sleep and Pain 2 (Gronseth) Flashcards
Fibers carrying fast pain are ______ whereas slow pain is carried on ______
Fast pain only thinly myelinated alpha delta fibers
Slow pain carries on unmyleinated C fibers
Fast pain feels like ____
Fast pain feels like pricking pain
The Neospinothalamic tract foes to the primary sensory cortex whereas the paleospinothalamic tract goes to large parts of the cortex and contains what are important for anesthesia?
Periaqueductal Gray
if you removed a specific part of the brain why wouldn’t the pain be removed?
there is less orderly arrangement of pain inputs to the cortex
What chemical mediators decrease the peripheral and CNS pain threshold?
Bradykinin (prostaglandins)
Substance P
Pathologic pain is
the abnormal sensitization to pain that has no physiological value.
This can be abnormal sensitization, conduction, modulation, and perceptions as we saw examples of in class
Visceral pain clinica characteristics?
Can present as referred pain to somatic structures (skin)
Higher proportion of C fibers (2:1 in the skin and 10:1 in the gut)
What is it called when you have a painful input but it is experienced as more painful?
Hyperalgesis
what about when there isn’t a painful input but you experience pain?
Allodynia
Clinical characteristics of complex regional pain disorder (causalgia/reflex sympathetic dystrophy*)
Persistent hyperpathia (hyperalgesia, allodynia, and spontaneous pain)
usually after someone has been in a sling and they’re well healed but have this oversensitization to stimuli
How will hyperpathia typically present?
Unilateral pain or allodynia in a limb
skin changes/trophic issues
4 strategies for treating pathological pain
Aggressive mobilization
Pain control
sympathetic blockade
Why is the periaqueductal gray important for central pain control?
It is rich in opiate receptors
The rostroventral medulla is a descending inhibitory pathway to the
Dorsal horn (NE and 5HT)
Excites Enkaphlin producing interneurons
Trigeminal neuroalgia presents as pain where
on the cheek or side of the face
Focal demyelination of the trigeminal from repeated cramped quarters (ephaptic transmission)
tx: tegretol (carbamazapine)
Shingles (Zoster) and post herpetic neuralgia deafferentation presents with pain because of what theory
The gate control theory that says you are getting non-pain and pain inputs and if you damage the non-pain one you will feel the pain inputs
methods of decreasing pain conduction
nerve block
Spinothalamic tractotomy
Stabilize nerves
methods of increasing modulation of pain
Increase non-painful stimuli: mechanical stimulation, transcut, posterior column, periaqueductal gray
antidepressants and opiates
What does RAS do?
involved in arousal and alertness.
in the brainstem
Inputs to the Thalamnic reticular network are _____ergic
GABAergic
EEG measures the ______potential
Resting membrane potential differences between large cortical neurons
NOT THE ACTION POTENTIALS
2 patterns assoc with wakefullness in adults?
alpha: wake with eyes closed
beta: alerta and awake
STages of sleep and respective EEG patterns
Awake: Alpha and beta
Stage 1: alpha—>theta
Stage 2: Sleep spindles and k-complexes
Stage 3/4: slow wave sleep
REM: mainly beta
Stages of sleep and phasic or tonic neurons
Awake: tonic (depolarized)
Stage 1: phasic (hyperpolarized)
Stage 2: phasic (hyperpolarized)
Stage 3/4: synchronized phasic
REM: desynchronized, mainly beta, tonic
how long for one complete slow-wave/REM cycle?
about 90 minutes then REM
REM precedes waking up
Which diencephalic nucleus is believe to synchronize EEG and neurotransmitter?
GABA
Diffiusley projecting neuronal systems that influence sleep
RAS Cholinergic Serotinergic Noradrenergic Dopaminergic
The suprachiasmatic nucleus in the anterior hypothalamus monitors light and dark cycles via input from what ganglia and regulates the _____ _____?
Melanopsin
Circadian rhythm
Nucleus and where is responsible for regulating the circadian rhytmn?
suprachiasmatic nucleus in the anterior hypothalamus
