Quiz 1

Question 1

Pain is an unpleasant _ and_ _ associated with _ or _ tissue damage, or described in terms of such damage.

Answer 1

Pain in an unpleasant SENSORY AND EMOTIONAL EXPERIENCE associated with ACTUAL OR POTENTIAL tissue damage or described in terms of such damage.

Question 2

How are nociceptive mechanisms classified? (2)

Answer 2

Peripheral and central

Question 3

Nociceptive neurons are excited by _ _ but does not necessarily correlate to _.

Answer 3

Nociceptive neurons are excited by NOXIOUS STIMULI but does not necessarily correlate to PAIN

Question 4

What are the 2 associated structures under the central pain mechanism?

Answer 4

Spinal/ brainstem mechanism

Cortical mechanism

Question 5

_ is noxious stimuli converted to electrical current. _ is communication along nociceptors axons to cell bodies in the DRG of spinal cord.

Answer 5

TRANSDUCTION is noxious stimuli converted to electrical current.

CONDUCTION is communication along nociceptors axons to cell bodies in the DRG of spinal cord.

Question 6

_ occurs when inflammatory mediator across synapse to dorsal horn.

Answer 6

TRANSMISSION occurs when . . .

Question 7

Inflammatory mediators and nociception is a _ process.

Answer 7

Is a COMPLEX PROCESS

Question 8

Substance P, immune cells (natural killer cells and T lymphocytes, WBC’s (neutrophils, mast cells, etc), cytokines, enzymes (cyclooxygenase- COX), and proteins (bradykinins, prostaglandins, etc) are all examples of

Answer 8

All examples of inflammatory neurotransmitters

Question 9

_ _ is increased responsiveness and reduced threshold of nociceptive neurons in the periphery to the stimulation of their receptive feilds.

Answer 9

PERIPHERAL SENSTIZATION

Question 10

_ _ is increased responsiveness of nociceptive neurons in the CNS to their normal or subthreshold afferent input

Answer 10

CENTRAL SENSITIZATION

Question 11

What is the term used for normal peripheral pain?

Answer 11

Primary hyperalgesia

Question 12

Primary hyperalgesia is a state of increased intensity of pain sensation induced by either a _ or _ _ _ of peripheral tissue.

Answer 12

Is a state of increased intensity of pain sensation induced by either a NOXIOUS or ORDINARILY NON-NOXIOUS STIMULATION of peripheral tissue.

Question 13

What is the term for chronic pain due to central sensitization?

Answer 13

ALLYODYNIA

Question 14

Allodynia is pain that is not induced by _ _ _, but is induced by _ _ _ or _ fibers.

Answer 14

Is not induced by NOCICEPTIVE NERV FIBERS but is induced by LOW-THRESHOLD ALPHABETA OR C fibers.

Question 15

Why is it important to know which mechanism is at play when it comes to pain?

Answer 15

So you can determine if meds are appropriate to presenting symptoms.

Question 16

_ _ and _ in the _ __ are the main target for nociceptive primary afferents

Answer 16

LAMINAE I AND II in the SPINAL DORSAL HORN are the main target for nociceptive primary afferents

Question 17

Laminae I-IV in the spinal dorsal horn are all _ _ _

Answer 17

Laminae I-IV in the spinal dorsal horn are all SENSORY PRIMARY AFFERENTS

Question 18

_ _ within Laminae _ and _ account for most nociceptive input to the brain.

Answer 18

PROJECTION NEURONS with Laminae I and IV account for most nociceptive input to the brain.

Question 19

1/3 of neurons use _ or _ as neurotransmitters to INHIBIT other spinal neurons like projection neurons

Answer 19

1/3 of neurons use GABA OR GLYCINE as neurotransmitters . . .

Question 20

The NK1 receptor for substance P has the highest concentration in?

Answer 20

In Laminae I

Question 21

Inhibitory neurons are _ and excitatory neurons are _.

Answer 21

inhibitory- GABAERGIC

Excitatory- GLUTAMATERGIC

Question 22

Which neural tract is responsible for nociception, temperature and itching sensation? Are most numerous in the _ and _ _. Another large populations of STT cells is widely distributed _ throughout the - _.

Answer 22

SPINOTHALAMIC

Are most numerous in the CERVICAL and LUMBOSACRAL ENLARGEMENTS

Another large population of STT cells is widely distributed BILATERALLY throughout the C1-C2 SEGMENTS

Question 23

There are _ _ _ that end in the thalamus.

Answer 23

There are 6 SPINOTHALAMIC TERMINATIONS that end in the thalamus

Question 24

STT termination: The posterior portion of the ventral medial nucleus projects to the _ _ _ for interoceptive sensory function. What does interoceptive mean in lay mans terms? Example. It’s the only pathway that _ the thalamus.

Answer 24

Posterior portion of the ventral medial nucleus projects to the POSTERIOR INSULAR CORTEX for interoceptive . .

Interoceptive sensory function is the body’s ‘gut feeling’ (ex. Feels like a knife in my back, bone on bone)

It’s the only pathway that bypasses the thalamus

Question 25

Interoceptive sensory function often gives?

Answer 25

Often gives faulty information

Question 26

STT termination in thalamus: ventral posterior nuclei to the _ cortex. AKA?

