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Advanced Neurosciences > Neurology Of Pain > Flashcards

Neurology Of Pain Flashcards

1
Q

What are the three forms of nociceptor stimuli?

A

Chemical
Mechanical
Thermal

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2
Q

Which forms of stimuli can be classified as fast, sharp pain?

A

Mechanical
Thermal

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3
Q

Which forms of stimuli can be classified as slow, dull pain?

A

Chemical
Mechanical
Thermal

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4
Q

How many types of nociceptors are there?

A

4
Thermal, mechanical, chemical AND poly modal

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5
Q

What types of fibres are found in thermal nociceptors?

A

A delta and C fibres

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6
Q

What types of fibres are found in mechanical nociceptors?

A

A delta and C fibres

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7
Q

What types of fibres are found in chemical nociceptors?

A

C fibres

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8
Q

Describe what the capsaicin receptor is.

A

A heat activated ion channel in the pain pathway.
A non-selective cation channel that is structurally related to members of the transient receptor potential family of ion channels.

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9
Q

Describe the action of capsaicin.

A

It elicits a sensation of burning pain by selectively activating sensory neurons that convey information about noxious stimuli to the CNS.

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10
Q

How are mechanical nociceptors activated?

A

Many ion channels are activated by membrane stretch (swelling)

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11
Q

Give some example of mechano-sensitive TRP channels.

A

TRPV1
TRPV 2
TRPV 4

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12
Q

What are the basic steps in unipolar conduction of pain?

A

Noxious stimulus
Transduction
Conduction
Transmission
Modulation

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13
Q

Describe acute pain.

A

Nociceptive and inflammatory
Sudden onset in response to discreet event
Recedes during healing

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14
Q

Describe chronic pain.

A

Neuropathic
Persists long after recovery (>3 months)
Often difficult to tie to a certain event
Often unresponsive to analgesics

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15
Q

What is neuropathic pain caused by?

A

A lesion or disease in the P/CNS
Change in the neurone not the tissue

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16
Q

What is neuropathic pain?

A

Can present as burning or tickling or dull aches
May be associated with allodynia or hyperalgesia

17
Q

Describe what allodynia is.

A

Sensation of pain in response to something not normally painful in nature

18
Q

Describe what hyperalgesia is.

A

Increased intensity of pain sensation for a given nociceptive stimulus.
More painful than it should be

19
Q

What is peripheral sensitisation?

A

Increased sensitivity of C and A delta fibres due to prostaglandins release
Increased voltage dependant Na+ channel expression

20
Q

Describe phantom limb pain.

A

It’s a peripheral mechanism
Proximal portion of the severed nerve sprouts to form neuromas
Increased Na+ channel expression
Hyper-excitability and spontaneous discharges
Doesn’t explain the presence of congenital phantom limb pain

21
Q

Which fibres are for fast pain?

A

Myelinated neurone
A delta fibres

22
Q

Which fibres are for slow pain?

A

Unmyelinated neurones
C fibres

23
Q

What are conduction velocities of fast vs slow pain?

A

Fast - 6-30 m/s
Slow - 0.5-2 m/s

24
Q

What responses are seen due to effects of the sympathetic nervous system?

A

Fear
Pupillary dilation
Pallor
Sweating

25
Q

What responses are seen due to the parasympathetic nervous system?

A

Bradycardia
Syncope
Hypotension
Urination
Nausea

26
Q

Which areas are involved in the natural analgesic pathway?

A

Periventricular nuclei (PVN)
Periaqueductal gray (PAG)
Raphe Magnus (RMN)

27
Q

What are the steps of the natural analgesic pathway?

A

PVN - PAG (enkephalins) RAM - serotonin releases - inhibitory interneurones - enkephalin / GABA release - (GABA)DHN Cl- channels activated - hyperpolarisation - reduced DHN firing - (enkephalin) opioid receptors activated

28
Q

How do enkephalins inhibit DHN firing?

A

Opens k+ ion channels
Hyperpolarises the DHN

29
Q

What other ion channels can enkephalins affect?

A

They can act presynaptically to inhibit the opening of Ca2+ channels
Less Ca2+ means less transmitter is released and there will be less firing

Advanced Neurosciences (20 decks)

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