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MSK > Physiology: pain > Flashcards

Physiology: pain Flashcards

1
Q

what is the definition of pain

A

an unpleasant sensory and emotional experience, associated with actual tissue damage or described in terms of such damage

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2
Q

what are the 4 distinct processes in the physiology of pain

A

transduction, transmission, modulation, perception

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3
Q

describe what the transduction process of pain involves

A

translation of noxious stimulus into electrical activity at the peripheral nociceptor

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4
Q

describe what the transmission process of pain involves

A

propagation of pain signals as nerve impulses through the nervous system

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5
Q

describe what the modulation process of pain involves

A

modification/hindering of pain transmission in the nervous system
(eg by inhibitory neurotransmitters)

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6
Q

describe what the perception process of pain involves

A

conscious experience of pain, causes physiological and behavioural responses

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7
Q

describe what a nociceptor is

A

specific primary sensory afferent neurones

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8
Q

how are nociceptors activated

A

normally activated by intense noxious stimuli, can be mechanical, thermal or chemical

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9
Q

what neurons are first order neurones

A

nociceptors

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10
Q

describe the action of first order neurones

A

relay info. to second order neurones in the CNS by chemical synaptic transmission

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11
Q

what neurotransmitters are involved in nociceptor pathway

A

glutamate and peptides(eg neurokinin A)

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12
Q

where are second order neurones found

A

ascend spinal cord along anterolateral system(terminate in thalamus)

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13
Q

what are the second order neurones mainly comprised of

A

the spinothalamic tract(STT) and the spinoreticular tract(SRT)

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14
Q

describe the role of the spinothalamic tract(STT) in pain

A

involved in pain perception(location + intensity)

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15
Q

describe the role of the spinoreticular tract(STR) in pain

A

involved in autonomic response to pain, arousal, emotional responses, fear of pain

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16
Q

describe the role of third order neurones in pain physiology

A

relay sensory info. from the thalamus to the primary sensory cortex

17
Q

what are the subtypes of nociceptor

A

A-gamma fibres and C-fibres

18
Q

describe the myelination of the A-gamma and C-fibres types of nociceptor

A

A-gamma fibre = thinly myelinated

C-fibre = no myelin

19
Q

describe what stimulus A-gamma and C fibre subtypes of nociceptor respond to

A

A-gamma fibre = noxious mechanical + thermal

C-fibre = all noxious stimuli

20
Q

describe the type of pain mediated by A-gamma fibre nociceptors

A

‘first’, or fast, pain

lancinating, stabbing, pricking sensations

21
Q

describe the type of pain mediated by C-fibre nociceptors

A

‘second’, or slow, pain

burning, throbbing, cramping, aching sensations

22
Q

what different ways is pain classified

A

mechanism, time course, severity, origin

23
Q

what types of pain are adaptive

A

nociceptive pain and inflammatory pain

24
Q

what is nociceptive pain stimulated by

A

intense stimulation of nociceptors by noxious stimuli, mechanical, chemical or thermal

25
Q

what is the function of nociceptive pain

A

early warning physiological protective system to detect + avoid noxious stimuli(therefore adaptive)

26
Q

what is inflammatory pain activated by

A

variety mediators released form site of infection, by leucocytes, vascular endothelium and resident mast cells

27
Q

inflammatory pain causes hyperalgesia and allodynia, describe what these are

A 
hyperalgesia = heightened pain sensitivity to noxious stimuli
allodynia = pain sensitivity to innocuous stimuli
28
Q

describe how inflammatory pain is adaptive

A

promotes repair until healing occurs

29
Q

what is neuropathic pain(pathological) pain caused by

A

damage to neural tissue

30
Q

what different ways can neuropathic pain be perceived

A

burning, shooting, numbness, pins and needles

may be less localised

31
Q

what is dysfunctional pain(pathological)

A

pain with no identifiable damage and no inflammation

32
Q

what different types of pain are pathological, and are they adaptive

A

neuropathic and dysfunctional are patholgical

maladaptive

33
Q

describe what referred pain is

A

feeling of pain in the skin distant to the internal organ it originates

34
Q

what types of pain can be felt as referred pain

A

deep pain or visceral pain

35
Q

what is referred pain caused by

A

convergence of nociceptive visceral and skin afferents upon same spinothalamic tract neurones

36
Q

what are some sites of referred pain

A

gall bladder = right shoulder
heart = left arm, jaw
liver = right base of neck

MSK (11 decks)

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