4 - Pain

Question 1

an unpleasant sensory and emotional experience associated with actual or potential tissue damage

Answer 1

pain

Question 2

with pain withdrawal reflex, sensory neuron goes through _ root ganglion
motor neuron travels though _ root

Answer 2

dorsal

ventral

Question 3

_ = the perception of pain

Answer 3

nociception

Question 4

nociceptors respond to extreme temps, mechanical and chemical stimuli
they are _ receptors (type)

Answer 4

free nerve endings

Question 5

the cells bodies of nociceptors are located in _ and _

Answer 5

spinal ganglia (body) and trigeminal ganglia (face)

Question 6

nociceptors _ adapt to stimuli

Answer 6

DO NOT

Question 7

continued stimulation of nociceptors _ threshold at which nociceptors respond, this is called _

Answer 7

decrease

sensitization

Question 8

A(delta) fibers
(are/not) myelinated
_ type of pain
_ stimuli

Answer 8

are
localized, sharp
mechanical/thermal
(Anitial - bee sting)

Question 9

C fibers
(are/not) myelinated
_ type of pain
_ stimuli

Answer 9

not
poorly localized, diffuse
mechanical, thermal, chemical

Question 10

3 neurotransmitters used for pain:

Answer 10

glutamate, substance P, CGRP

Question 11

NT are produced in _ and released _ or _

Answer 11

spinal ganglion

centrally (CNS) or peripherally (injury site)

Question 12

peripherally, NT lead to redness, swelling, and tenderness

they inc activation of nociceptors and _ threshold (sensitization)

Answer 12

decrease

Question 13

when “silent” nociceptors are activated, they _

Answer 13

expand receptive field area of painful stimulus

Question 14

activation of nociceptors results in opening on _ channels, leading to depolarization

Answer 14

Na+

Question 15

A(delta) and C fibers can be activated by heat:
_ - hot thermal stimulation
_ - cold thermal stimulation

Answer 15

TRPV1 (capsaicin)

TRPM8

Question 16

A(delta) and C fibers can ALSO be activated by _

Answer 16

mechanical stimulation

Question 17

A(delta) and C fibers can ALSO be activated by mechanical stimulation
-cannot be activated by _,

Answer 17

light touch

high threshold, only activated when potential for tissue damage

Question 18

C fibers are also activate by _

Answer 18

wide range of Chemicals

Question 19

chemicals that activate C fibers include:

Answer 19

external irritants and substances released during tissue damage by nociceptors and inflammation

Question 20

peripheral sensitization:
tissue damage->release of _,
these sensitize _

Answer 20

bradykinin & prostaglandins

peripheral nociceptors

Question 21

noxious stimulus is detected by nociceptor -> free nerve ending releases _ and _

Answer 21

substance P and CGRP

Question 22

substance P and CGRP stimulate _ cells to release histamine and bradykinin, which induce _ and further sensitization

Answer 22

mast, vasodilation

Question 23

heightened response to low-intensity painful stimulus (hot shower hurts)

Answer 23

hyperalgesia

Question 24

pain experienced with normally non-painful stimulus (water hitting your back)

Answer 24

allodynia

Question 25

when silent nociceptors are recruited, there is further amplification in posterior horn, _ temporal and spatial summation of incoming signal

Answer 25

increasing

Question 26

silent nociceptors only respond to molecules secreted by _

Answer 26

activated nociceptors

Question 27

synaptic targets in the spinal cord: | A(delta) and C fibers synapse with either _ or _

Answer 27

nociceptive-specific cells or Wide Dynamic Range (WDR)

Question 28

nociceptive specific cells synapse with _

Answer 28

only A(delta) and C fibers

Question 29

WDR cells synapse with _

Answer 29

ALL sensory fibers (including A(beta) nonpainful touch)

Question 30

the synapse in the _ is EXCITATORY

Answer 30

posterior horn

Question 31

AMPA and NMDA receptors of _

Answer 31

glutamate

Question 32

NK1 receptors of _

Answer 32

substance P

Question 33

CGRP receptors of _

Answer 33

CGRP

Question 34

Wind Up and Central Sensitization: | WDR cells fire in _ fashion, intensity determined by _

