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Block 5 Week 2 Dani > Somatosensory and Pain - Kenyon > Flashcards

Somatosensory and Pain - Kenyon Flashcards

1
Q

What is the general function of primary afferent neurons?

A

Encode mechanical, chemical, or thermal stimulus into a receptor or generator potential

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2
Q

Are generator and action potentials the same

A

NO

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3
Q

Describe a generator potential?

A

small, graded, and NOT CONDUCTED.

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4
Q

Generator potential is equivalent to what type of post-synaptic event?

A

EPSP

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5
Q

Where are the cell bodies of PANs?

A

in the DRG

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6
Q

Are there synapses in the DRG?

A

Normally speaking, NO

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7
Q

Are there IPSPs or EPSPs in the DRG?

A

No, all electrical activity passes right through it

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8
Q

“A” fibers have a (large/small) diameter and conduct (fast/slow)

A

large, fast

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9
Q

C fibers are (large/small) diameter and conduct (fast/slow)

A

small, slow

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10
Q

C and A-delta conduct what signals?

A

Pain and temperature

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11
Q

which fiber type is the fastest and what type of signal does it carry?

A

A-beta; TVP

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12
Q

what are the slowest fibers?

A

C and A-delta

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13
Q

Does the fast/slow differentiation have any impact on actual ability to conduct?

A

NO

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14
Q

Do specialized receptors of PAN’s adapt to stimuli?

A

Some adapt quickly, some slowly, some not at all. Theyre the goldilocks bears of neuroscience.

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15
Q

In two-pt. discrimination, what happens as you move the points farther apart?

A

AP frequency from the central receptive field lowers while frequency increases in the lateral receptive fields

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16
Q

Describe the pathway taken for TVP and Pain and Temp from the body and back of head?

A

PAN’s to DRG to dorsal roots to dorsal column to medial lemniscus

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17
Q

Describe the path for TVP, pain, and temp, form the the face and teeth?

A

PAN’s to trigeminal ganglion

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18
Q

When axons enter the spinal cord, what types of events utilize the pathway that synapse in Rexed Layer 3 of the cord?

A

spinal reflexes: knee jerk, somato-somatic, viscero-somatic

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19
Q

When axons enter the spinal cord and branch without synapsing, what do these form?

A

The dorsal columns of he spinal cord

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20
Q

Lower limbs form what tract?

A

medial gracile tract

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21
Q

Upper limbs, trunk and neck form what tract?

A

lateral cuneate tract

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22
Q

With respect to dorsal column somatotopy, what body structures will be more lateral? More medial?

A

lateral: occiput and neck
medial: lower limb and trunk

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23
Q

Will we see facial innervation in the the somatotopy of the dorsal column?

A

No, that stuff goes through the trigeminal!

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24
Q

What is the effect on TVP of lesions in the dorsal column? what does this tell us about TVP fibers?

A

There is PARTIAL loss of TVP; dorsal columns are NOT the only pathway for TVP

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25
Q

Axons from the dorsal columns synapse with second order neurons in which nuclei?

A

gracile nucleus

cuneate nucleus

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26
Q

Is the information at the gracile and cuneate nuclei simply relayed or is it processed?

A

it is processed

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27
Q

The (blank) tract is the pathway in which axons go ventral and corss over to form the medial lemniscus

A

Internal Arcuate tract

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28
Q

Axons from the lower body end up (ventral/dorsal)

A

ventral

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29
Q

Fibers from the gracile or cuneate tracts synapse in the (blank or blank) nuclei

A

Gracile or cuneate nuclei

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30
Q

The gracile and cuneate nuclei are in which brain layer?

A

Caudal medulla

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31
Q

The internal arcuate tract connects the gracile and cuneate nuclei to the (blank)

A

medial lemniscus

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32
Q

Axons in the medial lemniscus synapse with third order neurons where?

A

Ventral Posterior Lateral nucleus of the thalamus

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33
Q

The VPL nucleus of the thalamus sends its fibers to what cortical structure and to which gyrus?

A

Post central gyrus of the primary sensory cortex

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34
Q

does the VP complex have all peripheral somatic sensory fibers?

A

yes!

