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biochem exam 5 > Pain and anesthesia > Flashcards

Pain and anesthesia Flashcards

1
Q

What is pain?

A

an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage

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2
Q

What is nociception?

A

the unconscious activity induced by a harmful stimulus applied to sense receptors

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3
Q

What is a noxious stimuli?

A
  • harmful, poisonous or very unpleasant stimuli
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4
Q

What is hyperalgesia?

A

an exaggerated response to a noxious stimulus

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5
Q

What is allodynia?

A

a sensation of pain in response to a normally innocuous stimulus

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6
Q

What is sensitization?

A

when intense, repeated, or prolonged stimuli are applied to damaged or inflamed tissues, the threshold for activating primary afferent nociceptors is lowered, and the frequency of firing is higher for all stimulus intensities

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7
Q

hyperalgesia and allodynia signify increased sensitivity of _________________________________

A

nociceptive afferent fibers

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8
Q

What contributes to sensitization?

A

inflammatory mediators such as bradykinin (BK), nerve-growth factor (NGF), some prostaglandins (PGs), and leukotrienes (LTs)

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9
Q

What is the inability or reduced ability to feel pain without
loss of consciousness or other sensations?

A

analgesia

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10
Q

What are substances that reduce the ability to feel pain?

A

Analgesics

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11
Q

What is anesthesia and an anesthetic?

A

Anesthesia
* insensitivity to pain
Anesthetics
* substances that produce a general insensitivity to pain

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12
Q

How do general anesthetics work?

A

depress the CNS to a sufficient degree to permit the performance of surgery and unpleasant procedures

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13
Q

How do local anesthetics work?

A

substance that when in contact with a nerve trunk can cause both sensory and motor paralysis in the area innervated

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14
Q

What are mechanoreceptors?

A
  • mediate responses to touch and pressure
  • mechanical nociceptors respond to strong pressure (e.g. from a sharp object)
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15
Q

What are thermoreceptors?

A

detect the sensations of warmth and cold

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16
Q

What are chemoreceptors?

A

stimulated by a change in the chemical composition of the local environment (taste, smell, plasma levels of nutrients, etc.)

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17
Q

What are acid-sensing ion channel (ASIC) receptors activated by?

A

pH changes

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18
Q

What are transient receptor potential (TRP) channels activated by?

A

TRPV1 - intense heat, acids, and chemicals such as capsaicin

TRPA1 - noxious mechanical, cold, or chemical stimuli

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19
Q

ATP acts on ______________ receptors

A

purinergic

20
Q

Nerve growth factor acts on ________________________ receptors?

A

tyrosine receptor kinase A (TrkA)

21
Q

ATP signaling on ionotropic receptors is very similar to ______________

A

acetylcholine (ACh)

22
Q

What are agonists to the G-protein couples receptors?

A

bradykinin
histamine
prostaglandins
serotonin (5-HT)
substance P
CGRP

23
Q

What are the intermediate signaling molecules (pain)?

A
  • adenosine triphosphate (ATP)
  • bradykinin
  • histamine
  • prostaglandins
  • serotonin (5-hydroxytryptamine or 5HT)
  • substance P
  • calcitonin gene-related protein (CGRP)
  • nerve growth factor
24
Q

What are immediate changes in neuronal responsiveness?

A

changes in membrane potential produced by altered calcium concentrations

25
Q

What are prolonged changes in neuronal responsiveness?

A

produced by changes in gene expression

26
Q

Where are the cell bodies located of the primary sensory afferent nerves?

A

cell bodies located in the dorsal root ganglia within the vertebral foramina

27
Q

fibers from nociceptors and thermoreceptors synapse on ________________________

A

neurons in the dorsal horn of the spinal cord
* or the trigeminal ganglion if coming from the head

28
Q

Ventrolateral spinothalamic tract mediates…

A

pain and temperature

29
Q

Most nociceptors are…

A

unmyelinated

30
Q

Somatosensory neurons are located in…

A

peripheral ganglia (trigeminal and dorsal root ganglia)

31
Q

spinothalamic tract axons ascend to several regions of the

A

thalamus

32
Q

Noxious stimuli activate the sensitive peripheral ending of the primary afferent nociceptor by the process of __________

A

transduction

33
Q

visceral sensation travels along the same central pathways as somatic sensation in the…

A

spinothalamic tracts and thalamic radiations

34
Q

What causes referred pain?

A

cortical receiving areas for visceral sensation are intermixed with the somatic receiving areas

35
Q

What explains why you use a TENS (transcutaneous electrical nerve stimulation) for pain relief?

A

transmission in nociceptive pathways can be interrupted by actions within the dorsal horn of the spinal cord at the site of sensory afferent termination

36
Q

interneurons in the superficial regions of the dorsal horn contain…

A

endogenous opioid peptides

37
Q

Enkephalin (ENK)-containing interneurons mediate their effects via…

A

opioid receptors on the terminals of nociceptive afferent fibers and on dendrites of dorsal horn neurons

38
Q

What are some examples of opioid analgesics?

A
  • morphine
  • codeine
  • hydrocodone
  • oxycodone
  • fentanyl
39
Q

How do opioids work to modulate pain?

A
  • activate opioid receptors in neurons
  • inhibit Ca channels (reduced neurotransmitter secretion)
  • stimulates K channels (hyperpolarize the cell; reduced action potential propogation)
40
Q

What are some non-opioid analgesics?

A
  • aspirin
  • acetaminophen
41
Q

What are some non-steroidal anti-inflammatory drugs (NSAIDs)?

A
  • ibuprofen
  • naproxen
  • ketorolac
  • celecoxib
42
Q

What are some examples of local anesthetics?

A
  • articaine
  • bupivacaine
  • cocaine
  • lidocaine
  • mepivacaine
  • prilocaine
43
Q

What are some examples of inhalational anesthetics?

A
  • halothane
  • isoflurane
  • nitrous oxide
44
Q

What are some examples of parenteral (intravenous) anesthetics?

A
  • propofol
  • thiopental
  • ketamine
  • midazolam
45
Q

How do most general anesthetics work?

A

increase the sensitivity of the GABA receptor to gamma-aminobutyric acid

46
Q

How do most inhalational anesthetics work?

A

enhance the capacity of glycine to activate glycine receptors

47
Q

How do halogenated inhalational anesthetics work?

A

activate some K channels

biochem exam 5 (12 decks)

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