Week 5 Flashcards

1
Q

What is neuropathic pain?

A

Caused by damage or disease affecting the nervous system

Described as shooting or burning pain

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2
Q

What are symptoms of Neuropathic pain?

A

Shooting and burning pain

Tingling and numbness

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3
Q

What occurs after injury?

A

Lose function/ motor function

Lose sensory innervation

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4
Q

Where is Dorsal root ganglion located?

A

Spinal column and level lumbar 4,5,6

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5
Q

What do you find peripherally?

A

Spinal nerve and contribute to sub-sciatic nerve

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6
Q

When is neuropathic pain common?

A

After partial injuries

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7
Q

What is the role of Dorsal root Ganglia?

A

Modulation of peripheral and central sensory processing that include:
Inflammation
Somatic pain
Development of neuropathic pain

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8
Q

How do you partially injure a nerve?

A

Ligate/ cut some sciatic nerve

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9
Q

What is chronic construction injury?

A

Putting ligatures around the nerve
Cause inflammatory action
Constricts it

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10
Q

What is chronic constriction injury model?

A

Left sciatic nerve of a rat is ligated causing inflammation and swelling
Model was evaluated via paw mechanical withdrawal latency and DRG immunohistochemistry

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11
Q

What is the features of chronic constriction injury model?

A
  1. Investigate both pathophysiology and potential thereapeutic agent for treatment of neuropathic pain
  2. Behavioural signs of spontaneous pain can be observed e.g. limping of hind paw
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12
Q

What is the symptoms of chronic neuropathic pain?

A

Spontaneous pain
Paraesthesia
Allodynia
Hyperalgesia

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13
Q

What is sciatic nerve injury?

A

Loss of movement

Lack of sensation

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14
Q

What does sciatic nerve Contain?

A

Motor and sensory axon

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15
Q

What is peripheral sensitisation?

A

Increased sensitivity to afferent nerve stimuli

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16
Q

What is central sensitisation?

A

Condition of the nervous system that is associated with development and maintenance of chronic pain

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17
Q

What happens to the distal portion of nerve after an injury?

A

The axons will die

It will be cut off from the cell body

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18
Q

What is a neuroma?

A

A collection of growth cones

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19
Q

What are the changes in the peripheral nerve?

A

Distal portions of the axon die

Proximal portions attempt to regrow in the direction of target

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20
Q

What happens when axon regrowth is unsuccessful?

A

Formation of a focal tangle of proliferated growth comes
Together with massive Schwann cell proliferation
In-migration of inflammatory cells forming a neurons

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21
Q

What is the first active inflammatory response?

A

Infiltration of the neutrophils

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22
Q

What would be an inflammatory mediator that would cause peripheral sensitisation?

A

Prostaglandin
Histamine
Protons/ATP

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23
Q

Why is inflammatory response required?

A

Tissue to heal
Bring more blood into the region of injury
Take away toxin substances

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24
Q

What is required for maintenance for functional recovery?

A

Chenophlayphin interleukin 2

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25
Q

What is the role of clonidate?

A

Reduction in hypersensitivity and repair

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26
Q

What is wallerian (orthograde) degeneration?

A

Active process of degeneration that results when a nerve fibre is cut or crushed and the part of axon distal to injury degenerates
No metabolic support of that portion

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27
Q

What happens when degeneration occurs?

A

The myelin sheath breaks down

28
Q

What does wallerian degeneration show?

A

Mouse can have axons that are active

Able to propagate action potential up to 30 days

29
Q

Axonal degeneration can occur before what other events?

A

Myelin sheath breakdown

Accumulation and axonal regeneration

30
Q

What is maintaining the axon?

A

Peripheral tissue

31
Q

Retrograde degeneration

A

Loss of trophic support from peripheral target tissue

32
Q

What are the retrograde degeneration/changes?

A

Loss of trophic support from peripheral target
Signal from degenerating axons
Within hours, soma swells, reorganisation of nucleus and RER
Synaptic transmission proteins goes down
Growth associated proteins go up to enable regeneration
Growth cones of neurites elongate

33
Q

What does C fibre show?

A

Sprouting of intact axons going into a region they do not normally convey signals from

34
Q

What can damages axons do and what can intact axons do?

A

Damaged axons go to where it should

Intact axons can sprout and take over function of denervated area

35
Q

What stimulates sprouting?

A

Nerve growth factor

36
Q

What are all nociceptors cells dependent on?

A

NGF

37
Q

What receptors does NGF act through?

A

Neurotrophin receptors

Neurotrophin receptor kinase A

38
Q

What is an high affinity receptor?

A

TRAK A

39
Q

What is an accessory receptor ?

A

P75

40
Q

What happens if we block NGDF treatment?

A

The sprouting does. It occur putting more NGF into system

41
Q

Physiologically, where does NGF go up in?

A

Denervated skin in target tissue

42
Q

What is C-fos?

A

Immediate early gene that’s activated quickly at the transcription of that factor

43
Q

What is Paraesthesia?

A

Pins and needles

44
Q

What is Hyperpathia?

A

Someone in chronic pain continually

45
Q

What is Rhizotomy?

A

Surgical procedure that severe nerve roots in spinal cord

46
Q

What is spontaneous activity generated by?

A

Cell body

Neuroma

47
Q

What are neuroma?

A

Mechanosensitive
Pressing a neuroma causes action potential to go from area of injury
Originated from DRG

48
Q

What does 20% of the injured muscle afferent have?

A

Large diameter myelinated fibres

No cutaneous afferent firing

49
Q

What is peripheral nerve spared injury prep?

A
Cut some of them and leave others intact 
The area will still be innervating 
Detect signal 
Record from one site of injury
Determine what’s active or not
50
Q

What are low level C fibres essential for?

A

Central sensitisation

51
Q

Where does inputs from C fibres constantly go into?

A

Spinal cord
Lead to alterations in networks of spinal cord
Plasticity in spinal cord - easier to excite those second order neurons

52
Q

What factors are released centrally by C fibres that elicit central sensitisation

A

Peptide

Trophic factors

53
Q

What is polyneuropathy?

A

Damage or disease affecting peripheral nerves in roughly the same area in both sides of body

54
Q

What increases in the neuroma?

A

NaV1.3

55
Q

What are important for bursting patterns?

A

NaV1.8

56
Q

What regulates NaV1.3?

A

GDNF

57
Q

What is asphalting connections?

A

Demyleinated regions can send action potential ultimately down both the intact as well as injured afferent

58
Q

What is crossed after-discharge?

A

Neurotransmitters at the dorsal root ganglion May affect the function of intact axons, cells firing

59
Q

What goes up around the cell body?

A

Potassium levels

Impact on threshold of cell

60
Q

What is the consequence of down regulation of potassium channels?

A

Make cells more sensitive

61
Q

What causes neuropathetic pain type syndrome?

A

siRNA knock down

62
Q

What is Chromatolysis?

A

Packets of RER in normal neurons (missal substance) that becomes more diffused ultimately within an injury
Messenger RNA tend to go more peripherally around cell

63
Q

What causes more cell death?

A

Lesion close to the cell bodies

64
Q

Injury

A

Cell side changes and generally gets smaller

65
Q

What is stereology?

A

Assessing particularly small units, more or less randomly in different segments but adding all of the segments together in each of sample

66
Q

What happens if EPAC is knocked out?

A

There is less Allodynia response through injury