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35
Q

Fibers from the trigeminal ganglion first enter at what brain level?

A

PONS

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36
Q

trigeminal fibers synapse at what nucleus in the Pons?

A

principal nucleus of trigeminal complex

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37
Q

Do fibers from the trigeminal travel on the medial or lateral lemniscus?

A

medial

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38
Q

Where does the crossing over ocurr in the trigeminal pathway?

A

After synapsing in the principal nucleus and meeting up with the medial lemniscus

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39
Q

Where does the crossing over occur in the somatosensory pathway?

A

In the caudal medulla, after synapsing in the gracile or cuneate nuclei and becoming the medal leminscus

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40
Q

Fibers in the trigeminal lemniscus synapse where in the brain proper?

A

VPM of the thalamus

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41
Q

Trigeminal fibers in the VPM travel to what cortical structure?

A

pimary somatic sensory cortex

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42
Q

With regard to the sensory cortex somatotopy, are structures of the face more medial or lateral?

A

lateral

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43
Q

what structures are most medial on cortical somatotopy?

A

Trunk, leg, feet, toes

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44
Q

the Ant. cerebral artery supplies what somatotopic structures?

A

tunk, leg, foot, and genitals

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45
Q

the middle cerebral artery suppplies what somatotopic structures?

A

arms, hands, face, tongue

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46
Q

Does the posterior cerebral artery supply any somatotopic structures?

A

noooooope

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47
Q

Is there anything coming out of the primary sensory cortex?

A

YES, DESCENDING branches going to the secondary sensory cortex

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48
Q

From the SII, to what brain structures do fibers go? What are their functions?

A

Limbic structures, amygdala, and hippocampus.

Involved in inhibitory pathways blocking out proprioception (not always aware of your shoes/socks), as well as tactile sensation and learning memory

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49
Q

Are there more ascending or descending axons?

A

Descending!

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50
Q

effective analgesic therapy increases the (blank) of life for pts with pain

A

quality

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51
Q

What three classes of drugs help with neuropathic pain?

A
  1. COX 2 inhibitors
  2. opioid analgesics
  3. adjuvant analgesics
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52
Q

What fraction of pts actually get adequate neuropathic pain relief from current treatments?

A

1/3

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53
Q

When processing pain in the sensory-discriminative model, in what nucleus do pain fibers synapse?

A

Ventral posterior (VP) nucleus

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54
Q

After hitting the VP, where does pain go for the sensory-discriminatory model?

A

Somatosensory cortex (SI, SII)

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55
Q

In the affective-motivational model, what are the two cortical areas that are acivated?

A

Anterior cingulate cortex and insular cortex

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56
Q

From what nuclei do you travel to reach the ant. cingulate cortex and the insular cortex?

A

midline thalamic nucleus

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57
Q

lesions in what thalamic nuclei cause complete loss of contralateral pain and temp?

A

ventromedial nucleus

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58
Q

What are the two ways of measuring pain?

A

Self-reporting or fMRI

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59
Q

Nociceptors have their cell bodies where?

A

in the DRG

60
Q

the goal of pain management is to manipulate, aka (blank), nociceptors to control the first stage of pain generation

A

KILLLLLL

61
Q

Capsaicin receptors are part of the (blank) receptor family

A

TRPV1

62
Q

(Pre/post)ganglionic sympathetic neurons will synapse in the (blank) following injury

A

post, DRG

63
Q

Synapse of sympathetic fibers in the DRG will cause (blank)

A

pain

64
Q

Nociceptors have a (higher/lower) threshold than thermoreceptors

A

higher!! First something feels good and warm before it burns!

65
Q

Stimulation of (hi/low) threshold mechano/thermoreceptors is non painful

A

low

66
Q

stimulation of high threshold (thermoreceptor/nociceptors) is painful

A

nociceptor

67
Q

What is the order of conduction speed from fastest to slowest of c, A-delta, and TVP fibers?

A

TVP>A-delta>C

68
Q

do A-delta fibers carry first or second pain?

A

first pain

69
Q

T/F: C-fibers carry second pain

A

T

70
Q

Besides pain, what two other stimuli do A-delta fibers carry?

A

mechano and mechanothermal

71
Q

Can C-fibers carry several sorts of painful stimuli?

