L4 - pain Flashcards

1
Q

pain meaning

A

bad experience associated with tissue damage

-combo of sensory and emotional components

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2
Q

nocieption meaning

A

sensory component of pain without emotional component

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3
Q

how is pain detected

A

sensory receptors in the skin - nerve endings

  • activated by intense stimuli that is enough to cause tissue damage
  • AP generated
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4
Q

two kinds fo nociceptor

A

-mechanical
o
-polymodal

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5
Q

what is mechanicalnocieptor

A

activated by strong force in skin like cut

-leads to sharp pain

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6
Q

what is polymodal nocieptor

A

respond to many stimuli

  • EPSP is generated but once it reaches the threshold, the AP is generated and there is a dull, throbbing pain
  • pain causes by the chemical released by the damaged tissue
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7
Q

what fibre does mechanical nociceptor send the signal to

A

delta fibres - very fast

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8
Q

what fibres does the polymodel send the signal to

A

C fibres - unmyelinated, much slower

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9
Q

transmission of what sensory afferent nerves of sharp and dull pain

A

first - the sharp pain is transmitted through the delta fibres
second - then dull pain comes along when polymodal nociceptor is also activated

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10
Q

pathway of the primary afferent fibres into CNS

A

the signal is transmitted through the C fibres then spilt up into B fibres into substantia gelatinosa and C fibres into the brain

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11
Q

what section of the dorsal horn does the input from AB fibres go to

A

III-V sections

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12
Q

what section of the dorsal horn does the input from ASand C fibres go to

A

cutaneous I-II

viscera I, V X

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13
Q

what makes up the vast majority of the dorsal horn neurons

A

interneurons

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14
Q

are majority of interneurons are inhibitory or excitatory

A

inhibtiory so when the pain signal arrive here in the dorsal horn, it has to overcome in hibition to be sent to brain
- refer to gate their of the pain

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15
Q

what is the gate theory of pain

A

there is a gatekeeping neurone which prevents the signal from going to the brain

  • but there is an inhibitory neurone that can be activated. Then it stops action of the gatekeeping neurone
  • so the “gate” is open and sent to the brain
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16
Q

how to close the gate for the pain signal

A

stimulating mechanoreceptors like rubbing the injuired area.

  • this activates the AB fibres
  • send the signal to the spinal cord to the gate keeping neurone
  • -the gate is now closed, so the pain signal cant go to the brain
  • so relieving the pain
17
Q

pathway through the spinal cord for pain

A

spinothalamic pathway

  • perceived at subcortical level
  • localised at cortical level
18
Q

descending pathway for pain down the spinal cord

A

through the brainstem

  • releases chemicals like Nadr, ankephalin
  • to close the spinal gate -
19
Q

what happens during normal physio pain

A

sensation of pain is equal to the afferent input

20
Q

what happends during persistent pain

A

increases sensitivity to pain when oen is injuired

- peripheral and central sensitisation

21
Q

peripheral mechanism for increased sensitivity to pain

A

-area injuried so AP generated
- releases substance P and CGRP from nerve ending >
redness, swelling, >
immune cell migration and activation > release prostagladins, H+, cytokines> increases sensitivity and the area heats up >
activates ploymodal receptor

22
Q

why is it more painful to touch the injured

A

increases sensitivity due to lower threshold for AP to reacg

23
Q

what is primary hyperalgesia

A

increased pain sensitivity directly in damaged tissue

eg of peripheral sensitisation

24
Q

what is secondary hyper glasia

A

increased pain sensitivity distant from site of injury

- eg of central sensitisation

25
Q

mechanism of central sensitiation of pain

A

in primary afferent neuron:

glu released to bind to AMPA receptor > removes Mg channel blocker on NMDA>
glu bind to NMDA,and pore open up for Ca influx>
Substance P also released to bind to NK-1>
depolaristion in second order neuron