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A&P 1 > Somatosensory 2 > Flashcards

Somatosensory 2 Flashcards

1
Q

Anterolateral Pathway:

A

~ Poorly discrete localization from signal source.
~ No need for discrimination of fine degradations of intensity.
~ Pain, Heat, Cold, Crude, Tactile, Tickle, Itch, and Sexual Sensations.

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2
Q

Anteriolateral fibers of the spinal cord originate in the:

A

Dorsal horn laminae 1, 4, 5 and 6

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3
Q

Anteriolateral fibers cross ________ (decussate) in the anterior commissure of the cord to the opposite anterior & lateral white columns

A

Immediately

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4
Q

Anterolateral Pathway: Fibers progress cephalic (toward the head) via what two tracts?

A

The anterior spinothalamic tract and the lateral spinothalamic tract

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5
Q

What 4 places do the anterior spinothalamic tract and the lateral spinothalamic tracts terminate

A

1: Ventrobasl Complex (VPL) of the Thalamus (mostly tactile signals)
2: Reticular nuclei of the brainstem (think reticular activating system, sleep, consciousness)
3: Midbrain - Periaqueductal Gray & Locus Coeruleus (analgesia Modulation)
4: Hypothalamus

From these places the signals can be transmitted to the somatosensory Cortex along with the DCML signals

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6
Q

Velocity of the ALP is how fast compared to the DCML?

A

1/3rd the speed

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7
Q

In comparison to the DCML the Anterolateral Pathway is:

A

1/3rd the speed.
Spatial localization is poor.
Gradation intensities are much less accurate.
Poor ability to transmit rapidly changing or repetitive signals.
THINK CRUDE!

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8
Q

Does the Thalamus have the ability to discriminate tactical sensations?

A

The the somatosensory Cortex is destroyed a slight degree of crude sensation remains, indicating that although we tend to talk about the thalamus as a relay center, it also has a slight ability to discriminate tactile sensations

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9
Q

The somatosensory cortex is destroyed what effect does it have on pain sensation and perception and thermo perception?

A

When the somatosensory cortex is destroyed, it has little effect on pain sensation and perception and only a moderate effect on thermo perception.

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10
Q

What 3 areas of the brain play a primary role in discrimination of pain and thermo perception?

A

Brain stem
Thalamus
other basal regions

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11
Q

What are Cortiofugal signals?

A

Backward movement to control sensitivity and intensity of sensory input (lateral inhibition; controls range of sensitivity)

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12
Q

What is the function of Cortiofugal signals?

A

these fibers are INHIBITORY and act to suppress sensory input. they decrease the spread of a signal and sharpen degree of contrast and adjust the sensitivity of the system

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13
Q

What does Cortiofugal mean?

A

“Originating and running from the Cerebral Cortex”

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14
Q

C4:

A

Cape

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15
Q

C8:

A

Pinky Finger

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16
Q

T4:

A

Nipples

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17
Q

T10:

A

Belly Button

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18
Q

S2, S3, S4:

A

Keeps the poop off the floor

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19
Q

Opioid (mu) receptors exist in Rexed’s laminae/Tracts of Lissauer

A

~ Rexed Laminae: Substantia gelatinosa nucleus (a.l.a. gelatinous substance of posterior horn)
correlates to:
~ Tracts of Lissauer: 2 and 3

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20
Q

The spinal cord areas are defined by what two systems?

A

either by Rexed Laminae or Tracts of Lissauer

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21
Q

What are the 3 dimensions of pain?

A

Sensory - discriminative
Affective - motivational
Cognitive - evaluative

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22
Q

What type of pain is: felt within 0.1 seconds after pain is applied?

A

Fast pain

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23
Q

What type of pain is: Sharp, acute, pricking, electric?

A

Fast pain

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24
Q

What type of pain is: not felt in most deeper tissues?

A

Fast pain

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25
Q

What type of pain is: Caused by mechanical & thermal pain stimuli?

A

Fast pain

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26
Q

What type of pain is: Felt within 1 second after pain is applied & slowly increases over time?

A

Slow pain

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27
Q

What type of pain is: burning, throbbing, aching, chronic?

A

Slow pain

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28
Q

What type of pain is: Associated with tissue destruction?

A

Slow pain

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29
Q

What type of pain is: Caused by mechanical, thermal, and chemical stimuli?

A

Slow pain

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30
Q

What type of nerves are - widespread superficially in layers of skin, arteries, periosteum, joint surfaces, flax, and tentorium?

A

Free Nerve Endings

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31
Q

In deep tissues, free nerve endings are only sparsely disrupted but when tissue damage is profound enough what type of pain develops?

A

Slow-chronic aching

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32
Q

What Chemical Stimuli excite pain?

A

Bradykinin, Serotonin, Histamine, Potassium ions, acids, ACh, & proteolytic ensymes

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33
Q

What enhances sensitivity of pain endings but does not directly excite them

A

Prostaglandins and substance P

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34
Q

Do pain receptors adapt?