A

Yes, this is called polymodal

72
Q

Is conduction rate the event that causes difference between first and second pain?

A

Nope

73
Q

What is the general reason for difference in first and second pain?

A

Fibers are going to different areas of the brain

74
Q

What three types of stimuli can excite nociceptors?

A
  1. mechanical
  2. thermal
  3. chemical (pH)
75
Q

what class of ion channels are involved in pain and temp info?

A

TRP channels

76
Q

What three stimuli open capsaicin channels?

A
  1. heat
  2. low pH
  3. capsaicin
77
Q

T/F: the capsaicin channel is selective for Ca

A

F! It is NONSELECTIVE

78
Q

T/F: capsaicin channels are regulated by intracellular Ca and enzymes

A

T

79
Q

does capsaicin bind to the receptor outside of the plasma membrane or within the cytosol?

A

On the cytosolic side

80
Q

Does the capsaicin receptor produce a generator potential or an AP?

A

generator potential

81
Q

What ion that TRPV1 lets into the cell causes autoregulation of the channel?

A

Ca, of course

82
Q

What receptor is involved in the itch response?

A

TRPA1

83
Q

is TRPA1 metabotropic or ionotropic?

A

metabotropic

84
Q

Binding different intracellular (blanks) will differentiate between pain and itch

A

GPCRs

85
Q

Pain and temperature afferents synapse in the (blank)

A

dorsal horn

86
Q

Axons from the secondary neurons cross and form the (blank) tract to the thalamus

A

anterolateral tract (spinothalamic)

87
Q

lesion of the dorsal column will result in what specific defieciency beyond partial TVP loss?

A

loss of ability to detect direction and speed of stimulus

88
Q

TVP and pain are (same/opposite) sides below the medulla

A

OPPOSITE

89
Q

TVP and pain are on (same/opposite) sides above the medulla

A

SAME

90
Q

TVP crosses over to the same as pain at what brain level?

A

caudal medulla

91
Q

What tract does TVP travel on to reach the medial lemniscus to decussate?

A

the internal arcuate tract

92
Q

At their entrances to the CNS, do both TVP and pain come up ipsilaterally?

A

NO; TVP ispalateral, pain contralateral

93
Q

Pain travels through what spinal tract?

A

The spinalreticular tract within the anterolateral system

94
Q

A lesion of one side of the spinal cord will result in reduced TVP on the (blank) side and reduced pain and temperature sensation on the (blank) side.

A

ispilateral, contralateral

95
Q

When pain and temp come in from the face, what direction (up/down) do they first travel in the CNS?

A

Descend

96
Q

Trigeminal pain and temp decussate onto the (blank) tract

A

trigeminothalamic tract

97
Q

to what brain level does the trigeminal dive down to for pain and temp?

A

Enters at mid-pons, dives down to middle medulla

98
Q

Between the mid pons and middle medulla pain and temp from BOTH sides of the face are on (blank) side(s) of the brainstem.

A

BOTH SIDES OF BRAINSTEM!

99
Q

Sensory discriminative pathway mediates what three things?

A
  1. location
  2. intensity
  3. quality of noxious stim
100
Q

Affective-motivational pathway mediates what three sensations?

A
  1. unpleasantness
  2. anxiety
  3. fear associated with pain
101
Q

Sensory discriminative is in what part of the brain

A

somatosensory cortex

102
Q

Affective-motivational pathway is associated with what parts of the brain? (6)

A 
Amgydala
Hypothalamus
Periaqueductal grey
Reticular Formation
Cingulate Cortex
Insula

It’s scary to sit down int the P-CHAIR (pain chair!)

103
Q

Besides making you feel like absolute dog shit while you throw a pity-party for your pain, what actual useful thing can the affective-motivational pathway do?

A

it can dampen down those debby downer thoughts!

104
Q

Projections to the reticular formation are in what brain structure?

A

Middle medulla

105
Q

Affective-motivational pathway synapses at what nucleus and at what level?

A

Parabrachial nucleus in the mid pons

106
Q

Fromt he affect-motivate path, Projections to these two structures come off at mid-pons

A

amygdala

hypothalamus

107
Q

What nucleus does the A-M pathway synapse in at the thalamus/

A

Intralaminar nuclei

108
Q

What two terminal brain structures does the A-M pathway go to?

