T7.5 Pain Flashcards
“First pain” is mediated by which type of fibers? (MG)
A. Adelta
B. C fibers
C. Abeta
D. Cgamma
A. Adelta are lightly myelinated so you experience pain from these first. Later, the C fibers mediate pain.
You drop your laptop on your foot and a bruise results. Later when you are getting in bed, the light top sheet causes pain where it touches you bruise. What condition is characterized here? (MG)
A. Hypoalgesia
B. Primary Hyperalgesia
C. Secondary Hyperalgesia
D. Allodynia
D. Allodynia: previously painless stimuli become painful due to hypersensitive nociceptors.
In the Gate Theory of Pain, which type of neurons are creating a gate to prevent the ascension of pain information? (MG)
A. Pseudounipolar
B. Bipolar
C. Multipolar
D. Polar Bear
B. Bipolar
Inhibitory INTERNEURONS in the spinal cord create a gate that stops pain information from ascending.
Which of the following substances can NOT activate Nociceptors?
A. Leukotrienes B. Potassium C. Bradykinin D. Being stabbed E. Histamine
FA
A. Leukotrienes are a substance released from damage cell that SENSITIZE nociceptors, they do not activate them, but reduce the threshold needed to cause activation of the pain receptor cells.
In pain gate control theory, the pain can be masked by the another stimulus. Which of the following types of fibers carries the stimulus that masks pain?
A. A-Alpha
B. A-Beta
C. A-Delta
D. C Fibers
FA
A. A-Alpha fibers, Large myelinated fibers, project to inhibitory interneurons that will inhibit the slower fibers that carry painful stimuli. these A-Alpha fibers carry fine touch and project through the DCML tract
Where does the trigeminal pathway for pain decussate?
A. VTT
B. Internal Capsule
C. VPM
D. Corona Radiata
RFA
Ans. A. VTT (Ventral Trigeminothalamic tract ) is the site of decussation for the Trigeminal pathway of pain
B. Internal capsule is the path the pain takes to be interpreted at the cortex after the 2nd synapse.
C. VPM (ventral posteromedial nucleus, is in the thalamus and is the site of the second synapse
A man comes in with pain in the left upper abdomen, extending to the back. What is the man most likely suffering from?
A. Heart Attack
B. Appendicitis
C. Pancreatitis
D. IBS
RFA
Ans C. The area described in the referred pain area of Pancreatitis
A. Heart Attack- pain in upper chest well and left arm
B. Appendicitis- Pain around the abdominal wall and navel
Ryan is super white. Like sour cream is considered dark compared to that dude. Like a dummy Ryan goes to the beach and doesn’t wear sunscreen. The next day he is as red as a Maine lobster. His friend Ahmed sees him and give him a friendly pat on the back and Ryan screams like mad in pain. This is an example of?
A. Hyperalgesia
B. Allodynia
C. Decerebrate Posture
D. Decorticate Posture
RFA
Ans. B. Allodynia- previously painless stimuli is now painful
A. Hyperalgesia- increased sensitivity to a painful stimulus
C. Decerebrate- Unrelated to this question but is Upper and lower limbs extended
D. Decorticate- also unrelated but is upper limbs flexed and lower limbs extended.
Where does the primary sensory neuron for pain synapse? (mm)
A) Substantia Gelatinosa B) Ventro Posterio-Lateral Nucleus C) S1 Cortex D) S2 Cortex E) Ventro Anterio- Lateral Nucleus
Answer - A- At the substantia gelatinosa in the dorsal horn of spinal cord
b- 2
c - tertiary
Explain how opioids reduce pain. (mm)
They reduce pain by mimicking enkephalins. They activated opioid receptors on primary and secondary pain neurons and activate inhibitory interneurons in gate control.
Explain the descending analgesic pathway (mm)
As the ALS tract ascends it sends collateral fibers to the reticular formation, periaquductal gray, and nucleus raphe Magnus. The periaqueductal gray and nucleus raphe Magnus release seratonergic fibers and the locus ceruleus releases noradrengic fibers to the dorsal horn to the opioidergic interneurons to control pain