A

Very little (this is good because it allows pain to keep a person aware of tissue damage that is occurring)

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35
Q

What type of pain: short duration, cause is usually clear cut, effects on behavior are usually obvious and easy to recognize, Treatments are highly effective, depending on access, Side effects of treatment although problematic can be tolerated for short periods.

A

Acute pain

36
Q

What type of pain: Long duration, e.g. longer than expected for healing (3 months). Cause may or may not be clear, Effects on behavior can be subtle and hard to understand, ‘Meds’ only partially effective multiple approaches needed, Side effects of treatment become harder to tolerate over time and interfere with normal function.

A

Chronic pain

37
Q

What type of pain is: Pain related to damage of somatic or visceral tissue, due to trauma or inflammation. e.g. Rheumatoid arthritis, osteoarthritis, gout

A

Nociceptive pain

38
Q

What type of pain is: Pain related to damage of peripheral or central nerve centers. e.g. painful diabetic peripheral neuropathy, postherpetic neuralgia

A

Neuropathic pain

39
Q

What type of pain is: Pain without identifiable nerve tissue damage, hypothesized to result form persistent neuronal dysregulation. e.g. Fibromyalgia

A

Sensory hypersensitivity

40
Q

What is: an increased sensitivity to pain, which may be caused by damage to nociceptors or peripheral nerves?

A

Hyperalgesia

41
Q

What is: meaning “other pain” , is a pain due to a stimulus which does not normally provoke pain and can be either thermal or mechanical?

A

Allodynia

42
Q

What is: a clinical symptom of certain neurological disorders wherein nociceptive stimuli evoke exaggerated levels of pain?

A

Hyperpathia

43
Q

What is: the sensation that an amputated or missing limb is still attached to the body and is moving appropriately with other body parts?

A

Phantom Limb Pain

44
Q

What chemical extract from tissue damage is said to be more painful than others (maybe the most responsible for pain after tissue damage)

A

Bradykinin

45
Q

What is it called when: Blood flow is stopped (pain within minutes), Lactic acid accumulates in tissues due to aerobic metabolism, Bradykinin and proteolytic enzymes form in the tissues due to cell damage?

A

Ischemia

46
Q

What is: A direct effect from stimulation of mechanosensitive pain receptors, indirect effect from compression of the blood vessels ensuing ischemia.

A

Muscle Spasm

47
Q

What type of pain pathway: Mechanical & Thermal Stimuli, Small type A delta fibers at velocities between 6-30m/sec

A

Fast - Sharp Pain Pathway

48
Q

Fast - Sharp Pain Pathway: Neospinaothalamic tract where does it begin?

A

Fast pain fibers enter and terminate at Lamina 1 of the dorsal horn (lamina marginalia) which excite 2nd order neuron.

49
Q

Fast - Sharp Pain Pathway: Neospinaothalamic tract where does it terminate?

A

~ Reticular areas of the brain stem.
~ Some pass right through the thalamus terminating in the ventrobasal complex along with the DCML tract.
~ Some terminate in the posterior aspect of the thalamus.
~ From all of these areas of termination, signals are then transmitted to numerous basal areas of the brain and some to the somatosensory cortex.

50
Q

What type of pain pathway: Mechanical, Thermal, & Chemical Stimuli, Mostly Chemical, C fibers at velocities between 0.5-2m/sec

A

Slow-Chronic Pain Pathway

51
Q

Slow-Chronic Pain Pathway: Paleospinothalamic tract (more lateral) where does it begin?

A

Peripheral nerves terminate in Lamina 2 and 3 (substance gelatinosa) (some sources say Lamina 1 as well) then pass through Lamina 5, Then passes through anterior commissure to a long axon which turns upward to opposite side of cord to the brain

52
Q

Often both pathways (Fast - Neospinaothalamic and Slow - Paleospinothalamic) are used when an acute painful stimulus occurs. this “Double” pain sensation uses what types of fibers?

A

A delta fibers - makes the person react
C fibers - intensifies the pain over time

53
Q

What Neurotransmitter is associated with A delta Fast Pain Fibers?

A

Glutamate

54
Q

What Neurotransmitters are associated with C Slow Pain Fibers?

A

Substance P and Glutamate

55
Q

In general what Neurotransmitter is associated with Fast pain and is instantaneous & short-lived?

A

Glutamate

56
Q

In general what Neurotransmitter is associated with Slow pain, released slowly, and concentrations build?

A

Substance P

57
Q

Slow-Chronic Pain Pathway: Paleospinothalamic tract (more lateral) where does it terminate?

A

~ Terminates widely (lots of places) in the brain stem
~ Only some fibers terminate in the thalamus
~ Most fibers terminate in the Reticular Nuclei of Medulla, Pons, and mesencephalon
~ Tectal area of the mesencephalon deep to the superior and inferior colliculi
~ Periaqueductal gray region surrounding the aqueduct of sylvius

58
Q

What regions of the brain are extremely important in feeling the chronic suffering types of pain?

