Reading 2 (Group 2) Flashcards

1
Q

What kind of experience is pain? What does it make us seek? Where does it make us go?

A

an unpleasant subjective experience

Ways to avoid it

It is also one of the main reasons people go to see a doctor.

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2
Q

What is one of the main functions of pain?

A

to tell us when something that’s going on in our body presents a potential or present danger to our physical well-being.

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3
Q

Is it the case that that sensations of pain are simply due to excessive stimulation of the same receptors that give us other information about the state of our bodies and the state of the world?

A

No.

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4
Q

Is alerting the brain to the dangers that a painful stimulus represents is different or similar from informing it of the presence of an innocuous tactile stimulus?

A

quite different

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5
Q

Does the perception of pain rely on the same receptors and pathways of other stimuli? What do they specialize in?

A

The perception of pain, or nociception, depends on pain-specific receptors and pain- specific neural pathways.

These receptors and pathways detect conditions that are potentially harmful to our bodies and arouse in us the particular conscious sensation that we call pain.

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6
Q

Are nociception and pain the same thing?

A

no. they are 2 different things

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7
Q

What is nociception?

A

Nociception is the sensory process that produces the nerve signals that trigger pain.

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7
Q

What is pain?

A

Pain itself is an aching subjective sensation linked to a specific part of the body.

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8
Q

Can nociception and pain can occur in absence of each other? Examples?

A

In some cases.

sometimes an individual’snociceptors may be highly activated without any experience of pain—think of the times that you have cut yourself without even realizing it, because you were so focused on whatever task you were doing. Similarly, people can be severely injured but feel no pain, because of intense stress or emotions that they are experiencing at the same time. Conversely, people can also experience very intense pain without any major activation of their nociceptors (the mysterious phenomenon known as neuropathic pain).

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9
Q

What is neuropathic pain?

A

people can also experience very intense pain without any major activation of their nociceptors (the mysterious phenomenon known as neuropathic pain).

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10
Q

Is pain always directly proportional to the seriousness of an injury or illness? Example?

A

NO.

Some cancers cause very little pain until they reach an advanced stage, while other, relatively benign problems such as kidney stones can be extremely painful.

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11
Q

Does pain have a highly formalized definition?

A

Because pain is such a complex, subjective phenomenon, it escapes any highly formalized definition

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12
Q

What is The International Association for the Study of Pain (IASP)’s definition of pain? Is this specific? What does it tend to be similar to?

A

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

this is a very vague description.

tends to be similar to pain is “anything identified as such by the patient”.

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13
Q

What are the 2 components of pain?

A

sensory and emotional

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14
Q

What is the sensory component of pain?

A

The sensory componentis one that pain shares with the other, conventional sensory modalities (vision, hearing, touch, taste, and smell). It is the discriminative component that enables any sensory modality to identify the location and intensity of a stimulus.

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15
Q

What cortexes does the sensory component of pain involve?

A

In the case of pain, this component involves the primary and secondary cortexes.

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16
Q

What is the emotional component of pain? What are some other names for it? What brain structures does it involve?

A

The other component of pain, variably described as emotional, affective, or motivational, involves the anterior cingulate cortex and the insula. It is this component that makes us subjectively experience discomfort and that drives us to do something to make it stop, or to reduce it, or to flee from it.

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17
Q

Is pain valuable?

A

yes.

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18
Q

What are some risks for people with congenital analgesia?

A

They live with the constant risk of getting themselves killed because they never realize when they are hurting themselves. They generally die fairly young. When these children do survive, they often suffer injuries to their mouth (because they bite their tongue without feeling it) or to their eyes (because they fail to remove foreign particles soon enough). They also commonly experience problems with their joints, as well as multiple broken bones. Even during sleep, the lack of nociception can lead to injuries caused by staying in uncomfortable positions for too long.

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19
Q

What terms do we use to refer to rare individuals who are born with a total inability to experience pain?

A

these people are said to have congenital insensitivity to pain or congenital analgesia

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20
Q

What are 2 possible explanations for congenital analgesia?

A

Some people with this condition appear to have excessively high levels of endorphins. The administration of endorphin-blocking substances reduces the intensity of the stimulus needed for such individuals to experience pain. Other people with this condition seem to have a problem with their nociceptive sensory fibers, as well as with the corresponding peripheral nociceptors.

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20
Q

What are three factors influencing the perception of pain?

A

cultural factors
cognitive or psychological factors
meaning

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21
Q

Why do our subjective experiences of pain vary so greatly?

