Lecture 35. Nociception and Pain

Question 1

What is the 1979 IASP definition of pain developed by Harold Merskey ?

Answer 1

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

Question 2

What is the new IASP definition of pain ?

Answer 2

An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage

Question 3

What can pain be influenced by ?

Answer 3

Biological, psychological and social factors

Question 4

Does everyone feel pain the same ?

Answer 4

No it is personal

Question 5

What are pain and nociception ?

Answer 5

Different phenomena

Question 6

What can pain not be inferred solely by ?

Answer 6

Activity in sensory neurons

Question 7

How can individuals learn the concept of pain ?

Answer 7

Through their life experience

Question 8

What does the inability to communicate not negate ?

Answer 8

The possibility that human or non human experiences pain

Question 9

What animal is often used as a model system to understand nociception ?

Answer 9

Apylsia Californica

Question 10

What is acute pain essential for ?

Answer 10

Avoidance of injury

Question 11

What is an avoidance tactic of acute pain ?

Answer 11

Withdrawal reflex

Question 12

What is chronic pain ?

Answer 12

Pain that lasts 3-6 months after initial injury

Question 13

What is chronic pain not beneficial for ?

Answer 13

Survival

Question 14

What may chronic pain be associated with ?

Answer 14

Cortical plasticity

Question 15

What does the nociceptor contain ?

Answer 15

Free nerve endings

Question 16

What detects pain ?

Answer 16

The free nerve endings of the nociceptors

Question 17

What are the types of fibres in the free nerve endings ?

Answer 17

1. C fibres
2. A delta fibres
3. A beta fibres

Question 18

Where do C fibres terminate ?

Answer 18

Laminae I and Laminae II

Question 19

What is laminae II also known as ?

Answer 19

The substantia gelatinosa

Question 20

What does the substantia gelatinosa do ?

Answer 20

Modulates sensory input

Question 21

What are the afferent or sensory nerves ?

Answer 21

1. Ia (A alpha)
2. Ib (A alpha)
3. II (A beta)
4. III (A delta)
5. IV (C)

Question 22

Where is Ia found ?

Answer 22

Muscle spindle, primary endings

Question 23

Where is Ib found ?

Answer 23

Golgi tendon organ

Question 24

Where is II found ?

Answer 24

Muscle spindle, secondary endings

Question 25

Where is III found ?

Answer 25

Muscle deep pressure endings

Question 26

Where is IV found ?

Answer 26

Nociceptors (pain)

Question 27

What are the efferent or motor ?

Answer 27

1. A alpha 2. A beta 3. A gamma

Question 28

Where is the A alpha found ?

Answer 28

Skeletal muscles

Question 29

Where is A beta found ?

Answer 29

Muscles and spindles

Question 30

Where is A gamma found ?

Answer 30

Muscle spindle

Question 31

What does the peripheral immune system work with to protect the body ?

Answer 31

Immune system

Question 32

What are the danger signal receptors ?

Answer 32

1. TRP channels 2. P2X channels 3. Danger associated molecular pattern (DAMP)

Question 33

What are transient receptive proteins (TRP) used for ?

Answer 33

Molecular mediators of nociception

Question 34

What are the pain pathways ?

Answer 34

1. Spinothalamic tract 2. Spinoparabrachial tract 3. Spinoreticular tract 4. Spinomesencephalic tract

Question 35

What are unmyelinated C fibres and small diameter A delta stimulated by ?

Answer 35

Injury

Question 36

What do C fibres and small diameter A delta do when stimulated by injury ?

Answer 36

Convey impulses to transmission cells in the spinal cord

Question 37

What do transmission cells receive input from ?

Answer 37

Large A beta fibres

Question 38

What do transmission cells receive inhibition from ?

Answer 38

Interneurons

Question 39

What influences inhibitory interneurons ?

Answer 39

Descending pathways

Question 40

What do large diameter and small diameter fibres project to in the gate theory

Answer 40

The substantia gelatinosa and the first central transmission cells

Question 41

What is inhibition from the substantia gelatinosa onto the afferent fibre terminals increased and decreased by ?

Answer 41

1. Increased by L fibre activity | 2. Decreased by S fibre activity

Question 42

What is the brain region involved in nocebo responses ?

Answer 42

Hippocampus

Question 43

What does direct electrical stimulation of the periaqueductal grey in a rodent produce ?

Answer 43

Analgesia

Question 44

What is analgesia ?

Answer 44

Pain relief

Question 45

What periaqueductal grey block ?

Answer 45

The nociceptor response

Question 46

What are the critical components of descending pain modulation ?

Answer 46

1. Periaqueductal grey | 2. Rostroventral medulla

Question 47

What does the periaqueductal grey coordinate ?

Answer 47

The defensive response to threat

Question 48

What are some interventional treatments for neuropathic pain ?

Answer 48

1. Spinal cord stimulation 2. Cortical stimulation 3. Deep brain stimulation 4. Intrathecal drug delivery

Question 49

What are the main component of phantom limb pain ?

Answer 49

Central changes

Question 50

What is there some evidence for regarding phantom limb pain ?

Answer 50

Peripheral changes

Question 51

In the brain what alters in amputees with chronic pain ?

Answer 51

Cortical representation

Question 52

What is a possible therapy for phantom limb pain ?

Answer 52

Mirror therapy