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Flashcards in Pain Deck (61):
1

What is nociception?

The sensory response to a noxious stimulus

2

What is pain?

The perception of nociceptive sensory information

3

What is congenital indifference to pain?

Congenital condition where a person is not responsive to pain

4

What are the two dimensions of pain?

1. sensory-discrimination
2. motivation-affective

5

What is the sensory-discrimination part of pain?

perception of exteroceptive (external) or enteroceptive (internal)
noxious information and ‘localization’ of the site.

6

What is the motivation-affective aspect of pain?

emotional and sympathetic responses and associated (learning) behaviors

7

What are the three types of pain?

1. Physical
2. Inflammatory
3. Neuropathic

8

What is the main part of the brain that is associated with the sensory-discriminatory part of pain?

Primary and secondary somatosensory cortices

9

What are the main part of the brain that is associated with the motivation-affective part of pain?

Frontal cortex
Limbic system
Brainstem areas

10

What are the three functions of the sensory-discriminative component of pain?

1. location
2. Intensity
3. Modality

11

What are the two components of the emotional component of pain?

Negative impact on affect/mood

Chronic pain accompanied by depression

12

How fast is acute pain felt?

0.1 sec after initiation of stimulus (very fast)

13

What is the fiber type that conducts pain?

A-delta fibers

14

How adaptive is physiologic pain?

Very--as tissue heals, pain lessens

15

What is the initial type of pain sensations that are felt?

Sharp, prickling, electric sensation

16

What is pathologic pain?

Chronic pain

17

When does pathologic pain begin?

>1 sec after the stimulus, then increases slowly

18

How can pathologic pain become maladaptive?

Persistence even without tissue damage

19

What type of fibers carry pathologic pain? Is this fast or slow conducting?

C fibers

Slow conducting

20

What are the sensations felt with pathologic pain?

Dull, throbbing, aching, nauseous senstion

21

What is the function for nociception? Inflammatory?

Nociception = warning
Inflammatory = promotes healing

22

What is dysfunctional pain?

Pain without understanding or the origin

23

What is neuropathic pain?

Pain d/t damage to nerves

24

What is the function of neuropathic pain?

It has no protective function

25

What are the two types of somatic pain? What is the quality of the pain for each? Well or not well localized?

Superficial pain (sharp, well localized)
Deep (dull, poorly localized)

26

What are the fibers that carry superficial pain (initial and delayed)?

A delta intially, followed by C fibers for delayed

27

Where is deep pain felt?

CT, bones, joints, muscles,

28

What type of fibers carry visceral pain?

C fibers

29

What type of pain follows a dermatomal distribution?

Visceral

30

What are the four processes of pain processing?

1. Transduction
2. Transmission
3. Modulation
4. Perception

31

What is transduction?

sensation taken in from receptors, transmitted

32

What are the nociceptors for pain?

Free nerve endings

33

Do pain neurons have a high or low threshold? Do they adapt slowly or fast?

High threshold
Slowly adapt

34

What are the three stimuli that nociceptors respond to?

Mechanical (nociceptive)
Thermal
Chemical

35

Free nerve endings that innervate the body go where (where are the cell bodies)? Face?

Body = spinal ganglia
Face = trigeminal ganglia

36

What is the first process that occurs with damage?

Nociception via direct activation of:
-open cation channels
-Membrane depolarization
-Generate action potential

37

What is the major mediator of pain? Other two? ("inflammatory soup") What do these do?

Bradykinin
5HT
Prostaglandin

These interact with primary afferent neurons near the site of pain to release other substances

38

What is the MOA of substance P, which is released in response to a painful stimulus? (What is the effect on blood vessels, and on the immune system)?

Vasodilation and inflammation
Mast cell release of histamine

39

What is the indirect sensitization of the peripheral nociceptive processing?

Lowered threshold of nociceptors

40

What is peripheral sensitization?

Spreading of the action potential over other areas where membrane is at a resting state

41

What does peripheral sensitization lead to? (4)

1. Increased sensitivity
2. Increased receptive field size
3. Inflammatory mediators release
4. Activation of silent nociceptors

42

What are the silent nociceptors? What is their function?

nociceptors that only respond to the molecules secreted by other activated nociceptors

Expand the receptive field for the pain stimulus

43

What is primary hyperalgesia?

Increase response to a stimulus that is normally painful

44

What is allodynia?

Pain resulting from non-noxious stimulus

45

What is the triple response of Lewis?

Erythema
Edema
Wheal

46

What type of pain is nociceptive pain (physiologic or chronic)?

Physiologic

47

Which has tissue damage, nociceptive pain or inflammatory pain?

Inflammatory pain

48

Fibromyalgia or IBS is what type of pain? What causes it?

Dysfunctional pain
--no understandable lesion found

49

Does neuropathic pain have a protective function?

No

50

True or false: neuropathic pain is disproportionate to the intensity of nociceptor activation

True

51

What are the receptors utilized for thermal stimuli?

TRP

52

What is the axon reflex?

Activation of the sympathetic system in response to pain

53

Activator of pain, or sensitizer: K

Acivator

54

Activator of pain, or sensitizer: prostaglandins

Sensitizer

55

Activator of pain, or sensitizer: hydrogen

Activator

56

Activator of pain, or sensitizer: substance P

Activator

57

Activator of pain, or sensitizer: leukotrienes

Sensitizer

58

Activator of pain, or sensitizer: ATP

Sensitizer

59

Activator of pain, or sensitizer: bradykinin

Activator

60

What are the type of fibers that sense mechanical sensations (2)? Which has a high threshold, and which a low?

A-alpha = low threshold
A-delta = high threshold

61

What is the type of fiber that senses heat, chemical, and other multimodal stimuli? Do theses have a high or low threshold? Fast or slow fibers?

C fibers
High threshold
Slow conduction