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M3.1 Flashcards

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1
Q
  • are NOT DISEASES but are symptoms of a certain pathologic states
  • are body’s response toward a physiologic event and may not always be pathologic
  • may lead to discomfort and creates an impact on patient’s health, mental, emotional, psychological, etc.
A

PAIN and INFLAMMATION

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2
Q
  • an UNPLEASANT SENSORY and emotional experience associated with actual or potential tissue damage, or described in terms of such damage
A

PAIN

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3
Q
  • an escessive NOXIOUS STIMULUS giving rise to intense and unpleasant sensation
  • pain of recent onset and porbable LIMITED DURATION
  • it is usually has an identifiable temporal and causal relationship to injury or disease
A

ACUTE pain

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4
Q
  • are associated with ABERRATIONS of the normal physiological pathway, giing rise to hyperalgesia, allodynia, or spontaneous spasm of pain with no precipitating stimulus
  • pain that commonly persists BEYOND THE TIME OF HEALING of an injury and frequently there may not be any clearly identifiable cause
  • impacts on emotional health
A

CHRONIC PAIN

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5
Q
  • SEVERE chronic pain produced by NEUROLOGICAL disease affecting the SENSORY pathway
  • the pathway itself ang may problema
A

NEUROPATHIC PAIN

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6
Q

QUALITY OF PAIN

signals tissue injury via an INTACT NERVOUS SYSTEM

A

NOCICEPTIVE PAIN

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7
Q

QUALITY OF PAIN

NOCICEPTIVE PAIN:
* easy to identify
* muscles, bones
* localized, aching, throbbing

A

SOMATIC PAIN

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8
Q

QUALITY OF PAIN

NOCICEPTIVE PAIN:
* hard to identify
* internal organs
* vague, diffuse, crampy

A

VISCERAL PAIN

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9
Q

QUALITY OF PAIN

  • signals injury to the NERVOUS PATHWAY ITSELF
  • common complication in DIABETES
  • burning, shooting, pins & needles, lancinating
A

NEUROPATHIC PAIN

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10
Q

QUALITY OF PAIN

  • PROPORTIONATE tot he stimulation of the nociceptor
  • pathologic when chronic
  • when acute
    * physiologic pain
    * serves a protective function
    * normal pain
  • pain in arthritis, chest pain in angina
A

NOCICEPTIVE PAIN

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11
Q

QUALITY OF PAIN

  • DIPROPORTIONATE to the stimulation of nociceptor
  • sustained by ABERRANT processes in PNS or CNS
  • serves NO protective function
  • pathologic pain
  • neuralgia, myalgia, cancer pain, neuropathies
A

NEUROPATHIC PAIN

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12
Q

GENERAL PAIN PATHWAY

brain does NOT have ____

A

nociceptors

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13
Q

GENERAL PAIN PATHWAY

STIMULATION OF PAIN RECEPTORS (NOCICEPTORS):
pain begins with the ____

A

activation of nociceptors

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14
Q

specialized receptors that detect HARMFUL STIMULI such as extreme temperatures, mechanical pressure, or chemical irritants

A

NOCICEPTORS

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14
Q

GENERAL PAIN PATHWAY

  • the pain signal is transmitted via ____ from the NOCICEPTOR to the DORSAL HORN of the spinal cord
  • this is the ENTRY POINT for sensory information in the CNS
A

1ST ORDER NEURON

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15
Q

GENERAL PAIN PATHWAY

1ST order neuron

A

Peripheral nerve (nociceptor) to Dorsal horn

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16
Q

GENERAL PAIN PATHWAY

  • the signal then crosses to the OPPOSITE SIDE of the spinal cord and ascends via the SPINOTHALAMIC TRACT to the thalamus
A

2nd order

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17
Q

GENERAL PAIN PATHWAY

2nd order neuron

A

Dorsal horn to Thalamus via Spinothalamic tract

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18
Q

a major RELAY CENTER in the brain

A

thalamus

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19
Q

GENERAL PAIN PATHWAY

in 2nd order neuron, the signal ascends to the thalamus via ____

A

spinothalamic tract

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20
Q

GENERAL PAIN PATHWAY

  • the signal is then sent to the CEREBRAL CORTEX, specifically the SOMATOSENSORY CORTEX, where the brain interprets the pain’s LOCATION, INTENSITY, and QUALITY
A

