Medial Pain System Lec17 Flashcards Preview

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Flashcards in Medial Pain System Lec17 Deck (40)
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1
Q

the medial pain system enable the limbic system to ____

A

assign emotional weights/salients to stimuli

2
Q

when asked to rate unpleasantness of a noxious heat simtulus

 

they activated the ___ and ___

A

acc and PAG (=medial pain system)

3
Q

when asked to attend to the location of the thermal stimulus the ____ and ___ are activated

A

midcingulate and thalamus

(=lateral pain system)

4
Q

what does the medial pain system include?

A

1. acc

2. anterior mCC

3. amygdala

3. anteriro insula

5. midline and intralaminar thalamus

5
Q

what are the major functions of the medial pain system? (5)

A

1. enable limbic system to assign emotion weight to stim.

2.  anticipation/learning

3. nocifensive behavior

4. pain empathy

5.pain inhibition

6
Q

the indirect pathway for pain perception involves what structures

A
7
Q

what is the path of the paleospinothalamic tract

A

 Dorsal horn & intermediate gray matter --> Reticular Formation --> MITN, Midline and Intralaminar Thalamic Nuclei --> Cingulate Gyrus

8
Q

what is the path of the spinoreticulotract (indirect AL)

Dorsal horn & intermediate gray matter --> splits CAUDAL

A

 splits (caudal) Pars Gigantocellularis of Medullary Reticular Formation --> back down to
sympathetics in IML cell column

 

9
Q

what is the path of the spinoreticulotract (indirect AL)

Dorsal horn & intermediate gray matter --> splits ROSTRAL

A

(rostral) Locus Coeruleus and Pontine Reticular Formation --> PVN and MITN

10
Q

what is the path of the SpinoMesencephalic Tract:  (indirect AL)

Dorsal horn & intermediate gray matter -->

A

 PAG, periaqueductal gray --> PB (parabrachial) nucleus --> amygdala --> PVN

11
Q

with the indirect pathway, projections to the 

_____ innervate many key
upper and lower limbic/autonomic/motor structures:


1. Nucleus ambiguus (breathing and heart rate)
2. Gigantocellular RF that projects to the sympathetic IML
3. Parabrachial nucleus (PB)
4. Paraventricular nucleus of hypothalamus (PVN)
5. Amygdala
6. Anterior Cingulate cortex

A

 RF, LC, MITN and PAG 

 

12
Q

PAG and RF regulates ANS via projections to (3)
 

A

NTS, DMX, IML

13
Q

PAG and RF regulates ANS via projections to
NTS, DMX, IML

 

this circuit modifies ____ in response to pain 

A

modify heart rate, BP, other sensory inputs

14
Q

what makes up the direct AL pathways 

A

A. Neospinothalamic (classic) Tract
B. Spinotrigeminothlamic (carries pain, temp, tacile from head and neck)

15
Q

what is the pathway of the neospinothlamic tract (its the classic/lateral spinothlaamic) 

A

Nucleus proprius (laminae III and IV of dorsal horn) --axons cross--> lateral
funiculus --> VPL of thalamus --> S1 of postcentral gyrus

16
Q

what does the The Posteriomedial Pathway carry? 

A

 visceral afferents from GI tract

17
Q

what is the pathway of the posteriomedial pathway

A

Initially follow autonomic nerves (vagus, sympathetics) --> Lamina X -->
Gracile nucleus --axons cross--> VPL & Central Lateral thalamic nuclei --> Insular &
Cingulate cortex

18
Q

____ myelotomy - can give relief for chronic, debilitating visceral pain

A

Posterior midline

19
Q

____ Creates and Stores “negative memories” associated with pain and distress

A

locus coeruleus

20
Q

_____ = any peripheral or central nervous system response to noxious stimuli

- often subconscious

- nerves end in somatosensory cortex (S1, S2)

A

Nociception

21
Q

Pain = emotional, ____ experience associated with a noxious stimuli that occurs in the cortex and thalamus

A

conscious

22
Q

lateral pain systems is involved in___ and ___

A

 stimulus localization and intensity coding

23
Q

____ is a key player for acute pain

A

PAG

24
Q

Pinched skin + electrical stimulation of ___ =
instant inhibition of nociceptive activity

A

PAG

25
Q

Central Sensitization is a major barrier to chronic pain relief.
- Occurs via___ release -

A

 Substance P 

26
Q

Central Sensitization is a major barrier to chronic pain relief.
- Occurs via Substance P release --> long depolarization periods --> Mg block on
NMDA receptor released --> ___

A

LTP of pain

27
Q

whay are opiate drugs the msot effective tx for chronic pain relief? what system do they work through? 

A

inhibit substance P release, glutamate, post synaptic nocipcetor

28
Q

Stress-Induced Analgesia (SIA) - acute, high-level stress can ____ pain sensation (via DNIS)

A

reduce

29
Q

why does referred pain occur?

A

not all visceral noiceptive info project to lamina X in the posteriomedial pathway

some synapses in dorsal horn, so cross wirign can occur

30
Q

what areas were activated with cue warning of shock (fear conditioning)

 

what connections does this depend on?

A

1. acc

2. medial mtoro areas, SMA and CMA

3. MITN thalamus

 

depends on connections with the amygdala and thlaamus

31
Q

nocifensive means ___

A

pain avoidance

32
Q

seeing pain ifnlicted on others activates what pain system

A

medial pain system and lateral pain system

33
Q

anterior cingulotomy for chronic pain relief

abolishes what?

A

nocifensive and many limbic/auntomic responses

34
Q

anterior cingulotomy for chronic pain relief

what remains nml?

A

ability to localize the noxious stimulus (they can feel stimulus but are not bothered by it)

35
Q

lesions to ventroposterior nucleus and somatosensory cortex results in

A

imapirs localization of pain, but not the perception 

36
Q

relief of pain is tied to activation in ___ and ___

A

perigenial and pag

37
Q

“Placebo” effect of telling patients what to expect after surgery, how to relax, etc: those who received pain counseling self-administered less morphine.

 

what was involved?

A

the ACC

38
Q

substance p release in the spinal cord leads to -->

A

release of Mg block of NMDA receptor

39
Q

central sensization si maldaptive learning in the

A

medial pain system

40
Q

Glia maintain central sensitization by releasing

A

 pro-inflammatory factors