Lecture 19: Pain Plasticity

Question 1

__________ terminate in free nerve endings.

Answer 1

Nociceptors/temp sensors

Question 2

What do nerve endings have that help detect specific stimuli?

Answer 2

Sensory afferents for temp. and pain have specialized receptors.

Question 3

_______ respond to noxius pinprick or pinch for example but not to non-noxious mechanical force.

Answer 3

Nociceptors

Question 4

T/F: Nociceptors can also express GPCRs and Trk receptors that can lead to sensitization of nerve endings

Answer 4

True

Question 5

Sensitization can lead to changes like…

Answer 5

lowered mechanical thresholds that increase sensitivity of nociceptors

Question 6

What is Familial Erythromelalgia?

Answer 6

Rare, autosomal dominant condition with spontaneous burning pain of feat and hands, increased skin temperature

Question 7

What is the mutation that causes Familial Erythromelalgia?

Answer 7

Mutation in SC9A

Question 8

What are the two types of pain and give an example of each?

Answer 8

Nociceptive pain: Noxius stimuli

Inflammatory pain: Inflammation

Question 9

What is the response to noxius stimuli?

Answer 9

automatic, withdrawal reflex (early warning system)

Question 10

What is the response to inflammatory pain?

Answer 10

Pain hypersensitivity, adaptive, low threshold pain

Question 11

What are the other two types of pain and give an example of each?

Answer 11

Neuropathic pain: Pain hypersensitivity

Dysfunctional pain: Spontaneous pain, pain hypersensitivity

Question 12

Clinical pain is an ________ problem

Answer 12

amplification problem

Question 13

What are the symptoms of osteoarthritis?

Answer 13

hyperalgesia, incidence increases with age, no disease modifying drugs available

Question 14

What are the symptoms of rheumatoid arthritis?

Answer 14

hyperalgesia, allodynia, higher in younger people, disease modifying drugs available.

Question 15

Dysfunctional pain characteristics are?

Answer 15

Pain with no organic origin

peripheral nociceptor sensitization

Question 16

Name some types of dysfunctional pain?

Answer 16

Tension headaches
Migraine
IBS
Fibromyalgia

Question 17

Decreased inhibition is caused by ____________

Answer 17

spontaneous pain

Question 18

Increased facilitation is caused by __________

Answer 18

allodynia/hyperalgesia

Question 19

Damage of peripheral nerves leads to what?

Answer 19

epidermal damage
ectopic activity in co-mingling fibers
Sensitization of peripheral pain sensing neurons

Question 20

Damage of central sensitization leads to what?

Answer 20

• Amplification of incoming pain signals in the dorsal horn
• Probable amplification at other CNS pain perception centers
• Changes in gating of sensory info

Question 21

What kind of pain can lead to decreased cortical gray matter density?

Answer 21

Chronic low back pain

Question 22

Duration of pain is related to what changes…

Answer 22

Chronic low back pain induced changes

Question 23

grey matter density is bilaterally reduced in __________ and right
anterior thalamus

Answer 23

dorsal lateral prefrontal cortex

Question 24

Chronic pain negatively influences ____________

Answer 24

decision making

Question 25

What are Lamina I projection neurons a site of?

Answer 25

Major site of neuroplasticity

Question 26

A loss of epiderman lnerve fibers and insensate and painful distal limbs are associated with what condition?

Answer 26

Diabetic neuropathy

Question 27

Describe chemotherapy induced neuropathy?

Answer 27

Ectopic activity in sensory nerves and loos of epidermal nerves