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21 Pain > Physiology of Pain > Flashcards

Physiology of Pain Flashcards

1
Q

pain system components

A

nociceptors
ascending nociceptive tract
higher centers in cns
descending pathways

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2
Q

excitatory transmitters

A

AA: glutamate, aspartate

neuropeptides: substance p, cgrp
gfs: bdnf
peptides: bradykinin

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3
Q

inhibitory neuropeptides

A

endogenous opioids (aa): enkephalin, b-endorphin

neuropeptides: gaba
gfs: glycine

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4
Q

a high threshold sensory receptor of the peripheral somatosensory nervous system that is capable of transducing and encoding noxious stimuli

A

nociceptors

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5
Q

t/f in nociception, pain is always implied

A

false, pain sensation is not necessarily implied

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6
Q

what are a-delta fibers

A 
thinly myelinated
faster conduction (2-30 m/sec)
innervate mechano and thermoreceptors
more accurate pain localization
terminate laterally in lamina 1 and 5
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7
Q

what are c fibers

A 
unmyelinated
conduct at <2-30 m/sec
innervate mechano, thermo, and sympathetic postganglionic receptors
long lasting burning pain
located in lamina 2
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8
Q

interpret and relay sensory information from the body to the brain

A

dorsal horn arrangement

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9
Q

most nociceptive inputs in the dorsal horn arrangement

A

I (marginal zone)
II (substantia gelatinosa)
V

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10
Q

neural impulses from free nerve endings of nociception are transmitted via ____ to ____ to _____

A

via primary afferent nerves to spinal cord/cranial nerves to the brain stem

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11
Q

pathway of the spinothalamic tract

A

dorsal horn -> cross midline in vertebral white commisure of sc -> ascend in opposite anterolateral quadrant / some ipsilateral -> project to the thalamus

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12
Q

arise from laminae I, II, V and synapse with fibers that project to the somatosensory cortex

A

lateral thalamus

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13
Q

from deeper laminae VI, XI to reticular formation of brainstem and midbrain to the periaqueductal gray matter and hypothalamus or directly to areas of forebrain and somatosensory cortex

A

medial thalamus

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14
Q

aspects of pain lateral thalamus vs medial thalamus

A

lateral: sensory and DISCRIMINATIE
medial: AFFECTIVE, autonomic reflex responses, state-of-arousal, ad emotional aspects of pain

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15
Q

functions of spinohypothalamic tract

A

coordinates pain and autonomic functions: sleep, appetite, temperature regulation, stress response

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16
Q

senses of cn5

A

receives input from ophthalmic, maxillary, and mandibular branches

17
Q

senses of glossopharyngeal nerve

A

tactile sense, thermal sense, and pain from mucous membranes of posterior third of the tongue, tonsil, posterior pharyngeal wall, and eustachian tubes

18
Q

senses of the vagus nerve

A

tactile sense from post. auricular skin, ext. auditory meatus, visceral sensation from pharynx, larynx, trachea, esophagus, thoracic and abdominal viscera

19
Q

higher centers in cns

A

discriminative
affective (cingulate cortex, amygdala; integrates noxious stimuli)
memory (anterior insula)
motor control

20
Q

central switching station of the brain / relaying center for incoming nociceptive stimuli

A

thalamus

21
Q

receives innocous and noxious stimuli from all over the body including deep tissues

A

hypothalamus

22
Q

sends signals to pituitary gland to regulate ANS and neuroendocrine response to stress and pain

A

hypothalamus

23
Q

receives input from spinothalamic tract, thalamus, and reticular formation to project to cortex

A

limbic system

24
Q

location of somatosensory cortex

A

posterior to central sulcus – for localization of pain

25
Q

responses to pain

A 
motor effects
alter pain perception
stimulation of natural pain relieving neurotransmitters
autonomic reaction
psychogenic reaction
26
Q

t/f pain is both an adaptive and maladaptive sensation

A

true

adaptive = early warning to protect the body from tissue injury
maladaptive = pathological function of the NS
27
Q

t/f pain can aggravate or precipitate myocardial ischemia

A

true

28
Q

t/f pain increases movement of the chest wall, tidal volume, frc, and vc

A

false, it decreases

29
Q

t/f pain can impair coughing and clearing of secretions

A

true

30
Q

t/f pain can cause ileus and urinary retention

A

true

31
Q

t/f pain causes sodium and water excretion

A

false, sodium retention and water retention

32
Q

t/f pain causes hypercoagulability

A

true

33
Q

pharma review

A

acetaminophen: inhibits prostaglandin synthesis
morphine: opioid agonist
ketamine: nmda antagonist
local anesthetics: block Na channels

21 Pain (6 decks)

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