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Flashcards in Pain Deck (21):
1

2 types of pain

nociceptive: normal pain responding
neuropathic: malfunctioning pain reporting system

2

2 types of nociceptive mechs.

1. tissue damage
2. inflammatory pain

3

4 types of neuropathic pain

1. post-herpetic
2. central pain
3. phantom limb
4. diabetic neuropathy

4

3 types of nociceptors, what they respond to and fibers

1. thermal, 5-45C, Adelta
2. mechanical - intense pressure, Adelta
3. polymodal - mechanical, chemical, thermal - C

5

2 phases of pain signal

1. well localized fast pain
2. slow, diffuse distressing pain

6

2 immediate reactions to pain

1. withdrawal relfex - flexor muscles
2. perception of pain

7

2 mechanisms of inflammation

1. neurogenic - axon reflex
2. tissues damage

8

3 chars of inflammation

1. redness -rubor
2. warmth - calor
3. swelling - tumor

9

where is origin of axon relfex

C fiber at site of lesion

10

what is released in axon reflex

CGRP and substance P

11

3 targets of axon reflex

1. blood vessels (permeability, vasodilation, bradykinin)
2. mast cells (histamine release)
3. platelets - 5HT release

12

3 pathways that activate nociceptors

1. mast cells>histamine
2. platelets>5HT
3. plasma>bradykinin

13

4 pathways that sensitize nociceptors

From damaged cells
1. K
2. prostaglandins
3. leukotreins
From axons
4. substance P

14

2 types of hyperalgesia

1. primary - in region skin is damaged
2. secondary - in adjacent undamaged skin

15

how do NSAIDs work

COX inhib. so don't get prostaglandins, which would senstize the nociceptors

16

2 ways nociception is integrates in dorsal horn

1. convergent afferents from visc. and body
2. inhib. from touch afferents

17

what are fibers that open and close pain gate

open - direct Adelta and C fibers
close - Abeta activate inhibitory interneuron to close the gate

18

where do descending input to the dorsal horn orig.

periaqueductal grey of the brainstem

19

what does desceding input lead to

release of enkephalins (endogenous opids)

20

2 ways opiods work

1. inhbit NT release from promary afferent nerve
2. hyperpolarize the secondary neuron

21

how does emotion get brought into pain

3rd neurons from the VP thalmus also project to limbic system

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