Blake: Pain

Question 1

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

Answer 1

Pain

Question 2

Four forms of etiology-based pain

Answer 2

nociceptive
neuropathic
cancer
psychogenic

Question 3

Two types of nociceptive pain

Answer 3

somatic pain

visceral pain

Question 4

Pain arising from bone, muscle, ligament, subcutaneous tissue, or skin. (e.g. ankle sprain, arthritis)

Answer 4

somatic pain

Question 5

Pain arising from organs such as lung, liver, bowel, etc. (Nociceptive pain; e.g. cholecystitis, nephrolithiasis)

Answer 5

visceral pain

Question 6

Pain arising as a direct consequence of a lesion or disease affecting the somatosensory system (e.g. radiculopathy, CRPS)

Answer 6

neuropathic pain

Question 7

Both nociceptive and neuropathic pain. Common in cancer related pain. (e.g. chest wall pain from lung cancer)

Answer 7

mixed pain

Question 8

What are some pain assessment scales?

Answer 8

verbal pain intensity scale
0-10 numeric pain intensity scale
visual analog scale
faces scale

Question 9

Total number of cases of low back pain excluding back pain (what?)

Answer 9

1, 765,000

Question 10

Components of comprehensive treatment plan

• biological approaches
• psychological intervention
• social/rehabilitative issues

Answer 10

• pharm/nonpharm therapies
• mood disturbances, coping skills, sleep disturbances
• family/social relations, work issues, physical rehabilitation

Question 11

What does “noci” mean?

Answer 11

to injure, hurt, harm, harmful

Question 12

Sensory receptor that responds to noxious stimuli

When active or activated, can contribute to the experience of pain

Answer 12

nociceptor

Question 13

Pain fibers - usually unmyelinated axons and small cell body diameters

Answer 13

C fibers and A gamma fibers

Question 14

An important receptor in pain research - activated by Capsaicin, which is contained in chili peppers.

Answer 14

TRPV1

Question 15

What’s hyperalgesia?

Answer 15

heightened sense of pain to noxious stimuli (moves stimulus intensity curve to the left)

Question 16

What’s allodynia?

Answer 16

pain resulting from normally painless stimuli

Question 17

Predominant location of excitatory neuropeptide input from primary afferent neurons

Answer 17

lamina I and II

Question 18

What is lamina II?

Answer 18

substantia gelatinosa

Question 19

Spinomesencephalic neurons target the midbrain and the (blank) - very important in the regulation of nociception

Answer 19

periaqueductal grey (PAG)

Question 20

Located in the midbrain – key structure in relaying descending pain modulation via RVM nuclei

Answer 20

periaquaductal grey matter

Question 21

Portion of the diencephalon to which all (but olfactory) sensory systems send signals

Answer 21

thalamus

Question 22

All sensory systems send signals to the thalamus, and they are directed to the specific cortical representation areas. What are the two pain systems associated with the thalamus?

Answer 22

lateral and medial pain systems

Question 23

Two portions of the cerebrum

Answer 23

sensory cortex

limbic system

Question 24

Activation of Aβ fibers (Large diameter afferents) produces an inhibitory effect on the processing of signals from Aδ and C-fibers
E.g. Rubbing or massaging injured parts of body in order to achieve pain relief

Answer 24

Gate Control Theory

Question 25

the idea that physical pain is not a direct result of activation of pain receptor neurons, but rather its perception is modulated by interaction between different neurons

Answer 25

Gate Control Theory

Question 26

Phenomenon whereby repeated electrical C-fiber activation leads to a sequential increase in the number of action potentials evoked by each stimulus

Answer 26

Wind up

Question 27

Portion of the midbrain that represents a site that provides descending influences on spinal processing

Answer 27

periaquaductal grey (PAG)

Question 28

Excitatory amino acid neurotransmitters that act on ligand-activated ion channels

Answer 28

glutamate | aspartate

Question 29

Excitatory amino acid activated ion channels

Answer 29

AMPA | NMDA

Question 30

Responsible for "fast" nociceptive transmission

Answer 30

AMPA

Question 31

Responsible for sustained depolarization

Answer 31

NDMA

Question 32

2 phenomena linked to NMDA receptor activation

Answer 32

"Wind-Up” – increasing 2nd order neuron responses to repeated stimuli of equal intensity “Central sensitization” – decreased thresholds for response and/or increased vigor of responses

Question 33

Excitatory neurotransmitters via channel activation/2nd messenger system

Answer 33

CGRP | Substance P

Question 34

effects related to peripheral vasodilation (migraines?) | Augments nociception

Answer 34

CGRP

Question 35

co-released with glutamate; modifies the gain | Also important in neurogenic inflammation, where it is released from peripheral axons and produces local tissue effects

Answer 35

Substance P

Question 36

Neurotransmitters from interneurons

Answer 36

Inhibitory amino acids (IAA's): GABA Glycine Opioids Acetylcholine

Question 37

Neurotransmitters from supraspinal sources

Answer 37

serotonin: 5HT receptor of relevance to pain norepinephrine: alpha 1 or 2 receptors