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Physiology 2 > Somatosensation II > Flashcards

Somatosensation II Flashcards

1
Q

What are the two aspects of pain?

A

Sensory and affective

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2
Q

What is sensory pain?

A

Location, intensity, duration and quality

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3
Q

What is affective pain?

A

Unpleasantness (painfulness) or effects on arousal, mood and behaviour

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4
Q

What are nociceptors?

A

Neurons specialised for detection of painful stimuli

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5
Q

How does the skin differentiate between nociceptive and non-nociceptive stimuli?

A

Thermoreceptors respond above normal skin temp at a level rate, whereas nociceptors gradually increase beyond the thermoreceptor level

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6
Q

What is the difference between A delta and C fibres?

A

A delta fibres conduct quicker

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7
Q

What is the TRPV1 receptor involved in?

A

The transduction of noxious heat

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8
Q

How do the TRPV1 receptors work?

A

Noxious heat opens the channel, which allows calcium and sodium ions to depolarise it

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9
Q

How is nociceptive pain maintained after injury?

A

Inflammatory soup of cytokines, prostaglandins and small signalling molecules keep the depolarisation going

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10
Q

What is hyperalgesia?

A

Increased pain sensitivity

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11
Q

What is allodynia?

A

Painful response to normally non-painful stimuli

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12
Q

What does substance P cause?

A

Stimulation of mast cells and vasodilation

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13
Q

Where are dorsal horn interneurons located?

A

Superficial and deep layers of the dorsal horn

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14
Q

Where do the dorsal neurones get their synaptic input from?

A

C and A delta fibres

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15
Q

What does multimodal mean?

A

Receive convergent nociceptive and non-nociceptive inputs

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16
Q

What causes referred pain?

A

Dorsal horn interneurons receiving convergent inputs from visceral afferents

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17
Q

Where do dorsal horn interneurons cross and ascend?

A

Anterolateral white matter

18
Q

Where does the STT project to (and via?)

A

Primary somatosensory cortex

19
Q

Do the STT and DCML axons converge?

A

No because the pathways are parallel

20
Q

What is the primary somatosensory cortex necessary for?

A

Localisation of pain

21
Q

What does stimulation of the S1 give rise to?

A

Referred tactile sensations (not painful)

22
Q

What are the two systems involved in central pain processing?

A

Lateral and medial systems

23
Q

Where do the two central pain processing systems diverge

A

The level of the thalamus

24
Q

Which system is the lateral system in parallel with?

A

DCML

25
Q

Which type of pain is the lateral system involved in?

A

Sensory- discriminative

26
Q

Which part of the cortex does the lateral system arise from?

A

Primary and secondary somatosensory

27
Q

Where does the lateral system project via?

A

Specific somatosensory thalamic nuclei

28
Q

Where does the medial system arise from?

A

Anterior cingulate and insular cortex

29
Q

Which type of pain is the medial system involved in?

A

Affective- motivational

30
Q

Where does the medial system project to?

A

Different cortical areas via non-specific midline thalamic nuclei

31
Q

How do we know endogenous opioids are produced in the body?

A

Opium receptors in the body

32
Q

What is periaquiductal grey?

A

Major pain sensory cortex and the site of neurons that contain endogenous opioids

33
Q

Where is the main source of enkephalins?

A

Periaquiductal grey

34
Q

What are enkephalins mainly associated with?

A

Particular Neuro-modulatory transmitter substances

35
Q

What do enkephalins integrate with?

A

Opiate containing nuclei that project back down the dorsal horn of the spinal cord

36
Q

How do enkephalins produce an analgesiac effect?

A

Act on raphe nuclei which project into the spinal cord to release enkephalins that presynaptically inhibit incoming C fibres

37
Q

What are the types of pain treatment used as neurophysiological response to tissue damage?

A

NSAIDs and opiate drugs

38
Q

What drugs (/class of drugs) is used to treat chronic pain?

A

Antidepressants at a lower dose and without a diagnosis of clinical depression

39
Q

What is the definition of chronic pain?

A

Pain for >3 months with a high prevalence

40
Q

What may chronic pain be due to?

A

Nerve damage from prior injury - neuropathic pain

41
Q

How do you treat intractable pain as a last resort?

A

Anterior cingulotomy

42
Q

What is an anterior cingulotomy?

A

Targeted lesion to disconnect anterior cingulate cortex on both sides

Physiology 2 (38 decks)

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