Ch. 19 - Pain (neurosurgical management)

Question 1

What are the 3 major components of pain?

Answer 1

Sensory - discriminative
Motivational - affective
Cognitive - evaluative

Question 2

Sensory-discriminative component of pain

Answer 2

Spatial, temporal, magnitude aspects of pain

Question 3

Pathway of sensory-discriminative component of pain

Answer 3

Neospinothalamic projections to ventrobasal thalamus to somatosensory cortex

Question 4

Difference between A-delta and C fibers

Answer 4

A-delta: myelinated and fast

C: unmyelinated and slow

Question 5

Cognitive-evaluative component of pain

Answer 5

Person’s understanding of pain as it regards to their intellectual, social, and cultural background

Question 6

CNS regions involved in motivational-affective component of pain

Answer 6

Brainstem reticular formation and limbic system

Question 7

Motivational-affective component of pain

Answer 7

Aversive quality of pain

Question 8

Gate control theory of pain

Answer 8

Neural mechanisms in dorsal column of spinal cord act like a gate, which can either increase or decrease the flow of nerve impulses from periphery to CNS

Question 9

Neurosurgical procedures available for pain modulation

Answer 9

Nerve section, spinal cordotomy (section of lateral spinothalamic tract), spinal cord stimulation, sympathectomy, intracerebral procedures, deep brain stimulation (LAST RESORT)