The Pain Matrix

Question 1

What is the following a definition of?

An upleasant sensory and emotional experience related to physical tissue injury or the potential for tissue damage to occur

Answer 1

Pain

Question 2

Pain follows an intricate, variable interaction between ____ factors such as ____, ____ factors and ____ factors

Answer 2

Biological; genetics; psychological, social

Question 3

The processing of nocicpetive stimuli and the perception of pain involves what?

Answer 3

Multifactorial and multipathway system

Question 4

What parts of the brain does the Pain Matrix project to? (7)

Answer 4

• Brainstem
• Amyglada
• Hypothalamas
• Thalamus
• Anterior Cingulate Cortex
• Insula
• Somatosensory Cortices

Question 5

What are the 2 systems that the cortical represenation of pain been divided into?

Answer 5

Lateral pain system and medial pain system

Question 6

Which signals transfer up the pain matrix when stimulated?

Answer 6

Peripheral Nociceptors

Question 7

Which cortical representation of pain stimulus is this?

Recieves location and intensity of tissue damage or potential tissue damage

Answer 7

Lateral Pain System

Question 8

Which cortical representation of pain stimulus is this?

Affective and cognitive responses to the signals

Answer 8

Medial Pain System

Question 9

Name the structures of the lateral nociceptive system (3)

Answer 9

• Somatosensory cortex
• ventral posterolateral and ventral postermedial nuclei

Question 10

Name the structures of the medial nociceptive system (11)

Answer 10

• Insula
• Cingulate Cortex
• Prefrontal
• Parietal Cortex
• Amygdala
• Ventral Striatum of the Basal Ganglia
• Hypothalamus
• Intralaminar nuclei
• Periaqueductal gray
• Reticular formation
• Ventral Medulla

Question 11

The discriminative aspect of understanding pain is what?

Answer 11

Ability to localize the site, timing, and intensity of tissue damage or potential damage

Question 12

What is the discriminative aspect of pain processed by?

Answer 12

Travels the spinothalamic tract and is processed in the somatosensory cortex via the lateral pain system

Question 13

What is the motivational-affective aspect of the pain experience?

Answer 13

Effects of pain experience on emotions and behavior

Question 14

How the is the motivational-affective aspect processed?

Answer 14

Travels in the spinolimbic and spinoreticular tracts and then to emotional system

Question 15

What is the cognitive-evaluative aspect of the pain experience?

Answer 15

The meaning that the person assigns to the pain

Question 16

Does the pain matrix generate a top-down or down-top response to nociceptive signals that regulate affecrent nociceptive signals?

Answer 16

Top-down

Question 17

What is the following a defintion of?

The top-down inhibition of pain signals

Answer 17

Antinociception

Question 18

What is the following a defintion of?

The top-down amplification of pain signals

Answer 18

Pronociception

Question 19

What type of pain is this?

• Serves as a warning system and serves to protect from tissue damage
• Lasts for a short period of time and resolves after the noxious stimulus is removed or the tissue injury heals

Answer 19

Acute Pain

Question 20

What is acute pain detected by?

Answer 20

Sharp localizing pain, dull throbbing pain

Question 21

What are the 3 types of noxious stimuli?

Answer 21

• Mechanical
• Thermal
• Chemical

Question 22

What is the following a defintion of?

• First neurons to be activated
• Primary afferents as the noxious stimulus creates potentials that will eventually synapse in the dorsal horn of the spinal cord before making their way to the brain

Answer 22

Nociceptors

Question 23

Which nociceptor fiber is this?

• Fast and myelinated
• First to recognize and localize pain
• Activated by mechanical and thermal stimulation

Answer 23

A(delta) fiber

Question 24

What is the following a defintion of?

• Slow and myelinated
• Signals are diffuse and secondary
• activated by chemical reaction

Answer 24

C Fibers

Question 25

# What is the following a defintion of? - General sensory fibers - Invovled in pain modulation

Answer 25

A(beta) fibers

Question 26

How do nociception signals make their way to the spinal cord?

Answer 26

Via the dorsal root and into the dorsal horn

Question 27

When the A(gamma) axons enter the cord and branch to the levels of the spinal cord where do they go?

Answer 27

They enter the spinal cord through the dorsolateral tract before entering and terminating in the dorsal horn

Question 28

# What are the following characteristics of? - Synapse with A(gamma) and C fibers - Encode only for pain stimulti and project to higher centers

Answer 28

Nociceptive-Specific cells

Question 29

# What are the following characteristics of? - Recieve dynamic input from all types of sensory fibers - Can encode for a wide range of painful and nonpainful stimuli

Answer 29

Wide Dynamic Range Fibers

Question 30

# What area of the dorsal horn is this? Where the processing of nociceptive information can be altered by abnormal neural activity or by tissue injury

Answer 30

Laminae I, II, and V

Question 31

# What state of sensory processing in the dorsal horn is this? Signals resulting from stimuli are accurate

Answer 31

Normal state

Question 32

# What state of sensory processing in the dorsal horn is this? Touch, pressure, and vibration information is transmitted normally but nociceptive impulses are inhibited

Answer 32

Suppressed State

Question 33

# What state of sensory processing in the dorsal horn is this? Changes in the quantities and types of neurotransmitters and receptors produce painful response to A(beta), A(delta), and C activity

Answer 33

Sensitized State

Question 34

# What is the following a defintion of? Sensitized state in which neurons within the central nociceptive pathways exhibit elevated responses to incoming nociceptive and non-nociceptive stimuli

Answer 34

Central Sensitization

Question 35

Following an acute injury central sensitization is triggered by what?

Answer 35

Peripheral sensitization in nonciceptive afferents

Question 36

When does central sensitization occur?

Answer 36

In acute pain and chornic pain

Question 37

Where do axons in the nociceptive-specific cells and wide dynamic neurons decussate?

Answer 37

In the anterior white commisure of the spinal cord

Question 38

Where do axons in the nociceptive-specific cells and wide dynamic neurons ascend?

Answer 38

In the anterolateral system

Question 39

What does the anterolateral system consist of?

Answer 39

Fibers carrying pain and temperature from the spinal cord to the thalamus and brainstem

Question 40

# What is the following a definiton of? Persistent pain that has been identified as pain that persists past the normal time of tissue healing

Answer 40

Chronic Pain

Question 41

# Are the following charactersitics of primary or secondary chronic pain? - orignates independently of other conditions and is considered a disease - exists in the absence of tissue damage and has no beneficial biologic function - central sensitization intiated by gain of function in central nocicepetive pathways resulting in increased pain perception in the absence of tissue damage

Answer 41

Primary chronic pain

Question 42

What causes primary chronic pain to occur?

Answer 42

Gain of function in the central nociceptive system

Question 43

# Are the following charactersitics of primary or secondary chronic pain? - Pain that arises as a consequence of another medical condition - Nociceptive pain arises from stimulation of nociceptors; gain of function in central nociceptive pathways may be present - neuropathic chronic pain arises from damage to somatosensory system & nociceptors are not stimulated

Answer 43

Secondary Chronic Pain

Question 44

# What is the following a defintion of? Phenomenon of pain that is percieved as coming from an area of the body that is not directly innervated by the neurons exposed to the noxious stimulus

Answer 44

Referred Pain