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RUSVM Gross Anatomy 2 > Nocioception > Flashcards

Nocioception Flashcards

1
Q

Nociception

A

detection of noxious stimuli through the activatino of nociceptors

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2
Q

Stimulus for nociception

A

mechanical, thermal or chemical

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3
Q

The path of nociception for superficial and deep pain are the same. T/F

A

F. Superficial and Deep pain have completely different pathways

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4
Q

What are the two main two nerve fiber types:

A

A delta fibers and C fibers

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5
Q

Delta fibers sense

A

sharp and pricking pain

fast conducting, myelinated

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6
Q

C fibers sense

A

dull, ahcing, burning, throbbing pain

slow conducting, unmyelinated

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7
Q

What makes the refelx arc more exaggerated?

A

UMN damage

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8
Q

Is pain a reflex?

A

No, it is a voluntary behavior

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9
Q

acute pain

A

arises from trauma or inflammation

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10
Q

chronic pain

A

persists beyond the expected time fram for the given disease/injury (present longer than 3-6

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11
Q

Hypalgesia

A

decreased perception of pain

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12
Q

Analgesia

A

complete absence of pain perception

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13
Q

anesthesia

A

absense of all senesory perception

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14
Q

hypalgesia, algesia and anesthesia all refer to changes in

A

cortical perception

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15
Q

ARAS stands for

A

ascending reticular activating system

wakefullness system

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16
Q

What is clinically relevent about ARAS?

A

link between sensory stimulation and conscious awareness of stimuli (alertness)

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17
Q

Noxious stimuli increases:

A

alertness and autonomic functions (heart and respiratory rate)

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18
Q

spinocervicothalamic tract transmits

A

superficial pain and tactile sensation

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19
Q

How to test spinocervicothalamic tract?

A

lightly and briefly pinch the skin

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20
Q

Both proprioception and nociception decussate where?

A

to the contralateral cortex

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21
Q

The spinoreticular tract transmits

A

deep pain and visceral sensation

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22
Q

Spinoreticular tract is characteristically

A

indiscriminate- animal experiences pain/arousal, but cannot identify the source (diffuse nature)

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23
Q

How to test spinoreticular tract?

A

apply hemostats to the base of the toenail, dont include skin
(stimulates nociceptors in the periosteum)

24
Q

What is the goal of deep pain sensation?

A

To notify as much CNS as possible

25
Q

What kind of image does the deep pain pathway create?

A

2D impression of a massive recruitment of signaling, 3D to vast areas of the CNS

26
Q

Which tract is more susceptible to compressive injury: spinocervico thalamic or spinoreticular?

A

Spinocervicothalamic tract

27
Q

GVA generally respond to

A

stretch, ischemia, dilation or spasm (colic, GDV)

28
Q

What is the affective component of pain?

A

pain notifies the CNS of knowing the body is in trouble

29
Q

What does connecting pain pathways to the limbic system ensure?

A

that the individual will have a negative emotional reaction to pain

30
Q

How can a stimulus modify the perception of pain?

A

periphery, spinal cord, brainstem and higher centers

31
Q

Where are inflammatory mediates released at?

A

injured tissues

32
Q

What are examples of inflammatory mediators

A

prostaglandins, leukotriens

33
Q

Inflammatory mediators modulate pain by

A
  1. lowering the threshold of nociceptors

2. directly stimulate nociceptors

34
Q

hyperalgesia

A

minimal noxious stimuli produces greater than normal nociceptive activity

35
Q

allodynia

A

non-noxious stimuli activates nociceptors

36
Q

Wide- dynamic range (WDR) neurons respond to

A

noxious and non-noxious simuli

37
Q

What are WDR neurons associated with?

A

referred pain of visceral organs and cell associated “wind up”

38
Q

What are examples of referred pain?

A
  • kidney –> back pain

* heart attack–> left arm pain

39
Q

What is cell “wind-up”?

A

rapid, continuous firing of primary nociceptive afferents

ie. chronic or intense pain

40
Q

In cell wind up, how does activation of the 1st neuron effect the second neuron?

A

1st neuron activation can result in sustained, amplified depolarization of the 2nd neuron

41
Q

How do NMDA receptors function?

A

allow Ca and NA into the cell

42
Q

What are the effects of wind-up?

A

long term changes in the postsynaptic cell that decreases its threshold for excitement

43
Q

Does anesthesia prevent wind up?

A

NO

44
Q

How do you prevent wind-up?

A

nerve blocks and aggressive pain management

45
Q

What are Pre-med options to treat wind-up?

A

local nerve blocks, anti-inflammatories, opioids, NMDA reecptor inhibitors

46
Q

The gate control theory states that

A

pain perception is achieved, but decreased by:

  1. simultaneous tactile info traveling up the WDR neurons with the nociceptive info.
  2. inhibitory neurons directly affecting the C fiber
47
Q

What are examples of therapy that utilize the gat control theory

A

massage
compression
water therapy
acupuncture

48
Q

What are examples of neuotransmitters at the level of the spinal cord that have anti-nociceptive properties?

A

endorphins
serotonin
norepinephrine

49
Q

multimodal pain control

A
  1. modulate or prevent transduction at the nociceptor
  2. interfere with conduction to the CNS
  3. gate control therapy
  4. inhibit spinal cord sensitization
  5. augment descending modulatory mechanisms
  6. sedation/tranquilization/anxiolytic
50
Q

What stimuli provokes an itch?

A
  1. pressure
  2. thermal stimuli
  3. electricity
  4. chemicals (histamine)
51
Q

Neuropathic pain

A

results from injury to the nervous system, causing inappropriate pain signal

52
Q

What is an example of TRAUMA that can cause neuropathic pain?

A

amputation, crushing injury

declaw –> neuroma

53
Q

What is an example of vASCULAR INJURY that can cause neuropathic pain?

A

thromboembolic disease

54
Q

What is an example of ENDOCRINOPATHY that can cause neuropathic pain?

A

diabetes mellitus

55
Q

What is an example of INFECTION that can cause neuropathic pain?

A

post- herpetic neuralgia

56
Q

Dyesthesia

A

unpleasant sensation associated with neuropathic pain (tingling or electric)

RUSVM Gross Anatomy 2 (7 decks)

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