A

Lower regions

59
Q

From the termination points of the Paleospinothalamic Pathway, numerous short-fiber neurons relay info to:

A

the intralaminal and ventrolateral nuclei of the thalamus and to parts of the hypothalamus and other basal regions

60
Q

What is the Cortex important for in relation to pain?

A

The cortex is important for interpreting pain quality, even though perception is in the lower brain centers

61
Q

Why may we be woken up suddenly due to pain or can’t fall sleep due to pain?

A

The Reticular Areas of the brain through which many pain pathways are transmitted, are also responsible for sleep.

62
Q

What 3 major components block pain signals before they are relayed to the brain?

A

1: Periaqueductal Gray & Periventricular Areas
2: Raphe Magnus Nucleus & Paragigantocellularis in the medulla
3: Pain inhibitory Complex in the Dorsal Horn of the Spinal Cord

63
Q

What are 2 particularly important Analgesia Substances inherent to the body?

A

Enkephalins and Serotonin

64
Q

What Analgesia substance is secreted by fibers from periaqueductal gray periventricular nuclei and are considered to cause both pre- and post-synaptic inhibition of incoming C and A delta fibers where they synapse with the dorsal horn/

A

Enkephalins

65
Q

What Analgesia substance is secreted by raphe Magnus nucleus with causes local cord neurons to secrete enkephalins?

A

Serotonin

66
Q

What are 3 Opiate-like substances in the nervous system that come from the degradation of 3 large protein molecules?

A

1: Proopiomelanocortins
2: Proenkephalins
3: Prodynorphins

67
Q

What are 4 endogenous opiate like substances?

A

1: B- endorphins (hypothalamus, pituitary)
2: Met-enkephalins (brain-stem, spinal cord)
3: Leuenkephalins (brain-stem, spinal cord)
4: Dynorphins (brain stem, spinal cord - lower in quantity than the above)

68
Q

What is: feeling pain in a part of the body that is remote from the tissue causing the pain?

A

Referred pain

69
Q

What is: Cause by stimuli that excites pain nerve endings in a widespread area of the organ (consists of ischemia, chemical, spasms, and stretching)

A

Visceral pain

70
Q

Leakage from GI tract into peritoneal cavity. Acidic contents stimulates excruciating pain.

A

Chemical

71
Q

Mechanical stimulus and/or diminished blood flow (like ischemia)

A

Spasms

72
Q

Overdistention of hollow organs can cause collapse of encircling blood vessels (ischemia)

A

Stretch

73
Q

What pathway is: Transmitted via sensory fibers within autonomic nerve bundles and sensations of referred pain to the skin far away for the source of pain e.g. Heart Attack

A

Visceral Pathway

74
Q

What pathway is: Localized to the region of the painful stimulus, Direct irritation/ inflammation of somatically innervated parietal peritoneum, Localized in the dermatomes supplied by segmental nerve roots innervating the parietal peritoneum. Often dual pathways e.g. Appendix

A

Parietal Pathways

75
Q

Triggered by inflammation, ischemia, distention, traction, and pressure.
Pain is midline, vague, deep, dull, and poorly localized.
Bilateral autonomics.
Intra-abdominal disease not but necessarily surgical.

A

Visceral

76
Q

Triggered by irritation of the parietal peritoneum.
Pain is sharp, Severe, and well localized
Unilateral somatics.
Local or diffuse peritonitis that frequently needs surgical intervention

A

Parietal

77
Q

Felt when noxious stimuli affect an abdominal viscus.
poorly localized
dull
gnawing or burning
secondary autonomic symptoms - swelling, nausea

A

Visceral

78
Q

Felt when noxious stimuli affect the parietal peritoneum
precisely localized
intense
aggravated by moment

A

Parietal

79
Q

Felt in remote areas supplied by the same neurosegments as the diseased organ
Well localized
Appears with intense visceral stimulus

A

Referred

80
Q

Cold receptors and warm receptors are located:

A

Immediately underneath the skin’s surface

81
Q

How many more cold than warm spots are there?

A

3-10x more cold than warm “spots”

82
Q

Cold-pain receptors and Warmth-pain receptors are only stimulated by:

A

Extreme degrees of heat or cold

83
Q

What fibers is warmth transmitted by?

A

C fibers (hypothesized as a type of free nerve ending)

84
Q

What fibers is cold transmitted by?

A

A delta fibers and some C fibers (hypothesized as a type of free nerve ending)

85
Q

Temperature alters the rate of intracellular chemical reactions more than two fold for each ____ degree C change.

A

10 degree

86
Q

Thermal signal transmission:

A

~ Signals travel a few segments upward or downward in the tract of Lissauer and terminate in Laminae 1, 2, and 3 of the dorsal horn (same as pain).
~ Decussate across the anterior commissure to the contra-lateral side of the spinal cord and ascend to the reticular areas of the brain stem and the ventrobasal complex of the thalamus.
~ Some thermal signals do reach the somatosensory cortex from the ventrobasal complex. However, removal of the SSA 1 reduces but does not eliminate pain localization

87
Q
A

A&P 1 (10 decks)

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