A

The reason that our subjective experience of pain varies so greatly is that so many different sets of factors that influence the way we perceive it.

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22
Q

How can cultural factors influence the perception of pain? Example.

A

if people have philosophical or religious beliefs that pain represents a test, a punishment, a necessary evil, or something unavoidable, those beliefs will definitely affect the way that those people experience pain. Thus, people who are raised in families or cultures where they are taught to endure pain stoically will show less discomfort than people who focus their attention on their pain.

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23
Q

How can the subjective perception of pain be influenced by cognitive or psychological factors? What are some of these factors?

A

Some of these factors, such as stress and depression, increase our perception of pain, while others, such as a calm, optimistic attitude, decrease it.

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23
Q

What are 2 of the cognitive factors that most amplify pain?

A

Distress and anxiety

24
Q

Can how much attention is paid to pain by the individuals experiencing it, or by the people close to them influence the subjective experience of pain? Examples (2)?

A

Another factor that can greatly increase pain is simply how much attention is paid to it by the individuals experiencing it, or by the people close to them.

For example, if the parents of children with a disease that makes their skin itch express sympathy when their children scratch the itch (even though they have been told not to), those children will scratch themselves more. than children whose parents do not pay such attention.

Similarly, in experiments where men were interviewed about their sensations of pain, those men who knew that their sympathetic wives were listening behind a two-way mirror evaluated their pain as more intense than those men who did not have this sympathetic ear.

25
Q

What is a cognitive factor that can reduce our perception of pain? Examples?

A

simple distraction has proven its effectiveness many times over.

Experiments have shown that simply listening to sounds while receiving a painful stimulus reduces the subjective perception of pain. This finding has also been confirmed by brain- imaging studies showing that the areas of the brain that are involved in processing pain become less active when sounds are played.

26
Q

Can the meaning that people ascribe to their pain also influence its perceived intensity? Examples?

A

yes.

If someone is stuck at home with a painful illness or injury but sees it in a positive light—for example, as a chance to think about the meaning of life, or to get some writing done, or to spend time with his or her children—that will have beneficial effects on his or her perception of the pain’s intensity.

27
Q

How do you experience pain in the following situations?

You close a door on your finger.
You bump your shin on a chair.
You burn your arm on the toaster.

A

In all three cases, you experience a pain withdrawal reflex first, then an acute sensation of pain, and then a duller one.

28
Q

What are the two main types of pain?

A

fast/acute pain and dull pain

29
Q

How do nociceptive fibers’ nerve endings differ from other types of sensory fibres?

A

First of all, in contrast to other types of sensory fibers such as those for the sense of touch, which have specialized structures at their endings, nociceptive fibers have none. Instead they have what are known as free nerve endings. These free nerve endings form dense networks with multiple branches that are regarded as nociceptors, that is, sensory receptors for pain.

30
Q

What is another word for nerve fibres?

A

axons

31
Q

What do nociceptive fibres connect to?

A

all connect peripheral organs to the spinal cord

32
Q

What determines the speed at which the axons conduct nerve impulses in nerve fibres?

A

diameter, and thickness of the myelin sheath (larger and more = faster)

33
Q

What are A- Alpha fibres used for? Are they myelinated? Are they the fatest/smallest? Are they the fastest/slowest?

A

proprioception
Myelinated
largest
fastest

34
Q

What are A- beta fibres used for? Are they myelinated? Are they the fatest/smallest? Are they the fastest/slowest?

A

touch
myelinated
second largest
second fastest

35
Q

What are C fibres used for? Are they myelinated? Are they the fatest/smallest? Are they the fastest/slowest?

A

Pain (Mechanical, thermal, and chemical)
not myelinated
skinniest
slowest

36
Q

What are A- Delta fibres used for? Are they myelinated? Are they the fatest/smallest? Are they the fastest/slowest?

A

Pain (mechanical and thermal)
myelinated
third largest
third fastest

37
Q

How many types of nociceptive nerve fibres are there?

A

2

38
Q

What are the 2 nociceptive nerve fibres?

A

A-Delta and c fibres

39
Q

What do A-delta and C fibres explain about pain?

A

explains why, when you are injured, you first feel a sharp, acute, specific pain, which gives way a few seconds later to a more diffuse, dull pain.

40
Q

Do the messages from A-delta and C-fibres reach the brain at the same time?

A

No.
C- fibres is slower

41
Q

Where does fast pain come from? How long does it last?

A

“Fast pain”, which goes away fairly quickly, comes from the stimulation and transmission of nerve impulses over A delta fibers

42
Q

Where does slow pain come from? How long does it last?