3rd order neuron

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21
Q

GENERAL PAIN PATHWAY

3rd order neuron

A

Thalamus to Cerebral cortex

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22
Q

GENERAL PAIN PATHWAY

where the brain interprets the pain’s location, intensity, and quality

A

SOMATOSENSORY CORTEX

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23
Q
  • thinly
  • FAST
  • SHARP, localized, IMMEDIATE pain
  • provides QUICK AWARENESS; triggers reflex actions
  • NEOSPINOTHALAMIC tract (direct, fast pathway)
  • a sudden CUT or BURN
A

MYELINATED FIBERS
(Aδ fibers)

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# **MYELINATED FIBERS** **conduction** speed
FAST
25
# **MYELINATED FIBERS** PAIN **type**
sharp localized immediate
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# **MYELINATED FIBERS** FUNCTION
provides **quick awareness** triggers **reflex actions**
27
# **MYELINATED FIBERS** PATHWAY
Neospinothalamic tract (**direct**, **fast** pathway)
28
# **MYELINATED FIBERS** example SENSATION
sudden cut or burn
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* **SLOW** * **DULL**, **ACHING**, **BURNING** or **THROBBING** pain * signals **PROLONGED** pain; encourages **rest** for recovery * **PALEOSPINOTHALAMIC** tract (**slower**, **emotional response** pathway) * **persistent SORENESS** or **aching pain**
UNMYELINATED FIBERS (C fibers)
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# **UNMYELINATED FIBERS** CONDUCTION speed
SLOW
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# **UNMYELINATED FIBERS** PAIN **type**
dull aching burning throbbing
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# **UNMYELINATED FIBERS** FUNCTION
signals **prolonged pain** encourages **rest** for recovery
33
# **UNMYELINATED FIBERS** PATHWAY
PALEOSPINOTHALAMIC tract (**slower**, **emotional response** pathway)
34
# **UNMYELINATED FIBERS** example SENSATION
persistent sorness or aching pain
35
**direct**, **fast** pathway
NEOSPINOTHALAMIC TRACT
36
**slower**, **emotional response** pathway
PALEOSPINOTHALAMIC tract
37
is the transmission of painful stimulus **from** the **SENSORY ORGAN** to the **BRAIN**
ASCENDING PATHWAY
38
**NEUTRALIZE** or **DIMINISH** the transmission of painful stimulus | **perceive the pain LESS**
DESCENDING INHIBITORY PATHWAYS (DIP)
39
# **PATHWAY** * carries pain signals from the **BODY** to the **BRAIN** * transmits pain stimuli for **processing** and **awareness** * **1st** order → **2nd** order → **3rd** order * **Glutamate**, **Substance P** * **ALERTS** the brain to potential or actual tissue damage * **SHARP** pain form a cut traveling up the spinothalamic tract * **increases** pain perception
ASCENDING PATHWAY
40
# **PATHWAY** ASCEDNING PATHWAY: **direction of signal**
body to brain
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# **PATHWAY** ASCENEDING PATHWAY: **purpose**
transmits pain stimula for **processing** and **awareness**
42
# **PATHWAY** ASCEDNING PATHWAY: **key neurons involved**
123 order neurons
43
# **PATHWAY** ASCEDNING PATHWAY: **neurotransmitters**
Glutamate, Substance P (excitatory)
44
# **PATHWAY** ASCENDING PATHWAY: **function**
alerts the brain
45
# **PATHWAY** ASCEDNING PATHWAY: **effect on pain**
increases pain perception
46
# **PATHWAY** * carries signals from the **BRAIN** to the **BODY** * **Modulates** or **inhibit** pain signals to control pain perception * originates in the **brainstem** and **descends** to the dorsal horn * **Endorphins**, **Enkephalins**, **Serotnin**, **Noradrenaline** (inhibitory) * **Release** of **endorphins** to reduce pain after injury * **decreases** pain perception
DESCENDING PATHWAY
47
# **PATHWAY** DESCENDING PATHWAY: **direction of signal**
brain to body
48
# **PATHWAY** DESCENDING PATHWAY: **purpose**
modulate or inhibit pain signals to control pain perception
49
# **PATHWAY** DESCENDING PATHWAY: **key neurons involved**
originates in the **brainstem** and **descends** to the **dorsal horn**
