Topic 5: Pain T3

Question 1

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.

Answer 1

True

Question 2

Pain can be classified in two ways.

What are they?

Answer 2

1. Adaptive

2. Maladaptive

Question 3

This type of pain is valuable because it serves as an early warning system of potential injury from a damaging stimulus.

Answer 3

Adaptive pain

Question 4

Pain that persists and becomes even more intense after healing is apparently complete.

Answer 4

Maladaptive pain

Question 5

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.

Answer 5

Nociceptive pain

Question 6

Demands immediate attention and action (withdrawal reflex) and when engaged, the system overrules most other neural functions.

Answer 6

Nociceptive pain

Also pain is often associated with acute pain

Question 7

True or False

In disease states, nociceptive pain may be protective.

Answer 7

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.

Question 8

Occurs in patients with peripheral neuropathy resulting from diverse conditions including diabetes mellitus, leprosy, syphilis, poliomyelitis, chronic alcoholism.

Answer 8

Charcot Arthropothy

Question 9

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.

Answer 9

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.

Question 10

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.

Answer 10

Pathological Pain

Question 11

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.

Answer 11

Pathological Pain

Question 12

What is the difference between inflammatory and pathological Pain?

Answer 12

Inflammatory pain is a hypersensitivity in reaction to a defined peripheral pathology, whereas pathological pain is the result of altered neural processing

Question 13

True or False

Nociceptive pain can lead to and co-exist with neuropathic pain

Answer 13

True

Question 14

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.

Answer 14

Epigenetics

Question 15

A-Delta and C-PMN Nociceptors

Answer 15

Review Page 9

Question 16

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.

Answer 16

Axoplasmic transport AKA Axonal Transport

Question 17

Denotes a movement of molecules/organelles outward, from the soma to the synapse of a multipolar neuron

Answer 17

Anterograde Transport

Question 18

Is movement of molecules/organelles inward, away from the synapse or plasma membrane toward the multipolar soma

Answer 18

Retrograde Transport

Question 19

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.

Answer 19

True

Question 20

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.

Answer 20

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.

Question 21

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

Answer 21

Substance P or Glutamate

Question 22

Small protein hormones that have many normal cell functions and regulate cells involved in non-specific and immune responses.

Answer 22

Cytokines

Question 23

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.

Answer 23

Purines

Question 24

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.

Answer 24

Leukotrines

Question 25

THIS Monitors algogenic substances released into the ECF when cells are injured or destroyed.

Answer 25

C-Fibres

Question 26

A diffuse redness of the skin extending beyond the local reaction of an irritant

Answer 26

Flare

Question 27

A small area of edema of skin

Answer 27

Wheal

Question 28

The axon reflex results in

Answer 28

Allodynia, pain from a normal non-noxious stimulus

Spontaneous pain

Secondary hyperalgesia which develops in the undamaged, unstimulated region.

Question 29

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)

Answer 29

Windup