A

insula and cingulate cortex

109
Q

Referred pain is (visceral/somatic) pain

A

visceral

110
Q

T/F: A lesion of the dorsal column could alleviate cancer pain

A

T; cancer is visceral pain

111
Q

What pathway does visceral/referred pain follow?

A

medial lemniscus, surprisingly

112
Q

Where does referred pain synapse in the thalamus

A

VP nucleus

113
Q

What terminal brain structure does referred pain go to? is this part of the A-M or S-D pathway?

A

insular cortex; A-M

114
Q

What is hyperalgesia?

A

Increases sensitivity to a painful stimulus

115
Q

What is allodynia?

A

Nonpainful simtuli now causes pain

116
Q

Hyperalgesia and allodynia arise from both (blank and blank) mechanisms

A

peripheral and central

117
Q

Sensitivity of nociceptors can be adjusted in the (blank)

A

periphery

118
Q

An “inflammatory soup” of substances is released following (blank)

A

injury

119
Q

What is result of releasing this inflammatory soup?

A

Sensitization of nociceptors

120
Q

What chemicals are released during injury that sensitize the nociceptor?

A 
ATP
prostaglandins
Histamine
Bradykynin
5-HT
H
Substance P
nerve growth factor
CGRP
121
Q

Peripheral sensitization acts on a (positive/negative) feedback system

A

Positive

122
Q

T/F: Nociceptive neurons themselves can release sensitizing compounds

A

T

123
Q

COX inhibitors reduce pain by inhibiting sythesis of:

A

prostaglandins

124
Q

What is windup?

A

progressive increase in response by a dorsal horn neuron due to repetitive stimulation

125
Q

In central sensitization, cytokines promote transcription of (blank) that make prostaglandins that increase neuronal activity

A

COX-2

126
Q

COX 2 inhibitors work on (blank) peripherally and (blank) centrally

A

DRG peripherally, spinal cord neurons centrally

127
Q

damage to the pain pathways results in what kind of pain?

A

neuropathic

128
Q

T/F: The perception and response to a painful stimulus is determined solely by the magnitude of the stimulus or activity in the primary afferent nociceptor.

A

F: IT IS NOT SOLEY DETERMINED

129
Q

Descending pathways activate neurons in the (blank) of the midbrain

A

periaqueductual grey

130
Q

A-M descending pathway is controlled at what 4 structures?

A
  1. Amygdala
  2. Hypothalamus
  3. midbrain periaqueductal grey
  4. Medullary reticular formation
131
Q

What are the nuclei that the periquedecutal grey project to? (4)

A
  1. parabrachial nucleus
  2. dorsal raphe nucleus
  3. locus coeruleus
  4. medullary reticular formation
132
Q

Where is the parabrachial nucleus?

A

junction of midbrain and pons

133
Q

Where is the dorsal raphe nucleus?

A

Medulla

134
Q

Where is the locus coeruleus/

A

PONS

135
Q

Where is the medullary reticular formation?

A

medulla

136
Q

In the (blank) horn of the spinal cord, activity in the descending pathways inhibits nociceptive activity

A

dorsal

137
Q

What neurotransmitters are used for inhibition of pain?

A

Serotonin

Enkephalins

138
Q

Activation of GPCRs coupled with inactivation of Ca channels modulates pain how?

A

inhibits it

139
Q

how does inactivation of Ca channels inhibit pain?

A

Inhibition of Ca influx prevents neurotransmitter release

140
Q

What types of nuerons release enkephalins/

A

interneurons

141
Q

Activation of low-threshold mechanoreceptors can also (blank) nociceptive activity.

A

inhibit

142
Q

Where are the opioid receptors?

A

Periaqueductal grey and spinal cord

143
Q

Is there a real neurochemical basis of the placebo effect?

A

YES

144
Q

What drug blocks the placebo effect?

A

naloxone

145
Q

Newborns exposed to repeated heel lances have increased

A

hyperalgesia and conditioning to painful stimuli

Block 5 Week 2 Dani (10 decks)

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