50
# **PATHWAY** DESCENDING PATHWAY: **neurotransmitters**
endorphins enkephalins serotonin noradrenaline
50
# **PATHWAY** DESCENDING PATHWAY: **function**
dampens or suppresses excessive pain signals
51
# **PATHWAY** DESCENDING PATHWAY: **effect on pain**
decreseas pain perception
52
# **MODULATORY MECHANISMS OF NOCICEPTIVE PATHWAY** BK, 5-HT, PGs, etc
pain promoter
53
# **MODULATORY MECHANISMS OF NOCICEPTIVE PATHWAY** inhibits **NEUROPEPTIDE RELEASE** and **excitation of transmission of neuron**
OPIATES | **pain reliever**
54
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# **MODULATORY MECHANISMS OF NOCICEPTIVE PATHWAY** **NITRIC OXIDE** formation
pain promoter
56
# **MODULATORY MECHANISMS OF NOCICEPTIVE PATHWAY** * inhibits **DESCENDING inhibitory pathways** * pain **promoter**
5-HT, NA
57
A physiologic **DEFENSE MECHANISM** (an **immune response**), and is NOT a disease but a **symptom** signaling tissue injury
INFLAMMATION
58
# **INFLAMMATORY RESPONSE** CAPILLARY WIDENING: **key event**
vasodilation
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# **INFLAMMATORY RESPONSE** CAPILLARY WIDENING: **effect**
INCREASED blood flow
60
# **INFLAMMATORY RESPONSE** CAPILLARY WIDENING: **symptom**
HEAT calor
61
# **INFLAMMATORY RESPONSE** INCREASED PERMEABILITY: **key event**
capillary walls become **more porous**
62
# **INFLAMMATORY RESPONSE** INCREASED PERMEABILITY: **effect**
fluid **leaks** into tissues
63
# **INFLAMMATORY RESPONSE** INCREASED PERMEABILITY: **symptom**
REDNESS rubor
64
# **INFLAMMATORY RESPONSE** LEUKOCYTE ATTRACTION: **key event**
immune cells are **recruited**
65
# **INFLAMMATORY RESPONSE** LEUKOCYTE ATTRACTION: **effect**
immune response at the **injury site**
66
# **INFLAMMATORY RESPONSE** LEUKOCYTE ATTRACTION: **symptom**
SWELLING tumor
67
# **INFLAMMATORY RESPONSE** EXTRAVASATION: **key event**
leukocytes **exit** blood vessels to **attack pathogens**
68
# **INFLAMMATORY RESPONSE** EXTRAVASATION: **effect**
**direct** immune response at injury
69
# **INFLAMMATORY RESPONSE** EXTRAVASATION: **symptom**
Tenderness
70
# **INFLAMMATORY RESPONSE** SYSTEMIC RESPONSE: **key event**
**fever** and immune cell porliferation
71
# **INFLAMMATORY RESPONSE** SYSTEMIC RESPONSE: **effect**
**enhanced** immune cell activation
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# **INFLAMMATORY RESPONSE** SYSTEMIC RESPONSE: **symptom**
PAIN dolor
73
# **INFLAMMATORY RESPONSE** loss of function
functio laesa
74
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** VASOACTIVE AMINES: **key mediators**
histamine serotonin
75
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** VASCOACTIVE AMINES: **source**
mast cells platelets
76
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** vaso**dilation**, increased vascular **permeability**, and **itching**
vasoactive amines
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# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** EICOSANOIDS: **key mediators**
prostaglandins leukotrienes
78
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** EICOSANOIDS: **source**
arachidonic acid metabolism
79
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** **PROSTAGLANDINS** cause **pain**, **fever**, and vaso**dilation**; **LEUKOTRIENES** promote **bronchoconstriction** and **inflammation**
EICOSANOIDS
80
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** CYTOKINES: **key mediators**
interleukins TNF-a
81
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** CYTOKINES: **source**
activated immune cells
82
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** promote **fever**, **pain**, and immune cell **recruitment**
CYTOKINES
83
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** KININS: **key mediators**
bradykinin
84
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** KININS: **source**
plasma proteins
85
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** **strong** pain **inducer**, increases vascular **permeability**
