W9 Physiology and Pathophysiology of Pain

Question 1

-rapidly conducting, low stimulus threshold
-light touch, vibration, or movement of hairs

Answer 1

A(beta)

Question 2

-intermediate velocity - sharp, intense pain
-cold, heat, and high-intensity mechanical stimuli

Answer 2

A(delta)

Question 3

-slow conducting - dull, burning pain
-polymodal nociceptors: heat, warmth, intense mechanical stimuli, or chemical irritants
-some are silent (sleeping fibers) but become responsive during inflammation

Answer 3

C

Question 4

dorsal horn of the spinal cord uses what neurotransmitters

Answer 4

glutamate
Co-transmitters include substance P and cGRP

Question 5

visceral pain is mediated by both what type of nerve fibers

Answer 5

both sympathetic and parasympathetic afferent nerve fibers

Question 6

visceral pain is typically linked to what

Answer 6

ischemia, inflammation, smooth muscle spasms and distention

Question 7

what amplifies signals by increasing sensitivity of nerve endings to stimuli through direct stimulation, altering neural membrane thresholds to stimuli and by modifying the environment of the neural receptive fibers

Answer 7

inflammatory cytokines

Question 8

what includes Beta-endorphins, enkephalins, and dynorphins
-alters mood and reduce emotional response to pain
-enhance descending inhibitory actions, inhibit release of pain neurotransmitters from pre-synaptic neurons, and hyperpolarize post synaptic neurons

Answer 8

opioids

Question 9

what results in increased K+ conductance and decrease ca2+ conductance and acts via what

Answer 9

norepinephrine acts via alpha 2 recptors

Question 10

what are 5 opioid receptors in the body

Answer 10

-brain
-brainstem
-spinal cord
-peripheral neurons
-intestine

Question 11

what do endocannabinoids do

Answer 11

lipid metabolites that play a supportive role in homeostatis in general

Question 12

what are central inhibitors of pain

Answer 12

NRM and NRPG

Question 13

what is hyperalgesia

Answer 13

increased sensitivity to pain

Question 14

what is central sensitization

Answer 14

enhanced response to same stimuli w repetitive, high intensity simulation (can be short or long term)

Question 15

what receptor blockade prevents induction and maintenance of central sensitization

Answer 15

NMDA

Question 16

activation fo what brain parts (3) produce autonomic responses

Answer 16

superior colliculus, hypothalamic, medial thalamic nuclei produce autonomic responses

Question 17

how does NSAIDS work

Answer 17

anti-inflammatory action by inhibiting production of prostaglandins

Question 18

how does corticosteroids work

Answer 18

decrease release of inflammatory mediators and inhibition of pro inflammatory gene expression

Question 19

acetaminophen

Answer 19

little anti-inflammatory action but analgesic (relieve pain) and antipyretic (reduce pain) like aspirin

Question 20

what is COX1, COX2

Answer 20

targets for anti-inflammatory drugs

Question 21

what are pain receptors

Answer 21

nociceptors

Question 22

modulation of pain is attributed in part to the release of what

Answer 22

endogenous opioids

Question 23

what are descending pathways that are part of the intrinsic modulation of pain

Answer 23

NRM and NRPG neural pathways

Question 24

altered gene expression in neural pathways results in increased sensitivity to pain can characterize what kind of pain

Answer 24

chronic pain

Question 25

inhibition in post-synaptic neurons in the pain pathway is mediated by hyperpolarization or hyperpolarization

Answer 25

hyperporlarization

Question 26

drugs that inhibit COX-2 enzyme activity means a decreased production in what

Answer 26

prostaglandins

Question 27

cannabinoid CBD reduces what (2)

Answer 27

pain and inflammation