Topic 5: Pain T3 Flashcards
True or False
Because there is strong evidence suggesting that pain can exist without tissue damage and this pain cannot be detected by current diagnostic methods they suggest that if people report pain in the same way as pain caused by tissue damage, it should be accepted as pain.
True
Pain can be classified in two ways.
What are they?
- Adaptive
2. Maladaptive
This type of pain is valuable because it serves as an early warning system of potential injury from a damaging stimulus.
Adaptive pain
Pain that persists and becomes even more intense after healing is apparently complete.
Maladaptive pain
A sensation associated with the detection of potentially tissue-damaging noxious stimuli. Also an adaptive and protective early warning system to detect and minimize contact with damaging or noxious stimulus.
Nociceptive pain
Demands immediate attention and action (withdrawal reflex) and when engaged, the system overrules most other neural functions.
Nociceptive pain
Also pain is often associated with acute pain
True or False
In disease states, nociceptive pain may be protective.
True
Ex. Excessive use of an osteoarthritic joint because of complete pain relief could conceivably accelerate joint destruction; symptomatic treatment may be problematic in some settings.
Occurs in patients with peripheral neuropathy resulting from diverse conditions including diabetes mellitus, leprosy, syphilis, poliomyelitis, chronic alcoholism.
Charcot Arthropothy
Caused by activation of the immune system by tissue injury or infection and is also adaptive and protective.
Also, heightens pain sensitivity after tissue damage and assists in the healing by discouraging contact and movement.
Inflammatory Pain
Note: while adaptive, it still needs to be reduced in patients with ongoing inflammation, as with RA or in cases of severe or extensive injury.
This type of pain that is not protective (maladaptive pain) and results from abnormal functioning of the NS. Not a symptom of some disorder but a disease state of the NS and can occur after damage to the NS.
Pathological Pain
Can occur where there is no damage or inflammation (conditions that can evoke maladaptive pain include fibromyalgia, irritable bowel syndrome, tension type headache, temperomandibular joint disease (TMD), interstitial cystitis) and other syndromes in which there exists substantial pain but no noxious stimulus and no, or minimal, peripheral inflammatory pathology.
Pathological Pain
What is the difference between inflammatory and pathological Pain?
Inflammatory pain is a hypersensitivity in reaction to a defined peripheral pathology, whereas pathological pain is the result of altered neural processing
True or False
Nociceptive pain can lead to and co-exist with neuropathic pain
True
The study of changes in organisms caused by modification of gene expression (phenotype) rather than alteration of genetic code itself (genotype). The phenotype is how genetic and environmental influences come together to create an organisms physical appearance and behaviour.
Epigenetics
A-Delta and C-PMN Nociceptors
Review Page 9
A cellular process responsible for movement of mitochondria, lipids, synaptic vesicles, proteins, and organelles to and from a multipolar neuron’s cell body (soma), through the cytoplasm of its axon.
Axoplasmic transport AKA Axonal Transport
Denotes a movement of molecules/organelles outward, from the soma to the synapse of a multipolar neuron
Anterograde Transport
Is movement of molecules/organelles inward, away from the synapse or plasma membrane toward the multipolar soma
Retrograde Transport
True or False
C fibres nociceptors are polymodal, detecting thermal, mechanical and chemical stimuli and a C-Fibre axon reflex is a local reflex arc that ONLY involves the distal/peripheral part of the neuron.
True
Occur when a nerve ending is depolarized by local factors (irritation, pressure, other chemical signals) triggering an AP that travels anterograde along the axon to a branch point. There the AP propagates down another branch and cause the release of various chemicals.
Axon Reflexes
In other words: in a unipolar C-Fibre the AP travels anterograde to where the axon branches. The AP then travels retrograde to the ends of the collateral branches. At the same time there is an anterograde AP travelling toward the CNS.
A release of this substance from the proximal end of the 1st order neuron contributes to the transmission of the AP to the 2nd order neuron of the pain pathway
Substance P or Glutamate
Small protein hormones that have many normal cell functions and regulate cells involved in non-specific and immune responses.
Cytokines
A group of organic compounds (found in high concentration in meat and meat products, especially internal organs such as liver and kidney; in general plant-based diets are low in these.
Purines
Any group of compounds derived from unsaturated fatty-acids, are extremely potent mediators of immediate hypersensitivity reactions and inflammation, producing smooth muscle contraction especially bronchoconstriction, migration of leukocytes of areas of inflammation.
Leukotrines
THIS Monitors algogenic substances released into the ECF when cells are injured or destroyed.
C-Fibres
A diffuse redness of the skin extending beyond the local reaction of an irritant
Flare
A small area of edema of skin
Wheal
The axon reflex results in
Allodynia, pain from a normal non-noxious stimulus
Spontaneous pain
Secondary hyperalgesia which develops in the undamaged, unstimulated region.
The often used term for an increasing response and expansion receptive fields to repeated input from C-Fibers
This results in enhanced CNS excitability and sensitization increases due to repeated or prolonged application of noxious stimuli (hyperalgesia) and non-noxious stimuli (allodynia)
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