Answer 34

graded; frequency of C fiber signaling

Question 35

WDR amplify signal through _

Answer 35

windup

Question 36

windup is: chronic bombardment of C fibers in dorsal horn leads to _

Answer 36

increased kinase production

Question 37

inc kinase from windup causes: 1. _ of NMDA receptors 2. increased _ production 3. "_" is dorsal horn

Answer 37

upregulation glutamate sprouting

Question 38

chronic bombardment also leads to _ production in dorsal horn, which travels to periphery via _

Answer 38

substance P; C fibers

Question 39

substance P travels via C fibers to periphery to _ threshold and _ receptive fields

Answer 39

decrease; increase

Question 40

sensitization serves to _ pain signal to _ behavioral changes

Answer 40

amplify, evoke

Question 41

sensitization mechanisms can become maladaptive and lead to _

Answer 41

permanent changes in wiring

Question 42

pain modulation: descending inhibition - _ descending facilitation - _

Answer 42

mind/matter, need to be able to function | we don't want the pain to go away, it protects us

Question 43

Gate Control Theory of Pain 1. balance between nociceptive input (Adelta and C) and touch input (Abeta): rubbing painful area shifts input towards _ and away from _

Answer 43

touch (abeta) pain (Adelta and C)

Question 44

Gate Control Theory of Pain 2. inhibitory interneurons that synapse with WDR neurons in posterior horn: they are inhibited by _, excited by _

Answer 44

nociceptive input, touch input

Question 45

Gate Control Theory of Pain (2.) | Adelta and C -> inhibit inhibitory interneurons -> __

Answer 45

more signaling = pain

Question 46

Gate Control Theory of Pain (2.) | Abeta - > excite inhibitory interneurons -> __

Answer 46

less signaling = less pain

Question 47

descending influences on pain act as _

Answer 47

salience filter (how important is this pain)

Question 48

reticular formation: locus coeruleus produces Norepi and modulates _ response to pain

Answer 48

physiological

Question 49

Periaqueductal Gray (PAG) receives input from cortex and hypothalm and projects to superior colliculus to:

Answer 49

make you look where you feel the pain

Question 50

opiod receptors are found at _ levels of pain system

Answer 50

all

Question 51

opioid drugs influence _ pain processing

Answer 51

cortical

Question 52

opioid receptors are physiologically active by _ molecules that act as NT including: enkephalins, endorphins, dynorphins

Answer 52

endogenous (our body makes them)

Question 53

opioid receptors inhibit _ influx or facilitate _ efflux, hyperpolarizing the cell, less pain perceived

Answer 53

Ca++, K+

Question 54

morphine blocks _

Answer 54

wound healing

Question 55

chronic pain is experienced by chronic activation of nociceptors; therapy is to _

Answer 55

treat underlying inflammation

Question 56

chronic neuropathic pain arises with a lesion to somatosensory system and _

Answer 56

persists after the injury has healed (Herpes Zoster)

Question 57

spontaneous tingling

Answer 57

paresthesia

Question 58

burning, electric, shooting pain

Answer 58

dysesthesia

Question 59

increased pain to low intensity stimulus

Answer 59

hyperalgesia

Question 60

painful reaction to innocuous stimuli

Answer 60

allodynia

Question 61

repeat small pain = incr pain with brushing hair

Answer 61

summation

Question 62

maladaptive peripheral sensitization: overexpression of TRPV1 receptors = burning sensation overexpression of Na+ channels=_

Answer 62

lower threshold for signaling, spontaneous discharge of signals

Question 63

maladaptive central sensitization | changes _ receptor physiology, increases expression leading to spontaneous activity _ _

Answer 63

paresthesias, dysesthesias

Question 64

maladaptive central sensitization | sprouting phenomenon: disruption of _ ----> _

Answer 64

spinal cord lamella; allodynia