sensory aspects of respiratory disease Flashcards
chest pain: explain the pathophysiology of chest pain, including thoracic sensory receptors, afferent neural pathways, and brain regions involved in nociception; explain the concept of referred chest pain and explain typical patterns of chest pain that may differentiate the underlying cause
sensory inputs of chest pain
from lungs (vagus X), airways, chest wall (spinal nerves); larynx (vagus X), pharynx (glossopharyngeal IX and vagus X), nose (trigeminal V)
significance of vagus input of chest pain
not much pain
pain anatomical pathway
A delta, C receptors (front of spine)→ cross over at same entry of nerves (spino-thalamic tract) → up to thalamus → primary somato-sensory cortex
types of pain
somatic, visceral
where is somatic pain from and describe pain (including musculoskeletal)
from skin - localised, sharp and stabbing pain (more somatic afferents vs visceral afferents)
where is visceral pain from and describe pain (including cardiac)
from visceral organs - difficult to localise, diffuse in character, referred to somatic structures e.g. neck and left arm; dull and crushing
chest pain from respiratory system
pleuropulmonary disorders (somatic as pleura inflamed and move), tracheobronchitis, inflammation or trauma to chest wall, skin (Herpes), referred pain (e.g. shoulder-tip pain of diaphragmatic irritation), nerve root
chest pain from non-respiratory disorders
cardiovascular disorders (MI, pericarditis), gastrointestinal disorders (rupture, GORF), psychiatric disorders (panic), musculoskeletal
brain pathways in pain
somatosensory, motor (move from pain), affective (crying, depressed), attentional processing, autonomic function
concept of referred pain
pain that appears to arise in a location that does not correspond to it’s original location (e.g. appendicitis visceral pain in centre abdomen until pushes against skin, causing somatic pain)
where does CNS perceive pain from heart coming from
somatic portion of the body supplied by thoracic spinal cord segments 1-4(5)
touch anatomical pathway
Aa, AB receptors via doral horn (back of spine) → dorsal columns → somatosensory cortex
