Test 3 -11

Question 1

Where are the two conscious pathways located

Answer 1

touch and proprioception - dorsal columns

pain and temperature - anterolateral columns

Question 2

What is the sensory pathway for discriminative touch and conscious proprioception?

Answer 2

dorsal columns and medial lemniscus
1.dorsal root gang-dorsal root-SC-caudal medulla
synapse in medulla
2. medulla to thalamus
synapse in thalamus
3. thalamus to post central gyrus of parietal lobe

Question 3

What do both the primary and secondary somatosensory detect?

Answer 3

primary: size, texture, shape
secondary: memory of tactile

Question 4

What is the sensory pathway of pain and temperature?

Answer 4

anterolateral columns
1. Free N endings - dorsal horn
synapse
2. dorsal horn (cell body) to thalamus
synapse in thalamus
3. thalamus to cerebral cortex (post-central gyrus)

Question 5

Which pathway is labeled the spinothalamic pathway and what fibers does it use?

Answer 5

pain and temperature
LATERAL PAIN SYSTEM
A-Delta

Question 6

What are the three divergent pathways for emotional and autonomic systems? What is this pathway termed? What fibers are used in this pathway? Which one uses a 3 neuron pathway?

Answer 6

Spinoreticular
spinomescencephalic
spino-emotional (3)

medial pain system
C Fiber

Question 7

spinoreticular

Answer 7

synapse in BS reticular formation
to midline
to thalamus

arousal, attention and sleep wake cycles

Question 8

spinomescencephalic

Answer 8

SC to midbrain

1. turns head to noxious stimuli
2. activates neurons projecting from BS -> SC to shut off pain pathway (periaqueduct)

Question 9

Spino-emotional

Answer 9

synapses in thalamus

1. alerts autonomic
2. makes mad

Question 10

peripheral sesnitization

Answer 10

Free N endings slightly depolarized

easy to reach threshold

Question 11

What are the neurotransmitters of the first synapse for the spinothalamic and divergent pathways?

Answer 11

spinothalamic - glutamate - lateral pain - A-Delta -fast

divergent - Substance P -Medial pain - C-fiber - slow

Question 12

What would an increase in Glutamate elicit?

Answer 12

Fast pain by A-Delta fibers with spinothalamic pathway

Question 13

What would an increase in Substance P elicit?

Answer 13

Slow pain bu C-Fibers with divergent pathways

Question 14

What is a possible mechanism of referred pain?

Answer 14

afferents and somatics converge with spinothalamci

Question 15

What are the 3 aspects of the pain experience?

Answer 15

1. sensory
2. motivational
3. cognitive

Question 16

Suppressed dorsal horn processing

Answer 16

cannot pass AP, rub it

Question 17

sensitized (temporary) dorsal horn processing

Answer 17

neuropathic

increased neurotransmitters for temporary time from presynaptic cleft

Question 18

reorganized persistent

Answer 18

neuropathic

remap - LTP - PERMANENT

Question 19

What are the five sites of antinociception?

Answer 19

1. Peripheral
2. Dorsal horn
3. midbrain descending
4. hormonal - pituitary
5. Amygdala and cortex

Question 20

I. Peripheral antinociception

Answer 20

Free N endings
reduce depolarization of Substance P
stretch, mobilize, anti-inflammation, massage

Question 21

II. Dorsal Horn antinociception (1st synapse of Pain pathway)

Answer 21

Rub it where it hurts
moving activates mechanoreceptors - polarize A-Beta
E-Stim

Question 22

III. Midbrain descending antinociception

Answer 22

returns to site of P

narcotics

Question 23

IV. Hormonal - pituatary antinoception

Answer 23

autonomic - dump chemicals into blood
pharmacological
endogenous opioids

Question 24

V. Amygdala and cortex antinoception

Answer 24

THINK

can turn on inferior levels

Question 25

Which antinociception pathways do we have the most control over?

Answer 25

I, II, & V