Medial pain system

Question 1

Nociception

Answer 1

Noxious or highly unpleasant stimulus within the PNS or CNS

Question 2

Pain

Answer 2

Emotion

-conscious experience associated with noxious stimuli

Question 3

Direct Anterior lateral pathway

Answer 3

Nociception
temperature
tactile sensations

Question 4

Neospinothalamic tract

Answer 4

Part of the anterior lateral pathway

• Nucleus found in laminae IV of dorsal horn
• synapse on VPL in thalamic nucleus
• project to primary somatosensory cortex

Question 5

Indirect anterior lateral pathways

Answer 5

Limbic/ autonomic/ endocrine and motor components of pain

Question 6

Posterior medial pathways

Answer 6

Visceral nociceptive information
arises in the gut to convey
-tmeperature
-pain
-irritation
-chemical changes
-stretch from visceral organs
Run with Vagus and sympathetic

Question 7

Paleospinothalamic

Answer 7

Synapse in the reticular formation

-end up in ACC and insular cortex

Question 8

Spinoreticular

Answer 8

Caudal RF
- sends projections back to IML
-regulates sympathetic NS
Rostral RF and locus coeruleus (LC)
- innervate paraventricular nucleus of hypothalamus and MITN

Question 9

Spinomesencephalic

Answer 9

Axons from dorsal horn and intermediate gray

• Has PAG neurons that regulate ANS
• signals to the amygdala
• send descending projections to inhibit pain sensation

Question 10

Referred Pain

Answer 10

Cross wiring in the dorsal horn with visceral nociceptive input- perceived as cutaneous pain from segmentally related dermatomes
-cause limbic activation

Question 11

Posterior midline myelotomy

Answer 11

performed to get rid of the source of pain

Question 12

Reticular formation

Answer 12

important for pain processing

• Raphe nucleus
• Locus ceruleus
• parabrachial area- referred pain
• nucleus gigantocellularis

Question 13

Nucleus Ambiguus

Answer 13

breathing and HR

Question 14

Gigantocellular RF

Answer 14

projects to sympathetic IML

Question 15

Medial pain system activates

Answer 15

Limbic system

Question 16

Locus coeruleus

Answer 16

Alert and print to significant events

primes neuroendocrine and limbic system

Question 17

MITN (Midline and intralaminar nucleus of thalamus

Answer 17

engages cortical areas involved in pain perception and reactions to it

Question 18

PAG

Answer 18

Direct control of ANS–> HR and BP as result of painful stimulus

Question 19

Limbic/autonomic activation

Answer 19

Involves ACC/ PAG and MCC

• ACC/PAG- unpleasantness of pain
• MCC- location of stimulus

Question 20

Rostral RF

Answer 20

Ascending info to forebrain centers

Question 21

Caudal RF

Answer 21

Response- transmitted to lower motor and autonomic centers

Question 22

PAG and RF

Answer 22

Regulate the ANS

-modify HR/BP and other sensory inputs in response to pain

Question 23

Learning and anticipation

Answer 23

Depends on connects with amygdala and thalamus

• Medial motor areas– SMA and CMA
• ACC also involved

Question 24

Nocifensive behavior

Answer 24

Pain avoidance
- Medial motor areas- SMA and CMA
-S1 stimulus
-S2 motor response
Anticipation of pain is a learning process

Noxious pain increase membrane excitability
-increases Ca++ removing Mg++ and creating a memory

Question 25

Pain empathy

Answer 25

activation of lateral nociceptive and medial pain systems

-evokes sympathy pain

Question 26

Pain inhibition

Answer 26

MCS

-provides pain relief by activating descending pain signaling pathways from ACC

Question 27

Upper CBL changes in pain management

Answer 27

increase pain tolerance

Question 28

Lower CBF changes in pain management

Answer 28

decreased unpleasantness