Lecture 19- Pain Flashcards Preview

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Flashcards in Lecture 19- Pain Deck (41):
1

What is nociception?

-activation of nociceptive primary afferents

2

What is pain?

-conscious, affective unpleasant somaesthic percept localized to the body

3

What is hyperalgesia?

-increased sensitivity to noxious stimuli

4

Does nociception have specialised neurons?

-yes

5

How can you map the receptive fields of nociception neurons?

-with heat

6

What is the pattern of response of nociception afferents?

-do not respond till sth really happens

-high threshold

-can be chemical burn too (whereas mechanorecpetors are very sensitive)

-only starts to fire at 45 degrees then at 60 degrees very repsonsive but the non-nociceptive thermoreceptor plateus

-nociceptors= encode for temps etc that damage, opposed to other recpetors

7

What are the two categories of pain?

-first (sharp pain)

-second (duller, burning pain)

8

What pain do the A delta fiber convey?

-small thinly myelinated fibres, 5 microns= fast sharp pain (mechanosensors at high threshold)

9

What pain do C fibres convey?

thinnest nerve fibres - unmyelinated= C fiber (here myelin would slow it down if it were here due to the small size) -1 micron= sensation of diffuse, duller burning pain -the C fibres are polymodal= respond to noxius chemical and mechanical stress when very high, respond to proton concentration (acidity)

10

What is the most common peripheral nerve fibre?

C fibres -small and everywhere

11

What are the characteristics of C fibres?

-0.2-1.5 micometers -0.5-2.0 meters for second speed -temperature, pain, itch

12

What are the characteristics of A delta fibres?

-myelinated -1-5 micrometers diameter -5-30 M/s -pain and temperature

13

What are the characteristics of A beta fibres?

-6-12 micrometers diameter -35-75m/s -mechanoreceptors of skin

14

What are the characteristics of A alpha fibres?

-13-20 micrometers in diameter -80-120m/s -proprioceptors od skeletal muscle

15

Where does capsaicin bind?

-can diffuse through the membrane so it binds on the inside -VR-1 receptor

16

What binds to VR-1 receptor?

-capsaicin -heat and H+ (acidity)

17

What is capsaicin in?

-jalapeno -red chilli -habanero

18

What is the nociception pathway like?

-cell body in dorsal root ganglia -small cell bodies -do their transmitting locally (segment or two) find their target cell in the superficial dorsal horn -crosses over right away -the second neuron goes to the thalamus

19

How is the nociception pathway different from the touch pathway?

-very different to the touch pathway wher eit was on the same side till brain stem -here it crosses over right away

20

What is the spinalthalamic tract?

-the nociception pathway -also called anterior lateral system (ALS)

21

Where in the spine do the C fibres terminate?

-in the superficial dorsal horn(the purple)

-in the marginal zone or substantia gelatinosa

22

Where in the spine do A delta fibres terminate?

can terminate in areas further away = even in the base of the dorsal horn as well as the superficial basal horn

23

Is there mixing of information from nociception afferents in the spinal cord?

-yes -one cell body can get information from A delta as well as C fibre

24

What would happen if your spinal cord was cut in half of its width?

-feel only one side of the body

-lose nociception on one side and touch on the other

-nociception intact on one side as it crosses over locally

-the touch pathway stays on one side whereas the pain crosses over right away

-brown sicard syndrom

25

What are the two main pathways of the anterolateral system?

1.Sensory-discriminative(the one to somatosensory cortex) 2.Affective-motivational (the one to insular and anterior cingulate cortex)

26

What is the anterolateral system pathway (detail)?

-from the spine goes to different parts of the brainstem/forebrain

-first division is to ventral posterior nucleus in the thalamus to the somatosensory S1 and S2

-second division goes to the amygdala, hypothalamus, periaquiductal grey, superior colliculus, reticular formation

-third division goes to the midline thalamic nuclei and from there to the insular cortex and anterior cingulate cortex

27

What are the functions of the anterolateral system pathway?

-the one to the insularn cortex and anterior cingulate cortex is the pahtway of how it feels, motivational and connected to learning -the one to the amygdala etc. is about the emotional feelings associated with pain -the one going to the somatosensory cortex, this is how we can tell where sth hurts, can loacte it

28

Where is the cingulate cortex?

anterior cingulate cortex (blue)= where the last neuron from the nociceptors ends (the third goes from brain stem to here)

-lot of emotional states include this cortex (hunger, thirst)

29

Where is the insular cortex?

-more cortex again after removing he upper bit of the cortex

-get lot of receptor input, from organs

30

What is the nociception pathway mediating discriminative aspects of temperature like for the body(picture)?

-

31

What is the nociception pathway mediating discriminative aspects of temperature like for the face (picture)?

trigeminal nucleus= pain and temp from the face and head

32

What is the trigeminal nucleus for?

trigeminal nucleus= pain and temp from the face and head

33

What appears in the tissue when tissue damage?

-bradykinin= when damage in cells -ATP= leaks when cell damage -more acidic environment -histamine -prostaglandin

34

What activates C fibres?

-presence of bradykinin, increase in ATP, 5-HT(serotonin),prostaglandin,histamine

35

What is the reflex within C fibres?

-reflex= within branches of this fibre

-nerve impulse to other branches and release substance P (peptide) and CGRP=dilation of blood vessels

-red because of inflammation

-positive feedback effect= activation leads to more activation in the other terminals

36

Is pain a homeostatic system?

-yes! maintaining integrity of the skin

37

What are phantom limbs?

-part of the body removed but they still feel like it's there -ther is not a nerve saying this is your limb= this is constructed in the brain and that can exist without the mechanoreceptors

38

What are the descending systems that modulate the transmission of ascending pain signals?

-originates in the somatosensory cortex

-the raphe nuclei and all that line is in the brain stem! they project to the spinal cord to the first synapse in the anterolateral system

39

What happens at the first synapse of the anterolateral system when being modulated by ascending systems?

-this is how pain reduction occurs

-driven by cortical areas

-enkephalins are peptides

40

What is the dorsal column pathway fro visceral pain like?

-goes from the gut etc. to the spinal cord

-then synapses in the medulla and goes to the ventral posterior nuclear complex of the thalamus

-from there goes to the insular cortex

-in the medulla crosses over in the medial lemniscus

41

Is the idea of a pain pathway an oversimplification?

-yes