Test 3: 37 pain

Question 1

nociception

Answer 1

the sensory nervous system’s response to a harmful or potentially
harmful stimuli

Question 2

pain vs nociception

Answer 2

Nociception– the sensory nervous system’s response to a harmful or potentially harmful stimuli

Pain – nociception + perception (needs consciousness)

Question 3

acute pain

Answer 3

last less than 3 – 6 months, and/or is directly related to tissue damage. Short duration and gradually resolves as injured tissues heal.

Question 4

chronic pain

Answer 4

extends beyond the expected period of healing (long duration), is not related to resolving injury, has no useful purpose, and is refractory to treatment.

Question 5

abnormally increase in sensitivity to pain (“what hurts, now hurts a lot more”)

Answer 5

Hyperalgesia

Question 6

triggering of a pain response from a stimuli that do not normally provoke pain (“what should not hurt, now hurts”)

Answer 6

allodynia

Question 7

tranduction of pain

Answer 7

change of noxious stimuli into electrical impulse

Question 8

transmission of pain

Answer 8

• Propagation of impulse through the nervous system
• A-delta fibers – myelinated, fast speed, sharp pain
• C fibers – unmyelinated, slow speed, longer-lasting, dull, diffuse pain

Question 9

what kind of pain fibers for dull, diffuse pain

Answer 9

C fibers: unmyelinated, slow speed, longer-lasting, dull, diffuse pain

Question 10

what find of pain fibers for sharp pain

Answer 10

A-delta fibers: myelinated, fast speeds, sharp pain

Question 11

how does modulation of pain work

Answer 11

in spinal cord- will change the pain tranmission

activate descending analgesic systems: opioids, serotonin, NE

Question 12

perception of pain is by

Answer 12

Integration of thalamocortical, reticular, and limbic function to produce final conscious subjective and emotional experience

Question 13

3 neuron pain pathway simply is

Answer 13

First Order
* Originates in the periphery and projects to the spinal cord- primary afferent fiber

Second order
* Ascends to the spinal cord

Third order
* Projects into the cerebral cortex and other supraspinal structures

Question 14

how do TRP work

Answer 14

Transient receptor potential (TRP) vanilloid / capsaicin (TRPV1)

• TRP are activated and allow calcium influx into the 1st order neuron, activating an action potential
• Acute pain – receptor turns off as soon as the stimulus is gone
• Chronic pain – receptors don’t turn off, and activating substances persist : Substance P, Calcitonin gene-related peptide, Potassium ions and Inflammatory mediators

Question 15

lamina V contain — neurons that are able to respond to both — and —

Answer 15

wide dynamic range

noxious and non noxious stilumi

can be involed in wind up pain and the development of chronic pain

Question 16

what does plasticity in the dorsal horn mean

Answer 16

can modify the pain stimuli depending on the type and strength of signal input

Question 17

gate control theory

Answer 17

“Trick the nervous system to block painful stimuli transmission by sending non- painful stimuli”

when you hurt an area, you rub it, that rubbing will decrease painful signal

Question 18

antinociceptive system of the brain tries to decrease pain by —

Answer 18

releasing
* Endorphins (endorphin, enkephalin, and dynorphin)
* Serotonin
* norepinephrine

inhibits transmission in spinal cord pain pathway at the dorsal horn

Question 19

how does limbic system effect pain

Answer 19

limbic system will assign an negative emotional value to a painful experience

• pain hurts, avoid it

Question 20

why is acute pain important

Answer 20

occurs when there is tissue damage and resolves when healed

• Serves to alter animal behavior in order to avoid or minimize damage
• Protective mechanism

Question 21

two types of acute pain

Answer 21

nociceptive pain: radicular, somatic, visceral

inflammatory pain

Question 22

what types of nociceptive acute pain

Answer 22

Caused by the detection of (potential) harmful stimuli around the body by
nociceptors

• Radicular pain – from nerve root irritation
• Somatic pain – from tissues such as muscle, bone, or skin
• Visceral pain – from internal (hollow) organs

Question 23

Pain originated from an insult to the integrity of tissues at the cellular level

Answer 23

inflammatory pain
type of acute pain caused by release of inflammatory mediators and recruitment of inflammatory cells

Question 24

neuroplasticity

Answer 24

• Continuous process of short-, medium, and long-term remodeling of the neurosynaptic organization of the spinal
  cord and brain
• Ability to adapt to change
• Can be positive or negative changes for the wellbeing

Question 25

what is central sensitization

Answer 25

wind up

in responce to chronic pain, body will lower the threshold needed to cause pain

↑ activation of NMDA (glutamate) channels= ↑ excitability

Recruitment of silent nociceptors → hyperreactivity of 2nd order neurons in the spinal cord → recruitment of WDR neurons to function as pain transmitters (very difficult to turn off once activated)

results in hyperalgesia and allodynia

Question 26

central sensitization will cause the recruitment of —

Answer 26

silent nociceptors

Question 27

central sensitization results in — and —

Answer 27

Hyperalgesia – abnormally increase in sensitivity to pain (“what hurts, now hurts a lot more”)

Allodynia – triggering of a pain response from a stimuli that do not normally provoke pain (“what should not hurt, now hurts”)

Question 28

what are some simple pain scores

Answer 28

visual analogic scale (VAS): line with dash at pain scale
numeric rate: 1 out of 10
simple categorical scores: 1-3 mild, 4-6 moderate

Question 29

mulidimensional pain scores include

Answer 29

physiologic and behavior signs