KININS
86
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** COMPLEMENT SYSTEM: **key mediators**
C3a, C5a
87
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** COMPLEMENT SYSTEM: **source**
plasma
88
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** promote **chemotaxis**, mast cell **degranulation**, and enhance **inflammation**
COMPLEMENT SYSTEM
89
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** REACTIVE OXYGEN SPECIES: **key mediators**
Superoxide Hydrogen peroxide
90
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** REACTIVE OXYGEN SPECIES: **source**
activated neutrophils
91
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** **tissue** damage, **amplifies** inflammation
REACTIVE OXYGEN SPECIES
92
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** NEUROPEPTIDES: **key mediators**
Substance P Calcitonin Gene-related peptide (CGRP)
93
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** NEUROPEPTIDES: **source**
sensory nerve endings
94
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** enhance **pain signaling**, vaso**dilation**, and **neurogenic** inflammation
NEUROPEPTIDES
95
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** PLATELET-ACTIVATING FACTOR: **key mediators**
PAF
96
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** PLATELET-ACTIVATING FACTOR: **soource**
various immune cells
97
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** promotes platelet **aggregation**, vaso**dilation**, broncho**constriction**
PLATELET-ACTIVATING FACTOR
98
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** ____ and ____ are crucial in **EARLY INFLAMMATION**, causing **swelling** and **pain**
Histamine & Bradykinin
99
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** ____ **amplify** pain signals and **induce** fever
Prostaglandins
100
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** ____ like **IL-1** and **TNF-a** play a central role in **SYSTEMIC INFLAMMATION**
CYTOKINES
101
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** ____ **DIRECTLY** stimulates pain pathways
Substance P
102
# **CHEMICAL MEDIATORS OF PAIN AND INFLAMMATION** ____ **enhance** immune cell **RECRUITMENT** and **ATTACK PATHOGENS**
COMPLEMENT PROTEINS
103
# **ARACHIDONIC ACID METABOLISM** inhibits **PHOSPHOLIPASE**
Corticosteroids
104
# **ARACHIDONIC ACID METABOLISM** PHOSPHOLIPASE will turn into
arachidonic acid
105
# **ARACHIDONIC ACID METABOLISM** products of ARACHIDONIC ACID
Lipoxygenase Cyclo-oxygenase
106
# **ARACHIDONIC ACID METABOLISM** produces **LTA4 (leukotriene)**
LIPOXYGENASE
107
# **ARACHIDONIC ACID METABOLISM** produces **PROSTAGLANDINS (PGH2)**
CYCLO-OXYGENASE
108
# **ARACHIDONIC ACID METABOLISM** **GOOD** COX
COX 1
109
# **ARACHIDONIC ACID METABOLISM** CORTICOSTEROIDS
NSAID Celecoxib Rofecoxib
110
# **ARACHIDONIC ACID METABOLISM** inhibits **COX1&2**
NSAIDS
111
# **ARACHIDONIC ACID METABOLISM** inhibits **COX2** only
Celecoxib Rofecoxib
112
# **ARACHIDONIC ACID METABOLISM** LT**B4**
chemotaxis hyperalgesia
113
# **ARACHIDONIC ACID METABOLISM** LTC4, LTD4, LTE4
bronchoconstriction edema
114
# **ARACHIDONIC ACID METABOLISM** inhibits **LTC4**, **LTD4**, **LTE4**
Zafirlukast Montelukast | effective for **ASTHMA**
115
116
# **ARACHIDONIC ACID METABOLISM** inhibits **LIPOXYGENASE**
Zileuton
117
# **ARACHIDONIC ACID METABOLISM** PGF**2a**
uterine contraction
118
# **ARACHIDONIC ACID METABOLISM** PG**E2**
vasodilation gastric cytoprotection
119
# **ARACHIDONIC ACID METABOLISM** TXA2 (thromboxane)
platelet aggregation
120
# **ARACHIDONIC ACID METABOLISM** PG**I2** (prostacyclin)
inhibits platelet aggregation vasodilation gastric cytoprotection
121
# **ARACHIDONIC ACID METABOLISM** inhibits **THROMBOXANE (TXA2)**
Dazoxiben | lead to **BLEEDING**
122
# **ARACHIDONIC ACID METABOLISM** COX that can produce **prostanoids** with **cytoprotection**
COX1
123

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