia
hyperalgesia
burning, shooting, tingling pain

39
Q

What can cause neuropathic pain?

A 
shingles
surgery
trauma
diabetic neuropathy
amputation
40
Q

What can be used to treat neuropathic pain?

A 
tricyclic antidepressants - amytryptilline
anticonvulsants - gabapentin
capsicin 
GABA agonists
NMDA agonists
Na channel blockers
opioids

1. Neurology (32 decks)

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