A

“slow pain”, which persists longer, comes from stimulation and transmission over non-myelinated C fibers.

43
Q

What is an analogy for A-delta and C-fibres?

A

In relative terms, A delta fibers carry messages at the speed of a messenger on a bicycle, while C fibers carry them at the speed of a messenger on foot.

44
Q

Approximately what percent of nociceptive fibres in the body are A-delta fibres?

A

70%

45
Q

Explain the fast pain pathway.

A

fast-pain pathways, which evolved more recently in human history, and slow-pain pathways, which evolved longer ago. The fast-pain pathways, composed of A delta fibers, also carry the signals that trigger your withdrawal reflex within a few milliseconds when you receive a painful stimulus, such as when you step on a nail.

46
Q

Explain the ascending nociceptive pathways.

A

the ascending nociceptive pathways consist of A delta and C fibers that are unmyelinated or only slightly myelinated (compared with the highly myelinated tactile and proprioceptive fibers). The ascending nociceptive fibers follow several different pathways (which vary in their evolutionary age) that let the brain locate the sensation of pain and assign it an emotionally unpleasant connotation.

46
Q

What is another word for descending neural pathways? When is this mechanism at its greatest?

A

top-down

Though all human perceptions are subject to varying degrees of modulation by the CNS, the power of these top-down mechanisms is greatest when it comes to controlling pain. These descending pain-control mechanisms can sometimes even completely eliminate certain forms of pain.

46
Q

Are there neural pathways that descend from the CNS? What do they do?

A

there are also neural pathways that descend from the central nervous system (CNS) and diminish the pain signals travelling up the ascending pathways from the body to the brain.

47
Q

What does the existence of descending pain-control pathways mean?

A

The existence of descending pain-control pathways means that pain pathways in general cannot be seen as direct links between pain receptors in the body and “pain centers” in the brain.

47
Q

How can the link between the pain receptors and the body be best seen? When does this lead to pain?

A

These pathways are better described in terms of concurrent ascending and descending influences—a veritable symphony of neural activity occurring simultaneously in both directions. And it is when this delicate balance tips in favour of the excitatory nociceptive messages that an individual experiences pain.

48
Q

Is pain like a reflexive response to an injury? What has this understanding led to advances in?

A

Pain thus becomes less of a reflexive response to an injury and more of an “opinion” that the body forms about its physical integrity.

This understanding has yielded major advances in the treatment of pain, because researchers can now seek ways to potentiate these descending pathways that inhibit pain.

49
Q

What is the theory now recognized as best describing the mechanisms involved in the descending control of pain?

A

The theory now recognized as best describing the mechanisms involved in the descending control of pain is called the gate-control theory of pain.

50
Q

What is the gate control theory of pain?

A

In this theory, the primary metaphor is that at each of the main relay points along the ascending pain pathways, there are “gates” that can be closed to make it harder for nociceptive impulses to get through. Thus, depending on how open the gates are at each of these relay points, the same level of activity in a nociceptor will not always lead to perception of the same intensity of pain.

51
Q

What are the three different levels within the CNS, at which neural mechanisms can play this role of a biological gate or filter reducing the transmission of pain impulses?

A

1) The spinal cord (in which there are segmental controls of non-pain peripheral origin).

2) The brain stem, including the midbrain and medulla oblongata (where there are diffuse noxious inhibitory controls that can be induced by pain stimuli).

3) The brain, including the prefrontal cortex.

52
Q

What is visceral pain caused by?

A

Visceral pain is caused by activation of nociceptors of the internal organs

53
Q

What fibres are internal organs largely innervated by?

A

Internal organs are largely innervated by C fibers

54
Q

How is visceral pain different from somatic pain?

A

Unlike somatic pain, which is triggered by an external stimulus, visceral pain is highly sensitive to distension, ischemia and inflammation.

55
Q

Are visceral organs more or less sensitive to stimuli that would normally evoke pain?

A

visceral organs are relatively less sensitive to other stimuli that would normally evoke pain in other organs such as burning or cutting.

56
Q

what does visceral pain tend to be? What is it usually described as? What can it be associated with?

A

Visceral pain tends to be vague and is usually described as deep or dragging

It can be associated with nausea and changes in heart rate and most importantly it can also evoke emotional responses.

57
Q

What are the qualities of visceral pain due to?

A

These qualities of visceral pain are due to the low density of sensory innervation of viscera and the extensive divergence of visceral input onto the central nervous system (CNS).