Physiology - Pain 2 : Analgesia Flashcards

1
Q

the stress analgesia pathway begins with activation of neurones where

a.PVN
b.PAG
c.pons
d.RMN

A

a.PVN

of the hypothalamus

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2
Q

where is the PVN found

a.hypothalamus
b.thalamus
c.pons
d.medulla oblongata

A

a.hypothalamus

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3
Q

signals are relayed from the PVN to where

a.hypothalamus
b.PAG
c.pons
d.RMN

A

b.PAG

of mesencephalon and upper pons

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4
Q

where is the PAG found

a.hypothalamus
b.thalamus
c.pons
d.medulla oblongata
e.mesencephalon and upper pons

A

e.mesencephalon and upper pons

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5
Q

signals are relayed from the PAG to where

a.hypothalamus
b.PAG
c.pons
d.RMN

A

d.RMN
of pons

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6
Q

where is the RMN found

a.hypothalamus
b.thalamus
c.pons
d.medulla oblongata
e.mesencephalon and upper pons

A

c.pons

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7
Q

where do signals go from the RMN

a.hypothalamus
b.PAG
c.pons
d.RMN
E.Dorsal horn

A

E.Dorsal horn

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8
Q

what mediates the neurotransmission between RMN and dorsal horn neurones

a.glutamate
b.substance p
c.serotonin
d.dopamine

A

c.serotonin

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9
Q

in response to the stress analgesia pathway being activated what is released form inhibitory interneurones

a.serotonin and dopamine
b.GABA and dopamine
c.GABA and enkephalins
d.GAMA and enkephalins

A

c.GABA and enkephalins

prevent signals being carried further by 2nd order neurones

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10
Q

how does GABA prevent transmission of pain signals

a.closes cl- channels on postsynaptic DHN cells leading to hyperpolarisation

b.opens cl- channels on postsynaptic DHN cells leading to hyperpolarisation

c.closes cl- channels on postsynaptic DHN cells leading to depolarisation

b.opens cl- channels on postsynaptic DHN cells leading to depolarisation

A

b.opens cl- channels on postsynaptic DHN cells leading to hyperpolarisation

reduced firing of APs

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11
Q

what channels does enkephalin inhibit the opening of

a.cl-
b.voltage gated ca
c.voltage gated na

A

b.voltage gated ca

in presynpatic cell of DHN

and activated opiod receptors on a delta and c fibres and DHNs

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12
Q

what channels does enkephalin stimulate the opening of

a.cl-
b.voltage gated ca
c.voltage gated na
d.k+ channels

A

d.k+ channels

leading to hyperpolarisation of post synaptic DHN cell

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13
Q

TENS stimulates the peripheral inhibitor pathways by releasing which substance

a.GABA
b.serotonin
c.dopamine
d.enkepahlins

A

d.enkepahlins

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14
Q

local anaesthetic closes the inactivation gate of what type of channel closing the pore and reducing the ability of the nerve to propagate an AP in pain fibres

a.sodium
b.calcium
c.potassium

A

a.sodium

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15
Q

in more acidic extracellular environments the block of the inactivation gate of sodium channels in pain fibres is ..

a.slower
b.faster

A

a.slower

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16
Q

main side effect of local anaesthetic

a.rash
b.nausea
c.GI upset
d.constipation

A

b.nausea

17
Q

main side effect of NSAIDS

a.GI bleeding
b.nausea
c.respiratory depression
d.constipation

A

a.GI bleeding

18
Q

what type of drug is particularly helpful in management of chronic and neuropathic pain

a.NSAIDS
b.opiods
c.local anaesthetics
d. SSRIs

A

d. SSRIs

increase serotonin so increase inhibitory activation and less pain signals transmitted up past DHN