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Flashcards in lecture 5 Deck (14):

whatconditions influence modulation of noxious input?

psychological: emotional state and prior condition

physical: inflammation, duration of stimulation, state of rest or fatigue


study slide 8



WHAT is gate control theory?

nonpainful cutaneous stim system-->stmulate larger fibes around the painful site; must be constant


study slide 10



study slide 11 and 12



describe the types of pain

primary pain--source and site the same

heterotropic-->central, projected, and referred

central--tumor or other CNS disturbance often felt peripherally

projected--pain felt in the same nerve root

referred--sensation not felt in involved nerve but other branch of the nerve or differently nerve entirely; originates and felt in periphery; often follows certaon rules: most frequently in singe nerve root oassing from one branch to another (e.g. mand branch of CN V to max) or occasionally, pain felt outside the nerve responsible for it; site is generally cephalad (towards head) and not caudal; 3. in trigeminal area, pain does not ctoss midline unless it originates at midline


describe the central excitatory effect

deep pain can create an excitatory effect on other unassociated interneurons via 2 possiles mechs:
1. afferent infput is prolonged and constant, accum. of neurotransmitters can spill out and act on adjacent interneurons
2. convergence--many incoming enruons can synapse with single interneurons which is urn may be one of many interneurons that converge at the next level up;

these can confuse the cortex


what are the clinical manifestations of central excitatory effect?

depending on the interneuron stimmed

afferent--often referred pain reported; also secondary hyperalgesia-->increased sensitivity of a tissue without a local cause

efferent--reflex excitation f the muscle that slightly modifies it's functional activity; facial pain can cause a contactile muscle activity in masseter during opening-->causes decrease in velocity and decrease in mouth opening (protective co-contraction or muscle splinting); if it last long enough, muscle pain will ensue and represents a new source of deep pain which can produce more co-contraction

autonomic--causes reddening or blanching of the involved tissues; e.g. puffy eyelid or dry eye, or allergy symptoms; slight edema


how to tell if symptoms are from central excitatory?

unilateral symptoms; do not cross midline in trigeminal area;


study slide 27-29



what is translation?

movement in which each point of the moving objet has simultaneously the same velocity


think about the sagittal plane border movements

ye slide 34


postural position is not a true rest position; 2-4 mm below ICP; CRP is 8 mm inf and 3 mm ant to ICP (slack jaw)



study slide 48