Answer 26

Ventral posterior nuclei to the SENSORIMOTOR cortex AKA: motor humunculus

Question 27

STT termination of the thalamus: ventral lateral nucleus sensory motor activity as it projects _ to the _ _.

Answer 27

Ventral lateral nucleus sensory motor activity as it projects DIRECTLY to the MOTOR CORTEX.

Question 28

STT thalamus termination: central lateral nucleus to do with control of orientation and attention as well as motor set that projects to _ _ as well as to the _ and _ _ _.

Answer 28

Central lateral nucleus to do with control of orientation and attention as well as motor set that projects to BASAL GANGLIA as well as to the MOTOR and POSTERIOR PARIETAL CORTICES

Question 29

STT terminations in the thalamus: the parafascicular nucleus that projects into the _, _ _ and _ _ and is _ related.

Answer 29

The parafascicular nucleus that projects into the BASAL GANGLIA, SUBSTANTIA NIGRA, AND MOTOR CORTEX and is MOTOR related

Question 30

STT termination in the thalamus: The ventral caudal portion of the medial dorsal nucleus for affective/ motivational aspect of pain projects into the _ _ _. Which is associated with?

Answer 30

. . . Projects into the LIMBIC MOTOR SYSTEM Which is associated with EMOTIONS

Question 31

The _ _ which contributes to _ projects to the brainstem and then brainstem to forebrain.

Answer 31

The SPINOBULBAR PROJECTION which contribute to NOCICEPTION projects to the . . .

Question 32

The spinal bulbar tract has a similar distribution of Laminae as the _ tract, include Laminae _, _ and _.

Answer 32

Has a similar distribution of Laminae as the SPINOTHALAMIC tract, includes Laminae I, V, AND VII

Question 33

The spinobulbar tract has _ terminations in the _.

Answer 33

Has 4 terminations in the BRAINSTEM

Question 34

What does the spinobulbar projection to the hypothalamus responsible for the release of adrenocorticotrophic hormone vasopressin in response to _ and _ _. What is the hypothalamus primarily responsible for? (2)

Answer 34

... In response to TRAUMA and NOXIOUS STIMULATION The body's thermostat and hormone regulation

Question 35

SB termination: the parabrachial nucleus projects to the amygdala, hypothalamus and thalamus which relays to the _ cortex for _ _.

Answer 35

. . .relays to the INSULAR cortex for VISCERAL SENSATION

Question 36

SB projection: the periaqueductal gray has ascending projections to the _ and medial _, elicits _ changes, antinociceptive modulation and can affect _ production.

Answer 36

Has ascending projections to the HYPOTHALMUS and medial THALAMUS, elicits CARDIOVASCULAR CHANGES, anti-nociceptive modulation and can affect SEROTONIN production

Question 37

SB projection: The brain stem reticular formation directly projects to the _.

Answer 37

Directly projects to the THALAMUS

Question 38

There are _ _ between the spinothalamic and spinobulbar tracts.

Answer 38

There are MANY REDUNDANCIES between the . . .

Question 39

_ is part of the cortical mechanisms and involves _ pathways to the _. This is how we?

Answer 39

PERCEPTION is part of the cortical mechanism and involves ASCENDING pathways to the BRAIN. This is how we perceive pain

Question 40

What falls in the 'RED' category? BLUE category?

Answer 40

Red- AFFECTIVE EMOTIONAL PAIN Blue- NOCICEPTIVE pain

Question 41

Affective/ emotional pain is known as the _ pain system, involve _-_-_ function.

Answer 41

Known as the MEDIAL pain system, involves AFFECTIVE-COGNITIVE-EVALUATIVE function

Question 42

Nociceptive pain is associated with _ pain system and _ _.

Answer 42

Associated with LATERAL pain system and SENSORY DISCRIMINATION

Question 43

The lateral pain system involves _ and _ _ areas (_ and _), the _ _ cortex, the _ insula (intensity) and is mediated through the _ thalamic nuclei.

Answer 43

Lateral pain system involves PRIMARY and SECONDARY SOMATOSENSORY areas (SI and SII), the INFERIOR PARIETAL cortex, the POSTERIOR INSULA (intensity) and is mediated through the LATERAL thalamic nuclei.

Question 44

The medial pain system involves the _-_/ _ _ _ cortex (recognition), the _ cortex, and _ INSULA (emotions) and is mediated through the _ thalamic nuclei.

Answer 44

Involves the MID-CINGULATE/ PERIGENUAL ANTERIOR CINGULATE cortex (recognition), the PREFRONTAL cortex, and is mediated through the MEDIAL thalamic nuclei

Question 45

The amygdala has to do with _ _. The hippocampus has to do with _ _.

Answer 45

Amygdala has to do with EMOTIONAL MEMORY Hippocampus has to do with SPATIAL MEMORY

Question 46

The cingulate gyrus/ cortex has to do with _ and _.

Answer 46

Has to do with RECOGNITION and AWARENESS

Question 47

The _ _ has to do with smell.

Answer 47

The OLEFACTORY BULB has to do with smell

Question 48

Which area of the brain is associated with: error detection, pain registering, and cognitive decision making (connectivity with prefrontal cortex). Color?

Answer 48

POSTERIOR CINGULATE CORTEX

Question 49

Which area of the brain is associated with: affective measures of pain, OCD, catastrophizing, fear learning, anxiety and delayed error detection in fibromyalgia?

Answer 49

ANTERIOR CINGULATE CORTEX Color